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Dose-response relationship between cocoa flavanols and human endothelial function: a systematic review and meta-analysis of randomized trials.
Sun Y, Zimmermann D, De Castro CA, Actis-Goretta L.
Food Funct. 2019 Sep 16. doi: 10.1039/c9fo01747j. [Epub ahead of print]
PMID: 31524216
https://pubs.rsc.org/en/content/articlepdf/2019/fo/c9fo01747j
Abstract
BACKGROUND:
Several intervention studies have investigated the relationship between cocoa flavanols and endothelial function. However, the shape of the association and the type of compounds responsible for the effects are largely unknown.
OBJECTIVE:
To examine the dose-response association between the consumption of cocoa flavanols and endothelial function, measured by flow-mediated dilation (FMD).
DESIGN:
Two investigators searched Scopus® for the relevant human intervention studies, which were pooled and meta-analysed. Heterogeneity in the findings was explored with various subgroup analyses.
RESULTS:
Fifteen published articles with 18 intervention arms met the inclusion criteria. Participants in these intervention groups received 80 to 1248 mg (mean: 704 mg) more flavanols than control groups. A significant improvement of FMD by 1.17% (95% CI: 0.76% to 1.57%) was calculated, with strong evidence of a non-linear association (inverted U-shape) between cocoa flavanols and FMD.
CONCLUSIONS:
This meta-analysis provides evidence that cocoa flavanols could significantly improve endothelial function, with an optimal effect observed with 710 mg total flavanols, 95 mg (-)-epicatechin or 25 mg (+)-catechin. However, there was substantial variation in the results that could not be explained by the characteristics that we explored, and there were significant risk-of-bias concerns with a large majority of the studies.

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The Association of Sedentary Behaviour and Cognitive Function in People Without Dementia: A Coordinated Analysis Across Five Cohort Studies from COSMIC.
Maasakkers CM, Claassen JAHR, Gardiner PA, Olde Rikkert MGM, Lipnicki DM, Scarmeas N, Dardiotis E, Yannakoulia M, Anstey KJ, Cherbuin N, Haan MN, Kumagai S, Narazaki K, Chen T, Ng TP, Gao Q, Nyunt MSZ, Crawford JD, Kochan NA, Makkar SR, Sachdev PS; COSMIC Collaborators, Thijssen DHJ, Melis RJF.
Sports Med. 2019 Sep 16. doi: 10.1007/s40279-019-01186-7. [Epub ahead of print]
PMID: 31529300
Abstract
BACKGROUND:
Besides physical activity as a target for dementia prevention, sedentary behaviour is hypothesized to be a potential target in its own right. The rising number of persons with dementia and lack of any effective treatment highlight the urgency to better understand these modifiable risk factors. Therefore, we aimed to investigate whether higher levels of sedentary behaviour are associated with reduced global cognitive functioning and slower cognitive decline in older persons without dementia.
METHODS:
We used five population cohorts from Greece, Australia, USA, Japan, and Singapore (HELIAD, PATH, SALSA, SGS, and SLAS2) from the Cohort Studies of Memory in an International Consortium. In a coordinated analysis, we assessed the relationship between sedentary behaviour and global cognitive function with the use of linear mixed growth model analysis (mean follow-up range of 2.0-8.1 years).
RESULTS:
Baseline datasets combined 10,450 older adults without dementia with a mean age range between cohorts of 66.7-75.1 years. After adjusting for multiple covariates, no cross-sectional association between sedentary behaviour and cognition was found in four studies. One association was detected where more sedentary behaviour was cross-sectionally linked to higher cognition levels (SLAS2, B = 0.118 (0.075; 0.160), P < 0.001). Longitudinally, there were no associations between baseline sedentary behaviour and cognitive decline (P > 0.05).
CONCLUSIONS:
Overall, these results do not suggest an association between total sedentary time and lower global cognition in older persons without dementia at baseline or over time. We hypothesize that specific types of sedentary behaviour may differentially influence cognition which should be investigated further. For now, it is, however, too early to establish

Alcohol consumption and its interaction with genetic variants are strongly associated with the risk of type 2 diabetes: a prospective cohort study.
Yu H, Wang T, Zhang R, Yan J, Jiang F, Li S, Jia W, Hu C.
Nutr Metab (Lond). 2019 Sep 13;16:64. doi: 10.1186/s12986-019-0396-x. eCollection 2019.
PMID: 31528183
Abstract
BACKGROUND:
Both genetic and lifestyle factors contribute to the incidence of type 2 diabetes. It yet remains controversial whether and how alcohol consumption, one of the most prevalent lifestyle habits, influences type 2 diabetes. Moreover, whether alcohol consumption interacts with genetic risk is inconclusive. Thus, we aimed to explore the effects of alcohol, genetic risk and their potential interactions on type 2 diabetes risk.
METHODS:
The Shanghai Diabetes study (SHDS) had a total of 2546 participants with 611 incident cases of combined type 2 diabetes and impaired glucose regulation (IGR). We constructed weighted genetic risk score (GRS) for type 2 diabetes and categorized the GRS into three strata. And the homeostatic model assessment of β-cell function (HOMA-B) and insulin resistance (HOMA-IR) were calculated. Then we used logistic regression models and multiple linear regression models to examine the influence of both baseline alcohol consumption and genetic risk on blood glucose deterioration, insulin resistance (IR) and beta cell function (BC), respectively. Moreover, we investigated the interactions of alcohol intake with: (1) GRSs for type 2 diabetes, IR, BC, body mass index (BMI) and waist-to-hip ratio (WHR); and (2) each of the single nucleotide polymorphisms (SNPs) used to establish the GRSs mentioned above.
RESULTS:
Alcohol consumption and higher T2D-GRS both contributed to a higher incidence rate of blood glucose deterioration [odds ratio (OR), 2.24, 95% confidence interval (CI), 1.76-2.87; OR, 1.25, 95% CI, 1.11-1.42; respectively]. Alcohol reduced insulin sensitivity and compensated by enhancing beta cell function (β = 1.98, P < .0001 and β = - 1.97, P < .0001 for HOMA-IR and inverse HOMA-β, respectively). T2D-GRS deteriorated insulin secretion (β = 0.10, P = 0.0069 for inverse HOMA-B) but not insulin sensitivity (P = 0.0856). Moreover, there was a significant interaction between alcohol and T2D-GRS (Pinteraction = 0.0318), suggesting the association between alcohol and type 2 diabetes was much stronger in the lower T2D-GRS group than in the higher T2D-GRS group. And this interaction was more pronounced in men (Pinteraction = 0.0176) than in women (Pinteraction = 0.3285). No single SNP interacted strongly with alcohol intake.
CONCLUSIONS/INTERPRETATION:
Alcohol consumption strongly increased the risk of type 2 diabetes by increasing IR, especially in men with low T2D-GRS, highlighting the importance of refraining from drinking alcohol when making recommendations for healthy lifestyle habits to prevent diabetes.
KEYWORDS:
Alcohol; Beta cell function; Genetic risk; Insulin resistance; Interaction; Type 2 diabetes

The real facts supporting Jeanne Calment as the oldest ever human.
Robine JM, Allard M, Herrmann FR, Jeune B.
J Gerontol A Biol Sci Med Sci. 2019 Sep 16. pii: glz198. doi: 10.1093/gerona/glz198. [Epub ahead of print]
PMID: 31529019
https://watermark.silverchair.com/glz198.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAo4wggKKBgkqhkiG9w0BBwagggJ7MIICdwIBADCCAnAGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMFIHE-xu3kWTSac9iAgEQgIICQRs6jVHs2bJFQ4brkxwyOP5uCO9gARA58lQZAiHU0WRgdZJz2WJh7VLP6pSxqkFxJrtKSDofXzCLjSFon2szqv08k2lylxt93HPA2y-mHRRTwT2nXbsBQ0v88RlPS2iUnt8WraDj5jQmzqrWZiVKoKMbgT52Sntvzt37daH_tEfy-yOGmXzV87WAVKCyGdFfw-WiLxgFkGbrjLyAuv4124_8xT6jGxoefbfs_DUvmKsZiQK1C3SrYbKBtqalv74Y2n0Stg0HYGmoL5zb6oN2bYIpdjeegyZgphgQxKZDb_d3d4rv3ozRXV1gsBitjtt8TMrMiyGt1RfO9vHMJCX-VBx7QDRAv6uADQ1Lu3f8B7IMqewa13Ap51mAm23VIWArd3zBgmhYs5RUponAHg8VELf1Rr7KuMi7WiO3p7r8JpLL2pG2mNnoZdczrBL1VwXiLT8WwvQpgphCpMKMmpDP0vY_oa1cXbe1gdagDgw1vNR7f_epvhI-UXPQ7v0IZXfo7-7xx7CUyB-u4EGEcPSmKZSn_4v0TZOxVLG52RYC-P3cdNgpXVJuwqyppz7IxwAb2BeMGoRVv8KrIivrVNocH9KocHD77rLW0JjEWVuDI1Nxw0nSkNlbPh0mQWZnRaeL39nMqGIPR1PtL7it9GNXi2JAqIDX-cTPxUrNDp2czPkm63DUq4q3klV1WEFIq7Qi2o6olgl4JbsjJI1igoNxY_TxiZhk28BsEZNWI4AJUqa8AfFUyu4PV7_sUSR4cfY8Cu8
Abstract
The 122 years and 165 days age claim of Jeanne Calment, the world oldest person who died in 1997, is the most thoroughly validated age claim. Recently the claim that families Calment and Billot organized a conspiracy concerning tax fraud based on identity fraud between mother and daughter gained international media attention. Here, we reference the original components of the validation as well as additional documentation to address various claims of the conspiracy theory and provide evidence for why these claims are based on inaccurate facts or unrelated to the death of Yvonne Billot-Calment, the daughter of Jeanne Calment, in 1934. Also, countering the contention that the occurrence of a 122 year old person is statistically impossible, mathematical models are presented which also supports the hypothesis that though extremely rare, as would be expected for the oldest person ever, Jeanne Calment's age claim is plausible. In total, the quality of the investigation supporting the claim of conspiracy as well as the mathematical analysis aiming to back it do not reach the level expected for a scientific publication.
KEYWORDS:
Age validation; Centenarian; Demography; Mathematical simulation; Supercentenarian

Associations of alcohol consumption status with activities of daily living among older adults in China.
Lee YH, Lu P, Chang YC, Shelley M, Lee YT, Liu CT.
J Ethn Subst Abuse. 2019 Sep 18:1-16. doi: 10.1080/15332640.2019.1664961. [Epub ahead of print]
PMID: 31530097
Abstract
Background: With the rapid growth of the elderly population and public health challenges in China, concerns arise related to disability associated with activities of daily living (ADLs) and alcohol consumption status. This study assesses the relationships of alcohol consumption status with basic daily activities among Chinese older adults. Methods: A total of 5,133 participants aged 60 years or above from three waves of the Chinese Longitudinal Healthy Longevity Survey (2009, 2012, and 2014) were analyzed. Independent ADL items included bathing, dressing, toileting, indoor moving, continence, and feeding (without others' assistance). Multilevel ordered logistic regression model estimation was used to examine the results of total scores based on the Katz index. Multilevel logistic regression models also were estimated to study each index item separately to examine differences across each of the six ADLs. Additional confirmatory factor analysis (CFA) was performed to examine the validity of the index. Results: Preliminary CFA showed that most items had good factor loadings (>0.700), except for continence (0.256) and feeding (0.481). Based on the ordered regression model, former (AOR = 0.412, 95% CI: 0.294, 0.579, p < 0.001) and non-alcohol consumption (AOR = 0.598, 95% CI: 0.447, 0.800, p < 0.001) were negatively associated with the total score. Non-alcohol consumption status was negatively associated with ADL items separately (all ps < 0.05), with the exceptions of continence and feeding. Conclusion: Alcohol consumption may be associated with Chinese older adults' better ADLs. However, further clinical or experimental trials are needed to examine the impact of alcohol consumption on older adults' ADLs.
KEYWORDS:
China; alcohol consumption; daily activity; disability; multilevel analysis; older adults

Cold-induced lipid dynamics and transcriptional programs in white adipose tissue.
Xu Z, You W, Zhou Y, Chen W, Wang Y, Shan T.
BMC Biol. 2019 Sep 17;17(1):74. doi: 10.1186/s12915-019-0693-x.
PMID: 31530289
Abstract
BACKGROUND:
In mammals, cold exposure induces browning of white adipose tissue (WAT) and alters WAT gene expression and lipid metabolism to boost adaptive thermogenesis and maintain body temperature. Understanding the lipidomic and transcriptomic profiles of WAT upon cold exposure provides insights into the adaptive changes associated with this process.
RESULTS:
Here, we applied mass spectrometry and RNA sequencing (RNA-seq) to provide a comprehensive resource for describing the lipidomic or transcriptome profiles in cold-induced inguinal WAT (iWAT). We showed that short-term (3-day) cold exposure induces browning of iWAT, increases energy expenditure, and results in loss of body weight and fat mass. Lipidomic analysis shows that short-term cold exposure leads to dramatic changes of the overall composition of lipid classes WAT. Notably, cold exposure induces significant changes in the acyl-chain composition of triacylglycerols (TAGs), as well as the levels of glycerophospholipids and sphingolipids in iWAT. RNA-seq and qPCR analysis suggests that short-term cold exposure alters the expression of genes and pathways involved in fatty acid elongation, and the synthesis of TAGs, sphingolipids, and glycerophospholipids. Furthermore, the cold-induced lipid dynamics and gene expression pathways in iWAT are contrary to those previously observed in metabolic syndrome, neurodegenerative disorders, and aging, suggesting beneficial effects of cold-induced WAT browning on health and lifespan.
CONCLUSION:
We described the significant alterations in the composition of glyphospholipids, glycerolipids, and sphingolipids and expression of genes involved in thermogenesis, fatty acid elongation, and fatty acid metabolism during the response of iWAT to short-term cold exposure. We also found that some changes in the levels of specific lipid species happening after cold treatment of iWAT are negatively correlated to metabolic diseases, including obesity and T2D.
KEYWORDS:
Cold exposure; Fatty acid; Glycerophospholipid; Lipid metabolism; Lipidomics; RNA sequencing; Sphingolipid; Triacylglycerol; WAT browning

Infertility and Mortality.
Stentz NC, Koelper N, Barnhart KT, Sammel MD, Senapati S.
Am J Obstet Gynecol. 2019 Sep 14. pii: S0002-9378(19)31112-3. doi: 10.1016/j.ajog.2019.09.007. [Epub ahead of print]
PMID: 31526792
Abstract
BACKGROUND:
Infertility affects 1 in 10 American reproductive-age women. The impact of this disease beyond the reproductive years is largely unknown.
OBJECTIVE:
To determine the association of infertility history with all-cause and cause-specific mortality.
STUDY DESIGN:
This secondary analysis of a multicenter randomized clinical trial included 75,784 women (age 55-74) prospectively enrolled in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer screening trial from 1992-2001 and followed a minimum of 10 years for health-related outcomes and death (856,935 person-years). We examined the association of infertility history (inability to conceive for one year or greater) all-cause and cause-specific mortality using disease risk score adjusted Cox-proportional hazard regression models.
RESULTS:
Infertile women had a 10% increased risk of death (from any cause) during the study period compared to the unexposed (AHR 1.10, 95%CI 1.02-1.18, p=0.010). This effect was predominantly noted in women at an otherwise low risk of mortality, who had a 26% increased risk of death (AHR 1.26, 95%CI 1.12-1.42, p<0.001). No differences in cardiovascular or diabetic mortality were noted. The risk of cancer death at any time over the study period was increased by 23% in infertile women compared to the unexposed (AHR 1.23, 95%CI 1.10-1.37, p<0.001). This effect was predominantly noted in women at an otherwise low risk of cancer mortality, who had a 47% increased risk of cancer death (AHR 1.47, 95%CI 1.25-1.73, p<0.001). While no differences are seen in the risk of death from endometrial or ovarian cancer, the risk of death from breast cancer was more than doubled in infertile women at an otherwise low risk of breast cancer death compared to the unexposed (AHR 2.64, 95%CI 1.71-4.08, p<0.001).
CONCLUSIONS:
Infertility is a harbinger of future morbidity and mortality. Infertile women are at an increased risk of all-cause and cancer-related mortality. Consideration of infertility history in health care maintenance presents an opportunity for screening and early intervention for long-term health outcomes.
KEYWORDS:
Cancer; Infertility; Long-term Health; Mortality

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The Effects of Dairy Intake on Insulin Resistance: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.
Sochol KM, Johns TS, Buttar RS, Randhawa L, Sanchez E, Gal M, Lestrade K, Merzkani M, Abramowitz MK, Mossavar-Rahmani Y, Melamed ML.
Nutrients. 2019 Sep 17;11(9). pii: E2237. doi: 10.3390/nu11092237.
PMID: 31533272
Abstract
The incidence of type 2 diabetes mellitus (DM) has increased in the US over the last several years. The consumption of low-fat dairy foods has been linked with decreasing the risk of DM but studies have yet to show a clear correlation. We conducted a systematic review and meta-analysis of randomized clinical trials (RCTs) evaluating the effects of dairy intake on homeostatic model assessment of insulin resistance (HOMA-IR), waist circumference, and body weight. In MEDLINE and Embase, we identified and reviewed 49 relevant RCTs: 30 had appropriate data format for inclusion in the meta-analysis. Using the Review Manager 5 software, we calculated the pooled standardized mean differences comparing dairy dietary interventions to control for our outcomes of interest. For HOMA-IR (794 individuals), we found a mean difference of -1.21 (95% CI -1.74 to -0.67; p-value < 0.00001; I2 = 92%). For waist circumference (1348 individuals), the mean difference was -1.09 cm (95% CI 1.68 to -0.58; p-value < 0.00001; I2 = 94%). For body weight (2362 individuals), the dairy intake intervention group weighed 0.42 kg less than control (p-value < 0.00001; I2 = 92%). Our findings suggest that dairy intake, especially low-fat dairy products, has a beneficial effect on HOMA-IR, waist circumference, and body weight. This could impact dietary recommendations to reduce DM risk.
KEYWORDS:
dairy intake; diet; insulin resistance; low-fat dairy; waist circumference; weight loss

Processed meat intake and bladder cancer risk in the prostate, lung, colorectal and ovarian (PLCO) cohort.
Xu X.
Cancer Epidemiol Biomarkers Prev. 2019 Sep 18. pii: cebp.0604.2019. doi: 10.1158/1055-9965.EPI-19-0604. [Epub ahead of print]
PMID: 31533945
Abstract
BACKGROUND:
The association between processed meat intake and bladder cancer risk has been evaluated by several observational studies with inconsistent results.
METHODS:
In a cohort of 101,721 subjects in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, we analyzed the association of processed meat intake with bladder cancer risk.
RESULTS:
After a median of 12.5 years of follow-up, 776 new cases of bladder cancer were identified. Intake of processed red meat was significantly associated with the incidence of bladder cancer after multivariate adjustment (Highest vs. lowest quintile: HR 1.47, 95% CI 1.12-1.93; P for trend = 0.008). By contrast, there was only a suggestive but not significant association between intake of total processed meat and bladder cancer risk after multivariable adjustment (Highest vs. lowest quintile: HR 1.16, 95% CI: 0.89-1.50; P for trend = 0.073).
CONCLUSION:
This large prospective study suggests that intake of processed red meat is associated with a higher risk of bladder cancer.
IMPACT:
Bladder cancer risk is increased with cumulative intake of processed red meat.

