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Gut-Brain Cross-Talk in Metabolic Control.

Clemmensen C, Müller TD, Woods SC, Berthoud HR, Seeley RJ, Tschöp MH.

Cell. 2017 Feb 23;168(5):758-774. doi: 10.1016/j.cell.2017.01.025. Review.

PMID: 28235194

http://www.cell.com/cell/fulltext/S0092-8674(17)30110-1

http://www.cell.com/cell/pdf/S0092-8674(17)30110-1.pdf

Abstract

Because human energy metabolism evolved to favor adiposity over leanness, the availability of palatable, easily attainable, and calorically dense foods has led to unprecedented levels of obesity and its associated metabolic co-morbidities that appear resistant to traditional lifestyle interventions. However, recent progress identifying the molecular signaling pathways through which the brain and the gastrointestinal system communicate to govern energy homeostasis, combined with emerging insights on the molecular mechanisms underlying successful bariatric surgery, gives reason to be optimistic that novel precision medicines that mimic, enhance, and/or modulate gut-brain signaling can have unprecedented potential for stopping the obesity and type 2 diabetes pandemics.

KEYWORDS:

appetite; bariatric surgery; brain; diabetes; energy balance; gut; metabolic syndrome; obesity; pharmacology; satiety

PMID: 28235194 DOI: 10.1016/j.cell.2017.01.025

 

Association of dietary vitamin E intake with risk of lung cancer: a dose-response meta-analysis.

Zhu YJ, Bo YC, Liu XX, Qiu CG.

Asia Pac J Clin Nutr. 2017 Mar;26(2):271-277. doi: 10.6133/apjcn.032016.04.

PMID: 28244705

http://apjcn.nhri.org.tw/server/apjcn/26/3/0270.pdf

Abstract

BACKGROUND AND OBJECTIVES:

Several epidemiological studies investigating the association between dietary vitamin E intake and the risk of lung cancer have demonstrated inconsistent results. Hence, a meta-analysis was conducted to summarise evidence of the association of dietary vitamin E intake with the risk of lung cancer.

METHODS AND STUDY DESIGN:

In this meta-analysis, a systematic literature search of PubMed and Web of Science was conducted to identify relevant studies published from 1955 to April 2015. If p<0.05 or I2 >50%, a random effect model was used to estimate overall relative risks (RRs) and 95% confidence intervals (CIs). Otherwise, a fixed effect model was applied. Publication bias was estimated using the funnel plot and Egger's test. The doseresponse relationship was assessed using the method of restricted cubic splines with 4 knots at percentiles 5, 35, 65, and 95 of the distribution.

RESULTS:

The pooled RR of lung cancer for the highest versus lowest categories of dietary vitamin E intake was 0.84 (95% CI=0.76-0.93). With every 2 mg/d increase in dietary vitamin E intake, the risk of lung cancer statistically decreased by 5% (RR=0.95, 95% CI =0.91-0.99, plinearity=0.0237).

CONCLUSIONS:

Our analysis suggests that higher dietary vitamin E intake exerts a protective effect against lung cancer.

 

["next future" as opposed to "previous future" and "this future", I suppose.]

Centenarians as extreme phenotypes: an ecological perspective to get insight into the relationship between the genetics of longevity and age-associated diseases.

Giuliani C, Pirazzini C, Delledonne M, Xumerle L, Descombes P, Marquis J, Mengozzi G, Monti D, Bellizzi D, Passarino G, Luiselli D, Franceschi C, Garagnani P.

Mech Ageing Dev. 2017 Feb 24. pii: S0047-6374(16)30250-0. doi: 10.1016/j.mad.2017.02.007. [Epub ahead of print] Review.

PMID: 28242236

http://sci-hub.cc/10.1016/j.mad.2017.02.007

Abstract

In this review we address the genetic continuum between aging and age-related diseases, with particular attention to the ecological perspective. We describe the connections between genes that promote longevity and genes associated to age-related diseases considering trade-off mechanisms in which the same genetic variants could have different effect according to the tissue considered and could be involved in several biological pathways. Then we describe mechanisms of antagonistic pleiotropy, focusing on the complex interplay between genetic variants and environmental changes (internal or external). We sustain the use of centenarians as "super-controls" for the study of the major age-related diseases, starting from the concept that the maximization of the phenotypic differences in the considered cohort, achieved by selecting the most divergent phenotypes, could be useful for increasing the significant differences observed in the genetic association study. We describe the potential impact of the population genetic variability in the study of human longevity and the possible contribution of the past selective pressures in shaping the current genomic background of individuals. In conclusion we illustrate recent findings emerged from whole genome sequencing of long-lived individuals and future perspectives for interpreting the huge amount of genetic data that will be generated in the next future.

KEYWORDS:

Age-related diseases; Extreme-phenotypes; Gene-environment interactions; Longevity; Populations

 

[The below paper is pdf-availed.]

Reversible States of Physical and/or Cognitive Dysfunction: A 9-Year Longitudinal Study.

Qualls C, Waters DL, Vellas B, Villareal DT, Garry PJ, Gallini A, Andrieu S.

J Nutr Health Aging. 2017;21(3):271-275. doi: 10.1007/s12603-017-0878-3.

PMID: 28244566

Abstract

OBJECTIVES:

To determine 1) age-adjusted transition probabilities to worsening physical/cognitive function states, reversal to normal cognition/physical function, or maintenance of normal state; 2) whether these transitions are modulated by sex, BMI, education, hypertension (HTN), health status, or APOE4; 3) whether worsening gait speed preceded cognition change, or vice versa.

DESIGN:

Analysis of 9-year prospective cohort data from the New Mexico Aging Process Study.

SETTING:

Healthy independent-living adults.

PARTICIPANTS:

60+ years of age (n= 598).

MEASUREMENTS:

Gait speed, cognitive function (3MSE score), APOE4, HTN, BMI, education, health status.

RESULTS:

Over 9 years, 2129 one-year transitions were observed. 32.6% stayed in the same state, while gait speed and cognitive function (3MSE scores) improved for 38% and 43% of participants per year, respectively. Transitions to improved function decreased with age (P< 0.001), APOE4 status (P=0.02), BMI (P=0.009), and health status (P=0.009). Transitions to worse function were significantly increased for the same factors (all P<0.05). Times to lower gait speed and cognitive function did not precede each other (P=0.91).

CONCLUSIONS:

Transitions in gait speed and cognition were mutable with substantial likelihood of transition to improvement in physical and cognitive function even in oldest-old, which may have clinical implications for treatment interventions.

KEYWORDS:

Cognitive function; gait speed; multi-state modelling; reversible transitions

 

[The below paper is pdf-availed.]

Factors Affecting Functional Impairment among Elderly Germans - Results of a Longitudinal Study.

Hajek A, Luck T, Brettschneider C, Posselt T, Lange C, Wiese B, Steinmann S, Weyerer S, Werle J, Pentzek M, Fuchs A, Stein J, Bickel H, Mösch E, Wagner M, Heser K, Maier W, Scherer JM, Riedel-Heller SG, König HH.

J Nutr Health Aging. 2017;21(3):299-306. doi: 10.1007/s12603-016-0771-5.

PMID: 28244570

Abstract

OBJECTIVE:

To investigate causal factors of functional impairment in old age in a longitudinal approach.

DESIGN:

A population-based prospective cohort study.

SETTING:

Elderly individuals were recruited via GP offices at six study centers in Germany. They were observed every 1.5 years over six waves.

PARTICIPANTS:

Three thousand two hundred fifty-six people aged 75 years and older at baseline.

MEASUREMENTS:

Functional impairment was quantified by the Lawton and Brody Instrumental Activities of Daily Living scale (IADL) and the Barthel-Index (BI).

RESULTS:

Fixed effects regressions revealed that functional impairment (IADL; BI) increased significantly with ageing (β=-.2; β=-1.1), loss of a spouse (β= .5; β=-3.1), not living alone in private household (β=-1.2; β=-5.5), depression (solely significant for IADL: β= .6) and dementia (β=-2.3; β=-18.2). The comorbidity score did not affect functional impairment.

CONCLUSION:

Our findings underline the relevance of changes in sociodemographic variables as well as the occurrence of depression or dementia for functional impairment. While several of these causal factors for functional decline in the oldest old are inevitable, some may not be, such as depression. Therefore, developing interventional strategies to prevent depression might be a fruitful approach in order to delay functional impairment in old age.

KEYWORDS:

Functional impairment; dementia; depression; longitudinal study; older people

 

[The below paper is pdf-availed.]

The Role of Uric Acid for Predicting Future Metabolic Syndrome and Type 2 Diabetes in Older People.

Chang JB, Chen YL, Hung YJ, Hsieh CH, Lee CH, Pei D, Lin JD, Wu CZ, Liang YJ, Lin CM.

J Nutr Health Aging. 2017;21(3):329-335. doi: 10.1007/s12603-016-0749-3.

PMID: 28244574

Abstract

OBJECTIVE:

Although it is known that high uric acid (UA) level is associated with type 2 diabetes (T2DM) and metabolic syndrome (MetS), most of the previous studies were focused on adults. Since aging becomes a major problem for many societies, in this longitudinal study, we investigated the role of UA in future T2DM and MetS in a large cohort of people who were older than 65 years.

DESIGN:

A cross-sectional and longitudinal study.

SETTING/PARTICIPANTS:

18,907 elderly (9,732 men, 9,175 women) aged above 65 years, enrolled from health check-up centers, were classified into three subgroups by 10-year intervals (young old 65-74 years, YO; old old 75-84 years, OO; and oldest old 85-94 years, ODO), with the average follow-up period of 4.3 years.

MEASUREMENTS:

The optimal cut-off values (CoVs) of baseline UA to predict future MetS and T2DM were determined by receiving operating characteristic (ROC) curve analysis. Using these CoVs of UA, the participants were divided into normal- and high-level groups of UA. Cox proportional hazard analysis was used to calculate hazard ratios (HRs) for the subjects with a high level of UA for the risk of future MetS and T2DM. In addition, Kaplan-Meier plots and log rank test were used to evaluate the time effect on the incidence of developing MetS and T2DM between the two groups.

RESULTS:

In ROC curve analysis, the optimal CoVs of baseline UA were 6.0, 6.3 and 6.7 mg/dl in YO, OO, and ODO men, respectively; 5.5 and 4.9 mg/dl in YO and OO women, respectively (all p < 0.05). However, the CoVs of UA in ODO women (6.1 mg/dl) failed to show its discriminant power (p = 0.13). The Cox regression analysis showed the YO subjects with a higher baseline level of UA had a higher risk of developing MetS (HRs 1.56 and 1.58 for men and women, respectively, both p < 0.001); as for T2DM the HRs were 1.39 and 1.57. In OO men, the HRs was 1.89 for developing future MetS. However, no significant findings could be noted in the ODO group. Kaplan-Meier plots and log rank test also showed the same findings.

CONCLUSION:

Our study showed that old subjects with high levels of UA will have a higher chance to have MetS and T2DM, particularly in the YO group (6.0 mg/dl for men and 5.5 mg/dl for women, respectively). Using UA as one of the metabolic biomarkers may help clinicians to early detect and prevent MetS and diabetes.

KEYWORDS:

Diabetes; elderly; inflammation; metabolic syndrome; uric acid

 

Association of Serum Magnesium Level with Odds of Prediabetes and Diabetes in a Southern Chinese Population: a Prospective Nested Case-Control Study.

Fang C, Wang X, Wu W, Gu X, Ye T, Deng H, Wang X, Shen F.

Biol Trace Elem Res. 2016 Aug;172(2):307-14. doi: 10.1007/s12011-015-0594-y.

PMID: 26706038

http://sci-hub.cc/10.1007/s12011-015-0594-y

Abstract

Although emerging clinical evidence supports that magnesium deficiency is a risk factor for the development of type 2 diabetes, there are sparse studies concerning the dynamic change of serum magnesium with the risk of diabetes and its early stages. In this nested case-control study, we performed a 75-g oral glucose tolerance test or a standardized steamed bread meal test in 178 subjects with incident glucose metabolism impairment (33 with type 2 diabetes and 145 with prediabetes) and 178 matched controls at baseline and at 3-year follow-up and determined the associations between baseline serum magnesium levels as well as changes in serum magnesium levels at follow-up and odds of prediabetes and diabetes. After adjusting for potential confounders, the odds ratios of risk for prediabetes and type 2 diabetes in the highest quartile of serum magnesium levels were 0.22 (95 % confidence intervals [CI] 0.10-0.49; p for trend <0.001) and 0.02 (95 % CI 0.00-0.29; p for trend = 0.009), respectively, as compared with the lowest quartile. In addition, a significant decline in the serum magnesium level was detected in type 2 diabetes cases (p = 0.015) at 3 years as compared with at baseline. These results suggest that a low magnesium level is an independent risk factor for prediabetes and type 2 diabetes, and that the reduction of serum magnesium is associated with type 2 diabetes in a southern Chinese population.

KEYWORDS:

Diabetes; Dynamic change; Magnesium; Prediabetes

 

'Strong evidence' of link between obesity and some major cancers, new study finds

Improved obesity treatment and prevention is needed, says expert

By Darryl Hol, CBC News Posted: Feb 28, 2017

http://www.cbc.ca/news/health/obesity-linked-to-some-major-cancers-1.4003698

>>>>>>>>>>>>>>>>>>>>

Fresh evidence links adiposity with multiple cancers

BMJ 2017; 356 :j908; (Published 28 February 2017)

Yikyung Park, Graham A Colditz

http://www.bmj.com/content/356/bmj.j908

The association is now clear; it’s time to get serious about prevention

The International Agency for Research on Cancer (IARC) working group recently reviewed epidemiological data, studies in experimental animals, and mechanistic data and concluded that excess body fatness causes cancer of the colon and rectum, liver, gallbladder, pancreas, kidney, thyroid, breast (postmenopausal), endometrium, ovary, oesophagus (adenocarcinoma), and gastric cardia, as well as meningioma and multiple myeloma.1 This potentially makes excess body fat the second most important modifiable cancer risk factor after tobacco use.

The study by Kyrgiou and colleagues2 took up the challenge of evaluating the robustness of multiple, sometimes overlapping, meta-analyses that reported an association between body adiposity measures (such as body mass index, weight gain, and waist circumference) and cancer. The authors conducted an umbrella review, also known as a “review of reviews” or “meta-review,”34 and initially identified a total of 204 individual meta-analyses from 49 papers. They further examined the 95 meta-analyses that reported the association between body fatness measured on a continuous scale (mostly body mass index in 5 kg/m2 increase) and cancer in cohort studies. After a rigorous evaluation for strength and validity of reported associations, 13% (12 of 95) of meta-analyses were judged to provide strong evidence on the basis of their statistical criteria. The rest of the meta-analyses were deemed to be highly suggestive (18%), suggestive (25%), and weak (20%). Twenty four per cent of meta-analyses found no association between body fatness and cancer.

Nine obesity related cancers were supported by strong evidence: oesophageal adenocarcinoma, colon and rectal cancer (in men), biliary tract system, pancreatic, and kidney cancer, endometrial cancer (premenopausal women), breast cancer (postmenopausal), and multiple myeloma. A positive association between body mass index and liver, ovarian, or thyroid cancer was highly suggestive or suggestive; a negative association with oesophageal squamous cell carcinoma or lung cancer was highly suggestive. In additional analyses using obesity categories (obesity versus normal weight), strong evidence also supported increased risks of gastric cardia and ovarian cancer in obese individuals.

Both the IARC report and Kyrgiou and colleagues’ umbrella review consistently and strongly concluded that excess body fat increases the risk of most digestive system cancers as well as endometrial and postmenopausal breast cancer. However, for gastric cardia, and cancers of the liver, ovary, or thyroid, the strength of evidence differed between the two approaches, which can be explained by differences in the method used to summarise the evidence.

Firstly, unlike the IARC report, Kyrgiou and colleagues’ review did not evaluate the quality of the original meta-analyses. Although it reviews meta-analyses that may be susceptible to publication bias, the IARC report clearly demonstrated the importance of assessing the quality of each meta-analysis, including search strategy, inclusion and exclusion criteria, and data extraction,5 which is often outside the scope of an umbrella review.

Secondly, inclusion of suboptimal studies in a review, such as those that inadequately control for smoking in analyses exploring body mass index and lung cancer, may still provide a precise estimate, but biased in the wrong direction. This also limits the quality of the evidence. In contrast to the study by Kyrgiou and colleagues, the IACR report judged the evidence linking higher body mass index with lower risk of oesophageal squamous cell carcinoma and lung cancer as inadequate and inconsistent, partly owing to inadequate control for confounding by smoking and potential bias in the published literature.

Lastly, Kyrgiou and colleagues did not appraise meta-analyses of individual participant data but reviewed meta-analyses that combined results from published studies. Pooled analyses of individual participant data can be an efficient way to examine associations between obesity and cancer, especially for rare cancers,67 cancer subtypes (different histologies),8 and subgroups such as never smokers9 where individual studies and meta-analyses often do not have sufficient power. Associations deemed to be less convincing in Kyrgiou and colleagues’ review, such as those linking adiposity with cancers of the liver, ovary, and thyroid, were mostly downgraded because of heterogeneity between studies or the small number of cancer cases in each meta-analysis. Both these shortcomings can be overcome by including large pooled analyses. Although an umbrella review can be useful in providing a snapshot of evidence to explore a broad research question, the findings from umbrella reviews should be interpreted with caution as they are less comprehensive than reviews based on all available data.

Though some specifics remain to be worked out, the unavoidable conclusion from these data is that preventing excess adult weight gain can reduce the risk of cancer. Furthermore, emerging evidence suggests that excess body fat in early life also has an adverse effect on risk of cancer in adulthood.6710 Given the critical role of healthcare providers in obesity screening and prevention,1112 clinicians, particularly those in primary care, can be a powerful force to lower the burden of obesity related cancers, as well as the many other chronic diseases linked to obesity such as diabetes, heart disease, and stroke. The data are clear. The time for action is now.

>>>>>>>>>>>>>>>>>>>>>>>>>

Adiposity and cancer at major anatomical sites: umbrella review of the literature

BMJ 2017; 356 doi: https://doi.org/10.1136/bmj.j477(Published 28 February 2017)

BMJ 2017;356:j477

Maria Kyrgiou, senior lecturer12, Ilkka Kalliala, clinical postdoctoral fellow1, Georgios Markozannes, research fellow3, Marc J Gunter, section and group head4, Evangelos Paraskevaidis, professor5, Hani Gabra, professor12, Pierre Martin-Hirsch, professor67, Konstantinos K Tsilidis, assistant professor38

http://www.bmj.com/content/356/bmj.j477

Abstract

Objective

To evaluate the strength and validity of the evidence for the association between adiposity and risk of developing or dying from cancer.

Design

Umbrella review of systematic reviews and meta-analyses.

Data sources

PubMed, Embase, Cochrane Database of Systematic Reviews, and manual screening of retrieved references.

Eligibility criteria

Systematic reviews or meta-analyses of observational studies that evaluated the association between indices of adiposity and risk of developing or dying from cancer.

Data synthesis

Primary analysis focused on cohort studies exploring associations for continuous measures of adiposity. The evidence was graded into strong, highly suggestive, suggestive, or weak after applying criteria that included the statistical significance of the random effects summary estimate and of the largest study in a meta-analysis, the number of cancer cases, heterogeneity between studies, 95% prediction intervals, small study effects, excess significance bias, and sensitivity analysis with credibility ceilings.

Results

204 meta-analyses investigated associations between seven indices of adiposity and developing or dying from 36 primary cancers and their subtypes. Of the 95 meta-analyses that included cohort studies and used a continuous scale to measure adiposity, only 12 (13%) associations for nine cancers were supported by strong evidence. An increase in body mass index was associated with a higher risk of developing oesophageal adenocarcinoma; colon and rectal cancer in men; biliary tract system and pancreatic cancer; endometrial cancer in premenopausal women; kidney cancer; and multiple myeloma. Weight gain and waist to hip circumference ratio were associated with higher risks of postmenopausal breast cancer in women who have never used hormone replacement therapy and endometrial cancer, respectively. The increase in the risk of developing cancer for every 5 kg/m2 increase in body mass index ranged from 9% (relative risk 1.09, 95% confidence interval 1.06 to 1.13) for rectal cancer among men to 56% (1.56, 1.34 to 1.81) for biliary tract system cancer. The risk of postmenopausal breast cancer among women who have never used HRT increased by 11% for each 5 kg of weight gain in adulthood (1.11, 1.09 to 1.13), and the risk of endometrial cancer increased by 21% for each 0.1 increase in waist to hip ratio (1.21, 1.13 to 1.29). Five additional associations were supported by strong evidence when categorical measures of adiposity were included: weight gain with colorectal cancer; body mass index with gallbladder, gastric cardia, and ovarian cancer; and multiple myeloma mortality.

Conclusions

Although the association of adiposity with cancer risk has been extensively studied, associations for only 11 cancers (oesophageal adenocarcinoma, multiple myeloma, and cancers of the gastric cardia, colon, rectum, biliary tract system, pancreas, breast, endometrium, ovary, and kidney) were supported by strong evidence. Other associations could be genuine, but substantial uncertainty remains. Obesity is becoming one of the biggest problems in public health; evidence on the strength of the associated risks may allow finer selection of those at higher risk of cancer, who could be targeted for personalised prevention strategies.

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Health Risk Assessment of Dietary Cadmium Intake: Do Current Guidelines Indicate How Much is Safe?

Satarug S, Vesey DA, Gobe GC.

Environ Health Perspect. 2017 Mar;125(3):284-288. doi: 10.1289/EHP108.

PMID: 28248635

https://ehp.niehs.nih.gov/ehp108/

https://ehp.niehs.nih.gov/wp-content/uploads/125/3/EHP108.alt.pdf

Abstract

BACKGROUND:

Cadmium (Cd), a food-chain contaminant, is a significant health hazard. The kidney is one of the primary sites of injury after chronic Cd exposure. Kidney-based risk assessment establishes the urinary Cd threshold at 5.24 μg/g creatinine, and tolerable dietary intake of Cd at 62 μg/day per 70-kg person. However, cohort studies show that dietary Cd intake below a threshold limit and that tolerable levels may increase the risk of death from cancer, cardiovascular disease, and Alzheimer's disease.

OBJECTIVE:

We evaluated if the current tolerable dietary Cd intake guideline and urinary Cd threshold limit provide sufficient health protection.

DISCUSSION:

Staple foods constitute 40-60% of total dietary Cd intake by average consumers. Diets high in shellfish, crustaceans, mollusks, spinach, and offal add to dietary Cd sources. Modeling studies predict the current tolerable dietary intake corresponding to urinary Cd of 0.70-1.85 μg/g creatinine in men and 0.95-3.07 μg/g creatinine in women. Urinary Cd levels of < 1 μg/g creatinine were associated with progressive kidney dysfunction and peripheral vascular disease. A urinary Cd of 0.37 μg/g creatinine was associated with breast cancer, whereas dietary Cd of 16-31.5 μg/day was associated with 25-94% increase in risk of estrogen receptor-positive breast cancer.

CONCLUSION:

Modeling shows that dietary intake levels for Cd exceed the levels associated with kidney damage and many other adverse outcomes. Thus, the threshold level of urinary Cd should be re-evaluated. A more restrictive dietary intake guideline would afford enhanced health protection from this pervasive toxic metal.

 

Magnitude of Hypotension Based on Office and Ambulatory Blood Pressure Monitoring: Results From a Cohort of 5066 Treated Hypertensive Patients Aged 80 Years and Older.

Divisón-Garrote JA, Ruilope LM, de la Sierra A, de la Cruz JJ, Vinyoles E, Gorostidi M, Escobar-Cervantes C, Velilla-Zancada SM, Segura J, Banegas JR.

J Am Med Dir Assoc. 2017 Feb 25. pii: S1525-8610(17)30062-2. doi: 10.1016/j.jamda.2017.01.015. [Epub ahead of print]

PMID: 28246017

http://sci-hub.cc/10.1016/j.jamda.2017.01.015

Abstract

BACKGROUND AND OBJECTIVE:

Elderly patients can be particularly susceptible to the adverse effects of excessive blood pressure (BP) lowering by antihypertensive treatment. The identification of hypotension is thus especially important. Ambulatory BP monitoring (ABPM) is a more accurate technique than office for classifying BP status. This study examined the prevalence of hypotension and associated demographic and clinical factors among very old treated hypertensive patients undergoing ABPM.

DESIGN, SETTING, AND PARTICIPANTS:

Cross-sectional study in which 5066 patients aged 80 years and older with treated hypertension drawn from the Spanish ABPM Registry were included.

MEASUREMENTS:

Office BP and 24-hour ambulatory BP were determined using validated devices under standardized conditions. Based on previous studies, hypotension was defined as systolic/diastolic BP <110 and/or 70 mmHg with office measurement, <105 and/or 65 mmHg with daytime ABPM, <90 and/or 50 mmHg with nighttime ABPM, and <100 and/or 60 mmHg with 24-hour ABPM.

RESULTS:

Participants' mean age was 83.2 ± 3.1 years (64.4% women). Overall, 22.8% of patients had office hypotension, 33.7% daytime hypotension, 9.2% nighttime hypotension, and 20.5% 24-hour ABPM hypotension. Low diastolic BP values were responsible for 90% of cases of hypotension. In addition, 59.1% of the cases of hypotension detected by daytime ABPM did not correspond to hypotension according to office BP. The variables independently associated with office and ABPM hypotension were diabetes, coronary heart disease, and a higher number of antihypertensive medications.

CONCLUSIONS:

One in 3 very elderly treated hypertensive patients attended in usual clinical practice were potentially at risk of having hypotension according to daytime ABPM. More than half of them had masked hypotension; that is, they were not identified if relying on office BP alone. Thus, ABPM could be especially helpful for identifying ambulatory hypotension and avoiding overtreatment, in particular, in patients with diabetes, heart disease, or on antihypertensive polytherapy.

KEYWORDS:

Hypotension; ambulatory blood pressure monitoring; elderly; epidemiology; office blood pressure

 

Development and validation of multivariable models to predict mortality and hospitalization in patients with heart failure.

Voors AA, Ouwerkerk W, Zannad F, van Veldhuisen DJ, Samani NJ, Ponikowski P, Ng LL, Metra M, Ter Maaten JM, Lang CC, Hillege HL, van der Harst P, Filippatos G, Dickstein K, Cleland JG, Anker SD, Zwinderman AH.

Eur J Heart Fail. 2017 Mar 1. doi: 10.1002/ejhf.785. [Epub ahead of print]

PMID: 28247565

http://sci-hub.cc/10.1002/ejhf.785

Abstract

INTRODUCTION:

From a prospective multicentre multicountry clinical trial, we developed and validated risk models to predict prospective all-cause mortality and hospitalizations because of heart failure (HF) in patients with HF.

METHODS AND RESULTS:

BIOSTAT-CHF is a research programme designed to develop and externally validate risk models to predict all-cause mortality and HF hospitalizations. The index cohort consisted of 2516 patients with HF from 69 centres in 11 European countries. The external validation cohort consisted of 1738 comparable patients from six centres in Scotland, UK. Patients from the index cohort had a mean age of 69 years, 27% were female, 83% were in New York Heart Association (NYHA) class II-III and the mean left ventricular ejection fraction (LVEF) was 31%. The full prediction models for mortality, hospitalization owing to HF, and the combined outcome, yielded c-statistic values of 0.73, 0.69, and 0.71, respectively. Predictors of mortality and hospitalization owing to HF were remarkably different. The five strongest predictors of mortality were more advanced age, higher blood urea nitrogen and N-terminal pro-B-type natriuretic peptide, lower haemoglobin, and failure to prescribe a beta-blocker. The five strongest predictors of hospitalization owing to HF were more advanced age, previous hospitalization owing to HF, presence of oedema, lower systolic blood pressure and lower estimated glomerular filtration rate. Patients from the validation cohort were aged 74 years, 34% were female, 85% were in NYHA class II-III, and mean LVEF was 41%; c-statistic values for the full and compact model were comparable to the index cohort.

CONCLUSION:

A small number of variables, which are usually readily available in the routine clinical setting, provide useful prognostic information for patients with HF. Predictors of mortality were remarkably different from predictors of hospitalization owing to HF.

KEYWORDS:

Heart failure; Heart failure hospitalization; Mortality; Prediction model

 

Is tea consumption associated with the serum uric acid level, hyperuricemia or the risk of gout? A systematic review and meta-analysis.

Zhang Y, Cui Y, Li XA, Li LJ, Xie X, Huang YZ, Deng YH, Zeng C, Lei GH.

BMC Musculoskelet Disord. 2017 Feb 28;18(1):95. doi: 10.1186/s12891-017-1456-x.

PMID: 28245834

http://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-017-1456-x

http://download.springer.com/static/pdf/430/art%253A10.1186%252Fs12891-017-1456-x.pdf?originUrl=http%3A%2F%2Fbmcmusculoskeletdisord.biomedcentral.com%2Farticle%2F10.1186%2Fs12891-017-1456-x&token2=exp=1488491146~acl=%2Fstatic%2Fpdf%2F430%2Fart%25253A10.1186%25252Fs12891-017-1456-x.pdf*~hmac=8434803c6b18b2bb36efb1a53a0d57b6752100b59a65284fea08104f5539a7b5

Abstract

BACKGROUND:

The aim of this study was to examine the associations of tea consumption with the serum uric acid (SUA) level, hyperuricemia (HU) and the risk of gout.

METHODS:

A comprehensive literature search up to June 2016, using PUBMED and EMBASE databases, was conducted to identify the relevant observational studies that examined the associations of tea consumption with the SUA level, HU and the risk of gout.

RESULTS:

A total of fifteen observational studies were included in this study, and nine studies were extracted for meta-analysis. For the SUA level, seven studies were included. According to the combined weighted mean difference (WMD), there was no significant difference between the highest and the lowest tea intake category in terms of the SUA level (WMD = 7.41 μmol/L, 95%CI: -2.34 to 17.15; P = 0.136). In subgroup analysis including three studies, green tea consumption was positively associated with the SUA level (WMD = 17.20 μmol/L, 95%CI: 7.00 to 27.40; P = 0.01). For the prevalence of HU, five studies were included. The overall multi-variable adjusted odds ratio (OR) for the highest versus the lowest category of tea consumption was 0.98 (95%CI: 0.77 to 1.24; P = 0.839). For the risk of gout, two prospective cohort studies showed that there was no relationship between tea consumption and the risk of gout in males and females, respectively.

CONCLUSION:

The current evidences suggest that tea consumption does not seem to be associated with the SUA level, HU and the risk of gout. However, due to the limited number of studies, green tea consumption might be positively associated with the SUA level. More well-designed prospective cohort studies are needed to elaborate these issues further.

KEYWORDS:

Gout; Hyperuricemia; Meta-analysis; Serum uric acid; Systematic review; Tea

 

Three-Year Changes in Physical Activity and Decline in Physical Performance Over 9 Years of Follow-Up in Older Adults: The Invecchiare in Chianti Study.

Martinez-Gomez D, Bandinelli S, Del-Panta V, Patel KV, Guralnik JM, Ferrucci L.

J Am Geriatr Soc. 2017 Mar 1. doi: 10.1111/jgs.14788. [Epub ahead of print]

PMID: 28248412

http://sci-hub.cc/doi/10.1111/jgs.14788

Abstract

OBJECTIVES:

To examine the associations between cumulative physical activity (PA) and its changes over 3 years and changes over 9 years of follow-up in physical performance in older adults.

DESIGN:

Longitudinal.

SETTING:

Community-based.

PARTICIPANTS:

Men and women aged 65 and older from the Invecchiare in Chianti study (N = 782).

MEASUREMENTS:

Physical performance was assessed at baseline and at 3-, 6-, and 9-year follow-up using the Short Physical Performance Battery (SPPB). PA was assessed through an interviewer-administered questionnaire at baseline and 3-year follow-up. Analyses were adjusted for education, body mass index, smoking, alcohol intake, coronary heart disease, stroke, peripheral arterial disease, cancer, lung disease, lower extremity osteoarthritis, depression, and Mini-Mental State Examination.

RESULTS:

Over 3 years of follow-up, 27.8% of participants were inactive, 52.2% were minimally active, and 20.0% were active, and the PA of 37.2% decreased, there was no change in PA of 50.1% and the PA of 12.7% increased. After adjustment for potential covariates, being mostly active (-1.08, 95% confidence interval (CI) = -1.43 to -0.73) and minimally active (-1.33, 95% CI = -1.53 to -1.12) over 3 years of follow-up was associated with less decline in SPPB score than being mostly inactive (-2.60, 95% CI = -2.92 to -2.27). When analyzing changes, increasing PA (-0.57, 95% CI = -1.01 to -0.12) was associated with less decline in SPPB score over 9 years than decreasing PA (-2.16, 95% CI = -2.42 to -1.89).

CONCLUSION:

Maintaining or increasing PA levels may attenuate age-associated physical performance decline.

KEYWORDS:

aging; physical activity; physical performance

 

The prospective impact of food pricing on improving dietary consumption: A systematic review and meta-analysis.

Afshin A, Peñalvo JL, Del Gobbo L, Silva J, Michaelson M, O'Flaherty M, Capewell S, Spiegelman D, Danaei G, Mozaffarian D.

PLoS One. 2017 Mar 1;12(3):e0172277. doi: 10.1371/journal.pone.0172277.

PMID: 28249003

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0172277

http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0172277&type=printable

Abstract

BACKGROUND:

While food pricing is a promising strategy to improve diet, the prospective impact of food pricing on diet has not been systematically quantified.

OBJECTIVE:

To quantify the prospective effect of changes in food prices on dietary consumption.

DESIGN:

We systematically searched online databases for interventional or prospective observational studies of price change and diet; we also searched for studies evaluating adiposity as a secondary outcome. Studies were excluded if price data were collected before 1990. Data were extracted independently and in duplicate. Findings were pooled using DerSimonian-Laird's random effects model. Pre-specified sources of heterogeneity were analyzed using meta-regression; and potential for publication bias, by funnel plots, Begg's and Egger's tests.