Soy isoflavones interact with calcium and contribute to blood pressure homeostasis in women: a randomized, double-blind, placebo controlled trial.
Lu LW, Chen NW, Nayeem F, Nagamani M, Anderson KE.
Eur J Nutr. 2019 Sep 18. doi: 10.1007/s00394-019-02085-3. [Epub ahead of print]
PMID: 31535213
Abstract
BACKGROUND:
Estrogens and calcium regulate vascular health but caused adverse cardiovascular events in randomized trials.
OBJECTIVES:
Whether phytoestrogenic soy isoflavones modulate the physiological effects of calcium on blood pressure was explored.
DESIGN:
A double-blind, randomized study assigned 99 premenopausal women to 136.6 mg isoflavones (as aglycone equivalents) and 98 to placebo for 5 days per week for up to 2 years. Blood pressure, serum calcium and urinary excretion of daidzein (DE) and genistein (GE) were measured repeatedly before and during treatment.
RESULTS:
Isoflavones did not affect blood pressure per intake dose assignment (i.e. intention-to-treat, n = 197), but significantly affected blood pressure per measured urinary excretion of isoflavones (i.e. per protocol analysis, n = 166). Isoflavones inversely moderated calcium effects on systolic blood pressure (SBP) (interaction term β-estimates: - 3.1 for DE, - 12.86 for GE, all P < 0.05), and decreased diastolic blood pressure (DBP) (β-estimates: - 0.84 for DE, - 2.82 for GE, all P < 0.05) after controlling for calcium. The net intervention effects between the maximum and no isoflavone excretion were - 17.7 and + 13.8 mmHg changes of SBP, respectively, at serum calcium of 10.61 and 8.0 mg/dL, and about 2.6 mmHg decrease of DBP.
CONCLUSIONS:
Moderation by isoflavones of the physiological effect of calcium tends to normalize SBP, and this effect is most significant when calcium concentrations are at the upper and lower limits of the physiological norm. Isoflavones decrease DBP independent of calcium levels. Further studies are needed to assess the impact of this novel micronutrient effect on blood pressure homeostasis and cardiovascular health.
KEYWORDS:
Blood pressure homeostasis; Daidzein; Genistein; Micronutrients; Selective estrogen receptor modulator

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The Paradox of Coenzyme Q10 in Aging.
Díaz-Casado ME, Quiles JL, Barriocanal-Casado E, González-García P, Battino M, López LC, Varela-López A.
Nutrients. 2019 Sep 14;11(9). pii: E2221. doi: 10.3390/nu11092221. Review.
PMID: 31540029
https://www.mdpi.com/2072-6643/11/9/2221/htm
Abstract
Coenzyme Q (CoQ) is an essential endogenously synthesized molecule that links different metabolic pathways to mitochondrial energy production thanks to its location in the mitochondrial inner membrane and its redox capacity, which also provide it with the capability to work as an antioxidant. Although defects in CoQ biosynthesis in human and mouse models cause CoQ deficiency syndrome, some animals models with particular defects in the CoQ biosynthetic pathway have shown an increase in life span, a fact that has been attributed to the concept of mitohormesis. Paradoxically, CoQ levels decline in some tissues in human and rodents during aging and coenzyme Q10 (CoQ10) supplementation has shown benefits as an anti-aging agent, especially under certain conditions associated with increased oxidative stress. Also, CoQ10 has shown therapeutic benefits in aging-related disorders, particularly in cardiovascular and metabolic diseases. Thus, we discuss the paradox of health benefits due to a defect in the CoQ biosynthetic pathway or exogenous supplementation of CoQ10.
KEYWORDS:
aging-related diseases; anti-aging; antioxidant; diet; mitochondria; mitohormesis

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Excess Body Weight and the Risk of Liver Cancer: Systematic Review and a Meta-Analysis of Cohort Studies.
Yang C, Lu Y, Xia H, Liu H, Pan D, Yang X, Sun G.
Nutr Cancer. 2019 Sep 23:1-13. doi: 10.1080/01635581.2019.1664602. [Epub ahead of print]
PMID: 31544511
Abstract
Objective: To update and expand the previous meta-analysis including all prospective studies on the issue of the associations between overweight, obesity, and liver cancer risk. We also performed a meta-regression to investigate a potential nonlinear and/or linear association between body mass index (BMI) and liver cancer risk. Methods: Literature search was conducted in four libraries from the beginning of indexing for each database to 1st September, 2018. Results: The summary risk estimate was statistically significant on the association between overweight and the risk of liver cancer incidence (relative ratio [RR] = 1.19). The RRs were significantly stronger in people with known liver disease with overweight than in the general population with overweight (RR = 1.50 vs. RR = 1.10; Pdifference = .02). The meta-analysis showed an increase by 87% on the risk of liver cancer incidence in obesity categories, relative to categories of normal BMI (RR = 1.87, P < .01). Moreover, the results showed that, overweight was associated with 9% increased and obesity with 66% increased for risk of liver cancer mortality. In linear model, the relative risks of liver cancer were 1.32 for continuous BMI per 5 kg/m2 increase. Conclusion: This meta-analysis supports the hypothesis that overweight, obesity may significantly increase liver cancer risk.

Device-measured light-intensity physical activity and mortality: A meta-analysis.
Ku PW, Hamer M, Liao Y, Hsueh MC, Chen LJ.
Scand J Med Sci Sports. 2019 Sep 23. doi: 10.1111/sms.13557. [Epub ahead of print] Review.
PMID: 31545531
Abstract
INTRODUCTION:
The association of light-intensity physical activity (LPA) with mortality is poorly understood. This meta-analysis of cohort studies aimed to examine the dose-response relationships between daily device-measured LPA and mortality in adults aged 18 or older and to explore whether the associations were independent of moderate-to-vigorous physical activity (MVPA).
METHODS:
Searches for prospective cohort studies providing effect estimates of daily LPA (exposure) on all-cause mortality (outcome) were systematically undertaken in electronic databases up to 30 April 2019. Subgroup analyses and meta-regression analyses with random-effects models were performed to quantify the dose-response relationships between daily LPA and mortality. Sensitivity analyses were also conducted to assess the stability of the results.
RESULTS:
A total of 11 studies were included in the meta-analysis. Analyses contained 49,239 individuals (mean age 60.7, SD = 13.6) who were followed up for a mean 6.2 years (2.3 - 14.2 years), during which 3,669 (7.5%) died. In comparison with the reference group (< 3 hours/day), the pooled HRs (and 95% CIs) of mortality were 0.71 (0.62 - 0.82), 0.68 (0.59 - 0.79), 0.56 (0.44 - 0.71) for groups 3 - < 5 hours/day, 5 - < 7 hours/day, and more than 7 hours a day LPA respectively. Meta-regression models indicated that there was a log-cubic dose-response relationship between daily LPA and mortality in adults and older people, independent of MVPA.
CONCLUSIONS:
Time spent in daily LPA was associated with reduced risks of mortality in adults and older people. These data support the inclusion of LPA in the future physical activity guidelines.
KEYWORDS:
Guideline; LIPA; Meta-regression; Recommendation; Review

Antibiotic Use and Risk of Incident Kidney Stones in Female Nurses.
Ferraro PM, Curhan GC, Gambaro G, Taylor EN.
Am J Kidney Dis. 2019 Sep 17. pii: S0272-6386(19)30855-8. doi: 10.1053/j.ajkd.2019.06.005. [Epub ahead of print]
PMID: 31543288
Abstract
RATIONALE & OBJECTIVE:
The intestinal microbiome may affect urinary stone disease by modulating the amount of oxalate absorbed from the intestine and subsequently excreted in urine. This study sought to explore the association between antibiotics, which alter the intestinal microbiota, and risk for urinary stone disease.
STUDY DESIGN:
Prospective cohort study.
SETTING & PARTICIPANTS:
5,010 women in the Nurses' Health Study (NHS) I and II who had collected 24-hour urine samples.
EXPOSURES:
Use of antibiotics during the age range of 40 to 49 (NHS II), 40 to 59 (NHS I), and 20 to 39 years (both cohorts).
OUTCOMES:
Incident symptomatic urinary stone disease; urine composition.
ANALYTICAL APPROACH:
Cause-specific hazards regression adjusted for age, body mass index, comorbid conditions, thiazide use, and dietary factors. Follow-up was censored at the time of asymptomatic kidney stones, cancer, or death.
RESULTS:
Cumulative use of antibiotics for a total of 2 or more months during the age range of 40 to 49 years (NHS II) and 40 to 59 years (NHS II) was associated with significantly higher risk for developing incident stones compared with no use (pooled HR, 1.48; 95% CI, 1.12-1.96). Similar results were found for the period of 20 to 39 years (pooled HR, 1.36; 95% CI, 1.00-1.84). Results were unchanged after excluding participants who reported urinary tract infection with their stone event or as the most common reason for antibiotic use. Urine composition was generally similar across antibiotic groups except for marginally lower urine pH and citrate values among those taking antibiotics for 2 or more months.
LIMITATIONS:
Observational design; lack of information for type of antibiotic used; relatively large span of time between antibiotic use and urine collection.
CONCLUSIONS:
Use of antibiotics for more than 2 months in early adulthood and middle age is associated with higher risk for urinary stone disease in later life.
KEYWORDS:
Antibiotics; antibacterial agents; bacterial infection; cohort studies; cumulative antibiotic use; drug effects; intestinal microbiome; kidney stone; lithogenesis; stone formation; urine chemistry; urine composition; urolithiasis; women

Green tea and coffee intake and risk of cognitive decline in older adults: the National Institute for Longevity Sciences, Longitudinal Study of Aging.
Shirai Y, Kuriki K, Otsuka R, Kato Y, Nishita Y, Tange C, Tomida M, Imai T, Ando F, Shimokata H.
Public Health Nutr. 2019 Sep 23:1-9. doi: 10.1017/S1368980019002659. [Epub ahead of print]
PMID: 31544736
Abstract
OBJECTIVE:
To examine the association between green tea and coffee intake and cognitive decline in older adults.
DESIGN:
A prospective cohort study. The average intake of green tea and coffee in the previous year was assessed through a dietitian interview using a dietary questionnaire. A Mini-Mental State Examination (MMSE) was conducted up to six times biennially. Cognitive decline was screened using the MMSE; its incidence was defined as the first time a score of <27 points was obtained in a biennial test from the baseline. Hazard ratios for incidence of cognitive decline were estimated according to the intake of the two beverages using multivariable Cox proportional hazard regression, controlling for sociodemographic and lifestyle factors.
SETTING:
The National Institute for Longevity Sciences, Longitudinal Study of Aging (NILS-LSA) in Japan.
PARTICIPANTS:
Men (n 620) and women (n 685), aged 60-85 years, from the NILS-LSA.
RESULTS:
During a mean of 5·3 (sd 2·9) years of follow-up, 432 incident cases of cognitive decline were observed. Compared with participants who consumed green tea <once/d, the multivariable hazard ratio (95 % CI) was 0·70 (0·45, 1·06), 0·71 (0·52, 0·97) and 0·72 (0·54, 0·98) among those who consumed green tea once/d, 2-3 times/d and ≥4 times/d, respectively (Ptrend < 0·05). No significant association was found between coffee intake and cognitive decline.
CONCLUSIONS:
The intake of green tea, but not coffee, was shown to 

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Some tea bags may shed billions of microplastics per cup
'Silken' bags for premium teas are made of PET or nylon, but it's not known if that poses health risk
Emily Chung · CBC News
https://www.cbc.ca/news/technology/tea-bags-plastic-study-mcgill-1.5295662

Associations of vigorous physical activity with all-cause, cardiovascular and cancer mortality among 64 913 adults.
Rey Lopez JP, Gebel K, Chia D, Stamatakis E.
BMJ Open Sport Exerc Med. 2019 Aug 12;5(1):e000596. doi: 10.1136/bmjsem-2019-000596. eCollection 2019.
PMID: 31548909
Abstract
BACKGROUND:
Physical activity recommendations state that for the same energy expenditure, moderate-to-vigorous physical activities (MVPAs) produce similar health benefits. However, few epidemiological studies have tested this hypothesis.
DESIGN:
We examined whether, compared with moderate, vigorous activity was associated with larger mortality risk reductions.
METHODS:
Data from 11 cohorts of the Health Survey for England and the Scottish Health Survey, collected from 1994 to 2011 (mean (SD) follow-up, 9.0 (3.6) years). Adults aged ≥30 years reported MVPA and linkage to mortality records. Exposure was the proportion of self-reported weighted MVPA through vigorous activity. Outcomes were all-cause, cardiovascular disease (CVD) and cancer mortality.
RESULTS:
Among 64 913 adult respondents (44% men, 56% women, mean (SD) age, 49.8 (13.6) years), there were 5064 deaths from all-causes, 1393 from CVD and 1602 from cancer during 435 743 person-years of follow-up. Compared with those who reported no vigorous physical activity, and holding constant the volume of weighted MVPA, vigorous activity was associated with additional reductions in mortality risk. For all-cause mortality, the adjusted HR was HR=0.84 (95% CI 0.71, 0.99) and HR=0.84 (95% CI 0.76, 0.94) among those who reported between >0% and<30%, or ≥30% of their activity as vigorous, respectively. For CVD and cancer mortality, point estimates showed similar beneficial associations yet CIs were wider and crossed unity.
CONCLUSION:
Vigorous activities were associated with larger reductions in mortality risk than activities of moderate intensity, but no evidence of dose-response effects was found.
KEYWORDS:
cardio-protection; exercise; longevity; non-communicable diseases; physical activity

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Is carrot consumption associated with a decreased risk of lung cancer? A meta-analysis of observational studies.
Xu H, Jiang H, Yang W, Song F, Yan S, Wang C, Fu W, Li H, Lyu C, Gan Y, Lu Z.
Br J Nutr. 2019 Sep 14;122(5):488-498. doi: 10.1017/S0007114519001107.
PMID: 31552816
https://sci-hub.tw/10.1017/S0007114519001107
Abstract
Findings of epidemiological studies regarding the association between carrot consumption and lung cancer risk remain inconsistent. The present study aimed to summarise the current epidemiological evidence concerning carrot intake and lung cancer risk with a meta-analysis. We conducted a meta-analysis of case-control and prospective cohort studies, and searched PubMed and Embase databases from their inception to April 2018 without restriction by language. We also reviewed reference lists from included articles. Prospective cohort or case-control studies reporting OR or relative risk with the corresponding 95 % CI of the risk lung cancer for the highest compared with the lowest category of carrot intake. A total of eighteen eligible studies (seventeen case-control studies and one prospective cohort study) were included, involving 202 969 individuals and 5517 patients with lung cancer. The pooled OR of eighteen studies for lung cancer was 0·58 (95 % CI 0·45, 0·74) by comparing the highest category with the lowest category of carrot consumption. Based on subgroup analyses for the types of lung cancer, we pooled that squamous cell carcinoma (OR 0·52, 95 % CI 0·19, 1·45), small-cell carcinoma (OR 0·43, 95 % CI 0·12, 1·59), adenocarcinoma (OR 0·34, 95 % CI 0·15, 0·79), large-cell carcinoma (OR 0·40, 95 % CI 0·10, 1·57), squamous and small-cell carcinoma (OR 0·85, 95 % CI 0·45, 1·62), adenocarcinoma and large-cell carcinoma (OR 0·20, 95 % CI 0·02, 1·70) and mixed types (OR 0·61, 95 % CI 0·46, 0·81). Exclusion of any single study did not materially alter the pooled OR. Integrated epidemiological evidence from observational studies supported the hypothesis that carrot consumption may decrease the risk of lung cancer, especially for adenocarcinoma.
KEYWORDS:
Cancer prevention; Carrot consumption; Epidemiology; Lung cancer