RESULTS:

From 3,163 identified abstracts, 23 interventional studies and 7 prospective cohorts with 37 intervention arms met inclusion criteria. In pooled analyses, a 10% decrease in price (i.e., subsidy) increased consumption of healthful foods by 12% (95%CI = 10-15%; N = 22 studies/intervention arms) whereas a 10% increase price (i.e. tax) decreased consumption of unhealthful foods by 6% (95%CI = 4-8%; N = 15). By food group, subsidies increased intake of fruits and vegetables by 14% (95%CI = 11-17%; N = 9); and other healthful foods, by 16% (95%CI = 10-23%; N = 10); without significant effects on more healthful beverages (-3%; 95%CI = -16-11%; N = 3). Each 10% price increase reduced sugar-sweetened beverage intake by 7% (95%CI = 3-10%; N = 5); fast foods, by 3% (95%CI = 1-5%; N = 3); and other unhealthful foods, by 9% (95%CI = 6-12%; N = 3). Changes in price of fruits and vegetables reduced body mass index (-0.04 kg/m2 per 10% price decrease, 95%CI = -0.08-0 kg/m2; N = 4); price changes for sugar-sweetened beverages or fast foods did not significantly alter body mass index, based on 4 studies. Meta-regression identified direction of price change (tax vs. subsidy), number of intervention components, intervention duration, and study quality score as significant sources of heterogeneity (P-heterogeneity<0.05 each). Evidence for publication bias was not observed.

CONCLUSIONS:

These prospective results, largely from interventional studies, support efficacy of subsidies to increase consumption of healthful foods; and taxation to reduce intake of unhealthful beverages and foods. Use of subsidies and combined multicomponent interventions appear most effective.

 

Meal frequency patterns and glycemic properties of maternal diet in relation to preterm delivery: Results from a large prospective cohort study.

Englund-Ögge L, Birgisdottir BE, Sengpiel V, Brantsæter AL, Haugen M, Myhre R, Meltzer HM, Jacobsson B.

PLoS One. 2017 Mar 1;12(3):e0172896. doi: 10.1371/journal.pone.0172896.

PMID: 28249018

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0172896

http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0172896&type=printable

Abstract

BACKGROUND:

Dietary habits are linked to high maternal glucose levels, associated with preterm delivery. The aim of this study was to examine the associations between meal frequency and glycemic properties of maternal diet in relation to preterm delivery.

METHODS:

This prospective cohort study included 66,000 women from the Norwegian Mother and Child Cohort Study (MoBa). Meal frequency and food intake data were obtained from a validated food frequency questionnaire during mid-pregnancy. Principal component factor analysis was used with a data-driven approach, and three meal frequency patterns were identified: "snack meal", "main meal", and "evening meal". Pattern scores were ranked in quartiles. Glycemic index and glycemic load were estimated from table values. Intakes of carbohydrates, added sugar, and fiber were reported in grams per day and divided into quartiles. Gestational age was obtained from the Medical Birth Registry of Norway. Preterm delivery was defined as birth at <37 gestational weeks. A Cox regression model was used to assess associations with preterm delivery.

RESULTS:

After adjustments, the "main meal" pattern was associated with a reduced risk of preterm delivery, with hazard ratios (HRs) of 0.89 (95% confidence interval (CI): 0.80, 0.98) and 0.90 (95% CI: 0.81, 0.99) for the third and fourth quartiles, respectively, and p for trend of 0.028. This was mainly attributed to the group of women with BMI ≥25 kg/m2, with HRs of 0.87 (95% CI: 0.79, 0.96) and 0.89 (95% CI: 0.80, 0.98) for the third and fourth quartiles, respectively, and p for trend of 0.010. There was no association between glycemic index, glycemic load, carbohydrates, added sugar, fiber, or the remaining meal frequency patterns and preterm delivery.

CONCLUSION:

Regular consumption of main meals (breakfast, lunch, dinner) was associated with a lower risk of preterm delivery. Diet should be further studied as potential contributing factors for preterm delivery.

 

Exome-wide Association Study Identifies CLEC3B Missense Variant p.S106G as Being Associated With Extreme Longevity in East Asian Populations.

Tanisawa K, Arai Y, Hirose N, Shimokata H, Yamada Y, Kawai H, Kojima M, Obuchi S, Hirano H, Yoshida H, Suzuki H, Fujiwara Y, Ihara K, Sugaya M, Arai T, Mori S, Sawabe M, Sato N, Muramatsu M, Higuchi M, Liu YW, Kong QP, Tanaka M.

J Gerontol A Biol Sci Med Sci. 2016 May 6. pii: glw074. [Epub ahead of print]

PMID: 27154906

https://academic.oup.com/biomedgerontology/article-lookup/doi/10.1093/gerona/glw074

https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/biomedgerontology/72/3/10.1093_gerona_glw074/3/glw074.pdf?Expires=1488837701&Signature=dAfBpuz4a98eDCPOty49ZQNv2r3ScxIHsMi33JYgKVTisaF1aoRrWfyG~hGZP4DY0bZGhRTYJ3edmoNQUN5TdPGjdRb5gGHnUtqXoQXyvMUC3SN7r4yC10Zh0IKmyZGriIAS4x2en62hOF9jeErHeTlsYDkB87L3x8OdtrzUP79q4MANrwK92-IvUA9g3exvwWr-OGDfQDjO7-Bw3QQg1VkN96x-DHhfBJPB9qHDk-4cD4Cjp7HW31zfk2tyMwRny5DDH7TLJ0yK3AjmtLa9xHm94Q3xNq-5pBW7FuvuRP~Y0JIyrFypRAxBcRSJ7IkdVLM8JOhXy2peAYIjeX9C8g__&Key-Pair-Id=APKAIUCZBIA4LVPAVW3Q

Abstract

Life span is a complex trait regulated by multiple genetic and environmental factors; however, the genetic determinants of extreme longevity have been largely unknown. To identify the functional coding variants associated with extreme longevity, we performed an exome-wide association study (EWAS) on a Japanese population by using an Illumina HumanExome Beadchip and a focused replication study on a Chinese population. The EWAS on two independent Japanese cohorts consisting of 530 nonagenarians/centenarians demonstrated that the G allele of CLEC3B missense variant p.S106G was associated with extreme longevity at the exome-wide level of significance (p = 2.33×10-7, odds ratio [OR] = 1.50). The CLEC3B gene encodes tetranectin, a protein implicated in the mineralization process in osteogenesis as well as in the prognosis and metastasis of cancer. The replication study consisting of 448 Chinese nonagenarians/centenarians showed that the G allele of CLEC3B p.S106G was also associated with extreme longevity (p = .027, OR = 1.51), and the p value of this variant reached 1.87×10-8 in the meta-analysis of Japanese and Chinese populations. In conclusion, the present study identified the CLEC3B p.S106G as a novel longevity-associated variant, raising the novel hypothesis that tetranectin, encoded by CLEC3B, plays a role in human longevity and aging.

KEYWORDS:

Centenarian; Human aging; Human genetics; Longevity

 

Enhanced Cognition and Hypoglutamatergic Signaling in a Growth Hormone Receptor Knockout Mouse Model of Successful Aging.

Hascup KN, Lynn MK, Fitzgerald PJ, Randall S, Kopchick JJ, Boger HA, Bartke A, Hascup ER.

J Gerontol A Biol Sci Med Sci. 2016 May 21. pii: glw088. [Epub ahead of print]

PMID: 27208894

http://sci-hub.cc/10.1093/gerona/glw088

Abstract

Growth hormone receptor knockout (GHR-KO) mice are long lived with improved health span, making this an excellent model system for understanding biochemical mechanisms important to cognitive reserve. The purpose of the present study was to elucidate differences in cognition and glutamatergic dynamics between aged (20- to 24-month-old) GHR-KO and littermate controls. Glutamate plays a critical role in hippocampal learning and memory and is implicated in several neurodegenerative disorders, including Alzheimer's disease. Spatial learning and memory were assessed using the Morris water maze (MWM), whereas independent dentate gyrus (DG), CA3, and CA1 basal glutamate, release, and uptake measurements were conducted in isoflurane anesthetized mice utilizing an enzyme-based microelectrode array (MEA) coupled with constant potential amperometry. These MEAs have high temporal and low spatial resolution while causing minimal damage to the surrounding parenchyma. Littermate controls performed worse on the memory portion of the MWM behavioral task and had elevated DG, CA3, and CA1 basal glutamate and stimulus-evoked release compared with age-matched GHR-KO mice. CA3 basal glutamate negatively correlated with MWM performance. These results support glutamatergic regulation in learning and memory and may have implications for therapeutic targets to delay the onset of, or reduce cognitive decline, in Alzheimer's disease.

KEYWORDS:

Alzheimer’s disease; Biosensor; Electrode; Health span; Longevity

 

Biological Aging and the Future of Geriatric Psychiatry.

Rutherford BR, Taylor WD, Brown PJ, Sneed JR, Roose SP.

J Gerontol A Biol Sci Med Sci. 2016 Dec 18. pii: glw241. doi: 10.1093/gerona/glw241. [Epub ahead of print] Review.

PMID: 27994004

https://academic.oup.com/biomedgerontology/article/72/3/343/2706337/Biological-Aging-and-the-Future-of-Geriatric

https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/biomedgerontology/72/3/10.1093_gerona_glw241/4/glw241.pdf?Expires=1488819907&Signature=dAJxwPv1IF7OCShZTjU3UUNJt5Jb9NLomkQJ0g~oJ4CNNDKjn231R6~zzU6h7Y44dPAxSVR9AuT0Hy7K5oQuJXWviUKOXUbt22P27sKJiQYQ8VzNWSxUpUcQZtucLk63~Y4~qrMdWUo10KDBgT5Amf67QQHahqe9LCH19OvWQRJ37oCMbo6sqPJso2tSq2kRXCfFeCTRkH~aCb~fZZvCuZPwfherPfyg3OebAXUNxH4RaZRQ4L2xHCUjfwl04~aHSuNxldZSXmG8wff~iqOxP6eEplCmK~c~XkNpa0cgpJ8rk3g1UxOOU09MMDpZNj5kyuuqiSr37I4GllFRoP66jA__&Key-Pair-Id=APKAIUCZBIA4LVPAVW3Q

Abstract

Advances in understanding the biological bases of aging have intellectually revitalized the field of geriatric psychiatry and broadened its scope to include promoting successful aging and studying resilience factors in older adults. To describe the process by which this paradigm shift has occurred and illustrate its implications for treatment and research of late-life brain disorders, late-life depression is discussed as a prototype case. Prior phases of geriatric psychiatry research were focused on achieving depressive symptom relief, outlining pharmacokinetic and pharmacodynamic differences between older and younger adults, and identifying moderators of treatment response. Building on this work, current geriatric psychiatry researchers have begun to disentangle the etiologic complexity in late-life depression by focusing on the causative aging-related processes involved, identifying both neurobiological and behavioral intermediates, and finally delineating depression subtypes that are distinguishable by their underlying biology and the treatment approach required. In this review, we discuss several age-related processes that are critical to the development of late-life mood disorders, outline implications of these processes for the clinical evaluation and management of later-life psychiatric disorders, and finally put forth suggestions for better integrating aging and developmental processes into the National Institute of Mental Health's Research Domain Criteria.

KEYWORDS:

Brain aging; Depression; Frailty; Successful aging

 

A Comparison of Objective Physical Performance Tests and Future Mortality in the Elderly People.

Veronese N, Stubbs B, Fontana L, Trevisan C, Bolzetta F, Rui M, Sartori L, Musacchio E, Zambon S, Maggi S, Perissinotto E, Corti MC, Crepaldi G, Manzato E, Sergi G.

J Gerontol A Biol Sci Med Sci. 2016 Jul 28. pii: glw139. [Epub ahead of print]

PMID: 27470299

http://sci-hub.cc/10.1093/gerona/glw139

Abstract

BACKGROUND:

Physical performance is an important predictor of mortality, but little is known on the comparative prognostic utility of different objective physical performance tests in community-dwelling older adults. We compared the prognostic usefulness of several objective physical performance tests on mortality, adjusting our analyses for potential confounders.

METHODS:

Among 3,099 older community-dwelling participants included in the Progetto Veneto Anziani study, 2,096 were followed for a mean of 4.4 years. Physical performance tests measured were Short Physical Performance Battery (SPPB), 4-meter gait speed, chair stands time, leg extension and flexion, handgrip strength, and 6-Minute Walking Test (6MWT), treated as continuous variables and categorized in gender-specific quartiles. The main outcome was mortality assessed with death certificates.

RESULTS:

Participants who died during the follow-up (n = 327) scored significantly worse in all physical performance tests measured at baseline than those who survived (n = 1,769). Using a Harrell's C-index, the highest C-index was observed for 6MWT in men (C-index = 0.735; 95% confidence interval [CI]: 0.701-0.770, p < .0001) and SPPB in women (C-index = 0.781; 95% CI: 0.740-0.822, p = .0009). However, in both genders, only SPPB, 4-meter walking speed, and 6MWT are significant predictors of mortality. Analyses using sex-specific quartiles substantially confirmed these findings.

CONCLUSIONS:

Slow gait speed, 6MWT, and SPPB are significant predictors for mortality in community-dwelling older men and women. Physicians should consider using these tests to identify elderly individuals who are at higher risk of death to improve clinical decision making.

KEYWORDS:

Mortality; Physical activity; Physical performance

 

Physical Frailty, Cognitive Impairment, and the Risk of Neurocognitive Disorder in the Singapore Longitudinal Ageing Studies.

Feng L, Nyunt MS, Gao Q, Feng L, Lee TS, Tsoi T, Chong MS, Lim WS, Collinson S, Yap P, Yap KB, Ng TP.

J Gerontol A Biol Sci Med Sci. 2016 Mar 24. pii: glw050. [Epub ahead of print]

PMID: 27013397

http://sci-hub.cc/10.1093/gerona/glw050

Abstract

BACKGROUND:

The independent and combined effects of physical and cognitive domains of frailty in predicting the development of mild cognitive impairment (MCI) or dementia are not firmly established.

METHODS:

This study included cross-sectional and longitudinal analyses of physical frailty (Cardiovascular Health Study criteria), cognitive impairment (Mini-Mental State Examination [MMSE]), and neurocognitive disorder (DSM-5 criteria) among 1,575 community-living Chinese older adults from the Singapore Longitudinal Ageing Studies.

RESULTS:

At baseline, 2% were frail, 32% were prefrail, and 9% had cognitive impairment (MMSE score < 23). Frailty at baseline was significantly associated with prevalent cognitive impairment. Physical frailty categories were not significantly associated with incident NCD, but continuous physical frailty score and MMSE score showed significant individual and joint associations with incident mild NCD and dementia. Compared with those who were robust and cognitively normal, prefrail or frail old adults without cognitive impairment had no increased risk of incident NCD, but elevated odds of association with incident NCD were observed for robust with cognitive impairment (odds ratio [OR] = 4.04, p < .001), prefrail with cognitive impairment (OR = 2.22, p = .044), and especially for frail with cognitive impairment (OR = 6.37, p = .005). The prevalence of co-existing frailty and cognitive impairment (cognitive frailty) was 1% (95% confidence interval [CI]: 0.5-1.4), but was higher among participants aged 75 and older at 5.0% (95% CI: 1.8-8.1).

CONCLUSIONS:

Physical frailty is associated with increased prevalence and incidence of cognitive impairment, and co-existing physical frailty and cognitive impairment confers additionally greater risk of incident NCD.

KEYWORDS:

Cognitive impairment; Frailty; Neurocognitive disorders

 

Reference Ranges for Thyroid-Stimulating Hormone and Free Thyroxine in Older Men: Results From the Health In Men Study.

Yeap BB, Manning L, Chubb SA, Hankey GJ, Golledge J, Almeida OP, Flicker L.

J Gerontol A Biol Sci Med Sci. 2016 Jul 20. pii: glw132. [Epub ahead of print]

PMID: 27440910

http://sci-hub.cc/10.1093/gerona/glw132

Abstract

BACKGROUND:

In older adults, thyroid-stimulating hormone (TSH) concentrations are raised and higher free thyroxine (FT4) is associated with poorer health outcomes. As use of nonage-appropriate reference ranges could lead to suboptimal management, we aimed to define reference intervals for TSH and FT4 in older men.

METHODS:

We conducted the study on community-dwelling men aged 70-89 years. Baseline TSH and FT4 levels were assayed (Elecsys 2010, Roche Diagnostics). Conventional reference intervals for TSH and FT4 were 0.4-4.0 mIU/L and 10-23 pmol/L, respectively. Incident deaths were ascertained using data linkage.

RESULTS:

Of the 3,885 men included in the analysis, the 2.5th and 97.5th centiles for TSH and FT4 were 0.64-5.9 mIU/L and 12.1-20.6 pmol/L (0.94-1.60ng/dL), respectively. Of the 411 very healthy men defined by excellent or very good self-rated health and absence of major medical comorbidities, 2.5th to 97.5th centiles for TSH and FT4 were 0.67-4.98 mIU/L and 12.1-20.5 pmol/L (0.94-1.59ng/dL), respectively. TSH was not associated with mortality, whereas higher FT4 was associated with increased mortality. Applying intervals based on very healthy older men to the cohort as a whole led to the reclassification of 310 men (8.0%). More men were classified as being hyperthyroid or hypothyroid, or having subclinical hyperthyroidism, and fewer as having subclinical hypothyroidism.

CONCLUSIONS:

In older men, the reference interval for TSH in older men is shifted upward, whereas the reference interval for FT4 is compressed compared with the conventional reference ranges. Applying reference intervals based on healthy older men identifies a substantial number of older men as having overt thyroid disease or subclinical hyperthyroidism and reduces the number classified as having subclinical hypothyroidism.

© The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

KEYWORDS:

Free thyroxine; Mortality; Thyroid-stimulating hormone

 

Development and Validation of a 10-Year Mortality Prediction Model: Meta-Analysis of Individual Participant Data From Five Cohorts of Older Adults in Developed and Developing Countries.

Suemoto CK, Ueda P, Beltrán-Sánchez H, Lebrão ML, Duarte YA, Wong R, Danaei G.

J Gerontol A Biol Sci Med Sci. 2016 Aug 13. pii: glw166. [Epub ahead of print]

PMID: 27522061

http://sci-hub.cc/10.1093/gerona/glw166

Abstract

BACKGROUND:

Existing mortality prediction models for older adults have been each developed using a single study from the United States or Western Europe. We aimed to develop and validate a 10-year mortality prediction model for older adults using data from developed and developing countries.

METHODS:

We used data from five cohorts, including data from 16 developed and developing countries: ELSA (English Longitudinal Study of Aging), HRS (Health and Retirement Study), MHAS (Mexican Health and Aging Study), SABE-Sao Paulo (The Health, Well-being and Aging), and SHARE (Survey on Health, Ageing and Retirement in Europe). 35,367 older adults were split into training (two thirds) and test (one third) data sets. Baseline predictors included age, sex, comorbidities, and functional and cognitive measures. We performed an individual participant data meta-analysis using a sex-stratified Cox proportional hazards model, with time to death as the time scale. We validated the model using Harrell's C statistic (discrimination) and the estimated slope between observed and predicted 10-year mortality risk across deciles of risk (calibration).

RESULTS:

During a median of 8.6 years, 8,325 participants died. The final model included age, sex, diabetes, heart disease, lung disease, cancer, smoking, alcohol use, body mass index, physical activity, self-reported health, difficulty with bathing, walking several blocks, and reporting date correctly. The model showed good discrimination (Harrell's C = 0.76) and calibration (slope = 1.005). Models for developed versus developing country cohorts performed equally well when applied to data from developing countries.

CONCLUSION:

A parsimonious mortality prediction model using data from multiple cohorts in developed and developing countries can be used to predict mortality in older adults in both settings.

KEYWORDS:

Mortality; Older adults; Prediction models; Prevention

 

The association of change in physical activity and body weight in the regulation of total energy expenditure.

Drenowatz C, Hill JO, Peters JC, Soriano-Maldonado A, Blair SN.

Eur J Clin Nutr. 2016 Dec 14. doi: 10.1038/ejcn.2016.228. [Epub ahead of print]

PMID: 27966573

http://sci-hub.cc/10.1038/ejcn.2016.228

Abstract

BACKGROUND/OBJECTIVES:

The limited success in addressing the current obesity epidemic reflects the insufficient understanding of the regulation of energy balance. The present study examines the longitudinal association of body weight with physical activity (PA), total daily energy expenditure (TDEE) and total daily energy intake (TDEI).

SUBJECTS/METHODS:

A total of 195 adults (52% male) between 21 and 35 years of age with no intention for weight loss were followed over a 2-year period. Body weight, fat mass and fat-free mass were measured every 3 months. Participants were stratified into three groups based on change in body weight using a 5% cutpoint. TDEE and time spent in different PA intensities were determined via a multisensor device at each measurement time. TDEI was calculated based on change in body composition and TDEE.

RESULTS:

At 2-year follow-up, 57% of the participants maintained weight, 14% lost weight and 29% gained weight. Average weight change was -6.9±3.4 and 7.1±3.6 kg in the weight-loss and weight-gain groups, respectively. Average TDEE and TDEI did not change significantly in any weight change group (P>0.16). Moderate-to-vigorous PA, however, increased significantly in the weight-loss group (35±49 min/day; P<0.01) and decreased in the weight-gain group (-35±46 min/day; P<0.01).

CONCLUSIONS:

Results of this observational study indicate an inverse association between body weight and PA to maintain a stable TDEE and allow for a stable TDEI over time. Sufficient PA levels, therefore, are an important contributor to weight loss maintenance.

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Do symbiotic and Vitamin E supplementation have favorite effects in nonalcoholic fatty liver disease? A randomized, double-blind, placebo-controlled trial.

Ekhlasi G, Kolahdouz Mohammadi R, Agah S, Zarrati M, Hosseini AF, Arabshahi SS, Shidfar F.

J Res Med Sci. 2016 Nov 2;21:106. doi: 10.4103/1735-1995.193178.

PMID: 28250783

http://jrms.mui.ac.ir/files/journals/1/articles/10516/public/10516-39461-1-PB.pdf

Abstract

BACKGROUND:

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the world. Oral administration of symbiotic and Vitamin E has been proposed as an effective treatment in NAFLD patients. This study was carried out to assess the effects of symbiotic and/or Vitamin E supplementation on liver enzymes, leptin, lipid profile, and some parameters of insulin resistance (IR) in NAFLD patients.

MATERIALS AND METHODS:

We randomly assigned sixty NAFLD adult patients to receive (1) symbiotic twice daily + Vitamin E-like placebo capsule; (2) 400 IU/d Vitamin E + symbiotic-like placebo; (3) symbiotic twice daily + 400 IU/d Vitamin E; and (4) symbiotic-like placebo + Vitamin E-like placebo for 8 weeks.

RESULTS:

Symbiotic plus Vitamin E supplementation led to a significant decrease in concentrations of liver transaminase (P ≤ 0.05). Mean difference of apolipoprotein A-1 was more significant in symbiotic group compared to control. However, mean difference of apolipoprotein B100/A-1 was only significant in symbiotic group compared to control. At the end of the study, significant differences in total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) were seen between the symbiotic plus Vitamin E and control groups (P < 0.001). Furthermore, intake of symbiotic plus Vitamin E supplements led to a significant decrease in concentrations of triglycerides (TG) after the intervention. Significant differences in leptin, fasting blood sugar (FBS), and insulin levels were seen between the symbiotic plus Vitamin E and control groups at the end of the study (P < 0.001). In contrast, symbiotic and/or Vitamin E supplementation did not affect high-density lipoprotein cholesterol and homeostasis model assessment for IR levels.

CONCLUSION:

In our study, symbiotic plus Vitamin E supplementation was the most effective treatment in lowering liver enzymes, leptin, FBS, insulin, TG, TC, and LDL-C among NAFLD patients.

KEYWORDS:

Leptin; Vitamin E; lipid profile; nonalcoholic fatty liver disease; symbiotic

 

Nutrition and physical activity in the prevention and treatment of sarcopenia: systematic review.

Beaudart C, Dawson A, Shaw SC, Harvey NC, Kanis JA, Binkley N, Reginster JY, Chapurlat R, Chan DC, Bruyère O, Rizzoli R, Cooper C, Dennison EM; IOF-ESCEO Sarcopenia Working Group..

Osteoporos Int. 2017 Mar 1. doi: 10.1007/s00198-017-3980-9. [Epub ahead of print] Review.

PMID: 28251287

https://www.cambridge.org/core/journals/proceedings-of-the-nutrition-society/article/div-classtitlenutrition-and-physical-activity-for-the-prevention-and-treatment-of-age-related-sarcopeniadiv/B1952D7B7DB6DC23122A9554E96172F6/core-reader

https://www.cambridge.org/core/services/aop-cambridge-core/content/view/B1952D7B7DB6DC23122A9554E96172F6/S002966511500422Xa.pdf/div-class-title-nutrition-and-physical-activity-for-the-prevention-and-treatment-of-age-related-sarcopenia-div.pdf

Abstract

This systematic review summarizes the effect of combined exercise and nutrition intervention on muscle mass and muscle function. A total of 37 RCTs were identified. Results indicate that physical exercise has a positive impact on muscle mass and muscle function in subjects aged 65 years and older. However, any interactive effect of dietary supplementation appears to be limited.

INTRODUCTION:

In 2013, Denison et al. conducted a systematic review including 17 randomized controlled trials (RCTs) to explore the effect of combined exercise and nutrition intervention to improve muscle mass, muscle strength, or physical performance in older people. They concluded that further studies were needed to provide evidence upon which public health and clinical recommendations could be based. The purpose of the present work was to update the prior systematic review and include studies published up to October 2015.

METHODS:

Using the electronic databases MEDLINE and EMBASE, we identified RCTs which assessed the combined effect of exercise training and nutritional supplementation on muscle strength, muscle mass, or physical performance in subjects aged 60 years and over. Study selection and data extraction were performed by two independent reviewers.

RESULTS:

The search strategy identified 21 additional RCTs giving a total of 37 RCTs. Studies were heterogeneous in terms of protocols for physical exercise and dietary supplementation (proteins, essential amino acids, creatine, β-hydroxy-β-methylbuthyrate, vitamin D, multi-nutrients, or other). In 79% of the studies (27/34 RCTs), muscle mass increased with exercise but an additional effect of nutrition was only found in 8 RCTs (23.5%). Muscle strength increased in 82.8% of the studies (29/35 RCTs) following exercise intervention, and dietary supplementation showed additional benefits in only a small number of studies (8/35 RCTS, 22.8%). Finally, the majority of studies showed an increase of physical performance following exercise intervention (26/28 RCTs, 92.8%) but interaction with nutrition supplementation was only found in 14.3% of these studies (4/28 RCTs).

CONCLUSION:

Physical exercise has a positive impact on muscle mass and muscle function in healthy subjects aged 60 years and older. The biggest effect of exercise intervention, of any type, has been seen on physical performance (gait speed, chair rising test, balance, SPPB test, etc.). We observed huge variations in regard to the dietary supplementation protocols. Based on the included studies, mainly performed on well-nourished subjects, the interactive effect of dietary supplementation on muscle function appears limited.

KEYWORDS:

Dietary; Intervention; Physical activity; Sarcopenia

 

[The below paper is pdf-availed.]

Effects of feedback-based balance and core resistance training vs. Pilates training on cognitive functions in older women with mild cognitive impairment: a pilot randomized controlled trial.

Greblo Jurakic Z, Krizanic V, Sarabon N, Markovic G.

Aging Clin Exp Res. 2017 Mar 1. doi: 10.1007/s40520-017-0740-9. [Epub ahead of print]

PMID: 28251569

Abstract

BACKGROUND:

There is limited research about beneficial effects of physical activity in older adults suffering from mild cognitive impairment (MCI).

AIM:

The aim of the study was to provide preliminary evidence on the effects of two types of non-aerobic training on cognitive functions in older women suffering from MCI.

METHODS:

Twenty-eight participants aged 66-78 years with MCI were randomly assigned to a combined balance and core resistance training group (n = 14) or to a Pilates group (n = 14).

RESULTS:

Following completion of the 8-week exercise programme, both groups showed significant improvements in global and specific cognitive domains.

CONCLUSION:

Findings suggest that non-aerobic training should be further explored as a beneficial intervention for older adults suffering from MCI.

KEYWORDS:

Cognitive functions; Exercise; Mild cognitive impairment; Physical activity

 

[The below paper is pdf-availed.]

Dietary Supplementation With Nonfermentable Fiber Alters the Gut Microbiota and Confers Protection in Murine Models of Sepsis.

Morowitz MJ, Di Caro V, Pang D, Cummings J, Firek B, Rogers MB, Ranganathan S, Clark RS, Aneja RK.

Crit Care Med. 2017 Mar 1. doi: 10.1097/CCM.0000000000002291. [Epub ahead of print]

PMID: 28252538

Abstract

OBJECTIVES:

Links between microbial alterations and systemic inflammation have been demonstrated in chronic disease, but little is known about these interactions during acute inflammation. This study investigates the effect of dietary supplementation with cellulose, a nonfermentable fiber, on the gut microbiota, inflammatory markers, and survival in two murine models of sepsis.

DESIGN:

Prospective experimental study.

SETTING:

University laboratory.

SUBJECTS:

Six-week-old male C57BL/6 wild-type mice.

INTERVENTIONS:

Mice were assigned to low-fiber, normal-fiber, or high-fiber diets with or without antibiotics for 2 weeks and then subjected to sepsis by cecal ligation and puncture or endotoxin injection. Fecal samples were collected for microbiota analyses before and after dietary interventions.

MEASUREMENTS AND MAIN RESULTS:

Mice that received a high-fiber diet demonstrated increased survival after cecal ligation and puncture relative to mice receiving low-fiber or normal-fiber diets. The survival benefit was associated with decreased serum concentration of pro-inflammatory cytokines, reduced neutrophil infiltration in the lungs, and diminished hepatic inflammation. The high-fiber diet also increased survival after endotoxin injection. Bacterial 16S ribosomal RNA gene sequences from each sample were amplified, sequenced, and analyzed. Fiber supplementation yielded an increase in relative abundance of the genera Akkermansia and Lachnospiraceae, taxa commonly associated with metabolic health. Administration of antibiotics to mice on the high-fiber diet negated the enrichment of Akkermansia species and the survival benefit after cecal ligation and puncture.

CONCLUSION:

Dietary supplementation with cellulose offers a microbe-mediated survival advantage in murine models of sepsis. Improved understanding of the link between diet, the microbiota, and systemic illness may yield new therapeutic strategies for patients with sepsis.

 

Urinary metabolomics reveals glycemic and coffee associated signatures of thyroid function in two population-based cohorts.

Friedrich N, Pietzner M, Cannet C, Thuesen BH, Hansen T, Wallaschofski H, Grarup N, Skaaby T, Budde K, Pedersen O, Nauck M, Linneberg A.

PLoS One. 2017 Mar 2;12(3):e0173078. doi: 10.1371/journal.pone.0173078.

PMID: 28253303

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0173078

http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0173078&type=printable

Abstract

BACKGROUND:

Triiodothyronine (T3) and thyroxine (T4) as the main secretion products of the thyroid affect nearly every human tissue and are involved in a broad range of processes ranging from energy expenditure and lipid metabolism to glucose homeostasis. Metabolomics studies outside the focus of clinical manifest thyroid diseases are rare. The aim of the present investigation was to analyze the cross-sectional and longitudinal associations of urinary metabolites with serum free T4 (FT4) and thyroid-stimulating hormone (TSH).

METHODS:

Urine Metabolites of participants of the population-based studies Inter99 (n = 5620) and Health2006/Health2008 (n = 3788) were analyzed by 1H-NMR spectroscopy. Linear or mixed linear models were used to detect associations between urine metabolites and thyroid function.

RESULTS:

Cross-sectional analyses revealed positive relations of alanine, trigonelline and lactic acid with FT4 and negative relations of dimethylamine, glucose, glycine and lactic acid with log(TSH). In longitudinal analyses, lower levels of alanine, dimethylamine, glycine, lactic acid and N,N-dimethylglycine were linked to a higher decline in FT4 levels over time, whereas higher trigonelline levels were related to a higher FT4 decline. Moreover, the risk of hypothyroidism was higher in subjects with high baseline trigonelline or low lactic acid, alanine or glycine values.

CONCLUSION:

The detected associations mainly emphasize the important role of thyroid hormones in glucose homeostasis. In addition, the predictive character of these metabolites might argue for a potential feedback of the metabolic state on thyroid function. Besides known metabolic consequences of TH, the link to the urine excretion of trigonelline, a marker of coffee consumption, represents a novel finding of this study and given the ubiquitous consumption of coffee requires further research.

 

Can pulses play a role in improving cardiometabolic health? Evidence from systematic reviews and meta-analyses.

Viguiliouk E, Blanco Mejia S, Kendall CW, Sievenpiper JL.

Ann N Y Acad Sci. 2017 Mar 2. doi: 10.1111/nyas.13312. [Epub ahead of print]

PMID: 28253436

http://onlinelibrary.wiley.com/doi/10.1111/nyas.13312/full

http://onlinelibrary.wiley.com/doi/10.1111/nyas.13312/epdf

Abstract

Obesity, diabetes, and cardiovascular disease (CVD) present important unmet prevention and treatment challenges. Dietary pulses are sustainable, affordable, and nutrient-dense foods that have shown a wide range of health benefits in the prevention and management of these conditions. Despite these findings, recommendations for pulse intake continue to vary across chronic disease guidelines, and intake levels continue to remain low. Here, we summarize findings from recent systematic reviews and meta-analyses assessing the relationship between dietary pulse consumption and cardiometabolic health and assess the overall strength of the evidence using the Grading of Recommendations, Assessment, Development, and Evaluation tool. We conclude that systematic reviews and meta-analyses of prospective cohort studies assessing the relationship between legumes and the risk of coronary heart disease appear to provide moderate-quality evidence of a benefit, and several systematic reviews and meta-analyses of randomized controlled trials assessing the effect of pulses on cardiometabolic risk factors provide low- to moderate-quality evidence of a benefit. There remains an urgent need, however, for more high-quality prospective cohort studies and large, high-quality, randomized trials to clarify the benefits of dietary pulses in the prevention and management of overweight/obesity, diabetes, and CVD.