Association of BCG Vaccination in Childhood With Subsequent Cancer Diagnoses: A 60-Year Follow-up of a Clinical Trial.
Usher NT, Chang S, Howard RS, Martinez A, Harrison LH, Santosham M, Aronson NE.
JAMA Netw Open. 2019 Sep 4;2(9):e1912014. doi: 10.1001/jamanetworkopen.2019.12014.
PMID: 31553471
Abstract
IMPORTANCE:
The BCG vaccine is currently the only approved tuberculosis vaccine and is widely administered worldwide, usually during infancy. Previous studies found increased rates of lymphoma and leukemia in BCG-vaccinated populations.
OBJECTIVE:
To determine whether BCG vaccination was associated with cancer rates in a secondary analysis of a BCG vaccine trial.
DESIGN, SETTING, AND PARTICIPANTS:
Retrospective review (60-year follow-up) of a clinical trial in which participants were assigned to the vaccine group by systematic stratification by school district, age, and sex, then randomized by alternation. The original study was conducted at 9 sites in 5 US states between December 1935 and December 1998. Participants were 2963 American Indian and Alaska Native schoolchildren younger than 20 years with no evidence of previous tuberculosis infection. Statistical analysis was conducted between August 2018 and July 2019.
INTERVENTIONS:
Single intradermal injection of either BCG vaccine or saline placebo.
MAIN OUTCOMES AND MEASURES:
The primary outcome was diagnosis of cancer after BCG vaccination. Data on participant interval health and risk factors, including smoking, tuberculosis infection, isoniazid use, and other basic demographic information, were also collected.
RESULTS:
A total of 2963 participants, including 1540 in the BCG vaccine group and 1423 in the placebo group, remained after exclusions. Vaccination occurred at a median (interquartile range) age of 8 (5-11) years; 805 participants (52%) in the BCG group and 710 (50%) in the placebo group were female. At the time of follow-up, 97 participants (7%) in the placebo group and 106 participants (7%) in the BCG vaccine group could not be located; total mortality was 633 participants (44%) in the placebo group and 632 participants (41%) in the BCG group. The overall rate of cancer diagnosis was not significantly different in BCG vaccine vs placebo recipients (hazard ratio, 0.82; 95% CI, 0.66-1.02), including for lymphoma and leukemia. The rate of lung cancer was significantly lower in BCG vs placebo recipients (18.2 vs 45.4 cases per 100 000 person-years; hazard ratio, 0.38; 95% CI, 0.20-0.74; P = .005), controlling for sex, region, alcohol overuse, smoking, and tuberculosis.
CONCLUSIONS AND RELEVANCE:
Childhood BCG vaccination was associated with a lower risk of lung cancer development in American Indian and Alaska Native populations. This finding has potentially important health implications given the high mortality rate associated with lung cancer and the availability of low-cost BCG vaccines.

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Diet and risk of breast, endometrial and ovarian cancer: UK Women's Cohort Study.
Dunneram Y, Greenwood DC, Cade JE.
Br J Nutr. 2019 Sep 14;122(5):564-574. doi: 10.1017/S0007114518003665. Epub 2018 Dec 11.
PMID: 30526696 Free Article
Abstract
This study aimed to investigate the association between diet and the risk of breast, endometrial and ovarian cancer in the UK Women's Cohort Study. A total of 35 372 women aged 35-69 years were enrolled between 1995 and 1998 and completed a validated 217-item FFQ. The individual foods were collapsed into sixty-four main food groups and compared using Cox proportional models, adjusting for potential confounders. Hazard ratio (HR) estimates are presented per portion increase in food items. After approximately 18 years of follow-up, there were 1822, 294 and 285 cases of breast, endometrial and ovarian cancer, respectively. A high consumption of processed meat and total meat was associated with an increased risk of breast and endometrial cancer. High intake of tomatoes (HR 0·87, 99 % CI 0·75, 1·00) and dried fruits (HR 0·60, 99 % CI 0·37, 0·97) was associated with a reduced risk of breast and endometrial cancer, respectively. Mushroom intake was associated with a higher risk of ovarian cancer (HR 1·57, 99 % CI 1·09, 2·26). Subgroup analysis by pre- or postmenopausal cancer further demonstrated an association between processed meat intake and both postmenopausal breast cancer and endometrial cancer. Intake of dried fruits was associated with a reduced risk of postmenopausal endometrial cancer (HR 0·55, 99 % CI 0·31, 0·98). Our findings suggest that while some foods may trigger the risk of these cancers, some foods may also be protective; supporting the call for further randomised controlled trials of dietary interventions to reduce the risk of cancer among pre- and postmenopausal women.
KEYWORDS:
Breast cancer; Diet; Endometrial cancer; Food groups; Ovarian cancer; Postmenopausal women; Premenopausal women

Dietary Intake of Riboflavin and Unsaturated Fatty Acid Can Improve the Multi-Domain Cognitive Function in Middle-Aged and Elderly Populations: A 2-Year Prospective Cohort Study.
Tao L, Liu K, Chen S, Yu H, An Y, Wang Y, Zhang X, Wang Y, Qin Z, Xiao R.
Front Aging Neurosci. 2019 Aug 29;11:226. doi: 10.3389/fnagi.2019.00226. eCollection 2019.
PMID: 31555120
Abstract
OBJECTIVE:
This study was aimed to explore the effects of dietary nutrients on cognitive function among the middle-aged and elderly populations.
METHODS:
A prospective cohort study of 1,385 middle-aged and elderly people was conducted from January 2014 to December 2017. Dietary nutrients were assessed according to the food frequency questionnaire (FFQ) and China Food Composition Database (CFCD). Montreal cognitive assessment (MoCA) was used to evaluate the participants' global cognitive function. Six other neuropsychological measures [auditory verbal learning test-immediate recall (AVLT-IR), auditory verbal learning test-short recall (AVLT-SR), auditory verbal learning test-long recall (AVLT-LR), logical memory test (LMT), digit span forward (DST-F), and digit span backward (DST-B)] were used to assess the verbal memory domain and the attention domain by principal component analysis (PCA). Multiple linear regressions were conducted to explore associations between nutrients and cognition. Sensitivity analyses were performed to confirm the results.
RESULTS:
Dietary riboflavin was protective for global cognitive function (β = 1.31, 95% CI: 0.26, 2.35) and the verbal memory domain (β = 0.37, 95% CI: 0.02, 0.71). Unsaturated fatty acid (USFA) played a protective role in global cognitive function (β = 1.15, 95% CI: 0.16, 2.14). The protective effects of riboflavin and USFA on cognitive function were consistent and reliable when different confounders were adjusted during sensitivity analyses. During the follow-up, neuropsychological measure scores revealed a reduced decline in the high-riboflavin group (d-MoCA, P = 0.025; d-AVLT-IR, P = 0.001; d-DST-B, P = 0.004; and d-composite score, P = 0.004) and the high-USFA group (d-AVLT-IR, P = 0.007; d-LMT, P = 0.032; d-DST-B, P = 0.002; and d-composite score, P = 0.008).
CONCLUSION:
Higher intake of riboflavin and USFA can improve multi-dimensional cognitive functioning in middle-aged and elderly people. These findings were consistent in different models of sensitivity analyses.
KEYWORDS:
cognitive impairment; dietary nutrients; middle-aged and elderly people; riboflavin; unsaturated fatty acid

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Efficacy of l-carnitine supplementation for management of blood lipids: A systematic review and dose-response meta-analysis of randomized controlled trials.
Askarpour M, Hadi A, Symonds ME, Miraghajani M, Omid Sadeghi, Sheikhi A, Ghaedi E.
Nutr Metab Cardiovasc Dis. 2019 Jul 24. pii: S0939-4753(19)30280-7. doi: 10.1016/j.numecd.2019.07.012. [Epub ahead of print]
PMID: 31561944
Abstract
BACKGROUND AND AIM:
l-carnitine has an important role in fatty acid metabolism and could therefore act as an adjuvant agent in the improvement of dyslipidemia. The purpose of present systematic review and meta-analysis was to critically assess the efficacy of l-carnitine supplementation on lipid profiles.
METHODS AND RESULTS:
We performed a systematic search of all available randomized controlled trials (RCTs) in the following databases: Scopus, PubMed, ISI Web of Science, The Cochrane Library. Mean difference (MD) of any effect was calculated using a random-effects model. In total, there were 55 eligible RCTs included with 58 arms, and meta-analysis revealed that l-carnitine supplementation significantly reduced total cholesterol (TC) (56 arms-MD: -8.53 mg/dl, 95% CI: -13.46, -3.6, I2: 93%), low-density lipoprotein-cholesterol (LDL-C) (47 arms-MD: -5.48 mg/dl, 95% CI: -8.49, -2.47, I2: 94.5) and triglyceride (TG) (56 arms-MD: -9.44 mg/dl, 95% CI: -16.02, -2.87, I2: 91.8). It also increased high density lipoprotein-cholesterol (HDL-C) (51 arms-MD:1.64 mg/dl, 95% CI:0.54, 2.75, I2: 92.2). l-carnitine supplementation reduced TC in non-linear fashion based on dosage (r = 21.11). Meta-regression analysis indicated a linear relationship between dose of l-carnitine and absolute change in TC (p = 0.029) and LDL-C (p = 0.013). Subgroup analyses showed that l-carnitine supplementation did not change TC, LDL-C and TG in patients under hemodialysis treatment. Intravenous l-carnitine and lower doses (>2 g/day) had no effect on TC, LDL-C and triglycerides.
CONCLUSION:
l-carnitine supplementation at doses above 2 g/d has favorable effects on patients' lipid profiles, but is modulated on participant health and route of administration.
KEYWORDS:
Lipid profile; Meta-analysis; Systematic review; l-carnitine

Alcohol Consumption and Risk of Dementia and Cognitive Decline Among Older Adults With or Without Mild Cognitive Impairment.
Koch M, Fitzpatrick AL, Rapp SR, Nahin RL, Williamson JD, Lopez OL, DeKosky ST, Kuller LH, Mackey RH, Mukamal KJ, Jensen MK, Sink KM.
JAMA Netw Open. 2019 Sep 4;2(9):e1910319. doi: 10.1001/jamanetworkopen.2019.10319.
PMID: 31560382
Abstract
IMPORTANCE:
Substantial heterogeneity and uncertainty exist in the observed associations between alcohol consumption and dementia.
OBJECTIVE:
To assess the association between alcohol consumption and dementia and the roles of mild cognitive impairment (MCI) and apolipoprotein E ε4 (APOE E4) genotype in modifying this association.
DESIGN, SETTING, AND PARTICIPANTS:
This cohort study used data from the Ginkgo Evaluation of Memory Study, conducted from 2000 to 2008 among US community-dwelling participants. This study analyzed 3021 participants aged 72 years and older who were free of dementia. Data analysis was performed from 2017 to 2018.
EXPOSURES:
Self-reported alcohol consumption, drinking frequency, and quantity.
MAIN OUTCOMES AND MEASURES:
Using multivariable proportional hazards regression and linear mixed models, the risk of dementia and the rate of change over time in the Modified Mini-Mental State Examination were estimated.
RESULTS:
Among 3021 participants, the median (interquartile range) age was 78 (76-80) years; 1395 (46.2%) were female. During a median (interquartile range) follow-up of 6.0 (4.9-6.5) years, 512 cases of dementia occurred. For 7.1 to 14.0 drinks per week compared with less than 1.0 drink per week, the hazard ratios for dementia were 0.63 (95% CI, 0.38-1.06) among 2548 participants without MCI and 0.93 (95% CI, 0.47-1.84) among 473 participants with MCI. Among participants with MCI, the hazard ratio for dementia was 1.72 (95% CI, 0.87-3.40) for more than 14.0 drinks per week compared with less than 1.0 drink per week. The association of alcohol intake with dementia differed for participants with and without baseline MCI (P for interaction = .03). Among participants without MCI, daily low-quantity drinking was associated with lower dementia risk than infrequent higher-quantity drinking (hazard ratio, 0.45; 95% CI, 0.23-0.89; P = .02). Findings were consistent when stratified by sex, age, and APOE E4 genotype. Compared with drinking less than 1.0 drink per week, complete abstention (in participants without MCI) and the consumption of more than 14.0 drinks per week (in participants with MCI) were associated with lower Modified Mini-Mental State Examination scores (mean difference at follow-up compared with baseline, -0.46 point [95% CI, -0.87 to -0.04 point] and -3.51 points [95% CI, -5.75 to -1.27 points], respectively).
CONCLUSIONS AND RELEVANCE:
In this study, complete abstention and consuming more than 14.0 drinks per week (compared with drinking <1.0 drink per week) were associated with lower cognitive scores among participants aged 72 years and older. Particular caution is needed among individuals with MCI who continue to drink alcohol.

Why It Was Easier to Be Skinny in the 1980s
A study finds that people today who eat and exercise the same amount as people 20 years ago are still fatter.
The Atlantic
Olga Khazan 
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Secular differences in the association between caloric intake, macronutrient intake, and physical activity with obesity.
Brown RE, Sharma AM, Ardern CI, Mirdamadi P, Mirdamadi P, Kuk JL.
Obes Res Clin Pract. 2016 May-Jun;10(3):243-55. doi: 10.1016/j.orcp.2015.08.007. Epub 2015 Sep 14.
PMID: 26383959
Abstract
BACKGROUND:
To determine whether the relationship between caloric intake, macronutrient intake, and physical activity with obesity has changed over time.
METHODS:
Dietary data from 36,377 U.S. adults from the National Health and Nutrition Survey (NHANES) between 1971 and 2008 was used. Physical activity frequency data was only available in 14,419 adults between 1988 and 2006. Generalised linear models were used to examine if the association between total caloric intake, percent dietary macronutrient intake and physical activity with body mass index (BMI) was different over time.
RESULTS:
Between 1971 and 2008, BMI, total caloric intake and carbohydrate intake increased 10-14%, and fat and protein intake decreased 5-9%. Between 1988 and 2006, frequency of leisure time physical activity increased 47-120%. However, for a given amount of caloric intake, macronutrient intake or leisure time physical activity, the predicted BMI was up to 2.3kg/m(2) higher in 2006 that in 1988 in the mutually adjusted model (P<0.05).
CONCLUSIONS:
Factors other than diet and physical activity may be contributing to the increase in BMI over time. Further research is necessary to identify these factors and to determine the mechanisms through which they affect body weight.
KEYWORDS:
Body mass index; Energy intake; Epidemiology; Etiology; NHANES

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Dietary zinc intake, supplemental zinc intake and serum zinc levels and the prevalence of kidney stones in adults.
Sun Y, Wang Y, Wang D, Zhou Q.
J Trace Elem Med Biol. 2019 Sep 24:126410. doi: 10.1016/j.jtemb.2019.126410. [Epub ahead of print]
PMID: 31570252
Abstract
OBJECTIVE:
The association between zinc intake and the risk of kidney stones remains controversial. We examined the associations between dietary zinc intake, supplemental zinc intake and serum zinc levels and the prevalence of kidney stones in adults.
METHODS:
Adult participants from the 2007-2016 NHANES were included. Restricted cubic splines were adopted to assess the dose-response relationships.
RESULTS:
Dietary zinc intake was linearly associated with the prevalence of kidney stones (Pfor non-linearity = 0.50), and the odds ratios (95% confidence intervals) of kidney stones were 0.75 (0.51-1.04) for 10 mg/day, 0.65 (0.39-0.97) for 20 mg/day, 0.53 (0.30-0.94) for 30 mg/day and 0.45 (0.22-0.95) for 40 mg/day. The linear relationship was also observed among women and overweight/obese individuals. No association was found between supplemental zinc intake and the prevalence of kidney stones. A non-linear relationship was found between serum zinc levels and the prevalence of kidney stones (Pfor non-linearity = 0.02), and the odds ratios (95% confidence intervals) of kidney stones were 0.52 (0.33-0.82) for 70 ug/dL, 0.43 (0.24-0.77) for 90 ug/dL, 0.56 (0.32-0.98) for 110 ug/dL and 0.77 (0.37-1.62) for 130 ug/dL. The non-linear relationship was also observed among men and overweight/obese individuals.
CONCLUSIONS:
Dietary zinc intake and serum zinc levels were inversely associated with the prevalence of kidney stones in adults, and there may be effect modification by participant sex and body mass index. The present analysis is limited in its ability to establish causality.
KEYWORDS:
Adults; Dietary zinc intake; Kidney stones; National Health and Nutrition Examination Survey; Serum zinc levels; Supplemental zinc intake

How risky is eating red meat? New studies provoke controversy
The studies do not say red meat and processed meats like hot dogs and bacon are healthy
The Associated Press · Posted: Oct 01, 2019
https://www.cbc.ca/news/canada/hamilton/how-risky-is-eating-red-meat-new-studies-provoke-controversy-1.5303941
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Effect of Lower Versus Higher Red Meat Intake on Cardiometabolic and Cancer Outcomes: A Systematic Review of Randomized Trials.
Zeraatkar D, Johnston BC, Bartoszko J, Cheung K, Bala MM, Valli C, Rabassa M, Sit D, Milio K, Sadeghirad B, Agarwal A, Zea AM, Lee Y, Han MA, Vernooij RWM, Alonso-Coello P, Guyatt GH, El Dib R.
Ann Intern Med. 2019 Oct 1. doi: 10.7326/M19-0622. [Epub ahead of print]
PMID: 31569236
https://annals.org/aim/fullarticle/2752326/effect-lower-versus-higher-red-meat-intake-cardiometabolic-cancer-outcomes
Abstract
BACKGROUND:
Few randomized trials have evaluated the effect of reducing red meat intake on clinically important outcomes.
PURPOSE:
To summarize the effect of lower versus higher red meat intake on the incidence of cardiometabolic and cancer outcomes in adults.
DATA SOURCES:
EMBASE, CENTRAL, CINAHL, Web of Science, and ProQuest from inception to July 2018 and MEDLINE from inception to April 2019, without language restrictions.
STUDY SELECTION:
Randomized trials (published in any language) comparing diets lower in red meat with diets higher in red meat that differed by a gradient of at least 1 serving per week for 6 months or more.
DATA EXTRACTION:
Teams of 2 reviewers independently extracted data and assessed the risk of bias and the certainty of the evidence.
DATA SYNTHESIS:
Of 12 eligible trials, a single trial enrolling 48 835 women provided the most credible, though still low-certainty, evidence that diets lower in red meat may have little or no effect on all-cause mortality (hazard ratio


, 0.99 [95% CI, 0.95 to 1.03], cardiovascular mortality (HR, 0.98 [CI, 0.91 to 1.06]), and cardiovascular disease (HR, 0.99 [CI, 0.94 to 1.05]). That trial also provided low- to very-low-certainty evidence that diets lower in red meat may have little or no effect on total cancer mortality (HR, 0.95 [CI, 0.89 to 1.01]) and the incidence of cancer, including colorectal cancer (HR, 1.04 [CI, 0.90 to 1.20]) and breast cancer (HR, 0.97 [0.90 to 1.04]).
LIMITATIONS:
There were few trials, most addressing only surrogate outcomes, with heterogeneous comparators and small gradients in red meat consumption between lower versus higher intake groups.
CONCLUSION:
Low- to very-low-certainty evidence suggests that diets restricted in red meat may have little or no effect on major cardiometabolic outcomes and cancer mortality and incidence.
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Patterns of Red and Processed Meat Consumption and Risk for Cardiometabolic and Cancer Outcomes: A Systematic Review and Meta-analysis of Cohort Studies.
Vernooij RWM, Zeraatkar D, Han MA, El Dib R, Zworth M, Milio K, Sit D, Lee Y, Gomaa H, Valli C, Swierz MJ, Chang Y, Hanna SE, Brauer PM, Sievenpiper J, de Souza R, Alonso-Coello P, Bala MM, Guyatt GH, Johnston BC.
Ann Intern Med. 2019 Oct 1. doi: 10.7326/M19-1583. [Epub ahead of print]
PMID: 31569217
https://annals.org/aim/fullarticle/2752327/patterns-red-processed-meat-consumption-risk-cardiometabolic-cancer-outcomes-systematic
Abstract
BACKGROUND:
Studying dietary patterns may provide insights into the potential effects of red and processed meat on health outcomes.
PURPOSE:
To evaluate the effect of dietary patterns, including different amounts of red or processed meat, on all-cause mortality, cardiometabolic outcomes, and cancer incidence and mortality.
DATA SOURCES:
Systematic search of MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, CINAHL, Web of Science, and ProQuest Dissertations & Theses Global from inception to April 2019 with no restrictions on year or language.
STUDY SELECTION:
Teams of 2 reviewers independently screened search results and included prospective cohort studies with 1000 or more participants that reported on the association between dietary patterns and health outcomes.
DATA EXTRACTION:
Two reviewers independently extracted data, assessed risk of bias, and evaluated the certainty of evidence using GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria.
DATA SYNTHESIS:
Eligible studies that followed patients for 2 to 34 years revealed low- to very-low-certainty evidence that dietary patterns lower in red and processed meat intake result in very small or possibly small decreases in all-cause mortality, cancer mortality and incidence, cardiovascular mortality, nonfatal coronary heart disease, fatal and nonfatal myocardial infarction, and type 2 diabetes. For all-cause, cancer, and cardiovascular mortality and incidence of some types of cancer, the total sample included more than 400 000 patients; for other outcomes, total samples included 4000 to more than 300 000 patients.
LIMITATION:
Observational studies are prone to residual confounding, and these studies provide low- or very-low-certainty evidence according to the GRADE criteria.
CONCLUSION:
Low- or very-low-certainty evidence suggests that dietary patterns with less red and processed meat intake may result in very small reductions in adverse cardiometabolic and cancer outcomes.
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Reduction of Red and Processed Meat Intake and Cancer Mortality and Incidence: A Systematic Review and Meta-analysis of Cohort Studies.
Han MA, Zeraatkar D, Guyatt GH, Vernooij RWM, El Dib R, Zhang Y, Algarni A, Leung G, Storman D, Valli C, Rabassa M, Rehman N, Parvizian MK, Zworth M, Bartoszko JJ, Lopes LC, Sit D, Bala MM, Alonso-Coello P, Johnston BC.
Ann Intern Med. 2019 Oct 1. doi: 10.7326/M19-0699. [Epub ahead of print]
PMID: 31569214
https://annals.org/aim/fullarticle/2752321/reduction-red-processed-meat-intake-cancer-mortality-incidence-systematic-review
Abstract
BACKGROUND:
Cancer incidence has continuously increased over the past few centuries and represents a major health burden worldwide.
PURPOSE:
To evaluate the possible causal relationship between intake of red and processed meat and cancer mortality and incidence.
DATA SOURCES:
Embase, Cochrane Central Register of Controlled Trials, Web of Science, CINAHL, and ProQuest from inception until July 2018 and MEDLINE from inception until April 2019 without language restrictions.
STUDY SELECTION:
Cohort studies that included more than 1000 adults and reported the association between consumption of unprocessed red and processed meat and cancer mortality and incidence.
DATA EXTRACTION:
Teams of 2 reviewers independently extracted data and assessed risk of bias; 1 reviewer evaluated the certainty of evidence, which was confirmed or revised by the senior reviewer.
DATA SYNTHESIS:
Of 118 articles (56 cohorts) with more than 6 million participants, 73 articles were eligible for the dose-response meta-analyses, 30 addressed cancer mortality, and 80 reported cancer incidence. Low-certainty evidence suggested that an intake reduction of 3 servings of unprocessed meat per week was associated with a very small reduction in overall cancer mortality over a lifetime. Evidence of low to very low certainty suggested that each intake reduction of 3 servings of processed meat per week was associated with very small decreases in overall cancer mortality over a lifetime; prostate cancer mortality; and incidence of esophageal, colorectal, and breast cancer.
LIMITATION:
Limited causal inferences due to residual confounding in observational studies, risk of bias due to limitations in diet assessment and adjustment for confounders, recall bias in dietary assessment, and insufficient data for planned subgroup analyses.
CONCLUSION:
The possible absolute effects of red and processed meat consumption on cancer mortality and incidence are very small, and the certainty of evidence is low to very low.
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Red and Processed Meat Consumption and Risk for All-Cause Mortality and Cardiometabolic Outcomes: A Systematic Review and Meta-analysis of Cohort Studies.
Zeraatkar D, Han MA, Guyatt GH, Vernooij RWM, El Dib R, Cheung K, Milio K, Zworth M, Bartoszko JJ, Valli C, Rabassa M, Lee Y, Zajac J, Prokop-Dorner A, Lo C, Bala MM, Alonso-Coello P, Hanna SE, Johnston BC.
Ann Intern Med. 2019 Oct 1. doi: 10.7326/M19-0655. [Epub ahead of print]
PMID: 31569213
https://annals.org/aim/fullarticle/2752320/red-processed-meat-consumption-risk-all-cause-mortality-cardiometabolic-outcomes
Abstract
BACKGROUND:
Dietary guidelines generally recommend limiting intake of red and processed meat. However, the quality of evidence implicating red and processed meat in adverse health outcomes remains unclear.
PURPOSE:
To evaluate the association between red and processed meat consumption and all-cause mortality, cardiometabolic outcomes, quality of life, and satisfaction with diet among adults.
DATA SOURCES:
EMBASE (Elsevier), Cochrane Central Register of Controlled Trials (Wiley), Web of Science (Clarivate Analytics), CINAHL (EBSCO), and ProQuest from inception until July 2018 and MEDLINE from inception until April 2019, without language restrictions, as well as bibliographies of relevant articles.
STUDY SELECTION:
Cohort studies with at least 1000 participants that reported an association between unprocessed red or processed meat intake and outcomes of interest.
DATA EXTRACTION:
Teams of 2 reviewers independently extracted data and assessed risk of bias. One investigator assessed certainty of evidence, and the senior investigator confirmed the assessments.
DATA SYNTHESIS:
Of 61 articles reporting on 55 cohorts with more than 4 million participants, none addressed quality of life or satisfaction with diet. Low-certainty evidence was found that a reduction in unprocessed red meat intake of 3 servings per week is associated with a very small reduction in risk for cardiovascular mortality, stroke, myocardial infarction (MI), and type 2 diabetes. Likewise, low-certainty evidence was found that a reduction in processed meat intake of 3 servings per week is associated with a very small decrease in risk for all-cause mortality, cardiovascular mortality, stroke, MI, and type 2 diabetes.
LIMITATION:
Inadequate adjustment for known confounders, residual confounding due to observational design, and recall bias associated with dietary measurement.
CONCLUSION:
The magnitude of association between red and processed meat consumption and all-cause mortality and adverse cardiometabolic outcomes is very small, and the evidence is of low certainty.
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Dietary components and risk of cardiovascular disease and all-cause mortality: a review of evidence from meta-analyses.
Kwok CS, Gulati M, Michos ED, Potts J, Wu P, Watson L, Loke YK, Mallen C, Mamas MA.
Eur J Prev Cardiol. 2019 Sep;26(13):1415-1429. doi: 10.1177/2047487319843667. Epub 2019 Apr 11.
PMID: 30971126
Abstract
AIMS:
The optimal diet for cardiovascular health is controversial. The aim of this review is to summarize the highest level of evidence and rank the risk associated with each individual component of diet within its food group.
METHODS AND RESULTS:
A systematic search of PudMed was performed to identify the highest level of evidence available from systematic reviews or meta-analyses that evaluated different dietary components and their associated risk of all-cause mortality and cardiovascular disease. A total of 16 reviews were included for dietary food item and all-cause mortality and 17 reviews for cardiovascular disease. Carbohydrates were associated with a reduced risk of all-cause mortality (whole grain bread: relative risk (RR) 0.85, 95% confidence interval (CI) 0.82-0.89; breakfast cereal: RR 0.88, 95% CI 0.83-0.92; oats/oatmeal: RR 0.88, 95% CI 0.83-0.92). Fish consumption was associated with a small benefit (RR 0.98, 95% CI 0.97-1.00) and processed meat appeared to be harmful (RR 1.25, 95% CI 1.07-1.45). Root vegetables (RR 0.76, 95% CI 0.66-0.88), green leafy vegetables/salad (RR 0.78, 95% CI 0.71-0.86), cooked vegetables (RR 0.89, 95% CI 0.80-0.99) and cruciferous vegetables (RR 0.90, 95% CI 0.85-0.95) were associated with reductions in all-cause mortality. Increased mortality was associated with the consumption of tinned fruit (RR 1.14, 95% CI 1.07-1.21). Nuts were associated with a reduced risk of mortality in a dose-response relationship (all nuts: RR 0.78, 95% CI 0.72-0.84; tree nuts: RR 0.82, 95% CI 0.75-0.90; and peanuts: RR 0.77, 95% CI 0.69-0.86). For cardiovascular disease, similar associations for benefit were observed for carbohydrates, nuts and fish, but red meat and processed meat were associated with harm.
CONCLUSIONS:
Many dietary components appear to be beneficial for cardiovascular disease and mortality, including grains, fish, nuts and vegetables, but processed meat and tinned fruit appear to be harmful.
KEYWORDS:
Diet; epidemiology; systematic review
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The Efficacy And Safety Of Aspirin As The Primary Prevention Of Cardiovascular Disease: An Updated Meta-Analysis.
Xie W, Luo Y, Liang X, Lin Z, Wang Z, Liu M.
Ther Clin Risk Manag. 2019 Sep 24;15:1129-1140. doi: 10.2147/TCRM.S198403. eCollection 2019.
PMID: 31576136
[pdf availed from PubMed abstact site.]
Abstract
PURPOSE:
Information regarding the use of aspirin for patients with no known cardiovascular disease remains conflicting. We performed an updated meta-analysis to evaluate the efficacy and safety of aspirin for primary prevention of cardiovascular disease.
PATIENTS AND METHODS:
PubMed, MEDLINE, and Cochrane library databases were searched for randomized controlled trials comparing aspirin with placebos or no treatment published up until November 1, 2018. The primary efficacy endpoint was all-cause death. The secondary endpoints included cardiovascular death, myocardial infarction, and stroke. The safety endpoints included major bleeding, gastrointestinal bleeding, and hemorrhagic stroke.
RESULTS:
Fourteen studies were included. Aspirin use was associated with a lower risk of myocardial infarction than placebo use or no treatment (risk ratio [RR], 0.83, 95% confidence interval [CI]: 0.73-0.95, P = 0.005). Additionally, compared with the control groups, aspirin use was not associated with a lower risk of all-cause mortality or cardiovascular mortality. In terms of safety, aspirin use was associated with a higher risk of major bleeding (RR, 1.40, 95% CI: 1.25-1.57, P = 0.000), gastrointestinal bleeding (RR, 1.58, 95% CI: 1.25-1.99, P = 0.000), and hemorrhagic stroke (RR, 1.30, 95% CI: 1.06-1.60, P = 0.011). Furthermore, the treatment effect was not significantly modified by patients' clinical characteristics. No publication bias was present.
CONCLUSION:
Aspirin use reduced the myocardial infarction risk in patients without known cardiovascular disease, but had no effect in terms of reducing the risk of all-cause death, cardiovascular death, and stroke, and increased the risk of major bleeding, gastrointestinal bleeding, and hemorrhagic stroke.
KEYWORDS:
aspirin; cardiovascular disease; meta-analysis; primary prevention

Cause-specific mortality in the general population with transient dipstick-proteinuria.
Nagai K, Yamagata K, Iseki K, Moriyama T, Tsuruya K, Fujimoto S, Narita I, Konta T, Kondo M, Kasahara M, Shibagaki Y, Asahi K, Watanabe T.
PLoS One. 2019 Oct 2;14(10):e0223005. doi: 10.1371/journal.pone.0223005. eCollection 2019.
PMID: 31577820
Abstract
Recently, changes in urinary albumin and in GFR have been recognized as risk factors for the development of end-stage kidney disease and mortality. Though most clinical epidemiology studies of chronic kidney disease (CKD) used renal function and proteinuria at baseline alone, definitive diagnosis of CKD with multiple measurements intensifies the differences in the risk for mortality between the CKD and non-CKD populations. We hypothesized that a transient diagnosis of proteinuria and reduced renal function each indicate a significantly higher mortality compared to definitive non-CKD as the negative control and lower mortality compared with definitive CKD as the positive control. The present longitudinal study evaluated a general-population cohort of 338,094 persons who received annual health checkups, with a median 4.3-year study period. There were 2,481 deaths, including 510 CVD deaths (20.6%) and 1,328 cancer deaths (53.5%), and mortality risk was evaluated for transient proteinuria and for transiently reduced renal function. The hazard ratios (HRs) for all-cause mortality and cancer mortality were not significant, but that for cardiovascular mortality was significantly higher for transient proteinuria (HR, 1.94 [95% confidence interval, 1.27-2.96] in men and 2.78 [1.50-5.16] in women). On the other hand, transiently reduced renal function was not significant for either cardiovascular mortality risk or cancer mortality risk. We surmise that this is the first study of the mortality risk of transient dipstick proteinuria in a large general-population cohort with cause-specific death registration. Transiently positive proteinuria appears to be a significant risk specifically for cardiovascular mortality compared with definitely negative for proteinuria.

A prospective analysis of red and processed meat consumption and risk of colorectal cancer in women.
Mehta SS, Arroyave WD, Lunn RM, Park YM, Boyd WA, Sandler DP.
Cancer Epidemiol Biomarkers Prev. 2019 Oct 1. pii: cebp.0459.2019. doi: 10.1158/1055-9965.EPI-19-0459. [Epub ahead of print]
PMID: 31575555
Abstract
BACKGROUND:
Red and processed meats have been implicated as risk factors in the development of colorectal cancer (CRC) in U.S. women, but associations with cooking practices are less well established.
METHODS:
Data are from the Sister Study, a cohort of women 35-74 years old from U.S. and Puerto Rico who have a sister diagnosed with breast cancer. Red and processed meat consumption, meat cooking practices, and intake of common meat products were collected at baseline using self-administered questionnaires (N=48,704). Multivariable hazard ratios (HRadj) and 95% confidence intervals (95%CIs) were estimated.
RESULTS:
During a median 8.7 years follow-up (range <1-12.7 years), 216 CRC cases were diagnosed. In categorical analyses, an increased risk of CRC was seen in the highest quartile of processed meat consumption compared to the lowest [HRadj=1.52 (95%CI: 1.01-2.30); p-trend: 0.02], and for specific meat products, including breakfast sausages (HRadj=1.85 [95%CI: 1.30-2.64]) and bacon (HRadj=1.46 [95%CI: 1.01-2.11]). The adjusted HR for the highest quartile of red meat consumption was 1.04 (95%CI: 0.68-1.60), and little evidence of association was observed for cooking practices or doneness of red meat. We observed positive associations with specific red meat products when cooking methods were considered; e.g., grilled/ barbequed steaks (HRadj=2.23 [95%CI: 1.20-4.14]) and hamburgers (HRadj=1.98 [95%CI: 1.00-3.91]).
CONCLUSIONS:
Higher reported daily intake of processed meats and consumption of barbecued/grilled red meat products were associated with increased risk of CRC in women.
IMPACT:
Variability in CRC risk by meat type and cooking method should be considered when evaluating meat consumption.