KEYWORDS:

GRADE; cardiometabolic health; dietary pulses; review

 

Understanding the mechanisms underlying the neuroprotective role of calorie restriction in Parkinson’s Disease

Jacqueline Alyce Bayliss

PhD thesis for Monash University, 2016

pdf availed from: https://figshare.com/articles/Understanding_the_mechanisms_underlying_the_neuroprotective_role_of_calorie_restriction_in_Parkinson_s_Disease/4719760

Abstract

Parkinson’s Disease (PD) is a debilitating neurological condition classified by a reduction of dopamine in the nigrostriatal region of the brain, resulting in movement disorders. Calorie restriction (CR) has shown to be neuroprotective during PD however, adhering to CR is difficult. In this thesis we attempted to create an alternative option that can mimic CR without having to reduce the amount of calories we consume. Initially we focused on the “hunger hormone” ghrelin, as it is elevated in the plasma during CR and is known to be protective in PD. Ghrelin exists in two distinctive isoforms, each with its own metabolic profile. In PD acyl ghrelin administration is neuroprotective, however, the role of des-acylated ghrelin is unknown. We wanted to identify the relative contributions each isoform plays using the MPTP model of PD. Chronic administration of acyl ghrelin in mice lacking both isoforms of ghrelin (Ghrelin KO) attenuated the MPTP-induced loss on Tyrosine Hydroxylase (TH; marker for dopamine) neuronal number and volume and TH protein concentration in the nigrostriatal pathway. However, injection of acyl ghrelin also elevated plasma des-acylated ghrelin, indicating in vivo deacetylation. Next, we chronically administered des-acylated ghrelin to Ghrelin KO mice and observed no neuroprotective effects. The lack of a protective effect was mirrored in Ghrelin-O-Acyltransferase (GOAT) KO mice, which lacks the ability to acylate ghrelin and consequently chronically increases plasma des-acyl ghrelin. Using this information we wanted to determine if acyl ghrelin was responsible for the neuroprotective actions of CR. CR attenuated the MPTP-induced loss of substantia nigra (SN) dopamine neurons and striatal dopamine turnover in Ghrelin WT but not KO mice, demonstrating that ghrelin mediates CR’s neuroprotective effect. CR elevated phosphorylated AMPK-activated kinase (AMPK) levels in the SN of WT but not KO mice suggesting that AMPK is a target for ghrelin-induced neuroprotection. Indeed, exogenous acyl ghrelin significantly increased pAMPK in the SN. Genetic deletion of AMPKβ1 and 2 subunits only in dopamine neurons (AMPK KO) prevented ghrelin-induced AMPK phosphorylation and neuroprotection. Hence, ghrelin signaling through AMPK in SN dopamine neurons mediates CR’s neuroprotective effects. Next we wanted to recreate the neuroprotective actions of CR with an already safe therapeutic. Metformin is the most commonly used drug to treat type 2 diabetes. It acts via AMPK activation in the periphery to ultimately lower blood glucose levels. Recently Metformin has been shown to be neuroprotective in PD. We wanted to determine if this was due to a direct effect on AMPK activity in dopaminergic neurons. We show that Metformin is neuroprotective in a mouse model of PD by attenuating dopaminergic cell loss and gliosis. This effect was present in both AMPK WT and KO mice indicating that Metformin’s neuroprotective actions are not due to AMPK activation in the SN dopaminergic neurons. Overall, these studies suggest a pathway linking CR with elevated acyl ghrelin which in turn phosphorylates AMPK in dopaminergic neurons to elicit a neuroprotective effect. CR mimetics should focus on AMPK activation in dopaminergic neurons as one potential target for the treatment of PD.

 

Dietary Patterns and Risk of Colorectal Cancer: Analysis by Tumor Location and Molecular Subtypes.

Mehta RS, Song M, Nishihara R, Drew DA, Wu K, Qian ZR, Fung TT, Hamada T, Masugi Y, da Silva A, Shi Y, Li W, Gu M, Willett WC, Fuchs CS, Giovannucci EL, Ogino S, Chan AT.

Gastroenterology. 2017 Feb 26. pii: S0016-5085(17)30179-8. doi: 10.1053/j.gastro.2017.02.015. [Epub ahead of print]

PMID: 28249812

http://sci-hub.cc/10.1053/j.gastro.2017.02.015

Abstract

BACKGROUND & AIMS:

Western and prudent dietary patterns have been associated with higher and lower risks of colorectal cancer (CRC), respectively. However, little is known about associations between dietary patterns and specific anatomic subsite or molecular subtypes of CRC.

METHODS:

We used multivariable Cox proportional hazards models to examine associations between Western and prudent dietary patterns and CRC risk in the Health Professionals Follow-up Study and Nurses' Health Study.

RESULTS:

After up to 32 years of follow-up of 137,217 men and women, we documented 3260 cases of CRC. Among individuals from whom subsite data were available, we observed 1264 proximal colon, 866 distal colon, and 670 rectal tumors. Western diet was associated with an increased incidence of CRC (Ptrend<.0001), with a relative risk (RR) of 1.31 (95% CI, 1.15-1.48, comparing the highest to lowest quartile). The association of Western diet with CRC was evident for tumors of the distal colon (RR, 1.55; 95% CI, 1.22-1.96; Ptrend=.0004) and rectum (RR, 1.35; 95% CI, 1.03-1.77; Ptrend=.01) but not proximal colon (RR, 1.11; 95% CI, 0.91-1.35; Ptrend=.51) when we compared extreme quartiles. In contrast, for the prudent pattern, we observed a RR of 0.86 for overall CRC (95% CI, 0.77-0.95; Ptrend=.01), with similar trends at anatomic subsites. However, the trend appeared stronger among men than women. Among 1285 cases (39%) with tissue available for molecular profiling, Western diet appeared to be more strongly associated with some CRC molecular subtypes (no mutations in KRAS [KRAS wildtype] or BRAF [bRAF wildtype], no or a low CpG island methylator phenotype, and microsatellite stability), although formal tests for heterogeneity did not produce statistically significant results.

CONCLUSIONS:

Western dietary patterns are associated with an increased risk of CRC, particularly distal colon and rectal tumors. Western dietary patterns also appear more strongly associated with tumors that are KRAS wildtype, BRAF wildtype, have no or a low CpG island methylator phenotype, and microsatellite stability. In contrast, prudent dietary patterns are associated with a lower risk of CRC that does not vary according to anatomic subsite or molecular subtype.

KEYWORDS:

colon cancer risk; molecular epidemiology; processed meat; red meat

 

An Adolescent and Early Adulthood Dietary Pattern Associated with Inflammation and the Incidence of Breast Cancer.

Harris HR, Willett WC, Vaidya RL, Michels KB.

Cancer Res. 2017 Mar 1;77(5):1179-1187. doi: 10.1158/0008-5472.CAN-16-2273.

PMID: 28249935

http://sci-hub.cc/10.1158/0008-5472.can-16-2273

Abstract

Adolescence is a highly susceptible period for mammary carcinogenesis, but few prospective studies have examined the role of adolescent diet in breast cancer risk. Reduced rank regression has previously been used to identify a dietary pattern associated with markers of inflammation (C-reactive protein, IL6, and TNFα receptor 2). We investigated whether an adolescent and early adulthood inflammatory dietary pattern was associated with breast cancer among 45,204 women in the Nurses' Health Study II using reduced rank regression. Participants completed a food frequency questionnaire in 1998 about their high school diet (HS-FFQ) and a FFQ in 1991 when they were ages 27-44 years. Among women who completed the HS-FFQ, 1,477 cases of breast cancer were diagnosed during 22 years of follow-up. An adolescent and early adulthood dietary pattern characterized by inflammation was associated with an increased incidence of premenopausal but not postmenopausal breast cancer. Women in the fifth quintile of the inflammatory pattern score had multivariable adjusted HRs for premenopausal breast cancer of 1.35 for adolescent diet [95% confidence interval (95% CI), 1.06-1.73; Ptrend = 0.002] and 1.41 for early adulthood diet (95% CI, 1.11-1.78; Ptrend = 0.006) compared with women in the first quintile. The corresponding RRs for postmenopausal breast cancer were 0.84 (95% CI, 0.60-1.17) for adolescent and 0.76 (95% CI, 0.54-1.06) for adult intake. Overall, our findings support the notion that an adolescent and early adulthood diet characterized by high intake of sugar-sweetened and diet soft drinks, refined grains, red and processed meat, and margarine, and low intake of green leafy vegetables, cruciferous vegetables, and coffee may increase the incidence of premenopausal breast cancer.

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The association between adult attained height and sitting height with mortality in the European Prospective Investigation into Cancer and Nutrition (EPIC).

Sawada N, Wark PA, Merritt MA, Tsugane S, Ward HA, Rinaldi S, Weiderpass E, Dartois L, His M, Boutron-Ruault MC, Turzanski-Fortner R, Kaaks R, Overvad K, Redondo ML, Travier N, Molina-Portillo E, Dorronsoro M, Cirera L, Ardanaz E, Perez-Cornago A, Trichopoulou A, Lagiou P, Valanou E, Masala G, Pala V, Hm Peeters P, T van der Schouw Y, Melander O, Manjer J, da Silva M, Skeie G, Tjønneland A, Olsen A, J Gunter M, Riboli E, J Cross A.

PLoS One. 2017 Mar 3;12(3):e0173117. doi: 10.1371/journal.pone.0173117.

PMID: 28257491

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0173117

http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0173117&type=printable

Abstract

Adult height and sitting height may reflect genetic and environmental factors, including early life nutrition, physical and social environments. Previous studies have reported divergent associations for height and chronic disease mortality, with positive associations observed for cancer mortality but inverse associations for circulatory disease mortality. Sitting height might be more strongly associated with insulin resistance; however, data on sitting height and mortality is sparse. Using the European Prospective Investigation into Cancer and Nutrition study, a prospective cohort of 409,748 individuals, we examined adult height and sitting height in relation to all-cause and cause-specific mortality. Height was measured in the majority of participants; sitting height was measured in ~253,000 participants. During an average of 12.5 years of follow-up, 29,810 deaths (11,931 from cancer and 7,346 from circulatory disease) were identified. Hazard ratios (HR) with 95% confidence intervals (CI) for death were calculated using multivariable Cox regression within quintiles of height. Height was positively associated with cancer mortality (men: HRQ5 vs. Q1 = 1.11, 95%CI = 1.00-1.24; women: HRQ5 vs. Q1 = 1.17, 95%CI = 1.07-1.28). In contrast, height was inversely associated with circulatory disease mortality (men: HRQ5 vs. Q1 = 0.63, 95%CI = 0.56-0.71; women: HRQ5 vs. Q1 = 0.81, 95%CI = 0.70-0.93). Although sitting height was not associated with cancer mortality, it was inversely associated with circulatory disease (men: HRQ5 vs. Q1 = 0.64, 95%CI = 0.55-0.75; women: HRQ5 vs. Q1 = 0.60, 95%CI = 0.49-0.74) and respiratory disease mortality (men: HRQ5 vs. Q1 = 0.45, 95%CI = 0.28-0.71; women: HRQ5 vs. Q1 = 0.60, 95%CI = 0.40-0.89). We observed opposing effects of height on cancer and circulatory disease mortality. Sitting height was inversely associated with circulatory disease and respiratory disease mortality.

 

Adherence to Healthy Lifestyle and Cardiovascular Diseases in the Chinese Population.

Lv J, Yu C, Guo Y, Bian Z, Yang L, Chen Y, Tang X, Zhang W, Qian Y, Huang Y, Wang X, Chen J, Chen Z, Qi L, Li L; China Kadoorie Biobank Collaborative Group..

J Am Coll Cardiol. 2017 Mar 7;69(9):1116-1125. doi: 10.1016/j.jacc.2016.11.076.

PMID: 28254173

http://www.onlinejacc.org/content/69/9/1116

http://www.onlinejacc.org/content/accj/69/9/1116.full.pdf

Abstract

BACKGROUND:

Adherence to a combination of healthy lifestyle factors has been related to a considerable reduction of cardiovascular risk in white populations; however, little is known whether such associations persist in nonwhite populations like the Asian population.

OBJECTIVES:

This study aimed to examine the associations of a combination of modifiable, healthy lifestyle factors with the risks of ischemic cardiovascular diseases and estimate the proportion of diseases that could potentially be prevented by adherence to these healthy lifestyle patterns.

METHODS:

This study examined the associations of 6 lifestyle factors with ischemic heart disease and ischemic stroke (IS) in the China Kadoorie Biobank of 461,211 participants 30 to 79 years of age who did not have cardiovascular diseases, cancer, or diabetes at baseline. Low-risk lifestyle factors were defined as nonsmoking status or having stopped smoking for reasons other than illness, alcohol consumption of <30 g/day, a median or higher level of physical activity, a diet rich in vegetables and fruits and limited in red meat, a body mass index of 18.5 to 23.9 kg/m2, and a waist-to-hip ratio <0.90 for men and <0.85 for women.

RESULTS:

During a median of 7.2 years (3.3 million person-years) of follow-up, this study documented 3,331 incident major coronary events (MCE) and 19,348 incident ISs. In multivariable-adjusted analyses, current nonsmoking status, light to moderate alcohol consumption, high physical activity, a diet rich in vegetables and fruits and limited in red meat, and low adiposity were independently associated with reduced risks of MCE and IS. Compared with participants without any low-risk factors, the hazard ratio for participants with ≥4 low-risk factors was 0.42 (95% confidence interval: 0.34 to 0.52) for MCE and 0.61 (95% confidence interval: 0.56 to 0.66) for IS. Approximately 67.9% (95% confidence interval: 46.5% to 81.9%) of the MCE and 39.1% (95% confidence interval: 26.4% to 50.4%) of the IS cases were attributable to poor adherence to healthy lifestyle.

CONCLUSIONS:

Adherence to healthy lifestyle may substantially lower the burden of cardiovascular diseases in Chinese.

KEYWORDS:

cardiovascular diseases; cohort studies; health behavior; lifestyle

 

[The below paper is not pdf-availed.]

Meat consumption and colorectal cancer risk in Japan: The Takayama study.

Wada K, Oba S, Tsuji M, Tamura T, Konishi K, Goto Y, Mizuta F, Koda S, Hori A, Tanabashi S, Matsushita S, Tokimitsu N, Nagata C.

Cancer Sci. 2017 Mar 3. doi: 10.1111/cas.13217. [Epub ahead of print]

PMID: 28256076

Abstract

Compared with the abundant data from Western countries, evidence regarding meat consumption and colorectal cancer is limited in the Japanese population. We evaluated colorectal cancer risk in relation to meat consumption in a population-based prospective cohort study in Japan. Participants were 13,957 men and 16,374 women aged ≥35 years in September 1992. Meat intake, assessed with a validated food frequency questionnaire, was controlled for the total energy intake. The incidence of colorectal cancer was confirmed through regional population-based cancer registries and histological identification from colonoscopy in two main hospitals in the study area. From September 1992 to March 2008, 429 men and 343 women developed colorectal cancer. After adjustments for multiple confounders, a significantly increased relative risk of colorectal cancer was observed in the highest vs. lowest quartile of the intake of total and red meat among men; the estimated hazard ratios were 1.36 (95% CI: 1.03,1.79) for total meat (p for trend=0.022), and 1.44 (95% CI: 1.10, 1.89) for red meat (p for trend=0.009). A positive association between processed meat intake and colon cancer risk was also observed in men. There was no significant association between colorectal cancer and meat consumption in women. These results suggest that the intake of red and processed meat increases the risk of colorectal or colon cancer among Japanese men. Abstaining from excessive consumption of meat might be protective against developing colorectal cancer.

KEYWORDS:

cohort studies; colorectal cancer; epidemiology; processed meat; red meat

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The modelled impact of increases in physical activity: the effect of both increased survival and reduced incidence of disease.

Mytton OT, Tainio M, Ogilvie D, Panter J, Cobiac L, Woodcock J.

Eur J Epidemiol. 2017 Mar 3. doi: 10.1007/s10654-017-0235-1. [Epub ahead of print]

PMID: 28258521

https://link.springer.com/article/10.1007/s10654-017-0235-1/fulltext.html

http://download.springer.com/static/pdf/909/art%3A10.1007%2Fs10654-017-0235-1.pdf?originUrl=http%3A%2F%2Flink.springer.com%2Farticle%2F10.1007%2Fs10654-017-0235-1&token2=exp=1488736103~acl=%2Fstatic%2Fpdf%2F909%2Fart%253A10.1007%252Fs10654-017-0235-1.pdf%3ForiginUrl%3Dhttp%3A%2F%2Flink.springer.com%2Farticle%2F10.1007%2Fs10654-017-0235-1*~hmac=8acfa91dbe27e1fd4345a1ca02b3ee64e5a03cf4eeeffc30f273df1e28f00ec7

Abstract

Physical activity can affect 'need' for healthcare both by reducing the incidence rate of some diseases and by increasing longevity (increasing the time lived at older ages when disease incidence is higher). However, it is common to consider only the first effect, which may overestimate any reduction in need for healthcare. We developed a hybrid micro-simulation lifetable model, which made allowance for both changes in longevity and risk of disease incidence, to estimate the effects of increases in physical activity (all adults meeting guidelines) on measures of healthcare need for diseases for which physical activity is protective. These were compared with estimates made using comparative risk assessment (CRA) methods, which assumed that longevity was fixed. Using the lifetable model, life expectancy increased by 95 days (95% uncertainty intervals: 68-126 days). Estimates of the healthcare need tended to decrease, but the magnitude of the decreases were noticeably smaller than those estimated using CRA methods (e.g. dementia: change in person-years, -0.6%, 95% uncertainty interval -3.7% to +1.6%; change in incident cases, -0.4%, -3.6% to +1.9%; change in person-years (CRA methods), -4.0%, -7.4% to -1.6%). The pattern of results persisted under different scenarios and sensitivity analyses. For most diseases for which physical activity is protective, increases in physical activity are associated with decreases in indices of healthcare need. However, disease onset may be delayed or time lived with disease may increase, such that the decreases in need may be relatively small and less than is sometimes expected.

 

Current Literature: Caloric Intake in Medical ICU Patients: Consistency of Care With Guidelines and Relationship to Clinical Outcomes.

Canada T.

Nutr Clin Pract. 2004 Dec;19(6):645-646. doi: 10.1177/0115426504019006645.

PMID: 28256953

http://sci-hub.cc/10.1177/0115426504019006645

Abstract

OBJECTIVES:

To assess the consistency of caloric intake with American College of Chest Physicians (ACCP) recommendations for critically ill patients and to evaluate the relationship of caloric intake with clinical outcomes.

DESIGN:

Prospective cohort study.

SETTING:

Adult intensive care units (ICUs) at 2 teaching hospitals.

PARTICIPANTS:

Patients with an ICU length of stay of at least 96 hours.

MEASUREMENTS AND RESULTS:

On ICU admission, severity of illness (ie, simplified acute physiology score II) and markers of nutritional status (ie, serum albumin level and body mass index) were recorded. The route of feeding (ie, enteral or parenteral), actual caloric intake (ie, percentage of ACCP recommendations: 0% to 32% [tertile I]; 33% to 65% [tertile II]; ≥66% [tertile III]), and evidence of GI intolerance (ie, gastric aspirate levels, ≥100 mL) were recorded daily. The following outcomes were assessed: status on hospital discharge (alive vs dead); spontaneous ventilation before ICU discharge (yes vs no); and ICU discharge without developing nosocomial sepsis (yes vs no). The average caloric intake among 187 participants was 50.6% of the ACCP targets and was similar in both hospitals. Caloric intake was inversely related to the mean number of gastric aspirates≥ 100 mL/d (Spearman ρ =-.04; p = .06), but not to severity of illness, nutritional status, or route of feeding. After accounting for the number of gastric aspirates ≥100 mL, severity of illness, nutritional status, and route of feeding, tertile II of caloric intake ( vs tertile I) was associated with a significantly greater likelihood of achieving spontaneous ventilation before ICU discharge. Tertile III of caloric intake ( vs tertile I) was associated with a significantly lower likelihood of both hospital discharge alive and spontaneous ventilation before ICU discharge.

CONCLUSIONS:

Study participants were underfed relative to ACCP targets. These targets, however, may overestimate needs because moderate caloric intake (ie, 33% to 65% of ACCP targets; approximately 9 to 18 kcal/kg per day) was associated with better outcomes than higher levels of caloric intake.

 

Not so fast: The impact of impulsivity on weight loss varies by treatment type.

Manasse SM, Flack D, Dochat C, Zhang F, Butryn ML, Forman EM.

Appetite. 2017 Feb 28. pii: S0195-6663(17)30326-4. doi: 10.1016/j.appet.2017.02.042. [Epub ahead of print]

PMID: 28257940

http://sci-hub.cc/10.1016/j.appet.2017.02.042

Abstract

Behavioral weight loss (BWL) treatments result in suboptimal weight losses for many individuals. Impulsivity appears to be a maintenance factor of obesity, yet few studies have examined impulsivity as a predictor of outcomes from BWL. We examined specific facets of impulsivity (inhibitory control and delay discounting) as moderators of outcome in BWL. Overweight adults (n = 190) were randomized to standard behavioral treatment (SBT) or acceptance-based behavioral treatment (ABT). We hypothesized that impulsivity would be inversely associated with weight loss, and that the association between impulsivity and outcome would be attenuated in the ABT condition. Poorer general inhibitory control predicted lower percent weight lost at 12 months across conditions at the trend level (b = -0.003, p = 0.06). The negative impact of low inhibitory control on weight loss was attenuated by assignment to ABT versus SBT (b = 0.004, p = 0.03). Treatment condition, at trend level, also moderated the impact of delay discounting (b = -0.011, p = .098) and food-specific inhibitory control (b = 0.003, p = 0.06) on percent weight loss such that those with greater impulsivity benefitted most from ABT. Results reveal a potential pattern that impulsivity reduces benefit derived from SBT but not ABT. Further research on the moderating effect of impulsivity is necessary to inform the development of targeted treatments for clinically meaningful subtypes of patients.

KEYWORDS:

Acceptance-based treatment; Behavioral weight loss; Delay discounting; Impulsivity; Inhibitory control; Obesity

 

[i thought it might be interesting to compare the effects to the effects of number of fast food joints.]

Liquor landscapes: Does access to alcohol outlets influence alcohol consumption in young adults?

Foster S, Trapp G, Hooper P, Oddy WH, Wood L, Knuiman M.

Health Place. 2017 Feb 28;45:17-23. doi: 10.1016/j.healthplace.2017.02.008. [Epub ahead of print]

PMID: 28258014

http://linkinghub.elsevier.com.sci-hub.cc/retrieve/pii/S1353829216302246

Abstract

Few longitudinal studies have examined the impact of liquor licences on alcohol consumption, and none in young adults, the life stage when alcohol intake is at its highest. We examined associations between liquor licences (i.e., general licences, on-premise licences, liquor stores, and club licences) and alcohol consumption at 20-years (n=988) and 22-years (n=893), and whether changes in the licences between time-points influenced alcohol consumption (n=665). Only general licences were associated with alcohol consumption at 20-years (p=0.037), but by 22-years, all licences types were positively associated with alcohol consumption (p<0.05). Longitudinal analyses showed that for each increase in liquor stores over time, alcohol consumption increased by 1.22g/day or 8% (p=0.030), and for each additional club licence, consumption increased by 0.90g/day or 6% (p=0.007). Limiting liquor licences could contribute to a reduction in young adults' alcohol intake.

KEYWORDS:

Alcohol; Alcohol outlet density; Licence types; Longitudinal; Neighbourhood; Young adults

 

Multiple Risk Behavior Interventions: Meta-analyses of RCTs.

Meader N, King K, Wright K, Graham HM, Petticrew M, Power C, White M, Sowden AJ.

Am J Prev Med. 2017 Feb 28. pii: S0749-3797(17)30091-0. doi: 10.1016/j.amepre.2017.01.032. [Epub ahead of print] Review.

PMID: 28258777

http://sci-hub.cc/10.1016/j.amepre.2017.01.032

Abstract

CONTEXT:

Multiple risk behaviors are common and associated with developing chronic conditions such as heart disease, cancer, or Type 2 diabetes. A systematic review, meta-analysis, and meta-regression of the effectiveness of multiple risk behavior interventions was conducted.

EVIDENCE ACQUISITION:

Six electronic databases including MEDLINE, EMBASE, and PsycINFO were searched to August 2016. RCTs of non-pharmacologic interventions in general adult populations were selected. Studies targeting specific at-risk groups (such as people screened for cardiovascular risk factors or obesity) were excluded. Studies were screened independently. Study characteristics and outcomes were extracted and risk of bias assessed by one researcher and checked by another. The Behaviour Change Wheel and Oxford Implementation Index were used to code intervention content and context.

EVIDENCE SYNTHESIS:

Random-effects meta-analyses were conducted. Sixty-nine trials involving 73,873 individuals were included. Interventions mainly comprised education and skills training and were associated with modest improvements in most risk behaviors: increased fruit and vegetable intake (0.31 portions, 95% CI=0.17, 0.45) and physical activity (standardized mean difference, 0.25; 95% CI=0.13, 0.38), and reduced fat intake (standardized mean difference, -0.24; 95% CI= -0.36, -0.12). Although reductions in smoking were found (OR=0.78, 95% CI=0.68, 0.90), they appeared to be negatively associated with improvement in other behaviors (such as diet and physical activity). Preliminary evidence suggests that sequentially changing smoking alongside other risk behaviors was more effective than simultaneous change. But most studies assessed simultaneous rather than sequential change in risk behaviors; therefore, comparisons are sparse. Follow-up period and intervention characteristics impacted effectiveness for some outcomes.

CONCLUSIONS:

Interventions comprising education (e.g., providing information about behaviors associated with health risks) and skills training (e.g., teaching skills that equip participants to engage in less risky behavior) and targeting multiple risk behaviors concurrently are associated with small changes in diet and physical activity. Although on average smoking was reduced, it appeared changes in smoking were negatively associated with changes in other behaviors, suggesting it may not be optimal to target smoking simultaneously with other risk behaviors.

 

Association between a dietary quality index based on the food standard agency nutrient profiling system and cardiovascular disease risk among French adults.

Adriouch S, Julia C, Kesse-Guyot E, Ducrot P, Péneau S, Méjean C, Assmann KE, Deschasaux M, Hercberg S, Touvier M, Fezeu LK.

Int J Cardiol. 2017 Feb 24. pii: S0167-5273(17)31122-1. doi: 10.1016/j.ijcard.2017.02.092. [Epub ahead of print]

PMID: 28258849

Abstract

http://sci-hub.cc/10.1016/j.ijcard.2017.02.092

BACKGROUND:

In France, the implementation of a front-of-pack (FOP) nutrition label-the 5-Colour Nutrition Label (5-CNL) is currently under consideration as a strategic tool to allow consumers making healthier food choices. This FOP label is based on the British Food Standards Agency Nutrient Profiling System (FSA-NPS), reflecting the overall nutritional quality of foods. At the individual level, an energy-weighted mean of all FSA-NPS scores of foods usually consumed has been elaborated (FSA-NPS DI). Our objective was to investigate the prospective association between the FSA-NPS DI and cardiovascular disease (CVD) risk.

METHODS:

75,801 participants to the NutriNet-Santé cohort, who completed at least three 24h dietary records during the first 2y of the follow-up, were followed between 2009 and 2016. Multivariable Cox proportional hazards models were used to characterize the associations between FSA-NPS DI and the incidence of CVDs.

RESULTS:

509 major cardiovascular events were diagnosed (262 coronary heart diseases and 247 strokes). A higher FSA-NPS DI, characterizing lower dietary quality, was associated with increased CVD risk (HRfor a 1-point increment=1.08 (1.03-1.13); HRQ4vs.Q1=1.40 (1.06-1.84), Ptrend Q4-Q1=0.01). This association tended to be stronger in overweight subjects (HRfor a 1-point increment=1.12 (1.04-1.19); Pinteraction=0.003).

CONCLUSIONS:

These results suggest that lower dietary quality, as reflected by a higher FSA-NPS DI, may be associated with a significant increase in cardiovascular risk, especially in at-risk individuals (overweight population). They support the public health relevance of developing a front-of-pack nutrition label based on this score.

KEYWORDS:

Cardiovascular risk; FSA-NPS; Nutrient profiling system; Nutrition policy; Prospective study

 

Effects of Anabolic Androgenic Steroids on the Reproductive System of Athletes and Recreational Users: A Systematic Review and Meta-Analysis.

Christou MA, Christou PA, Markozannes G, Tsatsoulis A, Mastorakos G, Tigas S.

Sports Med. 2017 Mar 4. doi: 10.1007/s40279-017-0709-z. [Epub ahead of print] Review.

PMID: 28258581

http://sci-hub.cc/10.1007/s40279-017-0709-z

Abstract

BACKGROUND:

Anabolic androgenic steroids (AAS) are testosterone derivatives used by athletes and recreational users to improve athletic performance and/or enhance appearance. Anabolic androgenic steroids use may have serious and potentially irreversible adverse effects on different organs and systems, including the reproductive system.

OBJECTIVE:

This systematic review and meta-analysis aimed to critically assess the impact of AAS use on the reproductive system of athletes and recreational users.

METHODS:

An electronic literature search was conducted using the databases MEDLINE, CENTRAL, and Google Scholar. Studies were included when the following criteria were fulfilled: participants were athletes or recreational users of any age, sex, level or type of sport; AAS use of any type, dose, form or duration; AAS effects on the reproductive system were assessed as stated by medical history, clinical examination, hormone and/or semen analysis. Random-effects meta-analysis was performed to assess the weighted mean difference (WMD) of serum gonadotropin (luteinizing hormone, follicle-stimulating hormone) and testosterone levels compared with baseline, during the period of AAS use, as well as following AAS discontinuation.

RESULTS:

Thirty-three studies (three randomized clinical trials, 11 cohort, 18 cross-sectional, and one non-randomized parallel clinical trial) were included in the systematic review (3879 participants; 1766 AAS users and 2113 non-AAS users). The majority of the participants were men; only six studies provided data for female athletes. A meta-analysis (11 studies) was conducted of studies evaluating serum gonadotropin and testosterone levels in male subjects: (1) prior to, and during AAS use (six studies, n = 65 AAS users; seven studies, n = 59, evaluating gonadotropin and testosterone levels respectively); (2) during AAS use and following AAS discontinuation (four studies, n = 35; six studies, n = 39, respectively); as well as (3) prior to AAS use and following AAS discontinuation (three studies, n = 17; five studies, n = 27, respectively). During AAS intake, significant reductions in luteinizing hormone [weighted mean difference (WMD) -3.37 IU/L, 95% confidence interval (CI) -5.05 to -1.70, p < 0.001], follicle-stimulating hormone (WMD -1.73 IU/L, 95% CI -2.67 to -0.79, p < 0.001), and endogenous testosterone levels (WMD -10.75 nmol/L, 95% CI -15.01 to -6.49, p < 0.001) were reported. Following AAS discontinuation, serum gonadotropin levels gradually returned to baseline values within 13-24 weeks, whereas serum testosterone levels remained lower as compared with baseline (WMD -9.40 nmol/L, 95% CI -14.38 to -4.42, p < 0.001). Serum testosterone levels remained reduced at 16 weeks following discontinuation of AAS. In addition, AAS abuse resulted in structural and functional sperm changes, a reduction in testicular volume, gynecomastia, as well as clitoromegaly, menstrual irregularities, and subfertility.

CONCLUSION:

The majority of AAS users demonstrated hypogonadism with persistently low gonadotropin and testosterone levels, lasting for several weeks to months after AAS withdrawal. Anabolic androgenic steroid use results in profound and prolonged effects on the reproductive system of athletes and recreational users and potentially on fertility.

 

A Systematic Review of the Effects of Plant Compared with Animal Protein Sources on Features of Metabolic Syndrome.

Chalvon-Demersay T, Azzout-Marniche D, Arfsten J, Egli L, Gaudichon C, Karagounis LG, Tomé D.

J Nutr. 2017 Mar;147(3):281-292. doi: 10.3945/jn.116.239574. Review.

PMID: 28122929 Free Article

http://jn.nutrition.org/content/147/3/281.long

http://jn.nutrition.org/content/147/3/281.full.pdf+html

Abstract

Dietary protein may play an important role in the prevention of metabolic dysfunctions. However, the way in which the protein source affects these dysfunctions has not been clearly established. The aim of the current systematic review was to compare the impact of plant- and animal-sourced dietary proteins on several features of metabolic syndrome in humans. The PubMed database was searched for both chronic and acute interventional studies, as well as observational studies, in healthy humans or those with metabolic dysfunctions, in which the impact of animal and plant protein intake was compared while using the following variables: cholesterolemia and triglyceridemia, blood pressure, glucose homeostasis, and body composition. Based on data extraction, we observed that soy protein consumption (with isoflavones), but not soy protein alone (without isoflavones) or other plant proteins (pea and lupine proteins, wheat gluten), leads to a 3% greater decrease in both total and LDL cholesterol compared with animal-sourced protein ingestion, especially in individuals with high fasting cholesterol concentrations. This observation was made when animal proteins were provided as a whole diet rather than given supplementally. Some observational studies reported an inverse association between plant protein intake and systolic and diastolic blood pressure, but this was not confirmed by intervention studies. Moreover, plant protein (wheat gluten, soy protein) intake as part of a mixed meal resulted in a lower postprandial insulin response than did whey. This systematic review provides some evidence that the intake of soy protein associated with isoflavones may prevent the onset of risk factors associated with cardiovascular disease, i.e., hypercholesterolemia and hypertension, in humans. However, we were not able to draw any further conclusions from the present work on the positive effects of plant proteins relating to glucose homeostasis and body composition.

KEYWORDS:

animal protein; blood pressure; body composition; cholesterol; glucose homeostasis; metabolic syndrome; plant protein

 

Longitudinal association between fasting blood glucose concentrations and first stroke in hypertensive adults in China: effect of folic acid intervention.

Xu RB, Kong X, Xu BP, Song Y, Ji M, Zhao M, Huang X, Li P, Cheng X, Chen F, Zhang Y, Tang G, Qin X, Wang B, Hou FF, Dong Q, Chen Y, Yang T, Sun N, Li X, Zhao L, Ge J, Ji L, Huo Y, Li J.

Am J Clin Nutr. 2017 Mar;105(3):564-570. doi: 10.3945/ajcn.116.145656.

PMID: 28122783

http://sci-hub.cc/10.3945/ajcn.116.145656

Abstract

Background: Diabetes is a known risk factor for stroke, but data on its prospective association with first stroke are limited. Folic acid supplementation has been shown to protect against first stroke, but its role in preventing first stroke in diabetes is unknown.Objectives: This post hoc analysis of the China Stroke Primary Prevention Trial tested the hypotheses that the fasting blood glucose (FBG) concentration is positively associated with first stroke risk and that folic acid treatment can reduce stroke risk associated with elevated fasting glucose concentrations.Design: This analysis included 20,327 hypertensive adults without a history of stroke or myocardial infarction, who were randomly assigned to a double-blind daily treatment with 10 mg enalapril and 0.8 mg folic acid (n = 10,160) or 10 mg enalapril alone (n = 10,167). Kaplan-Meier survival analysis and Cox proportionate hazard models were used to test the hypotheses with adjustment for pertinent covariables.Results: During a median treatment duration of 4.5 y, 616 participants developed a first stroke (497 ischemic strokes). A high FBG concentration (≥7.0 mmol/L) or diabetes, compared with a low FBG concentration (<5.0 mmol/L), was associated with an increased risk of first stroke (6.0% compared with 2.6%, respectively; HR: 1.9; 95% CI: 1.3, 2.8; P < 0.001). Folic acid treatment reduced the risk of stroke across a wide range of FBG concentrations ≥5.0 mmol/L, but risk reduction was greatest in subjects with FBG concentrations ≥7.0 mmol/L or with diabetes (HR: 0.66; 95% CI: 0.46, 0.97; P < 0.05). There was a significant interactive effect of FBG and folic acid treatment on first stroke (P = 0.01).Conclusions: In Chinese hypertensive adults, an FBG concentration ≥7.0 mmol/L or diabetes is associated with an increased risk of first stroke; this increased risk is reduced by 34% with folic acid treatment. These findings warrant additional investigation.