Prospective randomized controlled pilot study on the effects of almond consumption on skin lipids and wrinkles.
Foolad N, Vaughn AR, Rybak I, Burney WA, Chodur GM, Newman JW, Steinberg FM, Sivamani RK.
Phytother Res. 2019 Oct 1. doi: 10.1002/ptr.6495. [Epub ahead of print]
PMID: 31576607
https://onlinelibrary.wiley.com/doi/epdf/10.1002/ptr.6495
Abstract
OBJECTIVE:
Almonds are a rich source of fatty acids and antioxidants, and their supplementation is known to significantly modulate serum lipids. The effects of almond on the skin's lipid barrier and the appearance of wrinkles have not yet been elucidated. The aim of this study was to investigate the effects of almond consumption on facial sebum production and wrinkles.
METHODS:
This was a prospective, investigator-blinded, randomized controlled trial in which subjects consumed 20% of their daily energy consumption in either almonds or a calorie-matched snack for 16 weeks. This study was completed at the UC Davis Dermatology clinic. Participants were a volunteer sample of generally healthy postmenopausal females with Fitzpatrick skin types 1 and 2. A facial photograph and image analysis system was used to obtain standardized photographs and information on wrinkle width and severity at 0, 8, and 16 weeks. Measurements of transepidermal water loss and sebum production were also completed at 0, 8, and 16 weeks.
RESULTS:
Fifty healthy postmenopausal females were recruited, 31 participants were enrolled, and 28 completed the study. Under photographic analysis, the almond group had significantly decreased wrinkle severity and width compared with the control group at 16 weeks (p < .02). Changes in skin barrier function were nonsignificant, measured by the transepidermal water loss (p = .65) between the almond and control groups relative to baseline after 16 weeks. No adverse effects were reported.
CONCLUSION:
Our study demonstrates that daily almond consumption may reduce wrinkle severity in postmenopausal females to potentially have natural antiaging benefits.
KEYWORDS:
almonds; fatty acids; lipids; skin barrier; skin physiology/structure; wrinkles

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The effects of omega-3 fatty acids on neuropsychological functioning and brain morphology in mid-life adults: a randomized clinical trial.
Leckie RL, Lehman DE, Gianaros PJ, Erickson KI, Sereika SM, Kuan DCH, Manuck SB, Ryan CM, Yao JK, Muldoon MF.
Psychol Med. 2019 Oct 4:1-10. doi: 10.1017/S0033291719002617. [Epub ahead of print]
PMID: 31581959
Abstract
BACKGROUND:
The diet of most adults is low in fish and, therefore, provides limited quantities of the long-chain, omega-3 fatty acids (LCn-3FAs), eicosapentaenoic and docosahexaenoic acids (EPA, DHA). Since these compounds serve important roles in the brain, we sought to determine if healthy adults with low-LCn-3FA consumption would exhibit improvements in neuropsychological performance and parallel changes in brain morphology following repletion through fish oil supplementation.
METHODS:
In a randomized, controlled trial, 271 mid-life adults (30-54 years of age, 118 men, 153 women) consuming ⩽300 mg/day of LCn-3FAs received 18 weeks of supplementation with fish oil capsules (1400 mg/day of EPA and DHA) or matching placebo. All participants completed a neuropsychological test battery examining four cognitive domains: psychomotor speed, executive function, learning/episodic memory, and fluid intelligence. A subset of 122 underwent neuroimaging before and after supplementation to measure whole-brain and subcortical tissue volumes.
RESULTS:
Capsule adherence was over 95%, participant blinding was verified, and red blood cell EPA and DHA levels increased as expected. Supplementation did not affect performance in any of the four cognitive domains. Exploratory analyses revealed that, compared to placebo, fish oil supplementation improved executive function in participants with low-baseline DHA levels. No changes were observed in any indicator of brain morphology.
CONCLUSIONS:
In healthy mid-life adults reporting low-dietary intake, supplementation with LCn-3FAs in moderate dose for moderate duration did not affect neuropsychological performance or brain morphology. Whether salutary effects occur in individuals with particularly low-DHA exposure requires further study.
KEYWORDS:
Cognitive functioning; magnetic resonance imaging; neuropsychological performance; omega-3 fatty acids; randomized clinical trial

Changes in Consumption of Sugary Beverages and Artificially Sweetened Beverages and Subsequent Risk of Type 2 Diabetes: Results From Three Large Prospective U.S. Cohorts of Women and Men.
Drouin-Chartier JP, Zheng Y, Li Y, Malik V, Pan A, Bhupathiraju SN, Tobias DK, Manson JE, Willett WC, Hu FB.
Diabetes Care. 2019 Oct 3. pii: dc190734. doi: 10.2337/dc19-0734. [Epub ahead of print]
PMID: 31582428
Abstract
OBJECTIVE:
We evaluated the associations of long-term changes in consumption of sugary beverages (including sugar-sweetened beverages and 100% fruit juices) and artificially sweetened beverages (ASBs) with subsequent risk of type 2 diabetes.
RESEARCH DESIGN AND METHODS:
We followed up 76,531 women in the Nurses' Health Study (1986-2012), 81,597 women in the Nurses' Health Study II (1991-2013), and 34,224 men in the Health Professionals' Follow-up Study (1986-2012). Changes in beverage consumption (in 8-ounce serving/day) were calculated from food frequency questionnaires administered every 4 years. Multivariable Cox proportional regression models were used to calculate hazard ratios for diabetes associated with changes in beverage consumption. Results of the three cohorts were pooled using an inverse variance-weighted, fixed-effect meta-analysis.
RESULTS:
During 2,783,210 person-years of follow-up, we documented 11,906 incident cases of type 2 diabetes. After adjustment for BMI and initial and changes in diet and lifestyle covariates, increasing total sugary beverage intake (including both sugar-sweetened beverages and 100% fruit juices) by >0.50 serving/day over a 4-year period was associated with a 16% (95% CI 1%, 34%) higher diabetes risk in the subsequent 4 years. Increasing ASB consumption by >0.50 serving/day was associated with 18% (2-36%) higher diabetes risk. Replacing one daily serving of sugary beverage with water, coffee or tea, but not ASB, was associated with a 2-10% lower diabetes risk.
CONCLUSIONS:
Increasing consumption of sugary beverages or ASBs was associated with a higher risk of type 2 diabetes, albeit the latter may be affected by reverse causation and surveillance bias.
Effects of Conjugated Linoleic Acid Intake in the Form of Dietary Supplement or Enriched Food on C-Reactive Protein and Lipoprotein (a) Levels in Humans: A Literature Review and Meta-Analysis.
Derakhshandeh-Rishehri SM, Rahbar AR, Ostovar A.
Iran J Med Sci. 2019 Sep;44(5):359-373. doi: 10.30476/IJMS.2019.44949. Review.
PMID: 31582860
Abstract
BACKGROUND:
C-reactive protein (CRP) and lipoprotein (a) (Lp[a]) play essential roles in cardiovascular disease incidence. This study aimed to review the association between the intake of conjugated linoleic acid (CLA) in the form of dietary supplement or enriched food with different treatment durations and the levels of Lp(a) and CRP in human studies.
METHODS:
All the articles published in Cochrane Library, ProQuest, Scopus, and Google Scholar from November 2014 to October 2015 were searched and the clinical trials on the effects of CLA on Lp(a) and CRP levels were assessed. Of the 2249 articles initially retrieved, 21 eligible randomized clinical trials were enrolled in this systematic review. The publication dates of the eligible articles ranged from 2005 to 2013. The mean difference and the standard deviation of changes in CRP and Lp(a) levels in intervention and control groups were used as effect-size measures for meta-analysis. The obtained data from the eligible randomized controlled trials were meta-analyzed using Stata, version 13.
RESULTS:
The intake of CLA as a dietary supplement led to a significant increase in CRP levels (standardized mean difference [SMD]=0.41, 95% CI: 0.28 to 0.54; P=0.001). Subgroup analysis based on the duration of CLA consumption showed that CLA consumption more than 24 weeks resulted in a significant increase in the levels of CRP (SMD=0.52, 95% CI: 0.36 to 0.68; P=0.001) and Lp(a) (SMD=0.24, 95% CI: 0.01 to 0.47; P=0.04).
CONCLUSION:
The current systematic review and meta-analysis showed that the long-term consumption of CLA increases the levels of CRP and Lp(a).
KEYWORDS:
C-reactive protein ; Lipoprotein (a) ; Meta-analysis; Conjugated linoleic acid

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Association between Macronutrient Intake and Excessive Daytime Sleepiness: An Iso-Caloric Substitution Analysis from the North West Adelaide Health Study.
Melaku YA, Reynolds AC, Gill TK, Appleton S, Adams R.
Nutrients. 2019 Oct 5;11(10). pii: E2374. doi: 10.3390/nu11102374.
PMID: 31590356
Abstract
Epidemiological evidence on the association between macronutrient intake and excessive daytime sleepiness (EDS) is scarce. Using data from the North West Adelaide Health Study, we aimed to determine the association between iso-caloric substitution of macronutrients and EDS. Data from 1997 adults aged ≥ 24 years were analyzed. Daytime sleepiness was measured using the Epworth Sleepiness Scale, a score ≥ 11 was considered EDS. Dietary intake data were collected using a food frequency questionnaire. We determined absolute and relative energy intake based on consumption of saturated and unsaturated fats, protein, and carbohydrate. Odds ratios (ORs) were used to determine the associations using log-binomial logistic regression with and without iso-caloric substitution methods, and models were adjusted for confounders. The prevalence of EDS in the sample was 10.6%. After adjusting for potential confounders, substituting 5% energy intake from protein with an equal amount of saturated fat (OR = 1.57; 95% CI: 1.00-2.45) and carbohydrate (OR = 1.23; 95% CI: 0.92-1.65) increased the odds of EDS. When carbohydrate was substituted with saturated fat (OR = 1.27; 95% CI: 0.93-1.59), the odds of EDS were increased. The odds of EDS were lower when saturated fat was substituted with unsaturated fat (OR = 0.74; 95% CI: 0.51-1.06), protein (OR = 0.63; 95% CI: 0.41-0.99) or carbohydrate (OR = 0.79; 95% CI: 0.57-1.08). While these results were consistent over different iso-caloric substitution methods, inconsistent results were found with standard regression. While substitution of fat and carbohydrate with protein was inversely associated with EDS, substitution of protein with fat and carbohydrate was positively associated with EDS. Randomized trials are needed to confirm if dietary interventions can be used to improve daytime alertness in those with EDS.
KEYWORDS:
carbohydrate; excessive daytime sleepiness; fat; protein; saturated fat; sleepiness; substitution analysis; unsaturated fat

Heart Histopathology and Mitochondrial Ultrastructure in Aged Rats Fed for 24 Months on Different Unsaturated Fats (Virgin Olive Oil, Sunflower Oil or Fish Oil) and Affected by Different Longevity.
Navarro-Hortal MD, Ramírez-Tortosa CL, Varela-López A, Romero-Márquez JM, Ochoa JJ, Ramírez-Tortosa M, Forbes-Hernández TY, Granados-Principal S, Battino M, Quiles JL.
Nutrients. 2019 Oct 7;11(10). pii: E2390. doi: 10.3390/nu11102390.
PMID: 31591312
[pdf availed by title Google.]
Abstract
Diet plays a decisive role in heart physiology, with lipids having especial importance in pathology prevention and development. This study aimed to investigate how dietary lipids varying in lipid profile (virgin olive oil, sunflower oil or fish oil) affected the heart of rats during aging. Heart histopathology, mitochondrial morphometry, and oxidative status were assessed. Typical histopathological features associated with aging, such as valvular lesions, endomyocardical hyperplasia, or papillary muscle calcification, were found at a low extent in all the experimental groups. The most relevant finding was that inflammation registered by fish oil group was lower compared to the other treatments. At the ultrastructural level, heart mitochondrial area, perimeter, and aspect ratio were higher in fish oil-fed rats than in those fed on sunflower oil. Concerning oxidative stress markers, there were differences only in coenzyme Q levels and catalase activity, lower in sunflower oil-fed animals compared with those fed on fish oil. In summary, dietary intake for a long period on dietary fats with different fatty acids profile led to differences in some aspects associated with the aging process at the heart. Fish oil seems to be the fat most protective of heart during aging.
KEYWORDS:
MUFA; PUFA; aging; fibrosis; histology; inflammation; mitochondrial morphology; n-3; n-6

Total Fermented Dairy Food Intake Is Inversely Associated with Cardiovascular Disease Risk in Women.
Buziau AM, Soedamah-Muthu SS, Geleijnse JM, Mishra GD.
J Nutr. 2019 Oct 1;149(10):1797-1804. doi: 10.1093/jn/nxz128.
PMID: 31192363
Abstract
BACKGROUND:
The relation between fermented dairy consumption and type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) in an Australian population remains to be established.
OBJECTIVES:
The aim of this study was to investigate the association between fermented dairy consumption and T2DM and CVD risk.
METHODS:
The Australian Longitudinal Study on Women's Health included Australian women (aged 45-50 y) at baseline in 2001, who were followed up through 5 surveys until 2016. Dietary intake was assessed through the use of a validated 101-item FFQ at baseline. Main study outcomes were self-reported physician-diagnosed T2DM and CVD. Logistic regression models adjusted for sociodemographic and lifestyle factors were used to estimate the association between dairy intake and T2DM and CVD risk.
RESULTS:
Of 7633 women free of diabetes at baseline, 701 (9.2%) developed T2DM during a maximum 15-y follow-up period. Women in the highest tertile of yogurt intake had lower adjusted odds of T2DM than those in the lowest tertile (OR: 0.81; 95% CI: 0.67, 0.99; P = 0.041). This relation became nonsignificant after adjustment for dietary variables and total energy intake (OR: 0.88; 95% CI: 0.71, 1.08; P = 0.21). Of 7679 women free of CVD at baseline, 835 (10.9%) cases of CVD were reported during follow-up. High intake of yogurt and total fermented dairy was associated with lower CVD risk (OR: 0.84; 95% CI: 0.70, 1.00; P = 0.05, 0.80; 0.67, 0.96; 0.017, respectively) than observed in the lowest tertile of dairy product intake. Additional adjustment attenuated the relation (OR: 0.87; 95% CI: 0.72, 1.04; P = 0.13, 0.83; 0.69, 1.00; 0.048, for yogurt and total fermented dairy, respectively). No associations were found with other dairy groups.
CONCLUSION:
The findings from this population-based study of Australian women suggest an inverse association between total fermented dairy intake and CVD risk, which may partly be accounted for by other dietary components.
KEYWORDS:
Australia; cardiovascular disease; cheese; coronary heart disease; dairy; fermented dairy; stroke; type 2 diabetes mellitus; women's health; yogurt

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A brief diet intervention can reduce symptoms of depression in young adults - A randomised controlled trial.
Francis HM, Stevenson RJ, Chambers JR, Gupta D, Newey B, Lim CK.
PLoS One. 2019 Oct 9;14(10):e0222768. doi: 10.1371/journal.pone.0222768. eCollection 2019.
PMID: 31596866
https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0222768&type=printable
Abstract
There is strong epidemiological evidence that poor diet is associated with depression. The reverse has also been shown, namely that eating a healthy diet rich in fruit, vegetables, fish and lean meat, is associated with reduced risk of depression. To date, only one randomised controlled trial (RCT) has been conducted with elevated depression symptoms being an inclusion criterion, with results showing that a diet intervention can reduce clinical levels of depression. No such RCTs have been performed in young adults. Young adults with elevated levels of depression symptoms and who habitually consume a poor diet were randomly allocated to a brief 3-week diet intervention (Diet Group) or a habitual diet control group (Control Group). The primary and secondary outcome measures assessed at baseline and after the intervention included symptoms of depression (Centre for Epidemiological Studies Depression Scale; CESD-R; and Depression Anxiety and Stress Scale- 21 depression subscale; DASS-21-D), current mood (Profile of Mood States), self-efficacy (New General Self-Efficacy Scale) and memory (Hopkins Verbal Learning Test). Diet compliance was measured via self-report questionnaires and spectrophotometry. One-hundred-and-one individuals were enrolled in the study and randomly assigned to the Diet Group or the Control Group. Upon completion of the study, there was complete data for 38 individuals in each group. There was good compliance with the diet intervention recommendations assessed using self-report and spectrophotometry. The Diet group had significantly lower self-reported depression symptoms than the Control Group on the CESD-R (p = 0.007, Cohen's d = 0.65) and DASS-21 depression subscale (p = 0.002, Cohen's d = 0.75) controlling for baseline scores on these scales. Reduced DASS-21 depression subscale scores were maintained on follow up phone call 3 months later (p = .009). These results are the first to show that young adults with elevated depression symptoms can engage in and adhere to a diet intervention, and that this can reduce symptoms of depression. The findings provide justification for future research into the duration of these benefits, the impacts of varying diet composition, and their biological basis.