KEYWORDS:

Chinese; folic acid; hyperglycemia; hypertension; stroke

 

Dietary intake and peripheral arterial disease incidence in middle-aged adults: the Atherosclerosis Risk in Communities (ARIC) Study.

Ogilvie RP, Lutsey PL, Heiss G, Folsom AR, Steffen LM.

Am J Clin Nutr. 2017 Mar;105(3):651-659. doi: 10.3945/ajcn.116.137497.

PMID: 28077376

http://sci-hub.cc/10.3945/ajcn.116.137497

Abstract

Background: Peripheral arterial disease (PAD) is a costly source of morbidity and mortality among older persons in the United States. Dietary intake plays a role in the development of atherosclerotic cardiovascular disease; however, few studies have examined the relation of food intake or dietary patterns with PAD.Objective: We examined the relation between habitual dietary intake at midlife and incident PAD over ∼20 y of follow-up.Design: Among 14,082 participants enrolled in the ARIC (Atherosclerosis Risk in Communities) Study initially free of PAD, dietary intake was assessed at baseline in 1987-1989 by using a modified Harvard food-frequency questionnaire. Food groups were created, and principal components analysis was used to develop "healthy" and "Western" dietary patterns; both were categorized into quintiles or quartiles. Incident PAD was determined by an ankle-brachial index <0.9 assessed at 2 subsequent examinations and hospital discharge codes through 2012. Multivariate-adjusted Cox proportional hazards regression was used.Results: During a mean follow-up of 19.9 y, 1569 participants developed incident PAD. In models adjusted for demographic characteristics, behaviors, and food groups, the HRs (95% CIs) for incident PAD increased across quintiles of meat consumption [quintile 1: reference, quintile 2: 1.38 (1.16, 1.65), quintile 3: 1.38 (1.16, 1.65), quintile 4: 1.45 (1.20, 1.74), quintile 5: 1.66 (1.36, 2.03); P-trend <0.001]. Compared with those who drank no alcohol, those who had 1-6 drinks/wk had a lower risk of incident PAD [0.78 (0.68, 0.89)]. For coffee, ≥4 cups/d compared with none was inversely associated with incident PAD [quintile 5 compared with quintile 1: 0.84 (0.75, 1.00); P-trend = 0.014]. There was no association between other food groups or patterns and incident PAD.Conclusions: In this prospective cohort study, greater meat consumption was associated with a higher risk, and moderate alcohol consumption was associated with a lower risk of incident PAD. Whether these associations are causal remains to be seen.

KEYWORDS:

alcohol; cardiovascular disease; dietary patterns; food groups; meat; peripheral arterial disease

 

Dietary protein is associated with musculoskeletal health independently of dietary pattern: the Framingham Third Generation Study.

Mangano KM, Sahni S, Kiel DP, Tucker KL, Dufour AB, Hannan MT.

Am J Clin Nutr. 2017 Mar;105(3):714-722. doi: 10.3945/ajcn.116.136762.

PMID: 28179224

http://sci-hub.cc/10.3945/ajcn.116.136762

Abstract

Background: Above-average dietary protein, as a single nutrient, improves musculoskeletal health. Evaluating the link between dietary protein and musculoskeletal health from a whole-diet perspective is important, as dietary guidelines focus on dietary patterns.Objective: We examined the prospective association of novel dietary protein food clusters (derived from established dietary pattern techniques) with appendicular lean mass (ALM), quadriceps strength (QS), and bone mineral density (BMD) in 2986 men and women, aged 19-72 y, from the Framingham Third Generation Study.Design: Total protein intake was estimated by food-frequency questionnaire in 2002-2005. A cluster analysis was used to classify participants into mutually exclusive groups, which were determined by using the percentage of contribution of food intake to overall protein intake. General linear modeling was used to 1) estimate the association between protein intake (grams per day) and BMD, ALM, appendicular lean mass normalized for height (ALM/ht2), and QS (2008-2011) and to 2) calculate adjusted least-squares mean outcomes across quartiles of protein (grams per day) and protein food clusters.Results: The mean ± SD age of subjects was 40 ± 9 y; 82% of participants met the Recommended Daily Allowance (0.8 g · kg body weight-1 · d-1). The following 6 dietary protein food clusters were identified: fast food and full-fat dairy, fish, red meat, chicken, low-fat milk, and legumes. BMD was not different across quartiles of protein intake (P-trend range = 0.32-0.82); but significant positive trends were observed for ALM, ALM/ht2 (P < 0.001), and QS (P = 0.0028). Individuals in the lowest quartile of total protein intake (quartile 1) had significantly lower ALM, ALM/ht2, and QS than did those in the higher quartiles of intake (quartiles 2-4; (P ranges = 0.0001-0.003, 0.0007-0.003, and 0.009-0.05, respectively). However, there were no associations between protein clusters and any musculoskeletal outcome in adjusted models.Conclusions: In a protein-replete cohort of adults, dietary protein is associated with ALM and QS but not with BMD. In this study, dietary protein food patterns do not provide further insight into beneficial protein effects on muscle outcomes.

KEYWORDS:

bone mineral density; dietary patterns; dietary protein; muscle mass; muscle strength

 

Total and subtypes of dietary fat intake and risk of type 2 diabetes mellitus in the Prevención con Dieta Mediterránea (PREDIMED) study.

Guasch-Ferré M, Becerra-Tomás N, Ruiz-Canela M, Corella D, Schröder H, Estruch R, Ros E, Arós F, Gómez-Gracia E, Fiol M, Serra-Majem L, Lapetra J, Basora J, Martín-Calvo N, Portoles O, Fitó M, Hu FB, Forga L, Salas-Salvadó J.

Am J Clin Nutr. 2017 Mar;105(3):723-735. doi: 10.3945/ajcn.116.142034.

PMID: 28202478

http://sci-hub.cc/10.3945/ajcn.116.142034

Abstract

Background: The associations between dietary fat and cardiovascular disease have been evaluated in several studies, but less is known about their influence on the risk of diabetes.Objective: We examined the associations between total fat, subtypes of dietary fat, and food sources rich in saturated fatty acids and the incidence of type 2 diabetes (T2D).Design: A prospective cohort analysis of 3349 individuals who were free of diabetes at baseline but were at high cardiovascular risk from the PREvención con DIeta MEDiterránea (PREDIMED) study was conducted. Detailed dietary information was assessed at baseline and yearly during the follow-up using a food frequency questionnaire. Multivariable Cox proportional hazards models were used to estimate T2D HRs and 95% CIs according to baseline and yearly updated fat intake.Results: We documented 266 incident cases during 4.3 y of follow-up. Baseline saturated and animal fat intake was not associated with the risk of T2D. After multivariable adjustment, participants in the highest quartile of updated intake of saturated and animal fat had a higher risk of diabetes than the lowest quartile (HR: 2.19; 95% CI: 1.28, 3.73; and P-trend = 0.01 compared with HR: 2.00; 95% CI: 1.29, 3.09; and P-trend < 0.01, respectively). In both the Mediterranean diet and control groups, participants in the highest quartile of updated animal fat intake had an ∼2-fold higher risk of T2D than their counterparts in the lowest quartile. The consumption of 1 serving of butter and cheese was associated with a higher risk of diabetes, whereas whole-fat yogurt intake was associated with a lower risk.Conclusions: In a Mediterranean trial focused on dietary fat interventions, baseline intake of saturated and animal fat was not associated with T2D incidence, but the yearly updated intake of saturated and animal fat was associated with a higher risk of T2D. Cheese and butter intake was associated with a higher risk of T2D, whereas whole-fat yogurt intake was associated with a lower risk of T2D.

KEYWORDS:

PREDIMED study; dietary fat; fat subtypes; monounsaturated fat; saturated fat; type 2 diabetes; ω-3 fatty acids

 

Influence of temperate, subtropical, and tropical fruit consumption on risk of type 2 diabetes in an Asian population.

Alperet DJ, Butler LM, Koh WP, Yuan JM, van Dam RM.

Am J Clin Nutr. 2017 Mar;105(3):736-745. doi: 10.3945/ajcn.116.147090.

PMID: 28179225

http://sci-hub.cc/10.3945/ajcn.116.147090

Abstract

Background: Findings on the relation between fruit consumption and the risk of type 2 diabetes mellitus (T2DM) have been inconsistent.Objectives: We examined whether the consumption of total, temperate, subtropical, and tropical fruit is associated with T2DM risk and whether differences in the carbohydrate quality of fruit influence T2DM risk in Asians.Design: We included 45,411 participants in the Singapore Chinese Health Study who were 45-74 y old and had no diabetes, cancer, or cardiovascular disease at recruitment (1993-1998). Fruit intake was assessed with the use of a validated food-frequency questionnaire. Physician-diagnosed incident T2DM cases were reported at follow-up 1 (1999-2004) and follow-up 2 (2006-2010) interviews. Cox proportional hazards regression was used to estimate HRs and 95% CIs of diabetes risk.Results: In 494,741 person-years of follow-up, 5207 participants developed T2DM. After adjustment for lifestyle and dietary risk factors, high total fruit consumption was not consistently associated with lower T2DM risk [men: HR of 1.33 (95% CI: 1.04, 1.71) for ≥3 servings/d compared with <1 serving/wk (P-trend = 0.17); women: HR of 0.88 (95% CI: 0.71, 1.11) (P-trend = 0.008); P-interaction = 0.003]. The direct association in men was observed for higher-glycemic index (GI) fruit [hr: 1.51 (95% CI: 1.22, 1.86) for ≥1 serving/d compared with rarely consumed; P-trend = 0.001] but not for lower or moderate GI fruit. In women, the consumption of temperate fruit, but not of subtropical or tropical fruit, was associated with lower T2DM risk [hr: 0.79 (95% CI: 0.67, 0.92) for ≥1 serving/d compared with rarely; P-trend = 0.006].Conclusions: The consumption of temperate fruit, such as apples, was associated with a lower risk of T2DM in women, whereas the consumption of higher-GI fruit, such as bananas, was associated with higher risk in men. The impact of fruit consumption on the risk of diabetes may differ by the type of fruit, which may reflect differences in the glycemic impact or phytochemical content.

KEYWORDS:

fruit; glycemic index; subtropical; temperate; tropical; type 2 diabetes mellitus

 

Probiotics (<i>Lactobacillus gasseri</i> KS-13, <i>Bifidobacterium bifidum</i> G9-1, and <i>Bifidobacterium longum</i> MM-2) improve rhinoconjunctivitis-specific quality of life in individuals with seasonal allergies: a double-blind, placebo-controlled, randomized trial.

Dennis-Wall JC, Culpepper T, Nieves C Jr, Rowe CC, Burns AM, Rusch CT, Federico A, Ukhanova M, Waugh S, Mai V, Christman MC, Langkamp-Henken B.

Am J Clin Nutr. 2017 Mar;105(3):758-767. doi: 10.3945/ajcn.116.140012.

PMID: 28228426 Free Article

http://ajcn.nutrition.org/content/105/3/758.long

http://ajcn.nutrition.org/content/105/3/758.full.pdf+html

Abstract

Background: Rhinoconjunctivitis-specific quality of life is often reduced during seasonal allergies. The Mini Rhinoconjunctivitis Quality of Life Questionnaire (MRQLQ) is a validated tool used to measure quality of life in people experiencing allergies (0 = not troubled to 6 = extremely troubled). Probiotics may improve quality of life during allergy season by increasing the percentage of regulatory T cells (Tregs) and inducing tolerance.Objective: The objective of this study was to determine whether consuming Lactobacillus gasseri KS-13, Bifidobacterium bifidum G9-1, and B. longum MM-2 compared with placebo would result in beneficial effects on MRQLQ scores throughout allergy season in individuals who typically experience seasonal allergies. Secondary outcomes included changes in immune markers as part of a potential mechanism for changes in MRQLQ scores.Design: In this double-blind, placebo-controlled, parallel, randomized clinical trial, 173 participants (mean ± SEM: age 27 ± 1 y) who self-identified as having seasonal allergies received either a probiotic (2 capsules/d, 1.5 billion colony-forming units/capsule) or placebo during spring allergy season for 8 wk. MRQLQ scores were collected weekly throughout the study. Fasting blood samples were taken from a subgroup (placebo, n = 37; probiotic, n = 35) at baseline and week 6 (predicted peak of pollen) to determine serum immunoglobulin (Ig) E concentrations and Treg percentages.Results: The probiotic group reported an improvement in the MRQLQ global score from baseline to pollen peak (-0.68 ± 0.13) when compared with the placebo group (-0.19 ± 0.14; P = 0.0092). Both serum total IgE and the percentage of Tregs increased from baseline to week 6, but changes were not different between groups.Conclusions: This combination probiotic improved rhinoconjunctivitis-specific quality of life during allergy season for healthy individuals with self-reported seasonal allergies; however, the associated mechanism is still unclear.

KEYWORDS:

Bifidobacterium bifidum; Bifidobacterium longum; Lactobacillus gasseri; allergic rhinitis; healthy adults; probiotics; quality of life; seasonal allergies

 

[The below paper is pdf-availed.]

Fear of Life Extension

James S. Goodwin

J Gerontol A Biol Sci Med Sci (2017) 72 (3): 353-354. DOI: https://doi.org/10.1093/gerona/glw340

Published: 18 January 2017

Extract

In about the year 2000, a commandment came down from the very heights of the Geriatric Olympus: “Thou Shalt Not Study Life Extension. Nay, nor shall thou speak wistfully of such a prospect. For it is written that life extension scares the bejesus out of the gods of policy.” The fear haunting policy makers is that medical progress will result in longer lives without better health—the specter of millions of empty shells in wheelchairs populating ever-expanding nursing homes. Ever since this commandment, the ruling concept has been “quality, not quantity.” We don’t want to live longer—just better. This concept ignores two realities:

[1. We do want to live longer.

2. At a population level, it’s impossible to live longer without living better. Conversely, living better means living longer.]

At one level, these realities are too obvious to require explanation. However, policy gods work at the level of abstract concepts, and strange...

[things can happen when abstractions are substituted for actual experience.

We do want to live longer. As any clinician knows, those with serious chronic illnesses not only cling to life but for the most part enjoy it and are grateful for the opportunity. Even in places with easy access to un-messy and legally sanctioned suicide, there are not that many takers.

And it is virtually impossible to separate quality from quantity in human life. Measures that reduce disease also increase longevity, and vice versa. There are rare examples where quality and quantity might diverge—perhaps chemotherapy and radiation for glioblastoma multiforme is one—but I challenge clinicians to come up with common examples. Aggressive end of life care does not increase quantity. Palliative care does not shorten life and in some trials even extends it (1–3).

Thirty years ago, there were serious articles by various experts about how the (then) continued increase in life expectancy would lead to an epidemic of Alzheimer’s and thence to a need for more nursing homes, more wheelchairs, more of everything unpleasant and costly. But that was silly. People live longer because they are healthier, not because some magic pill or machine keeps decrepit, barely functioning organisms alive.

The commandment outlawing enthusiasm for life extension requires groups like Espeland and colleagues (4) to start their articles with statements about wanting only to improve quality, not quantity of life.

Other than that minor quibble (stimulating my preceding and ongoing rant), Espeland and his colleagues have made a fine contribution to the literature on the feasibility of designing clinical trials that target the aging process per se, rather than a specific condition or complaint. They list several possible outcomes other than mortality that might be employed, such as active life expectancy and activities of daily living. They then rigorously explore the potential for using “incident multi morbidity” as an outcome.

What makes their work outstanding is their pragmatic approach. They test their constructs using data from three longitudinal studies, providing estimates of incident new chronic diseases, or new families of chronic diseases, that can be used in sample size calculations. Their preliminary analyses suggest that such trials are feasible, with good power to detect a 20% reduction in new chronic morbidity over 4–6 years with one to two thousand total participants. In other words, it should not take a huge bite out of the NIA budget to address this issue. This well-reasoned article should move such studies closer to reality.

There are potential limitations in moving from a hard outcome, mortality, to a somewhat fuzzier one, morbidity. Espeland and colleagues implicitly or explicitly recognize these limitations, which influenced their approach. First, mortality is dichotomous and objective. In contrast, multi morbidity is an abstract concept that must be operationalized to be used. Errors or variability can occur at each step in translating an abstract concept to a measurable entity. Multi morbidity is usually operationalized as having two or more conditions from a list of diseases. But some diseases are not really morbid, or even diseases. They are asymptomatic conditions, defined by a number produced by a machine. They are important risk factors for serious subsequent disease. Thus, a diagnosis of hypertension, osteoporosis or lipid disorders is important, but these conditions do not of themselves cause symptoms, or suffering, or increase “burden of disease.” Many studies investigating multi morbidity seem unaware of this distinction. Espeland and colleagues implicitly acknowledge this distinction by using hypertension and lipid disorders as selection criteria to identify appropriate participants in an intervention trial, rather than as outcomes of that trial.

Espeland and colleagues also wisely elected not to explore disability–free survival as an outcome. There is something distasteful about the quest for a world free of disability. All humans have disabilities: we cannot fly, nor breathe underwater, for example. Some of us also cannot walk well. Such individuals seem to do OK with the appropriate accommodations. However, if one uses the lens of “successful aging” and values only disability-free survival, those with disabilities can be viewed as failures.

It is reasonable to assume that some pill or treatment may indeed delay the onset of multi morbidity. It is certainly worth examining. Any successful treatment will also increase longevity, a prospect not to be feared.]

>>>>>>>>>>>>>>>>

4. Mark A. Espeland; Eileen M. Crimmins; Brandon R. Grossardt; Jill P. Crandall; Jonathan A. L. Gelfond; Tamara B. Harris; Stephen B. Kritchevsky; JoAnn E. Manson; Jennifer G. Robinson; Walter A. Rocca; Marinella Temprosa; Fridtjof Thomas; Robert Wallace; Nir Barzilai; for the Multimorbidity Clinical Trials Consortium

Clinical trials targeting aging and age-related multimorbidity.

J Gerontol A Biol Sci Med Sci (2017) 72 (3): 355-361. doi:10.1093/gerona/glw220

http://sci-hub.cc/10.1093/gerona/glw220

Abstract

Background:

There is growing interest in identifying interventions that may increase health span by targeting biological processes underlying aging. The design of efficient and rigorous clinical trials to assess these interventions requires careful consideration of eligibility criteria, outcomes, sample size, and monitoring plans.

Methods:

Experienced geriatrics researchers and clinical trialists collaborated to provide advice on clinical trial design.

Results:

Outcomes based on the accumulation and incidence of age-related chronic diseases are attractive for clinical trials targeting aging. Accumulation and incidence rates of multimorbidity outcomes were developed by selecting at-risk subsets of individuals from three large cohort studies of older individuals. These provide representative benchmark data for decisions on eligibility, duration, and assessment protocols. Monitoring rules should be sensitive to targeting aging-related, rather than disease-specific, outcomes.

Conclusions:

Clinical trials targeting aging are feasible, but require careful design consideration and monitoring rules.

Keywords: Clinical trial design, Geroscience, Chronic diseases

Edited by AlPater

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Effect of Alpha-Fetoprotein on Lifespan of Old Mice.

Krut'ko VN, Dontsov VI, Khalyavkin AV.

Biochemistry (Mosc). 2016 Dec;81(12):1477-1479. doi: 10.1134/S0006297916120087.

PMID: 28259124

http://sci-hub.cc/10.1134/s0006297916120087

Abstract

Alpha-fetoprotein (AFP) is one of the best-known embryo-specific proteins. It is used to diagnose fetal abnormalities and tumors of the gastrointestinal tract and liver. AFP has pronounced immunotropic and detoxifying effect and a direct apoptotic effect on tumor cells. The treatment of mice at the oldest age in our experiments with AFP dramatically increased the survival and markedly increased the relative weight of immunotropic organs, apparently due to the general effect of AFP in improving functions of tissues and detoxifying actions. It also improved appearance and the relative weight of internal organs with a reduced age of autoaggression.

 

[The below paper is not pdf-availed.]

The cost and mortality of hip fractures in centenarians.

Moore J, Carmody O, Carey B, Harty JA, Reidy D.

Ir J Med Sci. 2017 Mar 4. doi: 10.1007/s11845-017-1589-9. [Epub ahead of print]

PMID: 28260154

Abstract

BACKGROUND:

Centenarians are the fastest rising age group in Ireland. Hip fractures most commonly affect older adults and are associated with significant morbidity and mortality, as well as the financial cost of healthcare resources. Despite this, very little is known regarding hip fractures in centenarians. The aim of this study was to investigate our experience with hip fractures in this group and to record the cost of treating these fractures to identify both the social and economic impact these injuries impose on the health system.

METHODS:

The study was a retrospective data review at a major trauma centre. Nine proximal femoral fractures from June 2010-2016 were identified through a stepwise analysis of theatre data and patient notes. Time of death was recorded directly from patient records or by contacting the patient's general practitioner. With the assistance of the hospital finance department, individual inpatient costs were calculated using length of stay, theatre time and implant costs.

RESULTS:

Over the 7-year period we examined nine patients over 100 years of age were managed operatively for hip fractures with an average inpatient cost of €14,898. The mean age at the time of fracture was 101 years and 7 months. Eight of the patients were female and there was one male. Our inpatient, 30-day and 1-year mortality rate were 22, 22, and 71%.

CONCLUSIONS:

The 1-year mortality rate of any person aged 100 years or older is thought to be 67% for men and 59% for women. This suggests that the 1-year mortality rate of 71% in this current study is only slightly worse than the usual life expectancy of a person older than 100 years of age. Our data suggest that the extreme elderly should be offered operative management.

KEYWORDS:

100; Centenarian; Elderly; Health economics; Hip fracture; Savings

 

Is It Possible to Prove the Existence of an Aging Program by Quantitative Analysis of Mortality Dynamics?

Shilovsky GA, Putyatina TS, Lysenkov SN, Ashapkin VV, Luchkina OS, Markov AV, Skulachev VP.

Biochemistry (Mosc). 2016 Dec;81(12):1461-1476. doi: 10.1134/S0006297916120075. Review.

PMID: 28259123

http://istina.msu.ru/media/publications/article/e01/9ef/36565732/Shilovsky_2016_en.pdf

Abstract

Accumulation of various types of lesions in the course of aging increases an organism's vulnerability and results in a monotonous elevation of mortality rate, irrespective of the position of a species on the evolutionary tree. Stroustrup et al. (Nature, 530, 103-107) [1] showed in 2016 that in the nematode Caenorhabditis elegans, longevity-altering factors (e.g. oxidative stress, temperature, or diet) do not change the shape of the survival curve, but either stretch or shrink it along the time axis, which the authors attributed to the existence of an "aging program". Modification of the accelerated failure time model by Stroustrup et al. uses temporal scaling as a basic approach for distinguishing between quantitative and qualitative changes in aging dynamics. Thus we analyzed data on the effects of various longevity-increasing genetic manipulations in flies, worms, and mice and used several models to choose a theory that would best fit the experimental results. The possibility to identify the moment of switch from a mortality-governing pathway to some other pathways might be useful for testing geroprotective drugs. In this work, we discuss this and other aspects of temporal scaling.

 

Mediterranean diet adherence and risk of postmenopausal breast cancer: results of a cohort study and meta-analysis.

van den Brandt PA, Schulpen M.

Int J Cancer. 2017 Mar 5. doi: 10.1002/ijc.30654. [Epub ahead of print]

PMID: 28260236

http://sci-hub.cc/10.1002/ijc.30654

Abstract

The Mediterranean Diet (MD) has been associated with reduced mortality and risk of cardiovascular diseases, but there is only limited evidence on cancer. We investigated the relationship between adherence to MD and risk of postmenopausal breast cancer (and estrogen/progesterone receptor subtypes, ER/PR). In the Netherlands Cohort Study, 62,573 women aged 55-69 years provided information on dietary and lifestyle habits in 1986. Follow-up for cancer incidence until 2007 (20.3 years) consisted of record linkages with the Netherlands Cancer Registry and the Dutch Pathology Registry PALGA. Adherence to MD was estimated through the alternate Mediterranean Diet Score excluding alcohol. Multivariate case-cohort analyses were based on 2,321 incident breast cancer cases and 1,665 subcohort members with complete data on diet and potential confounders. We also conducted meta-analyses of our results with those of other published cohort studies. We found a statistically significant inverse association between MD adherence and risk of ER negative (ER-) breast cancer, with a hazard ratio of 0.60 (95% Confidence Interval, 0.39-0.93) for high versus low MD adherence (ptrend  = 0.032). MD adherence showed only nonsignificant weak inverse associations with ER positive (ER+) or total breast cancer risk. In meta-analyses, summary HRs for high versus low MD adherence were 0.94 for total postmenopausal breast cancer, 0.98 for ER+, 0.73 for ER- and 0.77 for ER - PR- breast cancer. Our findings support an inverse association between MD adherence and, particularly, receptor negative breast cancer. This may have important implications for prevention because of the poorer prognosis of these breast cancer subtypes.

KEYWORDS:

Mediterranean diet; breast cancer; cohort study

 

Efficacy and Blood Plasmalogen Changes by Oral Administration of Plasmalogen in Patients with Mild Alzheimer's Disease and Mild Cognitive Impairment: A Multicenter, Randomized, Double-blind, Placebo-controlled Trial.

Fujino T, Yamada T, Asada T, Tsuboi Y, Wakana C, Mawatari S, Kono S.

EBioMedicine. 2017 Feb 24. pii: S2352-3964(17)30071-3. doi: 10.1016/j.ebiom.2017.02.012. [Epub ahead of print]

PMID: 28259590

http://www.ebiomedicine.com/article/S2352-3964(17)30071-3/fulltext

http://www.ebiomedicine.com/article/S2352-3964(17)30071-3/pdf

Abstract

BACKGROUND:

Plasmalogens (Pls) reportedly decreased in postmortem brain and in the blood of patients with Alzheimer's disease (AD). Recently we showed that intraperitoneal administration of Pls improved cognitive function in experimental animals. In the present trial, we tested the efficacy of oral administration of scallop-derived purified Pls with respect to cognitive function and blood Pls changes in patients with mild AD and mild cognitive impairment (MCI).

METHODS:

The study was a multicenter, randomized, double-blind, placebo-controlled trial of 24weeks. Participants were 328 patients aged 60 to 85years who had 20 to 27 points in Mini Mental State Examination-Japanese (MMSE-J) score and five or less points in Geriatric Depression Scale-Short Version-Japanese (GDS-S-J). They were randomized to receive either 1mg/day of Pls purified from scallop or placebo. The patients and study physicians were masked to the assignment. The primary outcome was MMSE-J. The secondary outcomes included Wechsler Memory Scale-Revised (WMS-R), GDS-S-J and concentration of phosphatidyl ethanolamine plasmalogens (PlsPE) in erythrocyte membrane and plasma. This trial is registered with the University Hospital Medical Information Network, number UMIN000014945.

FINDINGS:

Of 328 patients enrolled, 276 patients completed the trial (140 in the treatment group and 136 in the placebo group). In an intention-to-treat analysis including both mild AD (20≤MMSE-J≤23) and MCI (24≤MMSE-J≤27), no significant difference was shown between the treatment and placebo groups in the primary and secondary outcomes, with no severe adverse events in either group. In mild AD patients, WMS-R improved significantly in the treatment group, and the between group difference was nearly significant (P=0.067). In a subgroup analysis of mild AD patients, WMS-R significantly improved among females and those aged below 77years in the treatment group, and the between-group differences were statistically significant in females (P=0.017) and in those aged below 77years (P=0.029). Patients with mild AD showed a significantly greater decrease in plasma PlsPE in the placebo group than in the treatment group.

INTERPRETATION:

Oral administration of scallop-derived purified Pls may improve cognitive functions of mild AD.

KEYWORDS:

Alzheimer's disease; Cognitive function; Mild cognitive impairment; Plasmalogen; Scallop

 

Physical Activity on the Weekend: Can It Wait Until Then?

Arem H, DiPietro L.

JAMA Intern Med. 2017 Jan 9. doi: 10.1001/jamainternmed.2016.8050. [Epub ahead of print] No abstract available.

PMID: 28097293

http://sci-hub.cc/10.1001/jamainternmed.2016.8050

>>>>>>>>>>>>>>>>>>>

Exercising as "weekend warrior" still yields mortality benefit, study finds.

Wise J.

BMJ. 2017 Jan 9;356:j126. doi: 10.1136/bmj.j126. No abstract available.

PMID: 28073747

http://sci-hub.cc/10.1136/bmj.j126

>>>>>>>>>>>>>>>>>>>>>>>>>>>>

Association of "Weekend Warrior" and Other Leisure Time Physical Activity Patterns With Risks for All-Cause, Cardiovascular Disease, and Cancer Mortality.

O'Donovan G, Lee IM, Hamer M, Stamatakis E.

JAMA Intern Med. 2017 Jan 9. doi: 10.1001/jamainternmed.2016.8014. [Epub ahead of print]

PMID: 28097313

https://www.upf.edu/upfsaludable/_pdf/Exercici_i_cap_de_setmana.pdf

Abstract

IMPORTANCE:

More research is required to clarify the association between physical activity and health in "weekend warriors" who perform all their exercise in 1 or 2 sessions per week.

OBJECTIVE:

To investigate associations between the weekend warrior and other physical activity patterns and the risks for all-cause, cardiovascular disease (CVD), and cancer mortality.

DESIGN, SETTING, AND PARTICIPANTS:

This pooled analysis of household-based surveillance studies included 11 cohorts of respondents to the Health Survey for England and Scottish Health Survey with prospective linkage to mortality records. Respondents 40 years or older were included in the analysis. Data were collected from 1994 to 2012 and analyzed in 2016.

EXPOSURES:

Self-reported leisure time physical activity, with activity patterns defined as inactive (reporting no moderate- or vigorous-intensity activities), insufficiently active (reporting <150 min/wk in moderate-intensity and <75 min/wk in vigorous-intensity activities), weekend warrior (reporting ≥150 min/wk in moderate-intensity or ≥75 min/wk in vigorous-intensity activities from 1 or 2 sessions), and regularly active (reporting ≥150 min/wk in moderate-intensity or ≥75 min/wk in vigorous-intensity activities from ≥3 sessions). The insufficiently active participants were also characterized by physical activity frequency.

MAIN OUTCOMES AND MEASURES:

All-cause, CVD, and cancer mortality ascertained from death certificates.

RESULTS:

Among the 63 591 adult respondents (45.9% male; 44.1% female; mean [sD] age, 58.6 [11.9] years), 8802 deaths from all causes, 2780 deaths from CVD, and 2526 from cancer occurred during 561 159 person-years of follow-up. Compared with the inactive participants, the hazard ratio (HR) for all-cause mortality was 0.66 (95% CI, 0.62-0.72) in insufficiently active participants who reported 1 to 2 sessions per week, 0.70 (95% CI, 0.60-0.82) in weekend warrior participants, and 0.65 (95% CI, 0.58-0.73) in regularly active participants. Compared with the inactive participants, the HR for CVD mortality was 0.60 (95% CI, 0.52-0.69) in insufficiently active participants who reported 1 or 2 sessions per week, 0.60 (95% CI, 0.45-0.82) in weekend warrior participants, and 0.59 (95% CI, 0.48-0.73) in regularly active participants. Compared with the inactive participants, the HR for cancer mortality was 0.83 (95% CI, 0.73-0.94) in insufficiently active participants who reported 1 or 2 sessions per week, 0.82 (95% CI, 0.63-1.06) in weekend warrior participants, and 0.79 (95% CI, 0.66-0.94) in regularly active participants.

CONCLUSIONS AND RELEVANCE:

Weekend warrior and other leisure time physical activity patterns characterized by 1 or 2 sessions per week may be sufficient to reduce all-cause, CVD, and cancer mortality risks regardless of adherence to prevailing physical activity guidelines.

 

[The first below paper is pdf-aviled.]

Toward a Healthier Patient Voice: More Independence, Less Industry Funding.

Moynihan R, Bero L.

JAMA Intern Med. 2017 Jan 17. doi: 10.1001/jamainternmed.2016.9179. [Epub ahead of print] No abstract available.

PMID: 28114596

Industry funding strengthens and extends the much-needed patient voice in health care, but at what cost? During the recent EpiPen scandal, the manufacturer-sponsored advocacy groups were largely silent about price gouging.1 Last year a drug company–funded “patient advocacy” campaign called “Even the Score” helped win regulatory approval for the thrice-rejected controversial female sex drug flibanserin.2 And not only does the National Osteoporosis Foundation accept funds from industry, mandatory transparency rules reveal that a majority of the medical leadership received a total of over $450 000 in payments in 2015, including for research projects.3,4 Patient advocacy groups play an increasingly powerful role in health care, sponsoring research, producing or promoting guidelines, driving media coverage, influencing regulatory decisions, promoting certain interventions, and shaping the way we think about disease. Just as the industry funding of clinical trials has been associated with more favorable findings,5 patient groups also face risks of bias when accepting money from companies seeking to expand markets for their new tests and treatments.

A survey by Rose and colleagues6 in this issue of JAMA Internal Medicine offers valuable and timely data on entanglement between patient advocacy organizations and for-profit companies. Two-thirds of groups reported receiving some industry funding, 1 in 10 reporting half their funding was from industry—defined in this study as any for-profit companies. Among groups accepting industry funding, the median amount was $50 000, with approximately 10% taking over $1 million annually—almost half of that from pharmaceutical and device companies. With rare candor, a small proportion of groups perceived “pressure to conform its positions to the interests of corporate donors or partners.” A minor limitation is the lack of disaggregation in the analysis of smaller organizations and the much larger influential groups—like the American Diabetes Association mentioned by Rose and colleagues6—that simultaneously accept corporate support and fund much medical research.