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Fermented Milk Products and Bone Health in Postmenopausal Women: A Systematic Review of Randomized Controlled Trials, Prospective Cohorts, and Case-Control Studies.
Ong AM, Kang K, Weiler HA, Morin SN.
Adv Nutr. 2019 Oct 11. pii: nmz108. doi: 10.1093/advances/nmz108. [Epub ahead of print]
PMID: 31603185
Abstract
Milk and milk product consumption is positively associated with bone mineral density (BMD). Emerging evidence suggests that fermented milk products (FMPs) may have specific beneficial effects on skeletal health. We conducted a systematic review and meta-analysis to assess the effect of FMPs on bone health indicators in postmenopausal women given their increased risk for osteoporosis and fragility fractures. Electronic databases were searched for randomized controlled trials (RCTs) and prospective cohort and case-control studies that examined the relation between FMPs and bone health outcomes (fracture incidence, BMD, BMD T-score, and percentage change in bone turnover markers) in postmenopausal women. Two reviewers independently conducted abstract and full-text screenings and data extractions. Risk of bias was assessed using the RoB 2.0 tool and the Newcastle-Ottawa scale for interventional and observational studies. Pooled RRs were obtained using a random-effects model by the DerSimonian-Laird method. Three RCTs, 3 prospective cohorts, and 3 case-control studies met the inclusion criteria. Results of the meta-analysis of 3 cohort studies (n = 102,819) suggest that higher yogurt consumption was associated with reduced hip fracture risk (pooled RR: 0.76; 95% CI: 0.63, 0.92, I2 = 29%), but no difference in hip fracture risk was found between higher and lower cheese consumption (pooled RR: 0.89; 95% CI: 0.73, 1.10, I2 = 0%). Case-control studies revealed that cheese intake had either a null or a protective effect against osteoporosis (BMD T-score ≤-2.5). Daily yogurt or cheese intervention (<2 mo) decreased bone resorption marker concentrations, but had no effect on bone formation markers. In postmenopausal women, of the FMPs studied, only greater yogurt consumption was associated with a reduced risk of hip fracture compared with low or no intake. Daily cheese intake may be associated with higher BMD T-scores, but evidence was limited. Additional and longer-term trials examining these relations are warranted.
KEYWORDS:
bone mineral density; bone turnover markers; cheese; fermented milk products; fractures; postmenopausal women; yogurt

Association of dietary lipid intake with low-density lipoprotein cholesterol levels: analysis of two independent population-based studies.
Kwon YJ, Lee HS, Chang HJ, Koh SB, Lee JW.
Eur J Nutr. 2019 Oct 10. doi: 10.1007/s00394-019-02104-3. [Epub ahead of print]
PMID: 31602495

Slow walking at 45 'a sign of faster ageing'
By Philippa Roxby
Health reporter, BBC News
12 October 2019
https://www.bbc.com/news/health-50015982
>>>>>>>>>>>>>>
October 11, 2019
Association of Neurocognitive and Physical Function With Gait Speed in Midlife
Line Jee Hartmann Rasmussen, PhD; Avshalom Caspi, PhD; Antony Ambler, MSc; Jonathan M. Broadbent, PhD; Harvey J. Cohen, MD; Tracy d’Arbeloff, BA; Maxwell Elliott, BS; Robert J. Hancox, MD; HonaLee Harrington, BA; Sean Hogan, BA; Renate Houts, PhD; David Ireland, PhD; Annchen R. Knodt, MSc; Kim Meredith-Jones, PhD; Miriam C. Morey, PhD; Lynda Morrison, BSc; Richie Poulton, PhD; Sandhya Ramrakha, PhD; Leah Richmond-Rakerd, PhD; Maria L. Sison, BS; Kate Sneddon, PhD; W. Murray Thomson, PhD; Ahmad R. Hariri, PhD; Terrie E. Moffitt, PhD
open access JAMA Netw Open. 2019; 2(10):e1913123. doi: 10.1001/jamanetworkopen.2019.13123
This 5-decade cohort study of a New Zealand population examines whether slow gait speed in middle age is associated with accelerated biological aging, as well as poor neurocognitive functioning in childhood and cognitive decline from childhood to middle age.
https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2752818
Key Points
Question  Is gait speed measured at age 45 years associated with accelerated biological aging, neurocognitive function, and cognitive decline?
Findings  In this 5-decade cohort study of 904 participants in New Zealand, physical and biological indicators of accelerated aging, including compromised brain integrity (eg, reduced brain volume and cortical thickness), were associated with slow gait measured at age 45 years. Lifelong compromised brain health—including poor neurocognitive functioning as early as age 3 years and childhood-to-adulthood decline in cognitive functioning—was associated with slower gait at midlife.
Meaning  Gait speed at midlife may be a summary index of lifelong aging with possible origins in childhood central nervous system deficits.
Abstract
Importance  Gait speed is a well-known indicator of risk of functional decline and mortality in older adults, but little is known about the factors associated with gait speed earlier in life.
Objectives  To test the hypothesis that slow gait speed reflects accelerated biological aging at midlife, as well as poor neurocognitive functioning in childhood and cognitive decline from childhood to midlife.
Design, Setting, and Participants  This cohort study uses data from the Dunedin Multidisciplinary Health and Development Study, a population-based study of a representative 1972 to 1973 birth cohort in New Zealand that observed participants to age 45 years (until April 2019). Data analysis was performed from April to June 2019.
Exposures  Childhood neurocognitive functions and accelerated aging, brain structure, and concurrent physical and cognitive functions in adulthood.
Main Outcomes and Measures  Gait speed at age 45 years, measured under 3 walking conditions: usual, dual task, and maximum gait speeds.
Results  Of the 1037 original participants (91% of eligible births; 535 [51.6%] male), 997 were alive at age 45 years, of whom 904 (90.7%) had gait speed measured (455 [50.3%] male; 93% white). The mean (SD) gait speeds were 1.30 (0.17) m/s for usual gait, 1.16 (0.23) m/s for dual task gait, and 1.99 (0.29) m/s for maximum gait. Adults with more physical limitations (standardized regression coefficient [β], −0.27; 95% CI, −0.34 to −0.21; P < .001), poorer physical functions (ie, weak grip strength [β, 0.36; 95% CI, 0.25 to 0.46], poor balance [β, 0.28; 95% CI, 0.21 to 0.34], poor visual-motor coordination [β, 0.24; 95% CI, 0.17 to 0.30], and poor performance on the chair-stand [β, 0.34; 95% CI, 0.27 to 0.40] or 2-minute step tests [β, 0.33; 95% CI, 0.27 to 0.39]; all P < .001), accelerated biological aging across multiple organ systems (β, −0.33; 95% CI, −0.40 to −0.27; P < .001), older facial appearance (β, −0.25; 95% CI, −0.31 to −0.18; P < .001), smaller brain volume (β, 0.15; 95% CI, 0.06 to 0.23; P < .001), more cortical thinning (β, 0.09; 95% CI, 0.02 to 0.16; P = .01), smaller cortical surface area (β, 0.13; 95% CI, 0.04 to 0.21; P = .003), and more white matter hyperintensities (β, −0.09; 95% CI, −0.15 to −0.02; P = .01) had slower gait speed. Participants with lower IQ in midlife (β, 0.38; 95% CI, 0.32 to 0.44; P < .001) and participants who exhibited cognitive decline from childhood to adulthood (β, 0.10; 95% CI, 0.04 to 0.17; P < .001) had slower gait at age 45 years. Those with poor neurocognitive functioning as early as age 3 years had slower gait in midlife (β, 0.26; 95% CI, 0.20 to 0.32; P < .001).
Conclusions and Relevance  Adults’ gait speed is associated with more than geriatric functional status; it is also associated with midlife aging and lifelong brain health.

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Sleep Duration and the Risk of Dementia: A Systematic Review and Meta-analysis of Prospective Cohort Studies.
Fan L, Xu W, Cai Y, Hu Y, Wu C.
J Am Med Dir Assoc. 2019 Oct 8. pii: S1525-8610(19)30495-5. doi: 10.1016/j.jamda.2019.06.009. [Epub ahead of print] Review.
PMID: 31604673
Abstract
OBJECTIVE:
Epidemiologic studies have reported inconsistent findings about the association between sleep duration and the risk of dementia. We aimed to clarify this association by method of meta-analysis.
DESIGN:
Systematic review and meta-analysis of prospective cohort studies.
SETTING AND PARTICIPANTS:
Community or clinical settings. Participants included patients with dementia or Alzheimer's disease and the general population.
MEASURES:
We systematically searched the PubMed, EMBASE, and Web of Science for prospective cohort studies investigating the association between sleep duration and all-cause dementia or Alzheimer's disease (AD). Generic inverse-variance method was used to combine the outcomes with a random effects model for the association between sleep duration (short or long vs normal) and all-cause dementia or AD.
RESULTS:
We identified 7 studies for all-cause dementia and 6 studies for AD. Pooled analyses showed that long sleep duration was associated with a 77% increased risk of all-cause dementia [hazard ratio (HR) = 1.77, 95% confidence interval (CI) = 1.32-2.37] and a 63% increased risk of AD (HR = 1.63, 95% CI = 1.24-2.13). Short sleep duration was not statistically associated with an increased risk of all-cause dementia (HR = 1.20, 95% CI = 0.91-1.59) or AD (HR = 1.18, 95% CI = 0.91-1.54).
CONCLUSIONS AND IMPLICATIONS:
Only long sleep duration is significantly associated with an increased risk of all-dementia and AD. Future studies are needed to better understand the mechanisms underlying this association.
KEYWORDS:
Alzheimer's disease; Sleep duration; all-cause dementia; meta-analysis

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Dietary interventions in mild cognitive impairment and dementia.
Vlachos GS, Scarmeas N.
Dialogues Clin Neurosci. 2019 Mar;21(1):69-82.
PMID: 31607782
Abstract
Dietary intervention is an enticing approach in the fight against cognitive impairment. Nutritional supplements and dietetic counseling are relatively easy and benign interventions, but research has not yet yielded irrefutable evidence as to their clinical utility. Heterogeneity in the results of available clinical studies, as well as methodological and practical issues, does not allow replication and generalization of findings. The paper at hand reviews only randomized clinical trials of single nutrients, multi-nutrient formulations and dietary counseling in mild cognitive impairment and dementia of the Alzheimer's type focusing on both cognitive and functional outcomes. Thus far, folate, vitamin E, Ω-3 fatty acids, and certain multi-nutrient formulations have shown some preliminary promising results; larger, well-designed trials are needed to confirm these findings before nutritional elements can be incorporated in recommended clinical guidelines.
KEYWORDS:
Alzheimer disease; controlled clinical trial; diet; mild cognitive impairment; nutrition; treatment

Protein intake per day and at each daily meal and skeletal muscle mass declines among older community dwellers in Japan.
Otsuka R, Kato Y, Tange C, Nishita Y, Tomida M, Imai T, Ando F, Shimokata H, Arai H.
Public Health Nutr. 2019 Oct 14:1-8. doi: 10.1017/S1368980019002921. [Epub ahead of print]
PMID: 31608843
Abstract
OBJECTIVE:
To examine associations between protein intake per day and at different meals and skeletal muscle mass declines.
DESIGN:
Two-year prospective cohort study among older community dwellers.
SETTING:
National Institute for Longevity Sciences-Longitudinal Study of Aging (NILS-LSA) in Japan.
PARTICIPANTS:
Older men (n 292) and women (n 363) aged 60-87 years who participated in the baseline (2006-2008) and follow-up studies (2008-2010) of NILS-LSA and did not exhibit low skeletal muscle mass at baseline. Muscle mass was assessed using dual-energy X-ray absorptiometry at baseline and follow-up. Low muscle mass was defined as skeletal muscle mass index <7·0 kg/m2 for men and <5·4 kg/m2 for women at follow-up. Daily protein intake and protein intake at each meal were calculated from 3 d dietary records at baseline and sex-stratified tertiles were determined.
RESULTS:
Mean (sd) protein intake at breakfast, lunch and dinner was 22·7 (7·8), 26·7 (9·3) and 37·4 (10·5) g for men and 19·3 (6·3), 23·2 (7·3) and 28·5 (7·0) g for women, respectively. After adjusting for age, baseline skeletal muscle mass and other confounders in logistic modelling, greater total protein intake was associated with lower prevalence of skeletal muscle mass decline among men at follow-up (P = 0·024). Particularly, the OR (95 % CI) for high lunchtime protein intake was low (0·11 (0·02, 0·61); P = 0·01). No significant association between total protein intake and prevalence of skeletal muscle mass decline was found among women.
CONCLUSIONS:
High total protein intake, particularly at lunchtime, is associated with retention of skeletal muscle mass in men.
KEYWORDS:
Lunch meal; Older community dwellers; Protein intake; Skeletal muscle mass

Green tea consumption and risk of hematologic neoplasms: the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study).
Takada M, Yamagishi K, Iso H, Tamakoshi A.
Cancer Causes Control. 2019 Nov;30(11):1223-1230. doi: 10.1007/s10552-019-01220-z. Epub 2019 Aug 26.
PMID: 31452000
Abstract
PURPOSE:
Experimental studies suggested that green tea may have an anticancer effect on hematologic neoplasms. However, few prospective studies have been conducted.
METHODS:
A total of 65,042 individuals aged 40-79 years participated in this study and completed a self-administered questionnaire about their lifestyle and medical history at baseline (1988-1990). Of these, 52,462 individuals living in 24 communities with information on incident hematologic neoplasms available in the cancer registry, who did not have a history of cancer and provided valid information on frequency of green tea consumption, were followed through 2009. Hazard ratios (HRs) and 95% confidence intervals (CIs) for the incidence of hematologic neoplasms according to green tea consumption were analyzed.
RESULTS:
The incidence of hematologic neoplasms during a median follow-up of 13.3 years was 323. Compared with the never-drinkers of green tea, the multivariate HRs and 95% CIs for total hematologic neoplasms in green tea drinkers of ≤ 2 cups/day, 3-4 cups/day, and ≥ 5 cups/day were 0.65 (0.42-1.00), 0.73 (0.47-1.13), and 0.63 (0.42-0.96), respectively. The association was more prominent for acute myeloid leukemias and follicular lymphomas.
CONCLUSIONS:
The present cohort study suggests a protective effect of green tea against hematologic neoplasms, especially acute myeloid leukemias.
KEYWORDS:
Acute myeloid leukemia; Epigallocatechin-3-gallate; Green tea; Hematologic neoplasm; Japan collaborative cohort study for evaluation of cancer risk; Preventive medicine

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Major cardiovascular disease (CVD) risk factors in midlife and extreme longevity.
Urtamo A, Jyväkorpi SK, Kautiainen H, Pitkälä KH, Strandberg TE.
Aging Clin Exp Res. 2019 Oct 14. doi: 10.1007/s40520-019-01364-7. [Epub ahead of print]
PMID: 31612429
https://sci-hub.tw/http://link.springer.com/10.1007/s40520-019-01364-7
Abstract
BACKGROUND:
The studies on the association of various midlife risk factors with reaching 90 years or more are scarce. We studied this association in a socioeconomically homogenous cohort of businessmen.
METHODS:
The study consists of men (n = 970) from the Helsinki Businessmen Study cohort (born 1919-1928). Five major cardiovascular disease (CVD) risk factors (smoking, BMI, blood pressure, serum lipids, fasting glucose), consumption of alcohol and coffee, self-rated health and self-rated fitness, were assessed in 1974, at an average age of 50 years. The number of major risk factors was tested as a risk burden. The Charlson Comorbidity Index and the RAND-36 (SF-36) Physical and Mental health summary scores were calculated from surveys in year 2000, at age of 73 years. Mortality dates were retrieved through 31 March 2018 from the Population Information System of Finland.
RESULTS:
244 men survived to the age of 90 representing 25.2% of the study cohort. The survivors had less risk factor burden in midlife, and less morbidity and higher physical health summary score in 2000. Of those with five major risk factors only 7% survived up to 90 years, whereas 51% of those without any risk factors reached that age. Single risk factors reducing odds of reaching 90 years were smoking (odds ratio [OR] 0.48, 95% confidence interval [CI] 0.34-0.67), glucose (0.66, 0.49-0.88), BMI (0.63, 0.46-0.86), and cholesterol (0.71, 0.53-0.96).
CONCLUSION:
Lack of five major CVD risk factors in midlife strongly increased odds of reaching 90 years of age and also predicted factors related to successful ageing in late life.
KEYWORDS:
Cardiovascular risk factors; Life-course; Longevity; Nonagenarians; Successful ageing

Association between soft drink consumption and osteoporotic fractures among postmenopausal women: the Women's Health Initiative.
Kremer PA, Laughlin GA, Shadyab ASH, Crandall CJ, Masaki K, Orchad T, LaCroix AZ.
Menopause. 2019 Oct 14. doi: 10.1097/GME.0000000000001389. [Epub ahead of print]
PMID: 31613830
Abstract
OBJECTIVE:
High consumption of soft drinks has been associated with lower bone mineral density among postmenopausal women. This study explores the association of soft drink consumption, osteoporosis, and incidental fractures in this population.
METHODS:
Cross-sectional (at baseline) and cohort combined designs, over 11.9 years of median follow-up for 72,342 postmenopausal women participating in the Women's Health Initiative Observational Study. Multiple linear regression models were used to examine the cross-sectional associations between soft drink consumption and hip and lumbar spine bone mineral density. Cox proportional hazards regression models were used to examine the association of soft drink consumption with incident hip fractures.
RESULTS:
There were no associations between soft drink consumption and hip or lumbar spine t scores. During 700,388 person-years of follow-up, 2,578 hip fractures occurred. Adjusted hazard ratios for incident hip fracture for the highest consumption category compared with no consumption were 1.26 (95% confidence interval [CI] 1.01-1.56) for total soda and 1.32 (95% CI 1.00-1.75) for caffeine-free soda. There was no association between caffeinated soda and incident hip fracture (hazard ratio = 1.16; 95% CI 0.86-1.57). There was no apparent linear trend in the risk of hip fracture across categories of soda consumption in the fully adjusted models, suggesting a threshold effect. A sensitivity analysis using adjudicated hip fractures showed significant associations for all three soda exposures in the highest intake groups.
CONCLUSIONS:
Consuming more than two servings of soft drinks per day on average showed potential associations with higher risk of hip fracture among postmenopausal women.