The study by Rose et al6 could not address the question of whether industry funding was associated with any bias, though the authors do raise concerns about the independence of groups receiving large amounts of money. While there is ample evidence across medicine more generally showing that funding has the potential to bias research, education, and practice,5,7 there are limited data on the possibility of similar associations between industry funding and advocacy group positions or activities. However, a small new study investigating this association by Lin and colleagues,8 also published in this issue of JAMA Internal Medicine, offers worrying findings. The team analyzed submissions from 158 organizations that commented on a draft guideline to address concerns about sharp increases in the use of opioids for chronic, noncancer pain, examining both their comments and funding sources. While most of the professional and patient groups supported the new Centers for Disease Control and Prevention (CDC) draft guidelines, including groups funded by opioid manufacturers, opposition was much more common among groups with funding from the manufacturers when compared with those with no industry funding: 38% vs 6%. In addition, the study found that of the 45 groups receiving funding from manufacturers, none disclosed this funding in comments to the CDC.

In light of the building evidence about funding source association with bias in medicine generally, it is easy to argue that advocacy groups should be totally free of such conflicts of interest. With the EpiPen saga, reports suggest it was the genuinely grass roots advocacy—not funded by industry—that helped bring the world’s attention to the excessive price hike.1 With flibanserin, groups without industry links, like the National Women’s Health Network, refused to support the company-sponsored “Even the Score” campaign to get the drug approved, due to concerns about its lack of meaningful benefits and serious, potentially fatal, harms.2 And while the National Osteoporosis Foundation continues to promote the idea of a widespread “disease,” others point to concern about the condition’s overdiagnosis and overtreatment, and call to reframe low bone mineral density as a risk factor rather than a disease.9

It is indisputable that industry and its tests and treatments are vital components of the health care system, bringing the benefits of extending human life and ameliorating suffering, and that many advocacy groups are motivated by good intentions. On the flip side, there is no doubt that industry funding can distort the patient voice. For the individual groups, the influence of a company sponsor is often invisible. Rarely does it lead to a clumsy intervention to change a group’s public position, but rather creates a routine awareness among sponsored groups that one doesn’t bite the hand that feeds it. Sometimes though the strings attached to funding are clear, with groups such as the Arthritis Foundation explicitly offering its sponsors “direct marketing” to over half a million constituents and “promotional tie-ins” with “educational initiatives” like National Arthritis Month and World Arthritis Day.10

At the system level, the aggregation of this influence raises substantial concerns. The results of the study by Rose and colleagues6 reveal that thousands of patient advocacy groups in the United States, including many that are wealthy and powerful, are reliant on support from the pharmaceutical and/or device industries. And these long shadows of corporate influence extend well beyond the nation’s borders, with impacts felt within health care systems globally. So much industry support for patient groups means certain perspectives and strategies are disproportionately supported. The very way we all think about disease—and the best ways to research, define, prevent, and treat it—is being subtly distorted because so many of the ostensibly independent players, including patient advocacy groups, are largely singing tunes acceptable to companies seeking to maximize markets for drugs and devices.

In our view this new work6,8 demonstrates an urgent need for patient advocacy organizations to explicitly focus much more on representing the interests of patients and citizens, rather than serving—inadvertently or otherwise—the interests of their industry sponsors. It also has key implications for broader reform. To ensure a healthier patient voice in medical research, education, policy, and practice, sponsored groups that want to be seen as independent and credible need to decrease their industry sponsorship and ultimately disentangle, gaining in authority what they lose in resources. In the meantime we need much greater transparency about industry funding, including prominently displayed disclosures of dollar amounts and proportions of total funding on group websites, as well as addition of patient advocacy groups to the Open Payments program established by the Sunshine Act (https://www.ama-assn.org/practice-management/physician-financial-transparency-reports-sunshine-act), which would mean mandatory disclosure of funding by sponsors. Finally, and perhaps most important, decisionmakers everywhere, including government agencies and others responsible for forging research agendas, setting health care standards, and regulating and paying for new technologies, should seek out and engage with genuinely independent patient and citizen voices, entirely free of the distorting impacts of industry funding, to help shape the future of health care.

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Patient Advocacy Organizations, Industry Funding, and Conflicts of Interest.

Rose SL, Highland J, Karafa MT, Joffe S.

JAMA Intern Med. 2017 Jan 17. doi: 10.1001/jamainternmed.2016.8443. [Epub ahead of print]

PMID: 28114624

http://sci-hub.cc/10.1001/jamainternmed.2016.8443

Abstract

IMPORTANCE:

Patient advocacy organizations (PAOs) are influential health care stakeholders that provide direct counseling and education for patients, engage in policy advocacy, and shape research agendas. Many PAOs report having financial relationships with for-profit industry, yet little is known about the nature of these relationships.

OBJECTIVE:

To describe the nature of industry funding and partnerships between PAOs and for-profit companies in the United States.

DESIGN, SETTING, AND PARTICIPANTS:

A survey was conducted from September 1, 2013, to June 30, 2014, of a nationally representative random sample of 439 PAO leaders, representing 5.6% of 7865 PAOs identified in the United States. Survey questions addressed the nature of their activities, their financial relationships with industry, and the perceived effectiveness of their conflict of interest policies.

MAIN OUTCOMES AND MEASURES:

Amount and sources of revenue as well as organizational experiences with and policies regarding financial conflict of interest.

RESULTS:

Of the 439 surveys mailed to PAO leaders, 289 (65.8%) were returned with at least 80% of the questions answered. The PAOs varied widely in terms of size, funding, activities, and disease focus. The median total revenue among responding organizations was $299 140 (interquartile range, $70 000-$1 200 000). A total of 165 of 245 PAOs (67.3%) reported receiving industry funding, with 19 of 160 PAOs (11.9%) receiving more than half of their funding from industry. Among the subset of PAOs that received industry funding, the median amount was $50 000 (interquartile range, $15 000-$200 000); the median proportion of industry support derived from the pharmaceutical, device, and/or biotechnology sectors was 45% (interquartile range, 0%-100%). A total of 220 of 269 respondents (81.8%) indicated that conflicts of interest are very or moderately relevant to PAOs, and 94 of 171 (55.0%) believed that their organizations' conflict of interest policies were very good. A total of 22 of 285 PAO leaders (7.7%) perceived pressure to conform their positions to the interests of corporate donors.

CONCLUSIONS AND RELEVANCE:

Patient advocacy organizations engage in wide-ranging health activities. Although most PAOs receive modest funding from industry, a minority receive substantial industry support, raising added concerns about independence. Many respondents report a need to improve their conflict of interest policies to help maintain public trust.

 

Conflict of Interest in Seminal Hepatitis C Virus and Cholesterol Management Guidelines.

Jefferson AA, Pearson SD.

JAMA Intern Med. 2017 Jan 17. doi: 10.1001/jamainternmed.2016.8439. [Epub ahead of print]

PMID: 28114439

http://sci-hub.cc/10.1001/jamainternmed.2016.8439

Abstract

IMPORTANCE:

Little is known regarding whether Institute of Medicine (IOM) standards for managing conflicts of interest (COI) have been met in the development of recent important clinical guidelines.

OBJECTIVE:

To evaluate adherence to the IOM standards for limits on commercial COI, guideline development, and evaluation of evidence by the 2013 American College of Cardiology and American Heart Association cholesterol management guideline and the 2014 American Association for the Study of Liver Diseases and Infectious Diseases Society of America hepatitis C virus management guideline.

DESIGN, SETTING, AND PARTICIPANTS:

This study was a retrospective document review of the June 2014 print version of the cholesterol guideline and the final September 2015 print version of the hepatitis C virus guideline. Each guideline was assessed for adherence to the IOM standards for commercial COI published in the 2011 special report Clinical Practice Guidelines We Can Trust.

MAIN OUTCOMES AND MEASURES:

The IOM standards call for no commercial COI among guideline committee chairs and cochairs and for less than 50% of committee members to have commercial COI. Guideline and contemporaneous article disclosure statements were used to evaluate adherence to these standards. Each guideline was also reviewed for adherence to other IOM standards for guideline development and evidence review.

RESULTS:

Among the 16 cholesterol guideline committee members, 7 (44%) disclosed commercial COI, all 7 reported industry-sponsored research, and 6 (38%) also reported consultancy. Of 3 guideline chairs and cochairs, 1 (33%) disclosed commercial COI. Review of contemporaneous articles identified additional commercial COI. Among the 29 hepatitis C virus guideline committee members, 21 (72%) reported commercial COI. Eighteen (62%) disclosed industry-sponsored research, 10 (34%) served on advisory boards, 5 (17%) served on data safety monitoring boards, 3 (10%) were consultants, and 3 (10%) reported other honoraria. Of 6 guideline cochairs, 4 (67%) disclosed commercial COI. All 4 disclosed additional COI in other publications that were not listed in their guideline disclosures. Contemporaneous literature review revealed an additional cochair with commercial COI. Of the 9 IOM guideline development and evidence standards, the cholesterol guideline met 5 (56%), and the hepatitis C virus guideline met them all.

CONCLUSIONS AND RELEVANCE:

Neither the cholesterol guideline nor the hepatitis C virus guideline fully met the IOM standards for commercial COI management, and discordance between committee leader guideline disclosures and those in contemporaneous articles was common. Adherence to additional IOM standards for guideline development and evidence review was mixed. Adoption of consistent COI frameworks across specialty societies may help ensure that clinical guidelines are developed in a transparent and trustworthy manner.

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Induction of lipogenesis in white fat during cold exposure in mice: link to lean phenotype.

Flachs P, Adamcova K, Zouhar P, Marques C, Janovska P, Viegas I, Jones JG, Bardova K, Svobodova M, Hansikova J, Kuda O, Rossmeisl M, Liisberg U, Borkowska AG, Kristiansen K, Madsen L, Kopecky J.

Int J Obes (Lond). 2017 Jan 17. doi: 10.1038/ijo.2016.228. [Epub ahead of print]

PMID: 28008171

Abstract

BACKGROUND/OBJECTIVE:

Futile substrate cycling based on lipolytic release of fatty acids (FA) from intracellular triacylglycerols (TAG) and their re-esterification (TAG/FA cycling), as well as de novo FA synthesis (de novo lipogenesis (DNL)), represent the core energy-consuming biochemical activities of white adipose tissue (WAT). We aimed to characterize their roles in cold-induced thermogenesis and energy homeostasis.

METHODS:

Male obesity-resistant A/J and obesity-prone C57BL/6J mice maintained at 30 °C were exposed to 6 °C for 2 or 7 days. In epididymal WAT (eWAT), TAG synthesis and DNL were determined using in vivo 2H incorporation from 2H2O into tissue TAG and nuclear magnetic resonance spectroscopy. Quantitative real-time-PCR and/or immunohistochemistry and western blotting were used to determine the expression of selected genes and proteins in WAT and liver.

RESULTS:

The mass of WAT depots declined during cold exposure (CE). Plasma levels of TAG and non-esterified FA were decreased by day 2 but tended to normalize by day 7 of CE. TAG synthesis (reflecting TAG/FA cycle activity) gradually increased during CE. DNL decreased by day 2 of CE but increased several fold over the control values by day 7. Expression of genes involved in lipolysis, glyceroneogenesis, FA re-esterification, FA oxidation and mitochondrial biogenesis in eWAT was induced during CE. All these changes were more pronounced in obesity-resistant A/J than in B6 mice and occurred in the absence of uncoupling protein 1 in eWAT. Expression of markers of glyceroneogenesis in eWAT correlated negatively with hepatic FA synthesis by day 7 in both strains. Leptin and fibroblast growth factor 21 plasma levels were differentially affected by CE in the two mouse strains.

CONCLUSIONS:

Our results indicate integrated involvement of (i) TAG/FA cycling and DNL in WAT, and (ii) hepatic very-low-density lipoprotein-TAG synthesis in the control of blood lipid levels and provision of FA fuels for thermogenesis in cold. They suggest that lipogenesis in WAT contributes to a lean phenotype.

 

Metabolic dysfunction following weight cycling in male mice.

Schofield SE, Parkinson JR, Henley AB, Sahuri-Arisoylu M, Sanchez-Canon GJ, Bell JD.

Int J Obes (Lond). 2017 Jan 17. doi: 10.1038/ijo.2016.193. [Epub ahead of print]

PMID: 27840414

Abstract

BACKGROUND:

Combatting overweight or obesity can lead to large fluctuations in an individual's body weight, often referred to as weight cycling or 'yo-yo' dieting. Current evidence regarding the potentially damaging effects of these changes is conflicting.

METHODS:

Here, we assess the metabolic effects of weight cycling in a murine model, comprising three dietary switches to normal or high-fat diets at 6 week intervals; male C57BL/6 mice were fed either a control © or high-fat (F) diet for 6 weeks (n=140/group). C and F groups were then either maintained on their initial diet (CC and FF, respectively) or switched to a high-fat (CF) or control (FC) diet (n=35/group). For the final 6 week interval, CC and CF groups were returned to the control diet (CCC and CFC groups), while FC and FF groups were placed on a high-fat diet (FCF and FFF) (n=28/group).

RESULTS:

For the majority of metabolic outcomes changes aligned with dietary switches; however, assessment of neuropeptides and receptors involved in appetite regulation and reward signalling pathways reveal variable patterns of expression. Furthermore, we demonstrate that multiple cycling events leads to a significant increase in internal fat deposition, even when compared with animals maintained on a high-fat diet (internal fat: FCF: 7.4±0.2 g vs FFF: 5.6±0.2 g; P<0.01).

CONCLUSIONS:

Increased internal adipose tissue is strongly linked to the development of metabolic syndrome associated conditions such as type 2 diabetes, cardiovascular disease and hypertension. Although further work will be required to elucidate the mechanisms underlying the neuronal control of energy homoeostasis, these studies provide a causative link between weight cycling and adverse health.

 

Patterned feeding induces neuroendocrine, behavioral and genetic changes that promote palatable food intake.

Sirohi S, Van Cleef A, Davis JF.

Int J Obes (Lond). 2017 Jan 31. doi: 10.1038/ijo.2016.235. [Epub ahead of print]

PMID: 28025575

Abstract

BACKGROUND:

Selection of a healthy diet is the cornerstone for treating obesity and metabolic disease. Unfortunately, the majority of diets fail leading to weight regain and in some cases, pathological feeding behavior. We hypothesize that alternating bouts of caloric overconsumption and caloric restriction, behavioral manifestations of dieting induce neuroendocrine, behavioral and genetic changes that promote future bouts of palatable food intake.

METHODS:

To test this hypothesis, we subjected male Long-Evans rats to a high-fat diet (HFD) feeding paradigm that induced a pattern of caloric overconsumption and caloric restriction. Under these conditions we measured operant responding for sucrose, pre-meal ghrelin secretion, the effects of peripheral ghrelin blockade on patterned feeding, HFD intake in an aversive environment and mRNA expression of the ghrelin receptor, orexin, orexin-1 and 2 receptors, and FTO in the medial prefrontal cortex, lateral hypothalamus and ventral tegmental area.

RESULTS:

Rats subjected to this feeding regimen displayed increased ghrelin levels prior to HFD exposure and blockade of this response attenuated patterned feeding behavior. In addition, patterned feeding promoted enhanced motivation for sucrose, diminished extinction of this response and increased HFD intake in an aversive environment. The neuroendocrine and behavioral changes correlated with increased hypothalamic expression of the ghrelin receptor and FTO.

CONCLUSION:

Collectively, these data indicate that patterns of feeding that include caloric overconsumption and caloric restriction induce neuroendocrine and neurobiological changes that signify an enhanced drive for palatable food.

 

Effects of aspartame-, monk fruit-, stevia- and sucrose-sweetened beverages on postprandial glucose, insulin and energy intake.

Tey SL, Salleh NB, Henry J, Forde CG.

Int J Obes (Lond). 2017 Jan 10. doi: 10.1038/ijo.2016.225. [Epub ahead of print]

PMID: 27956737

Abstract

BACKGROUND:

Substituting sweeteners with non-nutritive sweeteners (NNS) may aid in glycaemic control and body weight management. Limited studies have investigated energy compensation, glycaemic and insulinaemic responses to artificial and natural NNS.

OBJECTIVES:

This study compared the effects of consuming NNS (artificial versus natural) and sucrose (65 g) on energy intake, blood glucose and insulin responses.

METHODS:

Thirty healthy male subjects took part in this randomised, crossover study with four treatments: aspartame-, monk fruit-, stevia- and sucrose-sweetened beverages. On each test day, participants were asked to consume a standardised breakfast in the morning, and they were provided with test beverage as a preload in mid-morning and ad libitum lunch was provided an hour after test beverage consumption. Blood glucose and insulin concentrations were measured every 15 min within the first hour of preload consumption and every 30 min for the subsequent 2 h. Participants left the study site 3 h after preload consumption and completed a food diary for the rest of the day.

RESULTS:

Ad libitum lunch intake was significantly higher for the NNS treatments compared with sucrose (P=0.010). The energy 'saved' from replacing sucrose with NNS was fully compensated for at subsequent meals; hence, no difference in total daily energy intake was found between the treatments (P=0.831). The sucrose-sweetened beverage led to large spikes in blood glucose and insulin responses within the first hour, whereas these responses were higher for all three NNS beverages following the test lunch. Thus, there were no differences in total area under the curve (AUC) for glucose (P=0.960) and insulin (P=0.216) over 3 h between the four test beverages.

CONCLUSIONS:

The consumption of calorie-free beverages sweetened with artificial and natural NNS have minimal influences on total daily energy intake, postprandial glucose and insulin compared with a sucrose-sweetened beverage.

 

Sirtuin 1 regulates cardiac electrical activity by deacetylating the cardiac sodium channel.

Vikram A, Lewarchik CM, Yoon JY, Naqvi A, Kumar S, Morgan GM, Jacobs JS, Li Q, Kim YR, Kassan M, Liu J, Gabani M, Kumar A, Mehdi H, Zhu X, Guan X, Kutschke W, Zhang X, Boudreau RL, Dai S, Matasic DS, Jung SB, Margulies KB, Kumar V, Bachschmid MM, London B, Irani K.

Nat Med. 2017 Feb 13. doi: 10.1038/nm.4284. [Epub ahead of print]

PMID: 28191886

Abstract

The voltage-gated cardiac Na+ channel (Nav1.5), encoded by the SCN5A gene, conducts the inward depolarizing cardiac Na+ current (INa) and is vital for normal cardiac electrical activity. Inherited loss-of-function mutations in SCN5A lead to defects in the generation and conduction of the cardiac electrical impulse and are associated with various arrhythmia phenotypes. Here we show that sirtuin 1 deacetylase (Sirt1) deacetylates Nav1.5 at lysine 1479 (K1479) and stimulates INa via lysine-deacetylation-mediated trafficking of Nav1.5 to the plasma membrane. Cardiac Sirt1 deficiency in mice induces hyperacetylation of K1479 in Nav1.5, decreases expression of Nav1.5 on the cardiomyocyte membrane, reduces INa and leads to cardiac conduction abnormalities and premature death owing to arrhythmia. The arrhythmic phenotype of cardiac-Sirt1-deficient mice recapitulated human cardiac arrhythmias resulting from loss of function of Nav1.5. Increased Sirt1 activity or expression results in decreased lysine acetylation of Nav1.5, which promotes the trafficking of Nav1.5 to the plasma membrane and stimulation of INa. As compared to wild-type Nav1.5, Nav1.5 with K1479 mutated to a nonacetylatable residue increases peak INa and is not regulated by Sirt1, whereas Nav1.5 with K1479 mutated to mimic acetylation decreases INa. Nav1.5 is hyperacetylated on K1479 in the hearts of patients with cardiomyopathy and clinical conduction disease. Thus, Sirt1, by deacetylating Nav1.5, plays an essential part in the regulation of INa and cardiac electrical activity.

 

α5 nicotinic receptors link smoking to schizophrenia

Nat Med. 2017 Jan 23. pp277 - 278

Xin-an Liu and Paul J Kenny

doi:10.1038/nm.4300

http://sci-hub.cc/10.1038/nm.4300

A new study shows that nicotinic receptors activate a particular type of interneuron in the prefrontal cortex. Deficits in this relationship give rise to behavioral abnormalities similar to those associated with schizophrenia, which can be ameliorated by nicotine.

>>>>>>>>>>>>>>>>>>>>>>

Nicotine reverses hypofrontality in animal models of addiction and schizophrenia.

Koukouli F, Rooy M, Tziotis D, Sailor KA, O'Neill HC, Levenga J, Witte M, Nilges M, Changeux JP, Hoeffer CA, Stitzel JA, Gutkin BS, DiGregorio DA, Maskos U.

Nat Med. 2017 Jan 23. doi: 10.1038/nm.4274. [Epub ahead of print]

PMID: 28112735

Abstract

The prefrontal cortex (PFC) underlies higher cognitive processes that are modulated by nicotinic acetylcholine receptor (nAChR) activation by cholinergic inputs. PFC spontaneous default activity is altered in neuropsychiatric disorders, including schizophrenia-a disorder that can be accompanied by heavy smoking. Recently, genome-wide association studies (GWAS) identified single-nucleotide polymorphisms (SNPs) in the human CHRNA5 gene, encoding the α5 nAChR subunit, that increase the risks for both smoking and schizophrenia. Mice with altered nAChR gene function exhibit PFC-dependent behavioral deficits, but it is unknown how the corresponding human polymorphisms alter the cellular and circuit mechanisms underlying behavior. Here we show that mice expressing a human α5 SNP exhibit neurocognitive behavioral deficits in social interaction and sensorimotor gating tasks. Two-photon calcium imaging in awake mouse models showed that nicotine can differentially influence PFC pyramidal cell activity by nAChR modulation of layer II/III hierarchical inhibitory circuits. In α5-SNP-expressing and α5-knockout mice, lower activity of vasoactive intestinal polypeptide (VIP) interneurons resulted in an increased somatostatin (SOM) interneuron inhibitory drive over layer II/III pyramidal neurons. The decreased activity observed in α5-SNP-expressing mice resembles the hypofrontality observed in patients with psychiatric disorders, including schizophrenia and addiction. Chronic nicotine administration reversed this hypofrontality, suggesting that administration of nicotine may represent a therapeutic strategy for the treatment of schizophrenia, and a physiological basis for the tendency of patients with schizophrenia to self-medicate by smoking.

 

Aging and Veterinary Care of Cats, Dogs, and Horses through the Records of Three University Veterinary Hospitals.

Cozzi B, Ballarin C, Mantovani R, Rota A.

Front Vet Sci. 2017 Feb 14;4:14. doi: 10.3389/fvets.2017.00014.

PMID: 28261586

http://journal.frontiersin.org/article/10.3389/fvets.2017.00014/full

Abstract

The present article examines over 63,000 medical records belonging to the Veterinary Hospitals of the Universities of Bologna, Torino, and Padova, all in Northern Italy, and relative to dogs (approximately 50,000), cats (approximately 12,000), and companion horses (slightly less than 1,000). The animals of the three species were divided into age classes and categorized per sex into males, females, and neutered individuals. The mean age at visit and the effects of age classes and category (analyzed via ANOVA) are presented and discussed. The data indicate that many animals are presented to the hospitals either in the early phases of their life (presumably for vaccination and, in cats and dogs, gonadectomy) or in the advanced age (over 10 years in dogs, over 15 years in cats, and over 17 years in horses). The records of very old individuals of the three species are also reported. On the whole, the results suggest that a growing population of mature to old domestic carnivores or companion horses reaches ages that were considered exceptional only a few years ago. The data also testify an evolution in the animal-owner relationship and a renewed respect for the value of life in companion domestic mammals.

KEYWORDS:

aging; animal gerontology; animal hospital; animal life span; cat; dog; horse

 

Coronary Artery Bypass Graft Surgery and Dementia Risk in the Cardiovascular Health Study.

Kuźma E, Airdrie J, Littlejohns TJ, Lourida I, Thompson-Coon J, Lang IA, Scrobotovici M, Thacker EL, Fitzpatrick A, Kuller LH, Lopez OL, Longstreth WT Jr, Ukoumunne OC, Llewellyn DJ.

Alzheimer Dis Assoc Disord. 2017 Mar 3. doi: 10.1097/WAD.0000000000000191. [Epub ahead of print]

PMID: 28263191

http://ovidsp.tx.ovid.com.sci-hub.cc/sp-3.24.1b/ovidweb.cgi?WebLinkFrameset=1&S=MKBHFPDNNKDDAEEFNCHKIGDCFMEDAA00&returnUrl=ovidweb.cgi%3fMain%2bSearch%2bPage%3d1%26S%3dMKBHFPDNNKDDAEEFNCHKIGDCFMEDAA00&directlink=http%3a%2f%2fovidsp.tx.ovid.com%2fovftpdfs%2fFPDDNCDCIGEFNK00%2ffs046%2fovft%2flive%2fgv025%2f00002093%2f00002093-900000000-99490.pdf&filename=Coronary+Artery+Bypass+Graft+Surgery+and+Dementia+Risk+in+the+Cardiovascular+Health+Study.&navigation_links=NavLinks.S.sh.22.1&link_from=S.sh.22%7c1&pdf_key=FPDDNCDCIGEFNK00&pdf_index=/fs046/ovft/live/gv025/00002093/00002093-900000000-99490&D=ovft&link_set=S.sh.22|1|sl_10|resultSet|S.sh.22.23|0

Abstract

INTRODUCTION:

The association between history of coronary artery bypass graft surgery (CABG) and dementia risk remains unclear.

METHODS:

We conducted a prospective cohort analysis using data on 3155 elderly adults free from prevalent dementia from the US population-based Cardiovascular Health Study (CHS) with adjudicated incident all-cause dementia, Alzheimer disease (AD), vascular dementia (VaD), and mixed dementia.

RESULTS:

In the CHS, the hazard ratio (HR) for all-cause dementia was 1.93 [95% confidence interval (CI), 1.36-2.74] for those with CABG history compared with those with no CABG history after adjustment for potential confounders. Similar HRs were observed for AD (HR=1.71; 95% CI, 0.98-2.98), VaD (HR=1.42; 95% CI, 0.56-3.65), and mixed dementia (HR=2.73; 95% CI, 1.55-4.80). The same pattern of results was observed when these CHS findings were pooled with a prior prospective study, the pooled HRs were 1.96 (95% CI, 1.42-2.69) for all-cause dementia, 1.71 (95% CI, 1.04-2.79) for AD and 2.20 (95% CI, 0.78-6.19) for VaD.

DISCUSSION:

Our results suggest CABG history is associated with long-term dementia risk. Further investigation is warranted to examine the causal mechanisms which may explain this relationship or whether the association reflects differences in coronary artery disease severity.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

 

HISTORY OF VASCULAR DISEASE AND RISK OF DEMENTIA IN THE OLDEST-OLD: THE 90+ STUDY

Maria M. CorradaEmail the author Maria M. Corrada, Farah Mozaffar, Marcella A. Evans, Szofia S. Bullain, Ron Brookmeyer, Claudia H. Kawas

O2-09-06

DOI: http://dx.doi.org/10.1016/j.jalz.2016.06.447

http://sci-hub.cc/10.1016/j.jalz.2016.06.447

Table

Hazard Ratios of Developing All-Cause Dementia in Relation to Vascular Diseases in the Oldest-Old: The 90+ Study

-----------------------------------

Vascular Disease===Prevalence N (%)===Univariable Analyses===Multivariable Analysis

- - ===Hazard Ratio (95% CI) p-value===Hazard Ratio (95% CI) p-value

----------------------------------

Congestive heart failure 55 (10) 2.15 (1.43-3.25) <0.001 2.23 (1.47-3.39) <0.001

Heart valve disease 38 (7) 1.72 (1.08-2.73) 0.02 1.60 (0.96-2.67) 0.07

Stroke 53 (10) 1.72 (1.14-2.59) 0.01 1.68 (1.10-2.57) 0.02

Diabetes 33 (6) 1.53 (0.85-2.75) 0.16 - -

Myocardial infarction 65 (12) 1.32 (0.88-2.00) 0.18 -

Transient ischemic attack 83 (15) 1.29 (0.89 -1.87) 0.17 - -

Arrhythmia 150 (27) 1.20 (0.89 -1.63) 0.22 - -

Coronary artery disease 80 (15) 0.90 (0.59 -1.39) 0.64 - -

High cholesterol 190 (36) 0.78 (0.58-1.05) 0.10 - -

Hypertension 321 (58) 0.73 (0.56 -0.95) 0.02 0.74 (0.57-0.98) 0.04

 

Soft drink consumption and gestational diabetes risk in the SUN project.

Donazar-Ezcurra M, Lopez-Del Burgo C, Martinez-Gonzalez MA, Basterra-Gortari FJ, de Irala J, Bes-Rastrollo M.

Clin Nutr. 2017 Feb 20. pii: S0261-5614(17)30055-9. doi: 10.1016/j.clnu.2017.02.005. [Epub ahead of print]

PMID: 28262323

http://sci-hub.cc/10.1016/j.clnu.2017.02.005

Abstract

BACKGROUND & AIMS:

Gestational diabetes mellitus (GDM) prevalence is increasing worldwide. To the best of our knowledge the specific evaluation of soft drink consumption as a risk factor for developing GDM has only been conducted in the Nurses' Health Study II.

OBJECTIVE:

To investigate the incidence of GDM according to soft drink consumption in the SUN project.

DESIGN:

The "Seguimiento Universidad de Navarra" (SUN) project is a prospective and dynamic cohort which included data of 3396 women who notified at least one pregnancy between December 1999 and March 2012. A validated 136-item semi-quantitative food frequency questionnaire was used to assess soft drink consumption. Four categories of sugar-sweetened soft drink (SSSD) and diet soft drink (DSD) consumption (servings) were established: rarely or never (<1/month), low (1-3/month), intermediate (>3/month and ≤1/week) and high (≥2/week). Potential confounders were adjusted through non-conditional logistic regression models.

RESULTS:

During the follow-up, we identified 172 incident cases of GDM. After adjusting for age, baseline body mass index, family history of diabetes, smoking, total energy intake, physical activity, parity, fast-food consumption, adherence to Mediterranean dietary pattern, alcohol intake, multiple pregnancy, cardiovascular disease/hypertension at baseline, fiber intake, following special diet and snacking, SSSD consumption was significantly associated with an increased risk of incident GDM, with multivariable adjusted odds ratios (OR) of 2.03 (95% confidence interval [CI]: 1.25-3.31) and 1.67 (95% CI: 1.01-2.77) for the highest and intermediate categories, respectively, versus the lowest category (p for linear trend: 0.006). Conversely, DSD consumption was not associated with GDM incidence (adjusted OR: 0.82; 95% CI: 0.52-1.31) for the highest versus the lowest category (p for linear trend: 0.258). Additional sensitivity analyses did not change the results.

CONCLUSION:

Higher consumption of SSSDs before pregnancy was an independent risk factor for GDM, however, no association was observed between DSD consumption and GDM risk.

Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

KEYWORDS:

Cohort; Diet soft drinks; Gestational diabetes mellitus risk; Pre-pregnancy dietary pattern; Sugar-sweetened soft drinks; Western-style dietary pattern

 

Chronic alcohol consumption decreases brown adipose tissue mass and disrupts thermoregulation: a possible role for altered retinoid signaling.

Blaner WS, Gao MA, Jiang H, Dalmer TR, Hu XJ, Ginsberg HN, Clugston RD.

Sci Rep. 2017 Mar 6;7:43474. doi: 10.1038/srep43474.

PMID: 28262768

http://www.nature.com/articles/srep43474

Abstract

Retinoic acid, an active metabolite of dietary vitamin A, acts as a ligand for nuclear receptor transcription factors with more than 500 known target genes. It is becoming increasingly clear that alcohol has a significant impact on cellular retinoic acid metabolism, with resultant effects on its function. Here, we test the hypothesis that chronic alcohol consumption impairs retinoic acid signaling in brown adipose tissue (BAT), leading to impaired BAT function and thermoregulation. All studies were conducted in age-matched, male mice consuming alcohol-containing liquid diets. Alcohol's effect on BAT was assessed by histology, qPCR, HPLC, LC/MS and measures of core body temperature. Our data show that chronic alcohol consumption decreases BAT mass, with a resultant effect on thermoregulation. Follow-up mechanistic studies reveal a decreased triglyceride content in BAT, as well as impaired retinoic acid homeostasis, associated with decreased BAT levels of retinoic acid in alcohol-consuming mice. Our work highlights a hitherto uncharacterized effect of alcohol on BAT function, with possible implications for thermoregulation and energy metabolism in drinkers. Our data indicate that alcohol's effects on brown adipose tissue may be mediated through altered retinoic acid signaling.

 

Dietary isoflavone intake and all-cause mortality in breast cancer survivors: The Breast Cancer Family Registry.

Zhang FF, Haslam DE, Terry MB, Knight JA, Andrulis IL, Daly MB, Buys SS, John EM.

Cancer. 2017 Mar 6. doi: 10.1002/cncr.30615. [Epub ahead of print]

PMID: 28263368

http://sci-hub.cc/10.1002/cncr.30615

Abstract

BACKGROUND:

Soy foods possess both antiestrogenic and estrogen-like properties. It remains controversial whether women diagnosed with breast cancer should be advised to eat more or less soy foods, especially for those who receive hormone therapies as part of cancer treatment.

METHODS:

The association of dietary intake of isoflavone, the major phytoestrogen in soy, with all-cause mortality was examined in 6235 women with breast cancer enrolled in the Breast Cancer Family Registry. Dietary intake was assessed using a Food Frequency Questionnaire developed for the Hawaii-Los Angeles Multiethnic Cohort among 5178 women who reported prediagnosis diet and 1664 women who reported postdiagnosis diet. Cox proportional-hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

RESULTS:

During a median follow-up of 113 months (approximately 9.4 years), 1224 deaths were documented. A 21% decrease was observed in all-cause mortality for women who had the highest versus lowest quartile of dietary isoflavone intake (≥1.5 vs < 0.3 mg daily: HR, 0.79; 95% confidence interval CI, 0.64-0.97; Ptrend  = .01). Lower mortality associated with higher intake was limited to women who had tumors that were negative for hormone receptors (HR, 0.49; 95% CI, 0.29-0.83; Ptrend  = .005) and those who did not receive hormone therapy for their breast cancer (HR, 0.68; 95% CI, 0.51-0.91; Ptrend  = .02). Interactions, however, did not reach statistical significance.

CONCLUSIONS:

In this large, ethnically diverse cohort of women with breast cancer living in North America, a higher dietary intake of isoflavone was associated with reduced all-cause mortality.

[see editorial on pages 0000-000, this issue.] Cancer 2017.

KEYWORDS:

breast cancer; breast cancer survivors; isoflavone; mortality; soy; survival

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Soy foods, isoflavones, and breast cancer.

Kucuk O.

Cancer. 2017 Mar 6. doi: 10.1002/cncr.30614. [Epub ahead of print] No abstract available.