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Mung Bean Protein Supplement Improves Muscular Strength in Healthy, Underactive Vegetarian Adults.
Bartholomae E, Incollingo A, Vizcaino M, Wharton C, Johnston CS.
Nutrients. 2019 Oct 11;11(10). pii: E2423. doi: 10.3390/nu11102423.
PMID: 31614532
Abstract
Although vegetarian diets are considered generally protective against chronic disease, nutrient deficiencies, including protein, are possible due to low bioavailability from plant-based sources. The consequences of inadequate dietary protein include reduced lean body mass (LBM) and muscle weakness. This study examined relationships between protein intake, strength, and LBM in 37 underactive vegetarians and recorded the impact of protein supplementation (18 g/day mung bean protein) on these indices utilizing an eight-week, randomized, controlled, feeding trial. Both handgrip and knee flexor and extensor strength were measured at baseline and week eight. At baseline, LBM was significantly related to grams of protein consumed daily. LBM was also correlated to grip strength (r = 0.569, p < 0.001) and lower body strength (r = 0.763 to 0.784; p < 0.001). Twenty-five vegetarians completed the feeding trial, including 11 in the protein supplementation group (PRO) and 14 in the control group (CON). At the end of the trial, LBM and strength did not differ significantly between groups. However, the average percent change for grip, flexor, and extensor strength did differ between PRO and CON participants (+2.9 ± 7.2% and -2.6 ± 7.3% respectively, p = 0.05). Thus, there were strong associations between dietary protein, LBM, and strength in vegetarians and an indication that supplementary vegetarian protein increased strength in the absence of exercise and independent of LBM.
KEYWORDS:
lean body mass; mung bean protein; muscular strength; vegan; vegetarian

Serum uric acid and risk of cardiovascular mortality: a systematic review and dose-response meta-analysis of cohort studies of over a million participants.
Rahimi-Sakak F, Maroofi M, Rahmani J, Bellissimo N, Hekmatdoost A.
BMC Cardiovasc Disord. 2019 Oct 15;19(1):218. doi: 10.1186/s12872-019-1215-z.
PMID: 31615412
https://bmccardiovascdisord.biomedcentral.com/track/pdf/10.1186/s12872-019-1215-z
Abstract
BACKGROUND:
Cardiovascular disease (CVD) is the leading cause of death worldwide. Some studies have suggested anassociation between serum uric acid levels and cardiovascular mortality; however, the results have not been summarized in a meta-analysis.
METHODS:
A comprehensive search of all related studies until April 2018was performed in MEDLINE/PubMed and Scopus databases DerSimonianand Laird random-effects models were used to combine hazard ratios (HRs) with 95% confidence intervals (CIs). Dose-response analysis was also carried out.
RESULTS:
Thirty-two studies containing forty-four arms with 1,134,073 participants reported association between uric acid and risk of CVD mortality were included in our analysis. Pooled results showed a significant positive association between uric acid levels and risk of CVD mortality (HR 1.45, 95% CI 1.33-1.58, I2 = 79%). Sub-group analysis showed this relationshipwasstronger in women compared to men. Moreover, there was a significant non-linear association between uric acid levels and the risk of CVD mortality (r = 0.0709, p = 0.001).
CONCLUSION:
Our analysis indicates a positive dose-response association between SUA and CVD mortality risk.
KEYWORDS:
CVD mortality; Cardiovascular diseases mortality; Cohort; Longitudinal; Serum uric acid; Uric acid

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Regulation of lifespan by neural excitation and REST.
Zullo JM, Drake D, Aron L, O'Hern P, Dhamne SC, Davidsohn N, Mao CA, Klein WH, Rotenberg A, Bennett DA, Church GM, Colaiácovo MP, Yankner BA.
Nature. 2019 Oct;574(7778):359-364. doi: 10.1038/s41586-019-1647-8. Epub 2019 Oct 16.
PMID: 31619788
Abstract
The mechanisms that extend lifespan in humans are poorly understood. Here we show that extended longevity in humans is associated with a distinct transcriptome signature in the cerebral cortex that is characterized by downregulation of genes related to neural excitation and synaptic function. In Caenorhabditis elegans, neural excitation increases with age and inhibition of excitation globally, or in glutamatergic or cholinergic neurons, increases longevity. Furthermore, longevity is dynamically regulated by the excitatory-inhibitory balance of neural circuits. The transcription factor REST is upregulated in humans with extended longevity and represses excitation-related genes. Notably, REST-deficient mice exhibit increased cortical activity and neuronal excitability during ageing. Similarly, loss-of-function mutations in the C. elegans REST orthologue genes spr-3 and spr-4 elevate neural excitation and reduce the lifespan of long-lived daf-2 mutants. In wild-type worms, overexpression of spr-4 suppresses excitation and extends lifespan. REST, SPR-3, SPR-4 and reduced excitation activate the longevity-associated transcription factors FOXO1 and DAF-16 in mammals and worms, respectively. These findings reveal a conserved mechanism of ageing that is mediated by neural circuit activity and regulated by REST.

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The Evidence and Controversy Between Dietary Calcium Intake and Calcium Supplementation and the Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis of Cohort Studies and Randomized Controlled Trials.
Yang C, Shi X, Xia H, Yang X, Liu H, Pan D, Sun G.
J Am Coll Nutr. 2019 Oct 18:1-19. doi: 10.1080/07315724.2019.1649219. [Epub ahead of print]
PMID: 31625814
Abstract
Objective: Our objective was to synthesize both trial and observational studies and undertake a meta-analysis to explore the associations between calcium from dietary and supplemental intakes and cardiovascular disease (CVD) risks. Methods: Data sources were from PubMed, Cochrane Central, Scopus, and Web of Science, published from the inception dates up to March 2019. Randomized controlled trials (RCTs) and prospective cohort studies with data on dietary or supplemental intake of calcium, with or without vitamin D, and cardiovascular outcomes, were included. Results: Of the 1,212 identified studies, 26 prospective cohort studies and 16 RCTs were included. Results of cohort studies reveled that dietary calcium intakes (DCIs) ranging from 200 to 1500 mg/d did not affect the risk of CVD, coronary heart disease (CHD), and stroke (relative risk (RR) RR for CVD = 0.96, 95% CI, 0.87-1.05; RR for CHD = 0.98, 95% CI, 0.88-1.08; RR for stroke = 0.94, 95% CI, 0.85-1.04). Pooled RR of RCTs showed that the risk of CHD due to calcium supplements (CSs) increased 8% (RR = 1.08, 95% CI, 1.02-1.22; I2 = 0.0%) and increased 20% allocated to CSs alone (RR = 1.20, 95% CI, 1.08-1.33; I2 = 0.0%). CSs increased the risk of myocardial infarction (MI) by 14% (RR = 1.14, 95% CI, 1.05-1.25; I2 = 0.0%), and CSs alone increased the MI risk 21% (RR = 1.21, 95% CI, 1.08-1.35; I2 = 0.0%). Conclusions: We concluded that calcium intake from dietary sources do not adequately increase the risk of CVD including CHD and stroke, while calcium supplements might raise CHD risk, especially MI.
KEYWORDS:
Dietary calcium; calcium supplementation; cardiovascular disease; meta-analysis

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Oily Fish Consumption and the Risk of Dyslipidemia in Korean Adults: A Prospective Cohort Study Based on the Health Examinees Gem (HEXA-G) Study.
Kim SA, Lee JK, Kang D, Shin S.
Nutrients. 2019 Oct 17;11(10). pii: E2506. doi: 10.3390/nu11102506.
PMID: 31627478
https://www.mdpi.com/2072-6643/11/10/2506/htm
Abstract
Despite the beneficial effects of omega-3 fatty acids from fish or fish oil on cardiovascular diseases, limited information is available regarding the effects of oily fish in the diet on the risk of dyslipidemia. This study aimed to investigate the association between oily fish consumption and the incidence of dyslipidemia among Korean adults included in the Health Examinees Gem (HEXA-G) cohort during 5 years of follow-up. In total, 20,670 participants (5710 men and 14,960 women) were included in this study. The average intake of oily fish including dark meat fish, such as mackerel, pacific saury, and Spanish mackerel, and eel, was estimated using food frequency questionnaires. Oily fish consumption was associated with a significantly lower risk of hypertriglyceridemia in both men (Relative risk (RR) comparing extreme quintiles = 0.75; 95% CI 0.60-0.95; P for trend = 0.0121) and women (RR comparing extreme quintiles = 0.81; 95% CI 0.69-0.96; P for trend = 0.0110) after adjusting for potential confounders. In conclusion, increased consumption of oily fish was significantly associated with a lower risk of hypertriglyceridemia in the general Korean population. Future randomized clinical trials or prospective studies are required to confirm these findings in the Korean or other Asian populations.
KEYWORDS:
dyslipidemia; fish; hypertriglyceridemia; oily fish; omega-3 fatty acid

Insomnia and risk of mortality from all-cause, cardiovascular disease, and cancer: Systematic review and meta-analysis of prospective cohort studies.
Ge L, Guyatt G, Tian J, Pan B, Chang Y, Chen Y, Li H, Zhang J, Li Y, Ling J, Yang K.
Sleep Med Rev. 2019 Sep 24;48:101215. doi: 10.1016/j.smrv.2019.101215. [Epub ahead of print] Review.
PMID: 31630016
https://sci-hub.tw/10.1016/j.smrv.2019.101215
Abstract
Growing evidence indicates that insomnia may be associated with mortality. However, these findings have been inconsistent. We systematically searched MEDLINE and EMBASE to identify prospective cohort studies that assessed the association between insomnia disorder/individual insomnia symptoms and the risk of mortality among adults aged ≥18 yrs. We addressed this association using summary hazard ratios (HRs) and 95% confidence intervals (CIs) calculated using random-effects meta-analysis, and the GRADE approach to rate the certainty of evidence. Twenty-nine cohorts including 1,598,628 individuals (55.3% men; mean age 63.7 yrs old) with a median follow-up duration of 10.5 yrs proved eligible. Difficulty falling asleep (DFA) and non-restorative sleep (NRS) were associated with an increased risk of all-cause mortality (DFA: HR = 1.13, 95%CI 1.03 to 1.23, p = 0.009, moderate certainty; NRS: HR = 1.23, 95%CI 1.07 to 1.42, p = 0.003, high certainty) and cardiovascular disease mortality (DFA: 1.20, 95%CI: 1.01, 1.43; p = 0.04, moderate certainty; NRS: HR = 1.48, 95%CI 1.06 to 2.06, p = 0.02, moderate certainty). Convincing associations between DFA and all-cause mortality were restricted to the mid to older-aged population (moderate credibility). Insomnia disorder, difficulty maintaining sleep, and early morning awakening proved to be unassociated with all-cause and cardiovascular disease mortality. No insomnia symptoms proved to be associated with cancer-related mortality.
KEYWORDS:
Difficulty falling asleep; Difficulty maintaining sleep; Early morning awakening; Insomnia symptom; Meta-analysis; Mortality; Non-restorative sleep; Prospective cohort study

DNA methylation age and physical and cognitive ageing.
Maddock J, Castillo-Fernandez J, Wong A, Cooper R, Richards M, Ong KK, Ploubidis GB, Goodman A, Kuh D, Bell JT, Hardy R.
J Gerontol A Biol Sci Med Sci. 2019 Oct 20. pii: glz246. doi: 10.1093/gerona/glz246. [Epub ahead of print]
PMID: 31630156
Abstract
BACKGROUND:
DNA methylation (DNAm) age acceleration (AgeAccel) has been shown to be predictive of all-cause mortality but it is unclear what functional aspect/s of ageing it captures. We examine associations between four measures of AgeAccel in adults aged 45-87 years and physical and cognitive performance and their age-related decline.
METHODS:
AgeAccelHannum, AgeAccelHorvath, AgeAccelPheno and AgeAccelGrim were calculated in the Medical Research Council National Survey of Health and Development (NSHD), National Child Development Study (NCDS) and TwinsUK. Three measures of physical (grip strength, chair rise speed and forced expiratory volume in one second[FEV1]) and two measures of cognitive (episodic memory and mental speed) performance were assessed.
RESULTS:
AgeAccelPheno and AgeAccelGrim, but not AgeAccelHannum and AgeAccelHorvath were related to performance in random effects meta-analyses (n=1388-1685). For example, a one year increase in AgeAccelPheno/AgeAccelGrim was associated with a 0.01ml[95%CI:0.01,0.02]/0.03ml[95%CI:0.01,0.05] lower mean FEV1. In NSHD, AgeAccelPheno and AgeAccelGrim at 53 years were associated with age-related decline in performance between 53 and 69 years as tested by linear mixed models (p<0.05). In a subset of NSHD participants(n=482), there was little evidence that change in any AgeAccel measure was associated with change in performance conditional on baseline performance.
CONCLUSIONS:
We found little evidence to support associations between the first generation of DNAm-based biomarkers of ageing and age-related physical or cognitive performance in mid-life to early old age. However, there was evidence that the second generation biomarkers, AgeAccelPheno and AgeAccelGrim, could act as makers of an individual's health-span as proposed.

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Neurodegenerative Disease Mortality among Former Professional Soccer Players.
Mackay DF, Russell ER, Stewart K, MacLean JA, Pell JP, Stewart W.
N Engl J Med. 2019 Oct 21. doi: 10.1056/NEJMoa1908483. [Epub ahead of print]
PMID: 31633894
Abstract
BACKGROUND:
Neurodegenerative disorders have been reported in elite athletes who participated in contact sports. The incidence of neurodegenerative disease among former professional soccer players has not been well characterized.
METHODS:
We conducted a retrospective cohort study to compare mortality from neurodegenerative disease among 7676 former professional soccer players (identified from databases of Scottish players) with that among 23,028 controls from the general population who were matched to the players on the basis of sex, age, and degree of social deprivation. Causes of death were determined from death certificates. Data on medications dispensed for the treatment of dementia in the two cohorts were also compared. Prescription information was obtained from the national Prescribing Information System.
RESULTS:
Over a median of 18 years, 1180 former soccer players (15.4%) and 3807 controls (16.5%) died. All-cause mortality was lower among former players than among controls up to the age of 70 years and was higher thereafter. Mortality from ischemic heart disease was lower among former players than among controls (hazard ratio, 0.80; 95% confidence interval [CI], 0.66 to 0.97; P = 0.02), as was mortality from lung cancer (hazard ratio, 0.53; 95% CI, 0.40 to 0.70; P<0.001). Mortality with neurodegenerative disease listed as the primary cause was 1.7% among former soccer players and 0.5% among controls (subhazard ratio [the hazard ratio adjusted for competing risks of death from ischemic heart disease and death from any cancer], 3.45; 95% CI, 2.11 to 5.62; P<0.001). Among former players, mortality with neurodegenerative disease listed as the primary or a contributory cause on the death certificate varied according to disease subtype and was highest among those with Alzheimer's disease (hazard ratio [former players vs. controls], 5.07; 95% CI, 2.92 to 8.82; P<0.001) and lowest among those with Parkinson's disease (hazard ratio, 2.15; 95% CI, 1.17 to 3.96; P = 0.01). Dementia-related medications were prescribed more frequently to former players than to controls (odds ratio, 4.90; 95% CI, 3.81 to 6.31; P<0.001). Mortality with neurodegenerative disease listed as the primary or a contributory cause did not differ significantly between goalkeepers and outfield players (hazard ratio, 0.73; 95% CI, 0.43 to 1.24; P = 0.24), but dementia-related medications were prescribed less frequently to goalkeepers (odds ratio, 0.41; 95% CI, 0.19 to 0.89; P = 0.02).
CONCLUSIONS:
In this retrospective epidemiologic analysis, mortality from neurodegenerative disease was higher and mortality from other common diseases lower among former Scottish professional soccer players than among matched controls. Dementia-related medications were prescribed more frequently to former players than to controls. These observations need to be confirmed in prospective matched-cohort studies. 