PMID: 28263364

http://sci-hub.cc/10.1002/cncr.30614

Recent data from Asia and North America indicate that soy foods may decrease the risk of breast cancer and improve the results of treatment in patients with breast cancer. Studying soy foods and isoflavones promises to be an exceptionally fertile area for a wide range of cancer researchers.

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The efficacy of the modified Atkins diet in North Sea Progressive Myoclonus Epilepsy: an observational prospective open-label study.

van Egmond ME, Weijenberg A, van Rijn ME, Elting JW, Gelauff JM, Zutt R, Sival DA, Lambrechts RA, Tijssen MA, Brouwer OF, de Koning TJ.

Orphanet J Rare Dis. 2017 Mar 7;12(1):45. doi: 10.1186/s13023-017-0595-3.

PMID: 28264719

http://ojrd.biomedcentral.com/articles/10.1186/s13023-017-0595-3

Abstract

BACKGROUND:

North Sea Progressive Myoclonus Epilepsy is a rare and severe disorder caused by mutations in the GOSR2 gene. It is clinically characterized by progressive myoclonus, seizures, early-onset ataxia and areflexia. As in other progressive myoclonus epilepsies, the efficacy of antiepileptic drugs is disappointingly limited in North Sea Progressive Myoclonus Epilepsy. The ketogenic diet and the less restrictive modified Atkins diet have been proven to be effective in other drug-resistant epilepsy syndromes, including those with myoclonic seizures. Our aim was to evaluate the efficacy of the modified Atkins diet in patients with North Sea Progressive Myoclonus Epilepsy.

RESULTS:

Four North Sea Progressive Myoclonus Epilepsy patients (aged 7-20 years) participated in an observational, prospective, open-label study on the efficacy of the modified Atkins diet. Several clinical parameters were assessed at baseline and again after participants had been on the diet for 3 months. The primary outcome measure was health-related quality of life, with seizure frequency and blinded rated myoclonus severity as secondary outcome measures. Ketosis was achieved within 2 weeks and all patients completed the 3 months on the modified Atkins diet. The diet was well tolerated by all four patients. Health-related quality of life improved considerably in one patient and showed sustained improvement during long-term follow-up, despite the progressive nature of the disorder. Health-related quality of life remained broadly unchanged in the other three patients and they did not continue the diet. Seizure frequency remained stable and blinded rating of their myoclonus showed improvement, albeit modest, in all patients.

CONCLUSIONS:

This observational, prospective study shows that some North Sea Progressive Myoclonus Epilepsy patients may benefit from the modified Atkins diet with sustained health-related quality of life improvement. Not all our patients continued on the diet, but nonetheless we show that the modified Atkins diet might be considered as a possible treatment in this devastating disorder.

KEYWORDS:

Epilepsy; GOSR2 gene; Ketogenic diet; Modified Atkins diet; Myoclonus; North Sea Progressive Myoclonus Epilepsy; Quality of life; Treatment

 

Effects on Health Outcomes of a Mediterranean Diet With No Restriction on Fat Intake: A Systematic Review and Meta-analysis.

Bloomfield HE, Koeller E, Greer N, MacDonald R, Kane R, Wilt TJ.

Ann Intern Med. 2016 Oct 4;165(7):491-500. doi: 10.7326/M16-0361.

PMID: 27428849

http://sci-hub.cc/10.7326/m16-0361

Abstract

BACKGROUND:

Mediterranean diets may be healthier than typical Western diets.

PURPOSE:

To summarize the literature comparing a Mediterranean diet with unrestricted fat intake with other diets regarding their effects on health outcomes in adults.

DATA SOURCES:

Ovid MEDLINE, CINAHL, and the Cochrane Library from 1990 through April 2016.

STUDY SELECTION:

Controlled trials of 100 or more persons followed for at least 1 year for mortality, cardiovascular, hypertension, diabetes, and adherence outcomes, as well as cohort studies for cancer outcomes.

DATA EXTRACTION:

Data extracted by 1 investigator was verified by another. Two reviewers assessed risk of bias and strength of evidence.

DATA SYNTHESIS:

Two primary prevention trials found no difference in all-cause mortality between diet groups. One large primary prevention trial found that a Mediterranean diet resulted in a lower incidence of major cardiovascular events (hazard ratio {HR}, 0.71 [95% CI, 0.56 to 0.90]), breast cancer (HR, 0.43 [CI, 0.21 to 0.88]), and diabetes (HR, 0.70 [CI, 0.54 to 0.92]). Pooled analyses of primary prevention cohort studies showed that compared with the lowest quantile, the highest quantile of adherence to a Mediterranean diet was associated with a reduction in total cancer mortality (risk ratio [RR], 0.86 [CI, 0.82 to 0.91]; 13 studies) and in the incidence of total (RR, 0.96 [CI, 0.95 to 0.97]; 3 studies) and colorectal (RR, 0.91 [CI, 0.84 to 0.98; 9 studies]) cancer. Of 3 secondary prevention studies reporting cardiovascular outcomes, 1 found a lower risk for recurrent myocardial infarction and cardiovascular death with the Mediterranean diet. There was inconsistent, minimal, or no evidence pertaining to any other outcome, including adherence, hypertension, cognitive function, kidney disease, rheumatoid arthritis, and quality of life.

LIMITATIONS:

Few trials; medium risk-of-bias ratings for many studies; low or insufficient strength of evidence for outcomes; heterogeneous diet definitions and components.

CONCLUSION:

Limited evidence suggests that a Mediterranean diet with no restriction on fat intake may reduce the incidence of cardiovascular events, breast cancer, and type 2 diabetes mellitus but may not affect all-cause mortality.

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Effects on Health Outcomes of a Mediterranean Diet With No Restriction on Fat Intake.

Martínez-González MA, Estruch R, Corella D, Ros E, Fitó M, Schwingshackl L, Salas-Salvadó J.

Ann Intern Med. 2017 Mar 7;166(5):378. doi: 10.7326/L16-0589. No abstract available.

PMID: 28265657

TO THE EDITOR:

We are concerned by the statements on weak evidence of benefit of the traditional Mediterranean diet in Bloomfield and colleagues' systematic review (1). Rating the available evidence as limited is unfair. The quality and quantity of scientific evidence supporting the benefits of this diet are impressive and are lacking in other dietary patterns.

The PREDIMED (Prevención con Dieta Mediterránea) trial, a low-risk-of-bias study, was not designed to assess differences in all-cause mortality. The primary end point was cardiovascular disease—including myocardial infarction, stroke, and cardiovascular death, as stated in the protocol (2)—but not all-cause mortality. This is also the case in most cardiovascular trials, which are rarely powered for testing the effect on total mortality. The data and safety monitoring board recommended stopping the PREDIMED trial at 4.8 years for early evidence of benefit, although the planned duration was 6 years. The number of observed deaths was consequently even smaller than if the trial had been completed. Therefore, highlighting that no statistically significant results were observed for all-cause mortality is not fair. Doing so is even worse when these nonsignificant results are interpreted as evidence of equality and are placed as the first sentence in the Data Synthesis section of the abstract to support a conclusion of “no difference in all-cause mortality.” Dozens of adequately powered cohort studies already gave the correct conclusion: A strong inverse association exists between the Mediterranean diet and all-cause mortality (3, 4).

Why the authors included only cohort studies for cancer and rheumatoid arthritis but not other outcomes is unclear; they provided no rationale for this unusual decision. The whole available evidence should have been used. Why cohort studies for all-cause mortality, cardiovascular disease, and type 2 diabetes were discarded is difficult to understand. The conclusion that evidence is weak or limited is highly misleading given the consistent available scientific evidence (3, 4).

More important is the inappropriate and highly nonspecific definition of the Mediterranean diet (2 or more of 7 components) chosen by the authors. This definition is almost completely useless, because many studies meet at least 2 criteria but assess diets quite different from the traditional Mediterranean one. Some of these dietary patterns are also healthy, but they have little in common with the traditional Mediterranean diet (5). The criteria used for defining a Mediterranean diet in this systematic review are wrong and will only confuse readers. Such a peculiar definition of this diet should be avoided in the future.

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Effects on Health Outcomes of a Mediterranean Diet With No Restriction on Fat Intake.

Papadaki A, Martinez JA.

Ann Intern Med. 2017 Mar 7;166(5):377-378. doi: 10.7326/L16-0590. No abstract available.

PMID: 28265658

TO THE EDITOR:

Bloomfield and colleagues' systematic review (1) aims to examine the effect of a Mediterranean diet on various health outcomes. The authors mention the word “effect” throughout their article, which implies that only intervention studies were reviewed. This is not the case, because observational studies were also reviewed. According to the authors, “Observational studies were included if they assessed the association between 2 or more … [Mediterranean diet] components and any of our outcomes of interest.” As such, that they excluded not only observational studies examining the association between all Mediterranean diet components and health outcomes (which other systematic reviews of this diet have included [2]) but also those examining 2 or more components is surprising. For example, Fung and associates' 2008 trial (3) evaluating the role of a DASH (Dietary Approaches to Stop Hypertension)–style diet in coronary heart disease and stroke is a study of the latter that is not included in Bloomfield and colleagues' review.

The arbitrary definition of the Mediterranean diet used in this review also poses a major risk and makes the conclusions inappropriate. Granted, the food and nutrient components that the authors used to define the Mediterranean diet have been used before (4). However, consuming only 2 components of the ones listed does not make a diet Mediterranean. To our knowledge, all the Mediterranean scores and indices used so far in the literature have included 7 to 14 foods and/or nutrients (4), and a prespecified (or median) intake for each component usually needs to be met for a person to be considered adherent to this component. Adherence to the Mediterranean diet is then calculated by summing the adherence scores for each component; persons are then categorized as having high, moderate, or low adherence according to this overall score (4). The authors' definition does not comply with that of the traditional Mediterranean diet (4). Furthermore, adherence to the Mediterranean diet has never, to our knowledge, been assessed by having high adherence to only 2 (or 3 or 4) food components, even if those components are consumed in quantities considered to be in agreement with a “healthy” diet. Therefore, the authors' findings do not necessarily refer to the Mediterranean diet and should be viewed and used with this in mind.

Another issue to consider is the role of fat quality—not only quantity—that “Mediterranean” dietary patterns provide, as shown recently in menopausal women (5).

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Effects on Health Outcomes of a Mediterranean Diet With No Restriction on Fat Intake.

Bloomfield HE, Greer N, Kane R, Wilt TJ.

Ann Intern Med. 2017 Mar 7;166(5):378-379. doi: 10.7326/L16-0617. No abstract available.

PMID: 28265659

IN RESPONSE:

Drs. Papadaki and Martinez's and Dr. Martínez-González and colleagues' comments both express concern about our definition of a Mediterranean diet. Any effort to review this field must confront the lack of a clear definition of what constitutes a Mediterranean diet. Our definition was a modified version of the one used in a recent Cochrane review (1). It required a minimum of 2 of 7 dietary components and no restriction on total fat intake. A key purpose of an intervention definition in a systematic review is to ensure that all relevant studies are included; we are confident that our definition, coupled with a search strategy that included the term “Mediterranean diet,” accomplished that goal. The letter authors did not identify any studies that were inappropriately included or excluded from our review on the basis of our diet definition. The article cited by Drs. Papadaki and Martinez (2) was not included because it was an observational study of cardiovascular outcomes, whereas only clinical trials were included for these outcomes.

Dr. Martínez-Gonzáles and colleagues object to our characterization of the evidence as “limited.” We used this terminology to reflect that no or only a few controlled trials were available for many of our outcomes of interest. Although there may be “dozens of adequately powered cohort studies,” cohort studies provide only limited evidence because of their inability to control for confounding. Our study design inclusion criteria differed for cardiovascular outcomes (clinical trials only) and cancer, rheumatoid arthritis, and cognitive impairment (clinical trials and cohort studies) on the basis of availability of published literature. Five clinical trials were available for cardiovascular outcomes; for cancer, rheumatoid arthritis, and cognitive impairment, only 1, none, and 2, respectively, were available.

 

Change in serum TSH levels within the reference range was associated with variation of future blood pressure: a 5-year follow-up study.

Jiang F, Liu A, Lai Y, Yu X, Li C, Han C, Zhang Y, Wang X, Wang Z, Bao S, Lv N, Jin M, Yang F, Fan Y, Jin T, Zhao W, Shan Z, Teng W.

J Hum Hypertens. 2016 Aug 25. doi: 10.1038/jhh.2016.59. [Epub ahead of print]

PMID: 27557892

http://sci-hub.cc/10.1038/jhh.2016.59

Abstract

Controversy exists on the relationship between serum thyrotropin (TSH) and blood pressure, and only a few prospective studies are available up to now. The study aimed to investigate the association between serum TSH within the reference range and blood pressure through a 5-year follow-up study. A total of 623 subjects with normal TSH were followed up for 5 years, including the measurement of demographic data, blood pressure, height, weight and serum TSH. Finally, 531 subjects were included in this prospective study. Body mass index (BMI), prevalence of hypertension, and systolic and diastolic blood pressure were all higher at follow-up than at baseline. Adjusted for age, gender, smoking status, BMI and homoeostasis model assessment of insulin resistance (HOMA-IR) at baseline, multiple linear regression analyses found no relationship between serum TSH at baseline and levels of blood pressure at follow-up, but the changes in serum TSH levels during follow-up was positively associated with the changes in systolic blood pressure (B=2.134, P<0.05), which became more significant in women but not significant in men. The change of systolic blood pressure in group of TSH increase >0.5 mIU l-1 was significantly higher than in group of TSH decrease >0.5 mIU l-1 within reference, after adjusting for age, gender, smoking status, BMI and HOMA-IR at baseline. This result became more significant in women, but no statistical significance was observed in men. Co-variation with serum TSH levels and blood pressure was observed during 5-year follow-up among people with normal TSH.

 

Perfect 24-h management of hypertension: clinical relevance and perspectives.

Kario K.

J Hum Hypertens. 2016 Sep 8. doi: 10.1038/jhh.2016.65. [Epub ahead of print] Review.

PMID: 27604658

http://www.nature.com/jhh/journal/v31/n4/full/jhh201665a.html

http://www.nature.com/jhh/journal/v31/n4/pdf/jhh201665a.pdf

Abstract

Out-of-office blood pressure (BP) measured by home BP monitoring, or ambulatory BP monitoring, was demonstrated to be superior to office BP for the prediction of cardiovascular events. The J-HOP study of a nationwide Japanese cohort demonstrated that morning home BP is the best stroke predictor. In the prospective HONEST study of >21 000 hypertensives, on-treatment morning home BP was shown to be a strong predictor both of future coronary artery disease and stroke events. In subjects whose office BP was maintained at ⩾150 mm Hg, there was no increase in cardiovascular events when their morning systolic BP was well-controlled at <125 mm Hg. Since Asians show greater morning BP surges, it is particularly important for Asians to achieve 'perfect 24-hr BP control,' that is, the 24-h BP level, nocturnal BP dipping and BP variability including morning surge. The morning BP surge and the extremes of disrupted circadian rhythm (riser and extreme dipper patterns) are independent risks for stroke in hypertensives. A morning BP-guided approach is thus the first step toward perfect 24-h BP control, followed by the control of nocturnal hypertension. In the resonance hypothesis, the synergistic resonance of BP variability phenotypes would produce an extraordinary large 'dynamic BP surge' that can trigger a cardiovascular event, especially in high-risk patients with systemic hemodynamic atherothrombotic syndrome, a vicious cycle of exaggerated BP variability and vascular disease. In the future, information and communications technology and artificial intelligence technology with the innovation of wearable continuous surge BP monitoring will contribute to 'anticipation medicine' with the goal of zero cardiovascular events.

 

Leisure-time and commuting physical activity and high blood pressure: the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

Treff C, Benseñor IM, Lotufo PA.

J Hum Hypertens. 2016 Oct 13. doi: 10.1038/jhh.2016.75. [Epub ahead of print]

PMID: 27734826

http://www.nature.com/jhh/journal/v31/n4/full/jhh201675a.html

http://www.nature.com/jhh/journal/v31/n4/pdf/jhh201675a.pdf

Abstract

This study investigates the association between leisure-time physical activity and commuting-related physical activity and high blood pressure among participants in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Physical activity was assessed through application of the International Physical Activity Questionnaire, particularly the domains addressing leisure and transportation. We used the World Health Organization's definition (⩾150 min per week of moderate activities or 75 min per week of vigorous activities) to establish three categories: active, insufficiently active and inactive. Hypertension was defined as systolic/diastolic blood pressure of >140/90 mm Hg or use of antihypertensive medications. From a universe of 15 105 participants, we analysed 13 857 subjects without previous cardiovascular diseases. The association between physical activity and hypertension was obtained using Poisson regression with adjustment for age, race, education, income, body mass index, diabetes and sodium and alcohol intake. Men who were active during leisure time had a multivariate prevalence ratio (95% confidence interval) of 0.84 (0.77-0.92) for hypertension compared with inactive men. For women, the prevalence ratio of active vs inactive during leisure time was 0.86 (0.79-0.95). However, this protective effect of leisure-time physical activity was not observed among men and women with diabetes or obese women. The association found between commuting-related physical activity and hypertension was not detected among men, and the prevalence ratio for women who were active during commuting time compared with inactive women was 1.11 (1.01-1.21). In conclusion, leisure-time physical activity was protective against hypertension, and commuting-related physical activity was associated with high blood pressure among women.

 

A nutritional supplement containing lactoferrin stimulates the immune system, extends lifespan, and reduces amyloid <i>β</i> peptide toxicity in <i>Caenorhabditis elegans</i>.

Martorell P, Llopis S, Gonzalez N, Ramón D, Serrano G, Torrens A, Serrano JM, Navarro M, Genovés S.

Food Sci Nutr. 2016 Jul 28;5(2):255-265. doi: 10.1002/fsn3.388.

PMID: 28265360

http://onlinelibrary.wiley.com/doi/10.1002/fsn3.388/full

http://onlinelibrary.wiley.com/doi/10.1002/fsn3.388/epdf

Abstract

Lactoferrin is a highly multifunctional glycoprotein involved in many physiological functions, including regulation of iron absorption and immune responses. Moreover, there is increasing evidence for neuroprotective effects of lactoferrin. We used Caenorhabditis elegans as a model to test the protective effects, both on phenotype and transcriptome, of a nutraceutical product based on lactoferrin liposomes. In a dose-dependent manner, the lactoferrin-based product protected against acute oxidative stress and extended lifespan of C. elegans N2. Furthermore, Paralysis of the transgenic C. elegans strain CL4176, caused by Aβ1-42 aggregates, was clearly ameliorated by treatment. Transcriptome analysis in treated nematodes indicated immune system stimulation, together with enhancement of processes involved in the oxidative stress response. The lactoferrin-based product also improved the protein homeostasis processes, cellular adhesion processes, and neurogenesis in the nematode. In summary, the tested product exerts protection against aging and neurodegeneration, modulating processes involved in oxidative stress response, protein homeostasis, synaptic function, and xenobiotic metabolism. This lactoferrin-based product is also able to stimulate the immune system, as well as improving reproductive status and energy metabolism. These findings suggest that oral supplementation with this lactoferrin-based product could improve the immune system and antioxidant capacity. Further studies to understand the molecular mechanisms related with neuronal function would be of interest.

KEYWORDS:

Alzheimer's disease; Caenorhabditis elegans; immune system; lactoferrin; neuroprotection

 

Is There an Obesity Paradox for Outcomes in Atrial Fibrillation? A Systematic Review and Meta-Analysis of Non-Vitamin K Antagonist Oral Anticoagulant Trials.

Proietti M, Guiducci E, Cheli P, Lip GY.

Stroke. 2017 Mar 6. pii: STROKEAHA.116.015984. doi: 10.1161/STROKEAHA.116.015984. [Epub ahead of print]

PMID: 28265017

http://stroke.ahajournals.org.sci-hub.cc/lookup/doi/10.1161/STROKEAHA.116.015984

Abstract

BACKGROUND AND PURPOSE:

Obesity is a risk factor for all-cause and cardiovascular death but, despite this, an inverse relationship between overweight or obesity and a better cardiovascular prognosis in long-term follow-up studies has been observed; this phenomenon, described as obesity paradox, has also been found evident in atrial fibrillation cohorts.

METHODS:

We performed a systematic review on the relationship between body mass index and major adverse outcomes in atrial fibrillation patients. Moreover, we provided a meta-analysis of non-vitamin K antagonist oral anticoagulants (NOACs) trials.

RESULTS:

An obesity paradox was found for cardiovascular death and all-cause death in the subgroup analyses of randomized trial cohorts; however, observational studies fail to show this relationship. From the meta-analysis of NOAC trials, a significant obesity paradox was found, with both overweight and obese patients reporting a lower risk for stroke/systemic embolic event (odds ratio [OR], 0.75; 95% confidence interval [CI], 0.66-0.84 and OR, 0.62; 95% CI, 0.54-0.70, respectively). For major bleeding, only obese patients were at lower risk compared with normal weight patients (OR, 0.84; 95% CI, 0.72-0.98). A significant treatment effect of NOACs was found in normal weight patients, both for stroke/systemic embolic event (OR, 0.66; 95% CI, 0.56-0.78) and for major bleeding (OR, 0.72; 95% CI, 0.54-0.95). Major bleeding risk was lower in overweight patients treated with NOACs (OR, 0.84; 95% CI, 0.71-1.00).

CONCLUSIONS:

There may be an obesity paradox in atrial fibrillation patients, particularly for all-cause and cardiovascular death outcomes. An obesity paradox was also evident for stroke/systemic embolic event outcome in NOAC trials, with a treatment effect favoring NOACs over warfarin for both efficacy and safety that was significant only for normal weight patients.

KEYWORDS:

anticoagulants; atrial fibrillation; body weight; heart failure; obesity

 

Usefulness of Non-High-Density Lipoprotein Cholesterol as a Predictor of Cardiovascular Disease Mortality in Men in 22-Year Follow-Up.

Harari G, Green MS, Magid A, Zelber-Sagi S.

Am J Cardiol. 2017 Jan 25. pii: S0002-9149(17)30064-4. doi: 10.1016/j.amjcard.2017.01.008. [Epub ahead of print]

PMID: 28267961

http://sci-hub.cc/10.1016/j.amjcard.2017.01.008

Abstract

Non-high-density lipoprotein cholesterol (non-HDL-C) may be equivalent or superior to low-density lipoprotein cholesterol (LDL-C) for prediction of cardiovascular disease (CVD) risk. However, studies comparing the predictive values of LDL-C and non-HDL-C for CVD and total mortality in a long-term follow-up yielded conflicting results. The Cardiovascular Occupational Risk Factor Determination in Israel Study (CORDIS) is a prospective cohort study of a young industrial population of workers with a long-term follow-up. The initial phase of the study was carried out in 1985-1999. Interviews and physical examinations were conducted, and fasting blood samples, including lipid panels, were undertaken. In 2007, after a 22-year follow-up period, the baseline data were merged with data on all-cause and CVD mortality obtained from the Israeli National Death Registry. A total of 4,832 men were included in the analysis with a mean age of 42.1 ± 12.1 years. Univariate analysis indicated a positive association between non-HDL-C and LDL-C levels and an increased risk for both all-cause and CVD mortality. Multiple regression analysis, following adjustment for potential confounders, resulted in attenuation of the association of both lipoproteins with total mortality. The adjusted association between non-HDL-C levels ≥190 mg/dl and CVD mortality remained significant (hazard ratio 1.80, 95% confidence interval 1.10 to 2.96), but the association of LDL-C with CVD mortality was attenuated (hazard ratio 1.53, 95% confidence interval 0.98 to 2.39). In conclusion, non-HDL-C may be a more potent predictor of CVD mortality than LDL-C levels.

 

Effect of 25% Sodium Reduction on Sales of a Top-Selling Bread in Remote Indigenous Australian Community Stores: A Controlled Intervention Trial.

McMahon E, Webster J, Brimblecombe J.

Nutrients. 2017 Feb 28;9(3). pii: E214. doi: 10.3390/nu9030214.

PMID: 28264485

http://www.mdpi.com/2072-6643/9/3/214/htm

Abstract

Reducing sodium in the food supply is key to achieving population salt targets, but maintaining sales is important to ensuring commercial viability and maximising clinical impact. We investigated whether 25% sodium reduction in a top-selling bread affected sales in 26 remote Indigenous community stores. After a 23-week baseline period, 11 control stores received the regular-salt bread (400 mg Na/100 g) and 15 intervention stores received the reduced-salt version (300 mg Na/100 g) for 12-weeks. Sales data were collected to examine difference between groups in change from baseline to follow-up (effect size) in sales (primary outcome) or sodium density, analysed using a mixed model. There was no significant effect on market share (-0.31%; 95% CI -0.68, 0.07; p = 0.11) or weekly dollars ($58; -149, 266; p = 0.58). Sodium density of all purchases was not significantly reduced (-8 mg Na/MJ; -18, 2; p = 0.14), but 25% reduction across all bread could significantly reduce sodium (-12; -23, -1; p = 0.03). We found 25% salt reduction in a top-selling bread did not affect sales in remote Indigenous community stores. If achieved across all breads, estimated salt intake in remote Indigenous Australian communities would be reduced by approximately 15% of the magnitude needed to achieve population salt targets, which could lead to significant health gains at the population-level.

KEYWORDS:

salt; Indigenous Australians; bread; population health; reformulation; sales; sodium

 

Attributing Death to Diet: Precision Counts.

Mueller NT, Appel LJ.

JAMA. 2017 Mar 7;317(9):908-909. doi: 10.1001/jama.2017.0946. No abstract available.

PMID: 28267836

http://sci-hub.cc/10.1001/jama.2017.0946

A substantial body of evidence has implicated several aspects of diet with the occurrence of cardiometabolic disease (CMD)—heart disease, stroke, and type 2 diabetes. Dietary factors studied have included individual nutrients (macronutrients, micronutrients, minerals, vitamins, electrolytes, and phytochemicals), foods, and overall dietary patterns. It is generally accepted that a suboptimal diet is causally related to CMD, but scientists debate which factors are responsible and the relative importance of each factor given the challenges of isolating and estimating the potential effects of individual nutrients and foods, especially in observational studies. Another topic that is receiving considerably more attention is estimating the fraction of preventable deaths due to suboptimal diet and other factors. Policy makers, in particular, are eager to understand the total burden of CMD that may be attributable to suboptimal diet, given that modification of diet is a cornerstone of prevention policy.1

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Association Between Dietary Factors and Mortality From Heart Disease, Stroke, and Type 2 Diabetes in the United States.

Micha R, Peñalvo JL, Cudhea F, Imamura F, Rehm CD, Mozaffarian D.

JAMA. 2017 Mar 7;317(9):912-924. doi: 10.1001/jama.2017.0947.

PMID: 28267855

http://sci-hub.cc/10.1001/jama.2017.0947

Abstract

IMPORTANCE:

In the United States, national associations of individual dietary factors with specific cardiometabolic diseases are not well established.

OBJECTIVE:

To estimate associations of intake of 10 specific dietary factors with mortality due to heart disease, stroke, and type 2 diabetes (cardiometabolic mortality) among US adults.

DESIGN, SETTING, AND PARTICIPANTS:

A comparative risk assessment model incorporated data and corresponding uncertainty on population demographics and dietary habits from National Health and Nutrition Examination Surveys (1999-2002: n = 8104; 2009-2012: n = 8516); estimated associations of diet and disease from meta-analyses of prospective studies and clinical trials with validity analyses to assess potential bias; and estimated disease-specific national mortality from the National Center for Health Statistics.

EXPOSURES:

Consumption of 10 foods/nutrients associated with cardiometabolic diseases: fruits, vegetables, nuts/seeds, whole grains, unprocessed red meats, processed meats, sugar-sweetened beverages (SSBs), polyunsaturated fats, seafood omega-3 fats, and sodium.

MAIN OUTCOMES AND MEASURES:

Estimated absolute and percentage mortality due to heart disease, stroke, and type 2 diabetes in 2012. Disease-specific and demographic-specific (age, sex, race, and education) mortality and trends between 2002 and 2012 were also evaluated.

RESULTS:

In 2012, 702 308 cardiometabolic deaths occurred in US adults, including 506 100 from heart disease (371 266 coronary heart disease, 35 019 hypertensive heart disease, and 99 815 other cardiovascular disease), 128 294 from stroke (16 125 ischemic, 32 591 hemorrhagic, and 79 578 other), and 67 914 from type 2 diabetes. Of these, an estimated 318 656 (95% uncertainty interval [uI], 306 064-329 755; 45.4%) cardiometabolic deaths per year were associated with suboptimal intakes-48.6% (95% UI, 46.2%-50.9%) of cardiometabolic deaths in men and 41.8% (95% UI, 39.3%-44.2%) in women; 64.2% (95% UI, 60.6%-67.9%) at younger ages (25-34 years) and 35.7% (95% UI, 33.1%-38.1%) at older ages (≥75 years); 53.1% (95% UI, 51.6%-54.8%) among blacks, 50.0% (95% UI, 48.2%-51.8%) among Hispanics, and 42.8% (95% UI, 40.9%-44.5%) among whites; and 46.8% (95% UI, 44.9%-48.7%) among lower-, 45.7% (95% UI, 44.2%-47.4%) among medium-, and 39.1% (95% UI, 37.2%-41.2%) among higher-educated individuals. The largest numbers of estimated diet-related cardiometabolic deaths were related to high sodium (66 508 deaths in 2012; 9.5% of all cardiometabolic deaths), low nuts/seeds (59 374; 8.5%), high processed meats (57 766; 8.2%), low seafood omega-3 fats (54 626; 7.8%), low vegetables (53 410; 7.6%), low fruits (52 547; 7.5%), and high SSBs (51 694; 7.4%). Between 2002 and 2012, population-adjusted US cardiometabolic deaths per year decreased by 26.5%. The greatest decline was associated with insufficient polyunsaturated fats (-20.8% relative change [95% UI, -18.5% to -22.8%]), nuts/seeds (-18.0% [95% UI, -14.6% to -21.0%]), and excess SSBs (-14.5% [95% UI, -12.0% to -16.9%]). The greatest increase was associated with unprocessed red meats (+14.4% [95% UI, 9.1%-19.5%]).

CONCLUSIONS AND RELEVANCE:

Dietary factors were estimated to be associated with a substantial proportion of deaths from heart disease, stroke, and type 2 diabetes. These results should help identify priorities, guide public health planning, and inform strategies to alter dietary habits and improve health.

Edited by AlPater

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Dietary energy density and body weight changes after 3 years in the PREDIMED study.

Razquin C, Sanchez-Tainta A, Salas-Salvadó J, Buil-Cosiales P, Corella D, Fito M, Ros E, Estruch R, Arós F, Gómez-Gracia E, Fiol M, Lapetra J, Serra-Majem L, Pinto X, Schröder H, Tur J, Sorlí JV, Lamuela-Raventós RM, Bulló M, Bes-Rastrollo M, Martinez-Gonzalez MA; PREDIMED GROUP..

Int J Food Sci Nutr. 2017 Mar 6:1-8. doi: 10.1080/09637486.2017.1295028. [Epub ahead of print]

PMID: 28276290

http://sci-hub.cc/10.1080/09637486.2017.1295028

Abstract

The association of dietary energy density (ED) and overweight is not clear in the literature. Our aim was to study in 4259 of the PREDIMED trial whether an increase in dietary ED based on a higher adherence to a Mediterranean dietary pattern was associated with 3-year weight gain. A validated 137-item food-frequency questionnaire was administered. Multivariable-adjusted models were used to analyze the association between 3-year ED change and the subsequent 3-year body weight change. The most important weight reduction after 3-year follow-up was observed in the two lowest quintiles and the highest quintile of ED change. The highest ED increase was characterized by an increased intake of extra virgin olive oil (EVOO) and nuts and a decreased intake of other oils, vegetable and fruit consumption (p < .001). In conclusion, increased 3-year ED in the PREDIMED study, associated with a higher EVOO and nuts consumption, was not associated with weight gain.

KEYWORDS:

Mediterranean dietary pattern; PREDIMED; body weight change; dietary energy density; extra-virgin olive oil; nuts

 

The Impact of Virgin Coconut Oil and High-Oleic Safflower Oil on Body Composition, Lipids, and Inflammatory Markers in Postmenopausal Women.

Harris M, Hutchins A, Fryda L.

J Med Food. 2017 Mar 9. doi: 10.1089/jmf.2016.0114. [Epub ahead of print]

PMID: 28277823

http://sci-hub.cc/10.1089/jmf.2016.0114

Abstract

This randomized crossover study compared the impact of virgin coconut oil (VCO) to safflower oil (SO) on body composition and cardiovascular risk factors. Twelve postmenopausal women (58.8 ± 3.7 year) consumed 30 mL VCO or SO for 28 days, with a 28-day washout. Anthropometrics included body weight and hip and waist circumference. Fat percent for total body, android and gynoid, fat mass, and lean mass were measured using dual-energy X-ray absorptiometry. Women maintained their typical diet recording 28 days of food records during the study. Results were analyzed with SPSS v24 with significance at P ≤ .05. Comparisons are reported as paired t-test since no intervention sequence effect was observed. VCO significantly raised total cholesterol, TC (+18.2 ± 22.8 mg/dL), low-density lipoprotein (+13.5 ± 16.0 mg/dL), and high-density lipoprotein, HDL (+6.6 ± 7.5 mg/dL). SO did not significantly change lipid values. TC and HDL were significantly different between test oils. The TC/HDL ratio change showed a neutral effect of both VCO and SO. One person had adverse reactions to VCO and increased inflammation. VCO decreased IL-1β for each person who had a detected sample. The impact of VCO and SO on other cytokines varied on an individual basis. This was the first study evaluating the impact of VCO on body composition in Caucasian postmenopausal women living in the United States. Results are suggestive that individuals wishing to use coconut oil in their diets can do so safely, but more studies need to be conducted with larger sample sizes, diverse populations, and more specific clinical markers such as particle size.

KEYWORDS:

adiposity; cholesterol; cytokines; fatty acid

 

The association of protein intake (amount and type) with ovarian antral follicle counts among infertile women: results from the EARTH prospective study cohort.

Souter I, Chiu YH, Batsis M, Afeiche MC, Williams PL, Hauser R, Chavarro JE; EARTH Study Team..

BJOG. 2017 Mar 9. doi: 10.1111/1471-0528.14630. [Epub ahead of print]

PMID: 28278351

http://sci-hub.cc/10.1111/1471-0528.14630

Abstract

OBJECTIVE:

To evaluate the association between protein intake (amount and type) and antral follicle count (AFC).

DESIGN:

Prospective cohort.