Midlife physical activity is associated with lower incidence of vascular dementia but not Alzheimer's disease.
Hansson O, Svensson M, Gustavsson AM, Andersson E, Yang Y, Nägga K, Hållmarker U, James S, Deierborg T.
Alzheimers Res Ther. 2019 Oct 20;11(1):87. doi: 10.1186/s13195-019-0538-4.
PMID: 31630687
https://alzres.biomedcentral.com/track/pdf/10.1186/s13195-019-0538-4
Abstract
BACKGROUND:
Physical activity might reduce the risk of developing dementia. However, it is still unclear whether the protective effect differs depending on the subtype of dementia. We aimed to investigate if midlife physical activity affects the development of vascular dementia (VaD) and Alzheimer's disease (AD) differently in two large study populations with different designs.
METHODS:
Using a prospective observational design, we studied whether long-distance skiers of the Swedish Vasaloppet (n = 197,685) exhibited reduced incidence of VaD or AD compared to matched individuals from the general population (n = 197,684) during 21 years of follow-up (median 10, interquartile range (IQR) 5-15 years). Next, we studied the association between self-reported physical activity, stated twice 5 years apart, and incident VaD and AD in 20,639 participants in the Swedish population-based Malmo Diet and Cancer Study during 18 years of follow-up (median 15, IQR 14-17 years). Finally, we used a mouse model of AD and studied brain levels of amyloid-β, synaptic proteins, and cognitive function following 6 months of voluntary wheel running.
RESULTS:
Vasaloppet skiers (median age 36.0 years [IQR 29.0-46.0], 38% women) had lower incidence of all-cause dementia (adjusted hazard ratio (HR) 0.63, 95% CI 0.52-0.75) and VaD (adjusted HR 0.49, 95% CI 0.33-0.73), but not AD, compared to non-skiers. Further, faster skiers exhibited a reduced incidence of VaD (adjusted HR 0.38, 95% CI 0.16-0.95), but not AD or all-cause dementia compared to slower skiers. In the Malmo Diet and Cancer Study (median age 57.5 years [IQR 51.0-63.8], 60% women), higher physical activity was associated with reduced incidence of VaD (adjusted HR 0.65, 95% CI 0.49-0.87), but not AD nor all-cause dementia. These findings were also independent of APOE-ε4 genotype. In AD mice, voluntary running did not improve memory, amyloid-β, or synaptic proteins.
CONCLUSIONS:
Our results indicate that physical activity in midlife is associated with lower incidence of VaD. Using three different study designs, we found no significant association between physical activity and subsequent development of AD.
KEYWORDS:
Alzheimer’s disease; Amyloid-β; Exercise; Physical activity; Vascular dementia

Time-restricted eating and age-related muscle loss.
Tinsley GM, Paoli A.
Aging (Albany NY). 2019 Oct 20. doi: 10.18632/aging.102384. [Epub ahead of print] No abstract available.
PMID: 31631066
https://www.aging-us.com/article/102384/text
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Time-restricted feeding plus resistance training in active females: a randomized trial.
Tinsley GM, Moore ML, Graybeal AJ, Paoli A, Kim Y, Gonzales JU, Harry JR, VanDusseldorp TA, Kennedy DN, Cruz MR.
Am J Clin Nutr. 2019 Sep 1;110(3):628-640. doi: 10.1093/ajcn/nqz126.
PMID: 31268131 Free PMC Article
https://www.crsociety.org/topic/11800-als-cr-updates/?page=21&tab=comments#comment-32676
https://academic.oup.com/ajcn/article/110/3/628/5527779
Abstract
BACKGROUND:
A very limited amount of research has examined intermittent fasting (IF) programs, such as time-restricted feeding (TRF), in active populations.
OBJECTIVE:
Our objective was to examine the effects of TRF, with or without β-hydroxy β-methylbutyrate (HMB) supplementation, during resistance training (RT).
METHODS:
This study employed a randomized, placebo-controlled, reduced factorial design and was double-blind with respect to supplementation in TRF groups. Resistance-trained females were randomly assigned to a control diet (CD), TRF, or TRF plus 3 g/d HMB (TRFHMB). TRF groups consumed all calories between 1200 h and 2000 h, whereas the CD group ate regularly from breakfast until the end of the day. All groups completed 8 wk of supervised RT and consumed supplemental whey protein. Body composition, muscular performance, dietary intake, physical activity, and physiological variables were assessed. Data were analyzed prior to unblinding using mixed models and both intention-to-treat (ITT) and per protocol (PP) frameworks.
RESULTS:
Forty participants were included in ITT, and 24 were included in PP. Energy and protein intake (1.6 g/kg/d) did not differ between groups despite different feeding durations (TRF and TRFHMB: ∼7.5 h/d; CD: ∼13 h/d). Comparable fat-free mass (FFM) accretion (+2% to 3% relative to baseline) and skeletal muscle hypertrophy occurred in all groups. Differential effects on fat mass (CD: +2%; TRF: -2% to -4%; TRFHMB: -4% to -7%) were statistically significant in the PP analysis, but not ITT. Muscular performance improved without differences between groups. No changes in physiological variables occurred in any group, and minimal side effects were reported.
CONCLUSIONS:
IF, in the form of TRF, did not attenuate RT adaptations in resistance-trained females. Similar FFM accretion, skeletal muscle hypertrophy, and muscular performance improvements can be achieved with dramatically different feeding programs that contain similar energy and protein content during RT. Supplemental HMB during fasting periods of TRF did not definitively improve outcomes.
KEYWORDS:
body composition; energy restriction; fat loss; intermittent energy restriction; intermittent fasting; muscle mass; muscular strength; protein; resistance exercise; weight training

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Food deprivation during active phase induces skeletal muscle atrophy via IGF-1 reduction in mice.
Abe T, Kazama R, Okauchi H, Oishi K.
Arch Biochem Biophys. 2019 Oct 19:108160. doi: 10.1016/j.abb.2019.108160. [Epub ahead of print]
PMID: 31639326
Abstract
Skeletal muscle mass is largely influenced by nutritional status and physical activity. Although feeding at specific times of the day (time-restricted feeding, TRF) modulates obesity and other metabolic functions, its effects on skeletal muscles remain unclear. We explored the effects of feeding mice only during the inactive (daytime feeding, DF) or active (nighttime feeding, NF) phases for one week. Daytime feeding did not abolish the nocturnal activity rhythm, although total daily activity was reduced in these mice. Temporal expression of the circadian clock genes, Per2 and Rev-erbα, became synchronized to the feeding cycle in the liver, but not in skeletal muscle. Skeletal muscle mass, grip strength, and cross-sectional area were significantly lower in DF, than in NF mice, although DF increased body weight gain and lipid accumulation. Expression of the atrophy-related ubiquitin ligases, Atrogin-1 and Murf1 and the autophagy-related genes, Lc3b and Bnip3, was induced during the active phase in the gastrocnemius muscles of DF, compared with those of NF mice. Plasma IGF-1 concentrations and Igf-1 expression in the livers and gastrocnemius muscles during the active phase were lower in DF, than in NF mice. Furthermore, exogenous IGF-1 injection significantly suppressed DF-induced reduction in gastrocnemius muscle mass, which might at least partly explain the association between decreased plasma IGF-1 concentrations and reductions in the skeletal muscle mass of DF mice. These findings suggest that feeding only during the inactive phase reduces skeletal muscle mass via a decrease in plasma IGF-1 concentrations during the active phase.
KEYWORDS:
Circadian clock; Insulin; Insulin-like growth factor-1; Muscle atrophy; Obesity; Time-restricted feeding

Systemic GDF11 stimulates the secretion of adiponectin and induces a calorie restriction-like phenotype in aged mice.
Katsimpardi L, Kuperwasser N, Camus C, Moigneu C, Chiche A, Tolle V, Li H, Kokovay E, Lledo PM.
Aging Cell. 2019 Oct 22:e13038. doi: 10.1111/acel.13038. [Epub ahead of print]
PMID: 31637864
https://onlinelibrary.wiley.com/doi/full/10.1111/acel.13038
Abstract
Aging is a negative regulator of general homeostasis, tissue function, and regeneration. Changes in organismal energy levels and physiology, through systemic manipulations such as calorie restriction and young blood infusion, can regenerate tissue activity and increase lifespan in aged mice. However, whether these two systemic manipulations could be linked has never been investigated. Here, we report that systemic GDF11 triggers a calorie restriction-like phenotype without affecting appetite or GDF15 levels in the blood, restores the insulin/IGF-1 signaling pathway, and stimulates adiponectin secretion from white adipose tissue by direct action on adipocytes, while repairing neurogenesis in the aged brain. These findings suggest that GDF11 has a pleiotropic effect on an organismal level and that it could be a linking mechanism of rejuvenation between heterochronic parabiosis and calorie restriction. As such, GDF11 could be considered as an important therapeutic candidate for age-related neurodegenerative and metabolic disorders.
KEYWORDS:
GDF11; adiponectin; aging; calorie restriction; heterochronic parabiosis; rejuvenation

Caffeine intake and the risk of recurrent kidney stones in adults, an analysis of 2007-2014 National Health and Nutrition Examination Surveys.
Sun Y, Wang D, Zhou Q.
Eur J Nutr. 2019 Oct 21. doi: 10.1007/s00394-019-02115-0. [Epub ahead of print]
PMID: 31637466
Abstract
PURPOSE:
The association between caffeine intake and the risk of recurrent kidney stones is unknown. We examined the association between caffeine intake and the risk of recurrent kidney stones in adults.
METHODS:
Individuals with history of passing at least one kidney stone were included from 2007 to 2014 National Health and Nutrition Examination Survey. Recurrent kidney stones were defined using a standard questionnaire and structured dietary recalls were used to determine caffeine intake. The weighted logistic regression was used to assess the association between caffeine intake and the risk of recurrent kidney stones, and the non-linear relationship was explored with restricted cubic splines. Caffeine and dietary confounders (minerals and vitamins) were adjusted for total energy intake with residual model.
RESULTS:
The multivariate-adjusted odds ratios (95% confidence intervals) of recurrent kidney stones for per-quartile increment in caffeine intake were 1.15 (1.01-1.31) overall, 1.11 (0.96-1.29) for white race individuals, 1.33 (1.09-1.63) for non-white race individuals, 1.15 (0.97-1.36) for men, 1.24 (1.01-1.53) for women, 1.54 (1.08-2.19) for non-overweight individuals, 1.11 (0.97-1.28) for overweight/obese individuals, 1.13 (0.99-1.29) for caffeine from coffee, and 0.90 (0.79-1.03) for caffeine from non-coffee sources. A linear relationship was found between caffeine intake and the risk of recurrent kidney stones overall and in subgroup analyses.
CONCLUSION:
Compared with those who reported passing only one kidney stone, caffeine intake was independently and linearly associated with a higher risk of recurrent kidney stones in adults, especially for women, individuals of non-white race and non-overweight subjects. The increased risk may arise from caffeine from coffee.
KEYWORDS:
Caffeine intake; National Health and Nutrition Examination Survey; Recurrent kidney stones

Exploring the effect of fasting on age-related diseases
Date:
October 21, 2019
Source: EMBO
Summary:
There are many indications that fasting promotes longevity. In recent years, much attention has been devoted to so-called caloric restriction mimetics (CMRs), substances that simulate the health-promoting effects of fasting without the need of life-style change. A study reports the identification of a novel candidate CRM. The substance may prove useful in the further research for the treatment of age-related diseases.
https://www.sciencedaily.com/releases/2019/10/191021111842.htm
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3,4-Dimethoxychalcone induces autophagy through activation of the transcription factors TFE3 and TFEB.
Chen G, Xie W, Nah J, Sauvat A, Liu P, Pietrocola F, Sica V, Carmona-Gutierrez D, Zimmermann A, Pendl T, Tadic J, Bergmann M, Hofer SJ, Domuz L, Lachkar S, Markaki M, Tavernarakis N, Sadoshima J, Madeo F, Kepp O, Kroemer G.
EMBO Mol Med. 2019 Oct 14:e10469. doi: 10.15252/emmm.201910469. [Epub ahead of print]
PMID: 31609086 Free Article
Abstract
Caloric restriction mimetics (CRMs) are natural or synthetic compounds that mimic the health-promoting and longevity-extending effects of caloric restriction. CRMs provoke the deacetylation of cellular proteins coupled to an increase in autophagic flux in the absence of toxicity. Here, we report the identification of a novel candidate CRM, namely 3,4-dimethoxychalcone (3,4-DC), among a library of polyphenols. When added to several different human cell lines, 3,4-DC induced the deacetylation of cytoplasmic proteins and stimulated autophagic flux. At difference with other well-characterized CRMs, 3,4-DC, however, required transcription factor EB (TFEB)- and E3 (TFE3)-dependent gene transcription and mRNA translation to trigger autophagy. 3,4-DC stimulated the translocation of TFEB and TFE3 into nuclei both in vitro and in vivo, in hepatocytes and cardiomyocytes. 3,4-DC induced autophagy in vitro and in mouse organs, mediated autophagy-dependent cardioprotective effects, and improved the efficacy of anticancer chemotherapy in vivo. Altogether, our results suggest that 3,4-DC is a novel CRM with a previously unrecognized mode of action.
KEYWORDS:
TFEB ; TFE3; caloric restriction; caloric restriction mimetic; cardioprotection

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Predictive Effect of Malnutrition on Long-Term Clinical Outcomes among Older Men: A Prospectively Observational Cohort Study.
Hsu YH, Chou MY, Chu CS, Liao MC, Wang YC, Lin YT, Chen LK, Liang CK.
J Nutr Health Aging. 2019;23(9):876-882. doi: 10.1007/s12603-019-1246-2.
PMID: 31641739
https://www.mna-elderly.com/forms/mna_guide_english_sf.pdf
Abstract
OBJECTIVES:
To determine whether nutritional status can predict 3-year cognitive and functional decline, as well as 4-year all-cause mortality in older adults.
DESIGN:
Prospectively longitudinal cohort study.
SETTING AND PARTICIPANTS:
The study recruited 354 men aged 65 years and older in the veteran's retirement community.
MEASURES:
Baseline nutritional status was evaluated using the Mini-Nutritional Assessment-Short Form (MNA-SF). Cognitive function and Activities of Daily Living (ADL) function were determined by the Mini-Mental State Examination (MMSE) and the Barthel Index, respectively. Three-year cognitive and functional decline were respectively defined as a >3 point decrease in the MMSE scores and lower ADL scores than at baseline. Univariate and multivariable logistic regression analyses were conducted to identify nutritional status as a risk factor in poor outcome. The Kaplan-Meier method and Cox proportional regression models were used to estimate the effect of malnutrition risk on the mortality.
RESULTS:
According to MNS-SF, the prevalence of risk of malnutrition was 53.1% (188/354). Multivariate logistic regression found risk of malnutrition significantly associated with 3-year cognitive decline (Adjusted odds ratio [OR] 2.07, 95% Confidence Interval [CI] 1.05-4.08, P =0.036) and functional decline (Adjusted OR 1.83, 95% CI 1.01-3.34, P =0.047) compared with normal nutritional status. The hazard ratio (HR) for all-cause mortality was 1.8 times higher in residents at risk of malnutrition (Adjusted HR 1.82, 95% CI 1.19-2.79, P =0.006).
CONCLUSIONS:
Our results provide strong evidence that risk of malnutrition can predict not only cognitive and functional decline but also risk of all-cause mortality in older men living in a veteran retirement's community. Further longitudinal studies are needed to explore the causal relationship among nutrition, clinical outcomes, and the effect of an intervention for malnutrition.
KEYWORDS:
Malnutrition; cognitive decline; functional decline; mortality; older adults

Effects of eating with an augmented fork with vibrotactile feedback on eating rate and body weight: a randomized controlled trial.
Hermsen S, Mars M, Higgs S, Frost JH, Hermans RCJ.
Int J Behav Nutr Phys Act. 2019 Oct 22;16(1):90. doi: 10.1186/s12966-019-0857-7.
PMID: 31640791
https://ijbnpa.biomedcentral.com/track/pdf/10.1186/s12966-019-0857-7
https://www.amazon.com/10SFork-the-vibrating-fork-green/dp/B00P222XWE
Abstract
BACKGROUND:
Eating rate is a basic determinant of appetite regulation: people who eat more slowly feel sated earlier and eat less. A high eating rate contributes to overeating and potentially to weight gain. Previous studies showed that an augmented fork that delivers real-time feedback on eating rate is a potentially effective intervention to decrease eating rate in naturalistic settings. This study assessed the impact of using the augmented fork during a 15-week period on eating rate and body weight.
METHODS:
In a parallel randomized controlled trial, 141 participants with overweight (age: 49.2 ± 12.3 y; BMI: 31.5 ± 4.48 kg/m2) were randomized to intervention groups (VFC, n = 51 or VFC+, n = 44) or control group (NFC, n = 46). First, we measured bite rate and success ratio on five consecutive days with the augmented fork without feedback (T1). The intervention groups (VFC, VFC+) then used the same fork, but now received vibrotactile feedback when they ate more than one bite per 10 s. Participants in VFC+ had additional access to a web portal with visual feedback. In the control group (NFC), participants ate with the fork without either feedback. The intervention period lasted four weeks, followed by a week of measurements only (T2) and another measurement week after eight weeks (T3). Body weight was assessed at T1, T2, and T3.
RESULTS:
Participants in VFC and VFC+ had a lower bite rate (p < .01) and higher success ratio (p < .0001) than those in NFC at T2. This effect persisted at T3. In both intervention groups participants lost more weight than those in the control group at T2 (p < .02), with no rebound at T3.
CONCLUSIONS:
The findings of this study indicate that an augmented fork with vibrotactile feedback is a viable tool to reduce eating rate in naturalistic settings. Further investigation may confirm that the augmented fork could support long-term weight loss strategies.
KEYWORDS:
Eating rate; Feedback; Randomized controlled trial; Sensory; Weight loss

Relationship between meat/fish consumption and biliary tract cancer: The Japan Public Health Center-based Prospective Study.
Makiuchi T, Sobue T, Kitamura T, Ishihara J, Sawada N, Iwasaki M, Yamaji T, Shimazu T, Tsugane S.
Cancer Epidemiol Biomarkers Prev. 2019 Oct 22. pii: cebp.0514.2019. doi: 10.1158/1055-9965.EPI-19-0514. [Epub ahead of print]
PMID: 31641013
Abstract
BACKGROUND:
The effect of meat and fish consumption on cancer risk has been well studied in humans. However, studies related to biliary tract cancer (BTC) are scarce.
METHODS:
We examined the association between meat and fish consumption and the risk of BTC in a population-based prospective cohort study in Japan. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using the Cox proportional hazard model.
RESULTS:
During 1995-1999, 43,177 men and 49,323 women aged 45-74 years were enrolled and followed up for 607,757.0 person-years (men) and 728,820.3 person-years (women) until 2012, during which time 217 male and 162 female BTC cases were identified. Higher total meat consumption was significantly associated with a decreased BTC risk in men (HR for the highest versus lowest quartiles = 0.66; 95% CI: 0.44-0.98; P-trend = 0.011) but not in women. Similar association was observed with red meat, but no association was observed with poultry. Fish was not associated with BTC risk. We further analyzed each BTC subtype to confirm the observed association with BTC. However, significant association with each of BTC subtype was not observed, although a trend of decreased extrahepatic BTC risk was observed.
CONCLUSIONS:
BTC risk was lower among men who consumed more meat, particularly red meat, in Japan.
IMPACT:
This is the first prospective study that evaluated the relationship between meat and BTC. This may provide important suggestions to elucidate the etiology of BTC.

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