SETTING:

Academic fertility center.

POPULATION:

265 women undergoing fertility treatments at an academic fertility center and participating in an ongoing study on environment and reproductive health.

METHODS:

We measured AFC in ultrasonographic evaluation among women undergoing infertility treatments. Women completed a previously validated semi-quantitative food frequency questionnaire. We used Poisson regression to evaluate the relation between protein intake and AFC while adjusting for age, body mass index, race, smoking status, and total energy intake.

MAIN OUTCOME MEASURES:

Antral follicle count.

RESULTS:

Among 265 women (mean age: 35.0±3.9 years, 85% Caucasian), total protein intake (% energy) was unrelated to AFC. When protein from different food sources was considered separately, we found a negative association between dairy protein intake and AFC. The mean AFC was 14.4% (3.9%-23.7%) lower for women in the highest quintile of dairy protein intake than for women in the bottom quintile after adjusting for potential confounders (p-trend=0.04). This association was stronger among women who had never smoked (p-trend=0.002) but was not observed among previous smokers (p-trend=0.36). There were no associations between protein intake from either non-dairy animal or vegetable sources and AFC.

CONCLUSION:

Higher dairy protein intake (≥ 5.24% of energy) was associated with lower antral follicle counts among women presenting for infertility treatment. These findings should be further investigated in prospective studies designed to also clarify the biology underlying the observed associations.

KEYWORDS:

antral follicle count; dairy intake; female infertility; ovarian reserve; ovary; protein intake

 

[The below first paper is not pdf-availed.]

Uric Acid and Left Ventricular Hypertrophy: A Potentially New Modifiable Target?

Kuwabara M, Sato Y, Kanbay M, Johnson RJ.

Am J Hypertens. 2017 Jan 17. pii: hpw195. doi: 10.1093/ajh/hpw195. [Epub ahead of print] No abstract available.

PMID: 28096149

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Uric Acid and New Onset Left Ventricular Hypertrophy: Findings From the PAMELA Population.

Cuspidi C, Facchetti R, Bombelli M, Sala C, Tadic M, Grassi G, Mancia G.

Am J Hypertens. 2017 Jan 17. pii: hpw159. doi: 10.1093/ajh/hpw159. [Epub ahead of print]

PMID: 28096148

https://academic.oup.com/ajh/article/30/3/279/2870260/Uric-Acid-and-New-Onset-Left-Ventricular

https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/ajh/30/3/10.1093_ajh_hpw159/2/hpw159.pdf?Expires=1489441054&Signature=E4UTkNaJyoxAHuZm6luYdoorKLsjrGNHcWfOWNJn5X7dBaJXraS1u3qeO05~gQV-4E3EQUEbVVuuZpS9nDwkllmA1XMi8fIYLUWFPCckyn1b7XUHSBrabl1QqedwMEyZzHLVDcQxfjGJ4jnCodnHsU3~eI5OgK6OAEPklSK28Tdf99JY9J7-1Kdy2xY2-cpKZ0FUGR5dFX2JsnpUfH4BXxNClCSqs3H7ygNVObhsZIJnVIkLKQyPFovvXWsSgN9r22eWEmBYNrAWoeOF0lf8oaeNP99C-jTNQSs7oXu5BZZjWPEeH8OqT1mZOwo279RGWRnpfmtQPA-9j~ovEpRgDA__&Key-Pair-Id=APKAIUCZBIA4LVPAVW3Q

Abstract

BACKGROUND:

The association between serum uric acid (SUA) and left ventricular hypertrophy (LVH) is controversial and the ability of SUA in predicting incident LVH remains unsettled. Thus, we evaluated the relationship of SUA with new-onset echocardiographic LVH over a 10-year period in subjects of the general population enrolled in the Pressioni Arteriose Monitorate E Loro Associazioni (PAMELA) study.

METHODS:

The study included 960 subjects with normal LV mass index (LVMI) at baseline echocardiographic evaluation and a readable echocardiogram at the end of follow-up. Cut-points for LVH were derived from reference values of the healthy fraction of the PAMELA population.

RESULTS:

Over a 10-year period, 258 participants (26.9%) progressed to LVH. The incidence of new-onset LVH increased from the lowest (23%) to intermediate (25%) and the highest baseline SUA tertile (32%). After adjusting for confounders (not including body mass index (BMI)), each 1 mg/dl increase in SUA entailed a 26% higher risk of incident LVH. Adjusted odd ratio of LVH risk in the highest SUA tertile was 96% higher than in the lowest tertile (odds ratio (OR) = 1.966, 95% CI = 1.158-3.339, P = 0.0123). Correction for BMI reduced the magnitude and statistical significance of ORs.

CONCLUSIONS:

The study shows that SUA is a predictor of long-term echocardiographic changes from normal LVMI to LVH in a community sample. Thus, life-style and pharmacologic measures aimed to reduce SUA levels may concur to preventing LVH development in the general population.

KEYWORDS:

blood pressure; echocardiography; general population; hypertension; left ventricular hypertrophy; serum uric acid.

 

[The below paper is not pdf-availed.]

Alarming Prevalence of Emergency Hypertension Levels in the General Public Identified by a Hypertension Awareness Campaign.

Caligiuri SP, Austria JA, Pierce GN.

Am J Hypertens. 2017 Jan 5. pii: hpw136. doi: 10.1093/ajh/hpw136. [Epub ahead of print]

PMID: 28057629

Abstract

BACKGROUND:

Hypertension is a major cause of mortality and morbidity today. The "silent" nature of hypertension makes it critical to determine its prevalence and its severity in the general public and to identify strategies to identify people unaware of its presence. A mobile hypertension awareness campaign was created to: (i) determine the prevalence and types of hypertension in an urban North American center, (ii) increase hypertension awareness, and (iii) identify reasons for lack of therapy adherence.

METHODS:

Mobile clinics were provided at shopping malls, workplaces, hospitals, and community centres to measure blood pressure in the public. Blood pressure recordings were done on a voluntary basis.

RESULTS:

Of 1097 participants, 50% presented with high blood pressure which was higher than expected. Of particular clinical significance, an unexpectedly large number of participants (2%) exhibited a hypertensive urgency/emergency. Most of these people were not adherent to medications (if their hypertension was detected previously), were unaware of their hypertensive state, and/or unwilling to acknowledge or ignored the clinical significance of the extremely high blood pressure readings. Reasons for lack of adherence included: denial, being unaware of health consequences, and proper management of hypertension.

CONCLUSIONS:

A relatively large segment of an urban population lives unaware of severe emergency levels of hypertension. A public mobile hypertension clinic provides a valuable strategy for identifying hypertension in the general public and for knowledge translation of hypertension management.

KEYWORDS:

blood pressure; drug adherence; emergency blood pressure; hypertension; incidence of hypertension.

 

'Get out of your comfort zone:' Interval training benefits extend to aging

U.S. study indicates mixing speeds of aerobic exercise is 'good from an aging perspective'

By Amina Zafar, CBC News Posted: Mar 09, 2017

http://www.cbc.ca/news/health/interval-training-aging-1.4016429

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Enhanced Protein Translation Underlies Improved Metabolic and Physical Adaptations to Different Exercise Training Modes in Young and Old Humans.

Robinson MM, Dasari S, Konopka AR, Johnson ML, Manjunatha S, Esponda RR, Carter RE, Lanza IR, Nair KS.

Cell Metab. 2017 Mar 7;25(3):581-592. doi: 10.1016/j.cmet.2017.02.009.

PMID: 28273480

http://www.cell.com/cell-metabolism/fulltext/S1550-4131(17)30099-2

http://www.cell.com/cell-metabolism/pdf/S1550-4131(17)30099-2.pdf

Abstract

The molecular transducers of benefits from different exercise modalities remain incompletely defined. Here we report that 12 weeks of high-intensity aerobic interval (HIIT), resistance (RT), and combined exercise training enhanced insulin sensitivity and lean mass, but only HIIT and combined training improved aerobic capacity and skeletal muscle mitochondrial respiration. HIIT revealed a more robust increase in gene transcripts than other exercise modalities, particularly in older adults, although little overlap with corresponding individual protein abundance was noted. HIIT reversed many age-related differences in the proteome, particularly of mitochondrial proteins in concert with increased mitochondrial protein synthesis. Both RT and HIIT enhanced proteins involved in translational machinery irrespective of age. Only small changes of methylation of DNA promoter regions were observed. We provide evidence for predominant exercise regulation at the translational level, enhancing translational capacity and proteome abundance to explain phenotypic gains in muscle mitochondrial function and hypertrophy in all ages.

KEYWORDS:

aging; exercise; human; insulin clamp; interval; methylation; proteome; skeletal muscle; tracer; transcriptome

 

Sleep to Lower Elevated Blood Pressure: A Randomized Controlled Trial (SLEPT)

Emer R. McGrath Colin A. Espie Alice Power Andrew W. Murphy John Newell Caroline Kelly Niamh Duffy Patricia Gunning Irene Gibson Sophie Bostock Martin J. O’Donnell

Am J Hypertens (2017) 30 (3): 319-327. DOI: https://doi.org/10.1093/ajh/hpw132

Published: 19 January 2017 Article history

https://academic.oup.com/ajh/article/30/3/319/2927604/Sleep-to-Lower-Elevated-Blood-Pressure-A

https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/ajh/30/3/10.1093_ajh_hpw132/2/hpw132.pdf?Expires=1489441457&Signature=Qb7i8j494dqwwJ5uRj-UMiiowOaS1hHZAKcU-x76sRqxNf2DdDIIc3g8bENThG3Q-zLtj90RNHJFUuvz9-sAawzD0nUNAU3Xxx5VOnXenQnjRg3fQxs4UWsmBTJUTLI7~cuiacCaVQhRjnnrmfrYpY~41lhF8wES7NQDNNw2jCVcbGU6199ecLjga1NZjgZeKgddx29YUBlBOhzbPF9Nr2tnv~PsOJuN-pUp5FtJNljrJ9Rxrb3qScBT1RmA-HO5AVlOPuToIe9CKWF-HNzd0YNVGytN2-~Fo8r~oNAIEDF59XU3S7~0b9ncoF8GGkebvAcPUGl-JPfTwrwxjm3VLA__&Key-Pair-Id=APKAIUCZBIA4LVPAVW3Q

Abstract

BACKGROUND

Impaired sleep quality is common and associated with an increased risk of cardiovascular disease (CVD), thought to be mediated through adverse effects on established vascular risk factors, particularly hypertension. We determined if a web-delivered sleep intervention (sleep–hygiene education, stimulus control, and cognitive behavioral therapy) reduces blood pressure compared to vascular risk factor education (standard care) alone.

METHODS

Phase II randomized, blinded, controlled trial of 134 participants without CVD with mild sleep impairment and blood pressure 130–160/<110 mm Hg. The primary outcome was the difference in the mean change in 24-hour ambulatory systolic blood pressure (SBP) over 8 weeks between intervention and control groups. Secondary outcomes included measures of sleep quality and psychosocial health, namely Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI).

RESULTS

Participants in the sleep intervention group showed significantly greater improvements in sleep quality, including ISI [difference in mean improvement 2.8; 95% confidence interval (CI), 1.3–4.4], PSQI (1.1; 95% CI, 0.1–2.2), sleep condition indicator (0.8; 95% CI, 0.2–1.4), and psychosocial health, including BDI (2.0; 95% CI, 0.3–3.7) and BAI (1.4; 95% CI, 0.02–2.8). The mean improvement in 24-hour ambulatory SBP did not differ between the sleep intervention (0.9 mm Hg) and control (0.8 mm Hg) arms, (difference in mean improvement 0.1; 95% CI, −3.4 to 3.2).

CONCLUSION

A simple, low-cost, web-delivered sleep intervention is feasible and significantly improves sleep quality and measures of psychosocial health in individuals with mild sleep impairment but does not result in short-term improvements in blood pressure.

blood pressure, hypertension, primary prevention, risk factors, sleep.

Topic: hypertension blood pressure sleep arterial pressure, increased

 

Ambulatory Blood Pressure Characteristics and Long-Term Risk for Atrial Fibrillation.

Perkiömäki JS, Nortamo S, Ylitalo A, Kesäniemi A, Ukkola O, Huikuri HV.

Am J Hypertens. 2016 Nov 15. pii: hpw149. [Epub ahead of print]

PMID: 27852579

http://sci-hub.cc/10.1093/ajh/hpw149

Abstract

BACKGROUND:

We hypothesized that elevated nighttime systolic ambulatory blood pressure (ABP) yields additional information compared with daytime systolic ABP for the long-term risk of atrial fibrillation (AF) and perhaps should be taken into account in treatment strategies for preventing the increasing burden of AF during aging.

METHODS:

A total of 903 subjects with or without hypertension aged 40 to 59 years, who were recruited to the Oulu Project Elucidating Risk of Atherosclerosis (OPERA) study, underwent ABP monitoring, thorough clinical examinations and laboratory tests.

RESULTS:

After an average of 16.4 ± 3.6 years of follow-up, 91 (10%) of the study subjects had experienced a new-onset AF requiring a hospital emergency room or hospital visit. Of the components of baseline ABP, the nighttime mean systolic blood pressure had the strongest univariable association with the occurrence of AF (120.8 ± 15.9 vs. 116.4 ± 14.1 mm Hg, P = 0.006, in subjects with vs. without the occurrence AF). When the univariable predictors of AF, such as age, sex, body mass index, height, smoking history, alanine aminotransferase, uric acid, and fasting plasma glucose, were entered in the multivariable Cox hazards model, age (P < 0.001), and body mass index (P = 0.014) retained their significant predictive power. After adjustments in this clinical hazards model, the nighttime mean systolic blood pressure still predicted the occurrence of AF (hazards ratio = 1.07 per every 5 mm Hg increase, 95% confidence intervals = 1.004-1.15, P = 0.038).

CONCLUSION:

Of the baseline ABP characteristics, the nighttime systolic blood pressure is a significant independent contributor to the long-term risk of new-onset AF requiring a hospital visit.

KEYWORDS:

ambulatory blood pressure; atrial fibrillation; blood pressure; hypertension.

 

Neanderthal behaviour, diet, and disease inferred from ancient DNA in dental calculus.

Weyrich LS, Duchene S, Soubrier J, Arriola L, Llamas B, Breen J, Morris AG, Alt KW, Caramelli D, Dresely V, Farrell M, Farrer AG, Francken M, Gully N, Haak W, Hardy K, Harvati K, Held P, Holmes EC, Kaidonis J, Lalueza-Fox C, de la Rasilla M, Rosas A, Semal P, Soltysiak A, Townsend G, Usai D, Wahl J, Huson DH, Dobney K, Cooper A.

Nature. 2017 Mar 8. doi: 10.1038/nature21674. [Epub ahead of print]

PMID: 28273061

http://sci-hub.cc/10.1038/nature21674

Abstract

Recent genomic data have revealed multiple interactions between Neanderthals and modern humans, but there is currently little genetic evidence regarding Neanderthal behaviour, diet, or disease. Here we describe the shotgun-sequencing of ancient DNA from five specimens of Neanderthal calcified dental plaque (calculus) and the characterization of regional differences in Neanderthal ecology. At Spy cave, Belgium, Neanderthal diet was heavily meat based and included woolly rhinoceros and wild sheep (mouflon), characteristic of a steppe environment. In contrast, no meat was detected in the diet of Neanderthals from El Sidrón cave, Spain, and dietary components of mushrooms, pine nuts, and moss reflected forest gathering. Differences in diet were also linked to an overall shift in the oral bacterial community (microbiota) and suggested that meat consumption contributed to substantial variation within Neanderthal microbiota. Evidence for self-medication was detected in an El Sidrón Neanderthal with a dental abscess and a chronic gastrointestinal pathogen (Enterocytozoon bieneusi). Metagenomic data from this individual also contained a nearly complete genome of the archaeal commensal Methanobrevibacter oralis (10.2× depth of coverage)-the oldest draft microbial genome generated to date, at around 48,000 years old. DNA preserved within dental calculus represents a notable source of information about the behaviour and health of ancient hominin specimens, as well as a unique system that is useful for the study of long-term microbial evolution.

 

[The below paper is not pdf-availed.]

Significance to human health of carbamazepine detected in fruits and vegetables irrigated with recycled water.

Sheikh B.

Water Sci Technol. 2017 Mar;75(5):1059-1062. doi: 10.2166/wst.2016.585.

PMID: 28272035

Abstract

The relevance and significance of the findings of chemicals of emerging concern at nanogram concentrations in recycled water is critically important for the consumers of these crops. The relevance and significance of these chemicals at these concentrations is placed in perspective in terms of the number of years of consumption necessary to accrue one acceptable daily intake every day, over a lifetime, specifically for carbamazepine. In this paper, the number of years is calculated and found to far exceed the maximum human life expectancy, even assuming that the individual consumes a mix of fruits and vegetables irrigated with recycled water throughout an 80-year life span, excluding other food crops free from carbamazepine.

 

Trends in premature mortality in the USA by sex, race, and ethnicity from 1999 to 2014: an analysis of death certificate data

Dr Meredith S Shiels, PhDa, , , Pavel Chernyavskiy, PhDa, William F Anderson, MDa, Ana F Best, PhDa, Emily A Haozous, PhDb, Patricia Hartge, ScDa, Philip S Rosenberg, PhDa, David Thomas, PhDc, Show more

doi: 10.1016/S0140-6736(17)30187-3

http://sci-hub.cc/10.1016/S0140-6736(17)30187-3

Summary

Background

Reduction of premature mortality is a UN Sustainable Development Goal. Unlike other high-income countries, age-adjusted mortality in the USA plateaued in 2010 and increased slightly in 2015, possibly because of rising premature mortality. We aimed to analyse trends in mortality in the USA between 1999 and 2014 in people aged 25–64 years by age group, sex, and race and ethnicity, and to identify specific causes of death underlying the temporal trends.

Methods

For this analysis, we used cause-of-death and demographic data from death certificates from the US National Center for Health Statistics, and population estimates from the US Census Bureau. We estimated annual percentage changes in mortality using age-period-cohort models. Age-standardised excess deaths were estimated for 2000 to 2014 as observed deaths minus expected deaths (estimated from 1999 mortality rates).

Findings

Between 1999 and 2014, premature mortality increased in white individuals and in American Indians and Alaska Natives. Increases were highest in women and those aged 25–30 years. Among 30-year-olds, annual mortality increases were 2·3% (95% CI 2·1–2·4) for white women, 0·6% (0·5–0·7) for white men, and 4·3% (3·5–5·0) and 1·9% (1·3–2·5), respectively, for American Indian and Alaska Native women and men. These increases were mainly attributable to accidental deaths (primarily drug poisonings), chronic liver disease and cirrhosis, and suicide. Among individuals aged 25–49 years, an estimated 111 000 excess premature deaths occurred in white individuals and 6600 in American Indians and Alaska Natives during 2000–14. By contrast, premature mortality decreased substantially across all age groups in Hispanic individuals (up to 3·2% per year), black individuals (up to 3·9% per year), and Asians and Pacific Islanders (up to 2·6% per year), mainly because of declines in HIV, cancer, and heart disease deaths, resulting in an estimated 112 000 fewer deaths in Hispanic individuals, 311 000 fewer deaths in black individuals, and 34 000 fewer deaths in Asians and Pacific Islanders aged 25–64 years. During 2011–14, American Indians and Alaska Natives had the highest premature mortality, followed by black individuals.

Interpretation

Important public health successes, including HIV treatment and smoking cessation, have contributed to declining premature mortality in Hispanic individuals, black individuals, and Asians and Pacific Islanders. However, this progress has largely been negated in young and middle-aged (25–49 years) white individuals, and American Indians and Alaska Natives, primarily because of potentially avoidable causes such as drug poisonings, suicide, and chronic liver disease and cirrhosis. The magnitude of annual mortality increases in the USA is extremely unusual in high-income countries, and a rapid public health response is needed to avert further premature deaths.

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Referred to by

Anna Zajacova, Jennifer Karas Montez

Macro-level perspective to reverse recent mortality increases

The Lancet, Volume 389, Issue 10073, 11–17 March 2017, Pages 991-992

doi: 10.1016/S0140-6736(17)30186-1

http://sci-hub.cc/10.1016/S0140-6736(17)30186-1

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The Lancet

Premature deaths in the USA: repeal has no appeal

The Lancet, Volume 389, Issue 10067, 28 January–3 February 2017, Page 332

doi: 10.1016/S0140-6736(17)30196-4

Advances in treatment and access to care have seen premature deaths from HIV/AIDS and cancer decline dramatically for Americans. However, premature deaths from accidental causes—primarily drug overdoses, chronic liver disease, and suicide—have risen so precipitously that much of the good work on HIV/AIDS and cancer has been, in population terms, negated.

An Article by Meredith Shiels and colleagues in The Lancet today shows that between 1999 and 2014, white and native Americans aged 25–30 years have seen mortality rates rise steadily, an effect the authors call “extremely unusual”. While in Canada and England mortality rates continue a decline across the board, in the USA a 25-year-old white woman's death is now 3% more likely, while an American native or Alaskan native of the same age and gender faces a 5% increased risk of dying.

At root, addiction and suicide, two drivers in the mortality increase, could be addressed by better access to mental health and substance misuse counselling. The Mental Health Parity and Addiction Equity Act was enacted to equalise benefits for mental health care commensurate with other medical benefits, and expanded after the passage of the Affordable Care Act (ACA) to apply to individual health coverage plans. Although instrumental in improving parity for coverage of treatment for mental health, it is not perfect. Stigma around seeking treatment as well as rising costs and reduced provider and treatment facility capacity equates to profound gaps in care.

The potential repeal of the ACA, however, challenges those gains and threatens new hurdles. One risk is elimination of the pre-existing conditions clause, which prevents insurers from denying coverage on the grounds of previous illness. For people with mental health and substance misuse problems that are often recurrent and require substantial management, the inability to secure coverage can be life-threatening.

As Shiels and colleagues' Article underscores, such uncertainty comes at the worst possible time, when more Americans are vulnerable and the consequence is the most dire. We urge President Trump and his new administration to make tackling this surge in preventable deaths a priority, and to do so by retaining quality, affordable access to mental health care.

 

Impact of Physical Activity on Cognitive Decline, Dementia, and Its Subtypes: Meta-Analysis of Prospective Studies.

Guure CB, Ibrahim NA, Adam MB, Said SM.

Biomed Res Int. 2017;2017:9016924. doi: 10.1155/2017/9016924.

PMID: 28271072

https://www.hindawi.com/journals/bmri/2017/9016924/

Abstract

The association of physical activity with dementia and its subtypes has remained controversial in the literature and has continued to be a subject of debate among researchers. A systematic review and meta-analysis of longitudinal studies on the relationship between physical activity and the risk of cognitive decline, all-cause dementia, Alzheimer's disease, and vascular dementia among nondemented subjects are considered. A comprehensive literature search in all available databases was conducted up until April 2016. Well-defined inclusion and exclusion criteria were developed with focus on prospective studies ≥ 12 months. The overall sample from all studies is 117410 with the highest follow-up of 28 years. The analyses are performed with both Bayesian parametric and nonparametric models. Our analysis reveals a protective effect for high physical activity on all-cause dementia, odds ratio of 0.79, 95% CI (0.69, 0.88), a higher and better protective effect for Alzheimer's disease, odds ratio of 0.62, 95% CI (0.49, 0.75), cognitive decline odds ratio of 0.67, 95% CI (0.55, 0.78), and a nonprotective effect for vascular dementia of 0.92, 95% CI (0.62, 1.30). Our findings suggest that physical activity is more protective against Alzheimer's disease than it is for all-cause dementia, vascular dementia, and cognitive decline.

 

Tooth Loss and Risk of Dementia in the Community: the Hisayama Study.

Takeuchi K, Ohara T, Furuta M, Takeshita T, Shibata Y, Hata J, Yoshida D, Yamashita Y, Ninomiya T.

J Am Geriatr Soc. 2017 Mar 8. doi: 10.1111/jgs.14791. [Epub ahead of print]

PMID: 28272750

http://onlinelibrary.wiley.com/doi/10.1111/jgs.14791/full

http://onlinelibrary.wiley.com/doi/10.1111/jgs.14791/epdf

Abstract

OBJECTIVES:

To clarify the effect of tooth loss on development of all-cause dementia and its subtypes in an elderly Japanese population.

DESIGN:

Prospective cohort study.

SETTING:

The Hisayama Study, Japan.

PARTICIPANTS:

Community-dwelling Japanese adults without dementia aged 60 and older (N = 1,566) were followed for 5 years (2007-2012).

MEASUREMENTS:

Participants were classified into four categories according to baseline number of remaining teeth (≥20, 10-19, 1-9, 0). The risk estimates of the effect of tooth loss on the development of all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VaD) were computed using a Cox proportional hazards model.

RESULTS:

During follow-up, 180 (11.5%) subjects developed all-cause dementia; 127 (8.1%) had AD, and 42 (2.7%) had VaD. After adjusting for potential confounders, there was a tendency for the multivariable-adjusted hazard ratio of all-cause dementia to increase with decrease in number of remaining teeth (P for trend = .04). The risk of all-cause dementia was 1.62 times as great in subjects with 10 to 19 teeth, 1.81 times as great in those with one to nine teeth, and 1.63 times as great in those with no teeth as in those with 20 teeth or more. An inverse association was observed between number of remaining teeth and risk of AD (P for trend = .08), but no such association was observed with risk of VaD (P for trend = .20).

CONCLUSION:

Tooth loss is associated with an increased risk of all-cause dementia and AD in the Japanese population.

KEYWORDS:

Alzheimer's disease; epidemiology; oral health; prospective cohort study; vascular dementia

 

The effect of diurnal distribution of carbohydrates and fat on glycaemic control in humans: a randomized controlled trial.

Kessler K, Hornemann S, Petzke KJ, Kemper M, Kramer A, Pfeiffer AF, Pivovarova O, Rudovich N.

Sci Rep. 2017 Mar 8;7:44170. doi: 10.1038/srep44170.

PMID: 28272464

http://www.nature.com/articles/srep44170

Abstract

Diurnal carbohydrate and fat distribution modulates glycaemic control in rodents. In humans, the optimal timing of both macronutrients and its effects on glycaemic control after prolonged consumption are not studied in detail. In this cross-over trial, 29 non-obese men were randomized to two four-week diets: (1) carbohydrate-rich meals until 13.30 and fat-rich meals between 16.30 and 22.00 (HC/HF) versus (2) inverse sequence of meals (HF/HC). After each trial period two meal tolerance tests were performed, at 09.00 and 15.40, respectively, according to the previous intervention. On the HF/HC diet, whole-day glucose level was increased by 7.9% (p = 0.026) in subjects with impaired fasting glucose and/or impaired glucose tolerance (IFG/IGT, n = 11), and GLP-1 by 10.2% (p = 0.041) in normal glucose-tolerant subjects (NGT, n = 18). Diet effects on fasting GLP-1 (p = 0.009) and PYY (p = 0.034) levels were observed in IFG/IGT, but not in NGT. Afternoon decline of glucose tolerance was more pronounced in IFG/IGT and associated with a stronger decrease of postprandial GLP-1 and PYY levels, but not with changes of cortisol rhythm. In conclusion, the HF/HC diet shows an unfavourable effect on glycaemic control in IFG/IGT, but not in NGT subjects. Consequently, large, carbohydrate-rich dinners should be avoided, primarily by subjects with impaired glucose metabolism.

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Understanding the cognitive experience of death and the near-death experience

S. Parnia

QJM (2017) 110 (2): 67-69. DOI: https://doi.org/10.1093/qjmed/hcw185

Published: 01 November 2016

http://sci-hub.cc/10.1093/qjmed/hcw185

Transcendental mystical or spiritual experiences close to death have been described for millennia. However, following the birth of modern intensive care medicine four decades ago, the specific term ‘near-death experience’ (NDE) was coined.1 Current research indicates that, regardless of cultural background, adults and young children (<3 years) have described comparable experiences in association with death.1 These include: feelings of immense peace and love; a sensation of going through a tunnel; seeing a bright warm welcoming light that draws the person toward it; meeting a ‘being of light’; a feeling of entering a beautiful ‘heavenly’ domain; and encountering deceased relatives who are often perceived as greeting and welcoming the individual. A review of the person’s life from early childhood onward is another commonly reported experience,...

Topic: cardiac arrest, consciousness related finding, near-death experience

 

Why is the United States a sick country?

Donnelly SC.

QJM. 2017 Feb 1;110(2):57-58. doi: 10.1093/qjmed/hcx020. No abstract available.

PMID: 28204741

https://academic.oup.com/qjmed/article/110/2/61/2681813/American-health-care-paradoxhigh-spending-on

https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/qjmed/110/2/10.1093_qjmed_hcw187/1/hcw187.pdf?Expires=1489603188&Signature=PFD16I53cTV~~MJptWmz01Hb0ZaPHS4EFcZlTO4Po~PK5hcIRZwEAu2jIDARCVr0EdhuSeh5Ij3eoOBxd5oX-6CKb7LYl6WDMkodt8nwNc83Vy~CZJQ2cqmKWexgeG9155B9nNU3GgBQUZWVHpSUp62wFas6o4Lcy2Er2z3H9IvSiYJe86zRlrVhc3TjVKyhNi9QgpjtDYXyKEbeNR0BNnhNBsaldrCrKYcM9~bnlcCIYk-82v2ik2FBa3uteCrOu12Va8FfWzvDglwEvP~aukVlz1R1QOjphuWO7HY7j-IJ~jvqWXnFJF4NgP75jggljtHE1VCDWxTvr0qdHajQog__&Key-Pair-Id=APKAIUCZBIA4LVPAVW3Q

Abstract

BACKGROUND:

for decades, U.S. taxpayers have been lamenting the high cost of health care. Since the mid-1980s, Americans have had double-digit spending on health care. Despite this investment, Americans are less healthy than their European and Scandinavian counterparts across an array of health measures.

AIM:

We sought to explore how inadequate attention to the social, behavioral, and environmental determinants of health may contribute to the American health care paradox of high health care spending and poor health outcomes.

DESIGN:

Mixed methodsMethods: We report previous findings related from a 10-year analysis of national-level health and social service spending and health outcome data from the Organisation of Economic and Cooperation and Development (OECD). We also put forth case studies representing different socioeconomic strata to illustrate the relationship between health care and social service spending and health.

RESULTS:

Although the U.S. spending more of its GDP on health care than any other country, it is not a high spender when one sums spending on both health care and social services. The U.S. however has the lowest ratio of our social service spending to health care spending in the OECD, and countries with lower ratios on average have worse health outcomes. Cases from diverse socioeconomic strata demonstrate how limited attention to the social determinants of health can result in extremely high health care costs and poor health outcomes.

CONCLUSIONS:

Greater investment in addressing the social, behavioral, and environmental determinants of health may foster better health without accelerating health care costs in America.

 

The benefits and risks of consuming brewed tea: beware of toxic element contamination.

Schwalfenberg G, Genuis SJ, Rodushkin I.

J Toxicol. 2013;2013:370460. doi: 10.1155/2013/370460.

PMID: 24260033 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3821942/pdf/JT2013-370460.pdf

https://www.hindawi.com/journals/jt/2013/370460/

Abstract

Background. Increasing concern is evident about contamination of foodstuffs and natural health products. Methods. Common off-the-shelf varieties of black, green, white, and oolong teas sold in tea bags were used for analysis in this study. Toxic element testing was performed on 30 different teas by analyzing (i) tea leaves, (ii) tea steeped for 3-4 minutes, and (iii) tea steeped for 15-17 minutes. Results were compared to existing preferred endpoints. Results. All brewed teas contained lead with 73% of teas brewed for 3 minutes and 83% brewed for 15 minutes having lead levels considered unsafe for consumption during pregnancy and lactation. Aluminum levels were above recommended guidelines in 20% of brewed teas. No mercury was found at detectable levels in any brewed tea samples. Teas contained several beneficial elements such as magnesium, calcium, potassium, and phosphorus. Of trace minerals, only manganese levels were found to be excessive in some black teas. Conclusions. Toxic contamination by heavy metals was found in most of the teas sampled. Some tea samples are considered unsafe. There are no existing guidelines for routine testing or reporting of toxicant levels in "naturally" occurring products. Public health warnings or industry regulation might be indicated to protect consumer safety.

 

Nutrient sensing pathways as therapeutic targets for healthy ageing.

Aiello A, Accardi G, Candore G, Gambino CM, Mirisola M, Taormina G, Virruso C, Caruso C.

Expert Opin Ther Targets. 2017 Apr;21(4):371-380. doi: 10.1080/14728222.2017.1294684.

PMID: 28281903

http://sci-hub.cc/10.1080/14728222.2017.1294684

Abstract

INTRODUCTION:

In the present paper, the authors have discussed anti-aging strategies which aim to slow the aging process and to delay the onset of age-related diseases, focusing on nutrient sensing pathways (NSPs) as therapeutic targets. Indeed, several studies have already demonstrated that both in animal models and humans, dietary interventions might have a positive impact on the aging process through the modulation of these pathways. Areas covered: Achieving healthy aging is the main challenge of the twenty-first century because lifespan is increasing, but not in tandem with good health. The authors have illustrated different approaches that can act on NSPs, modulating the rate of the aging process. Expert opinion: Humanity's lasting dream is to reverse or, at least, postpone aging. In recent years, increasing attention has been devoted to anti-aging therapies. The subject is very popular among the general public, whose imagination runs wild with all the possible tools to delay aging and to gain immortality. Some approaches discussed in the present review should be able to substantially slow down the aging process, extending our productive, youthful lives, without frailty.

KEYWORDS:

Aging; anti-aging approaches; dietary patterns; nutraceuticals; nutrient sensing pathways

 

Introduction to the special focus issue on the impact of diet on gut microbiota composition and function and future opportunities for nutritional modulation of the gut microbiome to improve human health.

Donovan SM.

Gut Microbes. 2017 Feb 28:1-7. doi: 10.1080/19490976.2017.1299309. [Epub ahead of print]

PMID: 28282253

http://www.tandfonline.com/doi/full/10.1080/19490976.2017.1299309?scroll=top&needAccess=true

http://www.tandfonline.com/doi/pdf/10.1080/19490976.2017.1299309?needAccess=true

Abstract

Over the past decade, application of culture-independent, next generation DNA sequencing has dramatically enhanced our understanding of the composition of the gut microbiome and its association with human states of health and disease. Host genetics, age, and environmental factors such as where and who you live with, use of pre-, pro- and antibiotics, exercise and diet influence the short- and long-term composition of the microbiome. Dietary intake is a key determinant of microbiome composition and diversity and studies to date have linked long-term dietary patterns as well as short-term dietary interventions to the composition and diversity of the gut microbiome. The goal of this special focus issue was to review the role of diet in regulating the composition and function of the gut microbiota across the lifespan, from pregnancy to old age. Overall dietary patterns, as well as perturbations such as undernutrition and obesity, as well as the effects of dietary fiber/prebiotics and fat composition are explored.

KEYWORDS:

diet; fat; fiber; microbiota; undernutrition

 

[The below paper is not pdf-availed.]

Mediterranean Diet and 10-year (2002-2012) Incidence of Diabetes and Cardiovascular Disease in Participants with Prediabetes: The ATTICA study.

Filippatos TD, Panagiotakos DB, Georgousopoulou EN, Pitaraki E, Kouli GM, Chrysohoou C, Tousoulis D, Stefanadis C, Pitsavos C; ATTICA Study Group..

Rev Diabet Stud. 2016 Winter;13(4):226-235. doi: 10.1900/RDS.2016.13.226.

PMID: 28278309

Abstract

BACKGROUND:

Prediabetes has been related to an increased risk of developing diabetes and cardiovascular disease (CVD).

AIM:

The aim of the present study was to examine the effect of the Mediterranean diet on diabetes and CVD risk in subjects with impaired fasting glucose (IFG, i.e. fasting plasma glucose 100-125 mg/dl).

METHODS:

During 2001-2002, 3042 men and women (>18y) were enrolled for the study. The participants showed no clinical evidence of CVD or any other chronic disease, and were living in the greater Athens (Greece) area. In 2011 and 2012, the 10-year follow-up examinations were performed, including a working sample of n = 1875 participants without diabetes at baseline. Adherence to the Mediterranean diet at baseline evaluation was assessed using the MedDietScore (range 0-55).

RESULTS:

The prediabetic subjects (n = 343) had a significantly higher incidence of diabetes (25% vs. 10%, p < 0.001) and CVD (17.8% vs. 12.3%, p = 0.007) compared with subjects with normal glucose values. A significant trend towards lower diabetes and CVD incidence was observed with medium and high adherence to the Mediterranean diet compared with low adherence (p < 0.001). High adherence to the Mediterranean diet (>35/55 score) was associated with lower 10-year incidence of diabetes and CVD. In multiple logistic regression models, participants with high levels of adherence to the Mediterranean diet were significantly less affected by diabetes and CVD than those with low adherence levels.

CONCLUSION:

High adherence to the Mediterranean diet is associated with a low risk of developing diabetes and CVD in prediabetic subjects.

 

Effect of excess iodine intake on thyroid diseases in different populations: A systematic review and meta-analyses including observational studies.

Katagiri R, Yuan X, Kobayashi S, Sasaki S.

PLoS One. 2017 Mar 10;12(3):e0173722. doi: 10.1371/journal.pone.0173722.

PMID: 28282437

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0173722

http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0173722&type=printable

Abstract

BACKGROUND:

Although several reports concerning the association of iodine excess and thyroid disease have appeared, no systematic review of the association between iodine excess intake and thyroid diseases, especially hyperthyroidism and hypothyroidism, has yet been reported.

METHOD:

We conducted a systematic search of Ovid MEDLINE, PubMed, Cochrane Central Register of Controlled Trials databases, Ichushi-Web and CiNii database for intervention trials and observational studies. Search terms were constructed from related words for excess AND iodine intake or excretion AND thyroid hormones or diseases AND study designs. After considering the qualitative heterogeneity among studies, a meta-analysis was conducted and odds ratios and 95% confidence intervals (CI) were estimated in random-effects models. A protocol was registered with PROSPERO (No. CRD42015028081).

RESULTS:

50 articles were included, including three intervention trials, six case-control studies, six follow-up studies and 35 cross-sectional studies. Three cross-sectional studies in adults included in meta-analysis. Odds ratio of overt and subclinical hypothyroidism between excess and adequate populations were 2.78 (CI:1.47 to 5.27) and 2.03 (CI:1.58 to 2.62) in adults, respectively. Source of excess iodine status was mainly iodized salt or water in included studies.

CONCLUSION:

Although universal salt iodization has improved goiter rates, chronic exposure to excess iodine from water or poorly monitored salt are risk factors for hypothyroidism in free-living populations. Monitoring of both iodine concentration in salt as well as the iodine concentration in local drinking water are essential to preventing thyroid diseases. Hypothyroidism should be also carefully monitored in areas with excess iodine. Because of the low quality and limited number of included studies, further evidence and review are required.

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Profiles in emotional aging: does age matter?

Etxeberria I, Etxebarria I, Urdaneta E.

Aging Ment Health. 2017 Feb 17:1-9. doi: 10.1080/13607863.2017.1286450. [Epub ahead of print]

PMID: 28282728

http://sci-hub.cc/10.1080/13607863.2017.1286450

Abstract

OBJECTIVES:

The aim of this research project was to define emotional profiles in elderly people and to analyze the presence of each one in different age groups (from 65 to 74, 75 to 84, 85 to 94 and 95 to 104).

METHOD:

The sample group comprised 257 elderly people not suffering from cognitive impairment who were independent in the Basic and Instrumental Activities of Daily Living. The following emotional variables were analyzed: positive and negative affect, life satisfaction, loneliness, and regulation strategies.

RESULTS:

Cluster analyses revealed three emotional profiles: 'dissatisfied' (elderly people with high levels of negative affect and loneliness who are unhappy with their lives and use problem solving to regulate their emotions), 'happy' (those with good levels of positive affect and life satisfaction, low levels of loneliness and negative affect and little use of passive strategies), and 'resilient' (those with low levels of positive and negative affect and medium levels of loneliness who are more or less satisfied with their lives and who use passive strategies to regulate their emotions). A relationship was observed between age and profile. Among the under 85s, the most common profile was 'happy', while among the over 85s, the most common profile was 'resilient.' The 'happy' profile was also observed in participants over the age of 85, although to a lesser extent. The prevalence of the 'dissatisfied' profile decreased with age.

CONCLUSION:

These results highlight the fact that although age seems to be a key factor in determining profile, individual differences should not be overlooked, even among the oldest old.

KEYWORDS:

Emotional profiles; centenarians; oldest old

 

[i did not know cod had that much iodine.]

Lean Fish Consumption Is Associated with Beneficial Changes in the Metabolic Syndrome Components: A 13-Year Follow-Up Study from the Norwegian Tromsø Study.

Tørris C, Molin M, Småstuen MC.

Nutrients. 2017 Mar 8;9(3). pii: E247. doi: 10.3390/nu9030247.

PMID: 28282859

http://www.mdpi.com/2072-6643/9/3/247/htm

Abstract

BACKGROUND:

Fish consumption may have beneficial effects on metabolic syndrome (MetS); however, limited information of such associations exists. This study investigated possible associations between fish consumption and changes in MetS components during a 13-year follow-up period.

METHODS:

The sample included participants (26-69 years) from the Tromsø Study 4 (1994-1995, n = 23,907) and Tromsø Study 6 (2007-2008, n = 12,981). Data were collected using questionnaires including food frequency questions, non-fasting blood samples, and physical examinations. MetS was defined using the Joint Interim Societies (JIS) definition, in which one point was given for each MetS criteria fulfilled (metabolic score). Longitudinal analyses were performed using Linear mixed models.

RESULTS:

For both genders, lean fish consumption once a week or more was significantly associated with decreased future metabolic score, decreased triglycerides, and increased high-density lipoprotein (HDL)-cholesterol, whereas decreased waist circumference and blood pressure was identified only for men (age adjusted models). Fatty fish consumption was significantly associated with increased waist circumference for both genders and increased HDL-cholesterol levels in men. Conclusion: The results suggest that fatty and lean fish consumption may influence MetS differently and that lean fish consumption in particular seems to be associated with beneficial changes in the MetS components.

KEYWORDS:

diet; fatty fish; fish consumption; insulin resistance; lean fish; metabolic syndrome; processed fish

 

Clinical and Metabolic Response to Vitamin D Supplementation in Endometrial Hyperplasia: a Randomized, Double-Blind, Placebo-Controlled Trial.

Tabassi Z, Bagheri S, Samimi M, Gilasi HR, Bahmani F, Chamani M, Asemi Z.

Horm Cancer. 2017 Mar 10. doi: 10.1007/s12672-017-0290-9. [Epub ahead of print]

PMID: 28283863

http://sci-hub.cc/10.1007/s12672-017-0290-9

Abstract

There was inconsistent evidence showing that vitamin D intake may be associated with reduced cancer risk due to optimized metabolic profile and reduced oxidative stress. However, we are not aware of any study evaluating the effects of vitamin D supplementation on clinical response and metabolic status of patients with endometrial hyperplasia (EH). This research was done to evaluate the effects of vitamin D supplementation on clinical response and metabolic status of patients with EH. This randomized, double-blind, placebo-controlled trial was conducted among 60 women diagnosed with EH. EH diagnosis was made based on specific diagnostic procedures of biopsy. Participants were randomly assigned into two groups to intake either 50,000 IU vitamin D3 supplements (n = 30) or placebo (n = 30) every 2 weeks for 12 weeks. After the 12-week intervention, compared with the placebo, vitamin D supplementation increased serum-25(OH) vitamin D levels (+12.0 ± 10.4 vs. +1.9 ± 7.1 ng/mL, P < 0.001). In addition, vitamin D administration was associated with significant decreases in fasting plasma glucose (FPG) (-1.6 ± 7.0 vs. +2.1 ± 6.1 mg/dL, P = 0.03), serum insulin levels (-0.8 ± 1.9 vs. +1.1 ± 3.5 μIU/mL, P = 0.01), homeostasis model of assessment-insulin resistance (HOMA-IR) (-0.2 ± 0.6 vs. +0.3 ± 0.8, P = 0.01), and a significant increase in the quantitative insulin sensitivity check index (QUICKI) (+0.003 ± 0.01 vs. -0.01 ± 0.02, P = 0.02) compared with the placebo. Additionally, a significant decrease in serum high-sensitivity C-reactive protein (hs-CRP) (-1.9 ± 2.8 vs. -0.003 ± 2.0 μg/mL, P = 0.003) and a significant rise in plasma total antioxidant capacity (TAC) values (+62.5 ± 53.5 vs. +7.5 ± 34.1 mmol/L, P < 0.001) were observed following supplementation with vitamin D compared with the placebo. In conclusion, vitamin D3 supplementation for 12 weeks among women with EH had beneficial effects on glucose metabolism, serum hs-CRP, and plasma TAC concentrations. In addition, vitamin D may have played an indirect role in reducing complications of EH due to its effect on improved glycemic control, hs-CRP, and TAC concentrations.

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Cystic fibrosis patients living 10 years longer in Canada than U.S.

Researchers identify differences in diet, health insurance and access to lung transplants

By Susan Noakes,

CBC News

Posted: Mar 13, 2017

http://www.cbc.ca/news/health/cystic-fibrosis-survival-rates-1.4022970

 

Cognitive functioning of individuals aged 90 years and older without dementia: a systematic review.

Legdeur N, Binnekade TT, Otten RH, Badissi M, Scheltens P, Visser PJ, Maier AB.

Ageing Res Rev. 2017 Mar 8. pii: S1568-1637(16)30275-6. doi: 10.1016/j.arr.2017.02.006. [Epub ahead of print] Review.

PMID: 28284872

http://sci-hub.cc/10.1016/j.arr.2017.02.006

Abstract

INTRODUCTION:

Reference values to define cognitive impairment in individuals aged 90 years and older are lacking. We systematically reviewed the literature to determine the level of cognitive functioning of individuals aged 90 years and older without dementia.

METHODS:

The search identified 3972 articles of which 20 articles were included in the review. We calculated mean cognitive test scores and cut-off scores for cognitive tests published in two or more articles.

RESULTS:

The mean cognitive test scores (SD)/cut-off scores for individuals aged 90 years and older without dementia of the five most commonly used cognitive tests were: MMSE: 26.6 (2.6)/23.3 points, Digit Span forward: 5.9 (1.8)/3.6 digits, Digit Span backward: 4.4 (1.6)/2.4 digits, TMT-A: 85.8 (42.5)/140.2seconds and TMT-B: 220.3 (99.2)/347.3seconds.

DISCUSSION:

We provided mean cognitive test scores and cut-off scores that will improve the diagnostic process of cognitive impairment in individuals aged 90 years and older.

KEYWORDS:

cognitive functioning; cognitive impairment; healthy ageing; individuals aged 90 years and older; nonagenarians; reference values

 

Skipping breakfast reduces energy intake and physical activity in healthy women who are habitual breakfast eaters: A randomized crossover trial.

Yoshimura E, Hatamoto Y, Yonekura S, Tanaka H.

Physiol Behav. 2017 Mar 8. pii: S0031-9384(16)31165-9. doi: 10.1016/j.physbeh.2017.03.008. [Epub ahead of print]

PMID: 28284879

http://sci-hub.cc/10.1016/j.physbeh.2017.03.008

Abstract

Many epidemiological studies indicate a positive relationship between skipping breakfast (SB) and obesity. However, it is unclear whether SB affects energy intake and physical activity during the day. The objective of the present study was to evaluate the acute effects of SB on energy intake and physical activity under free-living conditions. The present study used a randomized, crossover trial design comparing eating breakfast (EB) and SB days. Twenty lean, healthy women 21-25years old who were habitual breakfast eaters (≥5daysperweek) took part in this study. On EB days, participants were provided a standard breakfast (542kcal). The meals and physical activity after breakfast were under free-living conditions. The meals consisted of foods available at supermarkets, restaurants, and convenience stores. Dietary intake was evaluated by adding values from food labels. Physical activity was assessed using a tri-axial accelerometer. Energy intake at lunch was significantly increased after SB compared with EB (+131±188kcal; p=0.0057). Total energy intake per day was significantly lower after SB compared with EB (-262±428kcal, p=0.013). Physical activity energy expenditure was slightly lower after SB compared with EB (-41±75kcal in the morning, p=0.024; -56±129kcalperday, p=0.064). Step counts and time spent physically active over the whole day were not significantly different between conditions. Skipping breakfast reduced energy intake during the day and morning physical activity in healthy women who were habitual breakfast eaters. The decreased energy expenditure related to physical activity after SB did not exceed the decreased energy intake.

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Age-Related Changes in Locomotor Performance Reveal a Similar Pattern for Caenorhabditis elegans, Mus domesticus, Canis familiaris, Equus caballus, and Homo sapiens.

Marck A, Berthelot G, Foulonneau V, Marc A, Antero-Jacquemin J, Noirez P, Bronikowski AM, Morgan TJ, Garland T Jr, Carter PA, Hersen P, Di Meglio JM, Toussaint JF.

J Gerontol A Biol Sci Med Sci. 2016 Aug 13. pii: glw136. [Epub ahead of print]

PMID: 27522057

https://academic.oup.com/biomedgerontology/article-lookup/doi/10.1093/gerona/glw136

https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/biomedgerontology/72/4/10.1093_gerona_glw136/2/glw136.pdf?Expires=1489767754&Signature=U9X684ofpQQHjlhm3-rJHc6vkZuUi1PidbWbrlqjlrkwi-uvDPYPKv9MccE79ucPUM4I0K7qXbc9MGILNCP44arrzci-hMLZcIEGDIfmDu0c-EeHIBHWFGK9YKIufiwgHPpe4dN9KCbymnZJF8T-ytKcdtw~Hus39CJ3tS9DNNpYRgZ2rHXxIAZr-eVLN4BYWRzdAHb1LqL~NvQh1pVSlX30unuffUT4rZ56MKJj48rPlD5E-o7GmLIsXTgGpD48~irXj-tDTbKbkgwWaOMJhymDZsYgGeEviFhQ6SRfPWMSf2tH4RFOkVJ39CCYXR-K1qXw0G3ic~8c3KUc9NjRGQ__&Key-Pair-Id=APKAIUCZBIA4LVPAVW3Q

Abstract

Locomotion is one of the major physiological functions for most animals. Previous studies have described aging mechanisms linked to locomotor performance among different species. However, the precise dynamics of these age-related changes, and their interactions with development and senescence, are largely unknown. Here, we use the same conceptual framework to describe locomotor performances in Caenorhabditis elegans, Mus domesticus, Canis familiaris, Equus caballus, and Homo sapiens We show that locomotion is a consistent biomarker of age-related changes, with an asymmetrical pattern throughout life, regardless of the type of effort or its duration. However, there is variation (i) among species for the same mode of locomotion, (ii) within species for different modes of locomotion, and (iii) among individuals of the same species for the same mode of locomotion. Age-related patterns are modulated by genetic (such as selective breeding) as well as environmental conditions (such as temperature). However, in all cases, the intersection of the rising developmental phase and the declining senescent phase reveals neither a sharp transition nor a plateau, but a smooth transition, emphasizing a crucial moment: the age at peak performance. This transition may define a specific target for future investigations on the dynamics of such biological interactions.

KEYWORDS:

Aging; Comparative biology; Epidemiology; Exercise physiology; Senescence

 

Chlorogenic Acid Extends the Lifespan of Caenorhabditis elegans via Insulin/IGF-1 Signaling Pathway.

Zheng SQ, Huang XB, Xing TK, Ding AJ, Wu GS, Luo HR.

J Gerontol A Biol Sci Med Sci. 2016 Jul 4. pii: glw105. [Epub ahead of print]

PMID: 27378235

http://sci-hub.cc/10.1093/gerona/glw105

Abstract

Coffee and tea, two of the most popular drinks around the world, share many in common from chemical components to beneficial effects on human health. One of their shared components, the polyphenols, most notably chlorogenic acid (CGA), was supposed to account for many of the beneficial effects on ameliorating diseases occurred accompanying people aging, such as the antioxidant effect and against diabetes and cardiovascular disease. CGA is also present in many traditional Chinese medicines. However, the mechanism of these effects was vague. The aging signaling pathways were conservative from yeast and worms to mammals. So, we tested if CGA had an effect on aging in Caenorhabditis elegans We found that CGA could extend the lifespan of C. elegans by up to 20.1%, delay the age-related decline of body movement, and improve stress resistance. We conducted genetic analysis with a series of worm mutants and found that CGA could extend the lifespan of the mutants of eat-2, glp-1, and isp-1, but not of daf-2, pdk-1, akt-1, akt-2, sgk-1, and clk-1 CGA could activate the FOXO transcription factors DAF-16, HSF-1, SKN-1, and HIF-1, but not SIR-2.1. Taken together, CGA might extend the lifespan of C. elegans mainly via DAF-16 in insulin/IGF-1 signaling pathway.

KEYWORDS:

Caenorhabditis elegans; Chlorogenic acid; DAF-16/FOXO; Longevity; Stress resistance

 

http://www.nutritionaloutlook.com/heart-health/ingredient-spotlight-lions-mane-mushroom

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Reduction of depression and anxiety by 4 weeks Hericium erinaceus intake.

Nagano M, Shimizu K, Kondo R, Hayashi C, Sato D, Kitagawa K, Ohnuki K.

Biomed Res. 2010 Aug;31(4):231-7.

PMID: 20834180 Free Article

http://sci-hub.cc/10.2220/biomedres.31.231

Abstract

Hericium erinaceus, a well known edible mushroom, has numerous biological activities. Especially hericenones and erinacines isolated from its fruiting body stimulate nerve growth factor (NGF) synthesis, which expects H. erinaceus to have some effects on brain functions and autonomic nervous system. Herein, we investigated the clinical effects of H. erinaceus on menopause, depression, sleep quality and indefinite complaints, using the Kupperman Menopausal Index (KMI), the Center for Epidemiologic Studies Depression Scale (CES-D), the Pittsburgh Sleep Quality Index (PSQI), and the Indefinite Complaints Index (ICI). Thirty females were randomly assigned to either the H. erinaceus (HE) group or the placebo group and took HE cookies or placebo cookies for 4 weeks. Each of the CES-D and the ICI score after the HE intake was significantly lower than that before. In two terms of the ICI, "insentive" and "palpitatio", each of the mean score of the HE group was significantly lower than the placebo group. "Concentration", "irritating" and "anxious" tended to be lower than the placebo group. Our results show that HE intake has the possibility to reduce depression and anxiety and these results suggest a different mechanism from NGF-enhancing action of H. erinaceus.

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Chemistry, Nutrition, and Health-Promoting Properties of Hericium erinaceus (Lion's Mane) Mushroom Fruiting Bodies and Mycelia and Their Bioactive Compounds.

Friedman M.

J Agric Food Chem. 2015 Aug 19;63(32):7108-23. doi: 10.1021/acs.jafc.5b02914. Review.

PMID: 26244378

http://sci-hub.cc/10.1021/acs.jafc.5b02914

Abstract

The culinary and medicinal mushroom Hericium erinaceus is widely consumed in Asian countries, but apparently not in the United States, for its nutritional and health benefits. To stimulate broader interest in the reported beneficial properties, this overview surveys and consolidates the widely scattered literature on the chemistry (isolation and structural characterization) of polysaccharides and secondary metabolites such as erinacines, hericerins, hericenones, resorcinols, steroids, mono- and diterpenes, and volatile aroma compounds, nutritional composition, food and industrial uses, and exceptional nutritional and health-promoting aspects of H. erinaceus. The reported health-promoting properties of the mushroom fruit bodies, mycelia, and bioactive pure compounds include antibiotic, anticarcinogenic, antidiabetic, antifatigue, antihypertensive, antihyperlipodemic, antisenescence, cardioprotective, hepatoprotective, nephroprotective, and neuroprotective properties and improvement of anxiety, cognitive function, and depression. The described anti-inflammatory, antioxidative, and immunostimulating properties in cells, animals, and humans seem to be responsible for the multiple health-promoting properties. A wide range of research advances and techniques are described and evaluated. The collated information and suggestion for further research might facilitate and guide further studies to optimize the use of the whole mushrooms and about 70 characterized actual and potential bioactive secondary metabolites to help prevent or treat human chronic, cognitive, and neurological diseases.

KEYWORDS:

Hericium erinaceus; anti-inflammatory effects; antioxidant capacity; bioactive compounds; cell, rodent, and human studies; erinaceolactones; erinacerins; erinacines; food processing; food use; fruit bodies; glycoproteins; health-promoting properties; immunostimulation; multifunctional health properties; mushrooms; mycelia; nutrients; phylogenetics; polysaccharides; research needs; resorcinols; sterols; volatile compounds

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Improving effects of the mushroom Yamabushitake (Hericium erinaceus) on mild cognitive impairment: a double-blind placebo-controlled clinical trial.

Mori K, Inatomi S, Ouchi K, Azumi Y, Tuchida T.

Phytother Res. 2009 Mar;23(3):367-72. doi: 10.1002/ptr.2634.

PMID: 18844328

http://sci-hub.cc/10.1002/ptr.2634

Abstract

A double-blind, parallel-group, placebo-controlled trial was performed on 50- to 80-year-old Japanese men and women diagnosed with mild cognitive impairment in order to examine the efficacy of oral administration of Yamabushitake (Hericium erinaceus), an edible mushroom, for improving cognitive impairment, using a cognitive function scale based on the Revised Hasegawa Dementia Scale (HDS-R). After 2 weeks of preliminary examination, 30 subjects were randomized into two 15-person groups, one of which was given Yamabushitake and the other given a placebo. The subjects of the Yamabushitake group took four 250 mg tablets containing 96% of Yamabushitake dry powder three times a day for 16 weeks. After termination of the intake, the subjects were observed for the next 4 weeks. At weeks 8, 12 and 16 of the trial, the Yamabushitake group showed significantly increased scores on the cognitive function scale compared with the placebo group. The Yamabushitake group's scores increased with the duration of intake, but at week 4 after the termination of the 16 weeks intake, the scores decreased significantly. Laboratory tests showed no adverse effect of Yamabushitake. The results obtained in this study suggest that Yamabushitake is effective in improving mild cognitive impairment.

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Stirring the Pot: Can Dietary Modification Alleviate the Burden of CKD?

Snelson M, Clarke RE, Coughlan MT.

Nutrients. 2017 Mar 11;9(3). pii: E265. doi: 10.3390/nu9030265. Review.

PMID: 28287463

http://www.mdpi.com/2072-6643/9/3/265/htm

Abstract

Diet is one of the largest modifiable risk factors for chronic kidney disease (CKD)-related death and disability. CKD is largely a progressive disease; however, it is increasingly appreciated that hallmarks of chronic kidney disease such as albuminuria can regress over time. The factors driving albuminuria resolution remain elusive. Since albuminuria is a strong risk factor for GFR loss, modifiable lifestyle factors that lead to an improvement in albuminuria would likely reduce the burden of CKD in high-risk individuals, such as patients with diabetes. Dietary therapy such as protein and sodium restriction has historically been used in the management of CKD. Evidence is emerging to indicate that other nutrients may influence kidney health, either through metabolic or haemodynamic pathways or via the modification of gut homeostasis. This review focuses on the role of diet in the pathogenesis and progression of CKD and discusses the latest findings related to the mechanisms of diet-induced kidney disease. It is possible that optimizing diet quality or restricting dietary intake could be harnessed as an adjunct therapy for CKD prevention or progression in susceptible individuals, thereby reducing the burden of CKD.

KEYWORDS:

advanced glycation end products; albuminuria; cardiovascular disease; chronic kidney disease; diabetes; diet; inflammation

 

COGNITIVE STATUS IN THE OLDEST OLD AND CENTENARIANS: A CONDITION CRUCIAL FOR QUALITY OF LIFE METHODOLOGICALLY DIFFICULT TO ASSESS.

Arosio B, Ostan R, Mari D, Damanti S, Ronchetti F, Arcudi S, Scurti M, Franceschi C, Monti D.

Mech Ageing Dev. 2017 Mar 9. pii: S0047-6374(16)30245-7. doi: 10.1016/j.mad.2017.02.010. [Epub ahead of print] Review.

PMID: 28286214

http://sci-hub.cc/10.1016/j.mad.2017.02.010

Abstract

Human life expectancy and the number of the oldest old are rapidly increasing worldwide. Advanced age is the main risk factor for dementia, representing one of the major causes of disability/dependency among older people with a strong impact on their families/caregivers. Centenarians have reached the extreme limits of human life escaping or delaying the major age-related diseases. Thus, these extraordinary individuals embody the best model to answer the crucial question if cognitive decline and dementia are progressive and unavoidable occurrences of increasing age. Despite a growing amount of data underlines the importance of cognitive function for quality of life and survival in old age, studies on centenarians have paid more attention to their physical condition rather than the assessment of their actual cognitive abilities. Accordingly, this work aims to summarize available data on the prevalence of dementia in centenarians and to critically address topics which can have a relevant impact on the cognitive assessment/status of the oldest old: i) lack of standardized tools for cognitive assessment; ii) criteria and threshold to establish the presence of dementia; iii) influence of birth cohort and education; iv) role of depression or positive attitude towards life; v) gender differences.

KEYWORDS:

Centenarians; cognitive assessment; cognitive decline; dementia; depression; gender

 

Thyroid hormones in extreme longevity.

Garasto S, Montesanto A, Corsonello A, Lattanzio F, Fusco S, Passarino G, Giarritta VP, Corica F.

Mech Ageing Dev. 2017 Mar 9. pii: S0047-6374(16)30180-4. doi: 10.1016/j.mad.2017.03.002. [Epub ahead of print] Review.

PMID: 28286215

http://sci-hub.cc/10.1016/j.mad.2017.03.002

Abstract

The aim of the present review was to summarize knowledge about thyroid hormones (THs) and longevity. Longevity is a complex multifactorial phenomenon on which specific biological pathways, including hormonal networks involved in the regulation of homeostasis and survival, exert a strong impact. THs are the key responsible for growth, metabolism rate and energy expenditure, and help in maintaining cognition, bone and cardiovascular health. THs production and metabolism are fine tuned, and may help the organism to cope with a variety of environmental challenges. Experimental evidence suggests that hypothyroid state may favor longevity by reducing metabolism rate, oxidative stress and cell senescence. Data from human studies involving healthy subjects and centenarians seem to confirm this view, but THs changes observed in older patients affected by chronic diseases cannot be always interpreted as a protective adaptive mechanism aimed at reducing catabolism and prolonging survival. Medications, selected chronic diseases and multi-morbidity can interfere with thyroid function, and their impact is still to be elucidated.

Copyright © 2017. Published by Elsevier B.V.

KEYWORDS:

Age-related diseases; Aging; Centenarians; Longevity; Thyroid

 

Treatment of reactive hypoglycemia with the macrobiotic Ma-pi 2 diet as assessed by continuous glucose monitoring: The MAHYP randomized crossover trial.

Soare A, Khazrai YM, Fontana L, Del Toro R, Lazzaro MC, Di Rosa C, Buldo A, Fioriti E, Maddaloni E, Angeletti S, Di Mauro A, Gesuita R, Skrami E, Tuccinardi D, Fallucca S, Pianesi M, Pozzilli P.

Metabolism. 2017 Apr;69:148-156. doi: 10.1016/j.metabol.2017.01.023.

PMID: 28285645

http://sci-hub.cc/10.1016/j.metabol.2017.01.023

Abstract

BACKGROUND AND AIMS:

Nutritional therapy is recommended for management of reactive hypoglycemia (RH), a condition characterized by hypoglycemia that occurs within four hours after a meal. The macrobiotic Ma-Pi 2 diet improves glycemic control in subjects with type 2 diabetes. We explored the effect of this diet on outcomes in non-diabetic individuals with RH.

MATERIALS AND METHODS:

Twelve subjects with RH were randomized to the Ma-Pi 2 diet for three days and a control diet for three days in a randomized crossover design. Subjects received snacks on two days out of each three-day period only, and were monitored using continuous glucose monitoring. The 24-h period was divided into daytime (08:00-22:30h [subdivided into 'daytime without snacks' and 'daytime with snacks']) and night-time (22:31-07:59h). The effects of the two diets on the number of RH events (blood glucose <70mg/dL [3.9mmol/L]) and the percentage distribution of glucose readings within each of 16 glycemic intervals from <40mg/dL (2.2mmol/L) to >180mg/dL (4.4mmol/L) were determined.

RESULTS:

There were significantly fewer RH events on the Ma-Pi 2 diet than the control diet during daytime without snacks (-2.5 events; 95% CI: -7.5, 0.0; P=0.022) and daytime with snacks (-4.25 events; 95% CI: -7.5; -2.0; P=0.013) but no difference at night. The percentage of glucose readings in the interval 71-80mg/dL (3.9-4.4mmol/L) was significantly higher on the control diet during daytime with and without snacks (P=0.03 for both), while the percentage of glucose readings in the interval 91-100mg/dL (5.1-5.6mmol/L) was significantly higher on the Ma-Pi 2 diet during daytime without snacks (P=0.02).

CONCLUSIONS:

The macrobiotic Ma-Pi 2 diet reduced blood glucose excursions during the day, thereby facilitating glycemic control in subjects with RH. The Ma-Pi 2 diet represents an effective nutritional tool for management of RH.

KEYWORDS:

Continuous glucose monitoring; Macrobiotic Ma-pi 2 diet; Reactive hypoglycemia; Type-2 diabetes

 

Associations between dietary intakes of iron, copper and zinc with risk of type 2 diabetes mellitus: A large population-based prospective cohort study.

Eshak ES, Iso H, Maruyama K, Muraki I, Tamakoshi A.

Clin Nutr. 2017 Feb 28. pii: S0261-5614(17)30060-2. doi: 10.1016/j.clnu.2017.02.010. [Epub ahead of print]

PMID: 28285974

http://sci-hub.cc/10.1016/j.clnu.2017.02.010

Abstract

BACKGROUND & AIMS:

Abnormal homeostasis of iron, copper and zinc has been included in the pathogenesis of type 2 diabetes mellitus (T2DM). However, the evidence of associations between dietary intakes of these elements and T2DM is limited. We thought to examine the association between dietary intakes of iron, copper and zinc with risk of T2DM in Japanese population.

METHODS:

A prospective study encompassing 16,160 healthy Japanese men and women aged 40-65 years in whom the associations between dietary intakes of iron, copper and zinc, determined by a validated self-administered food frequency questionnaire, with risk of 5-year cumulative incidence of validated physician-diagnosed T2DM, were evaluated by logistic regression model.

RESULTS:

We ascertained 396 self-reported new cases of diabetes within 5-year period. Dietary intakes of iron (total and nonheme but not heme iron) and copper were positively associated with risk of T2DM; the multivariable OR in the highest versus lowest quartiles of intakes were 1.32 (1.04, 1.70; P-trend = 0.03) and 1.55 (1.13, 2.02; P-trend = 0.003), respectively. These associations were more evident in the high risk group; older, overweight, smokers and those with family history of diabetes. The dietary intake of zinc was inversely associated with risk of T2DM; the multivariable OR was 0.64 (0.54, 1.00; P-trend = 0.003), and such association was evident among younger subjects (age 40-55 years) only.

CONCLUSIONS:

Dietary intakes of iron and copper were associated with a higher risk, while dietary intake of zinc was associated with a reduced risk of T2DM in Japanese population.

KEYWORDS:

Cohort study; Copper; Iron; Japanese; Type 2 diabetes mellitus; Zinc

 

Monounsaturated fatty acids might be key factors in the Mediterranean diet that suppress rheumatoid arthritis disease activity: The TOMORROW study.

Matsumoto Y, Sugioka Y, Tada M, Okano T, Mamoto K, Inui K, Habu D, Koike T.

Clin Nutr. 2017 Feb 21. pii: S0261-5614(17)30061-4. doi: 10.1016/j.clnu.2017.02.011. [Epub ahead of print]

PMID: 28285975

http://sci-hub.cc/10.1016/j.clnu.2017.02.011

Abstract

BACKGROUND & AIMS:

The Mediterranean diet is reportedly effective in suppressing disease activity in rheumatoid arthritis (RA), but the key elements responsible for this effect remain unknown. The presented study therefore aimed to identify such elements.

METHODS:

This study included 208 consecutive patients with RA (RA group) and 205 age- and sex-matched healthy volunteers (controls) from the prospective "TOMORROW" cohort study that has been ongoing since 2010 were included in this study. Food and nutrient intake was assessed using the brief self-administered diet history questionnaire (BDHQ), Mediterranean diet scores were calculated based on intake by controls and disease activity was determined from disease activity scores in 28 joints and erythrocyte sedimentation rates (DAS28-ESR).

RESULTS:

Intake of monounsaturated fatty acids (MUFA) was significantly lower in the RA, than in the control group (P = 0.003) and the ratio of consumed monounsaturated to saturated fatty acid (MUFA/SFA) significantly differed within the RA group after being sub-classified according to DAS28-ESR. Moreover, DAS28-ESR significantly correlated with MUFA/SFA intake after age adjustment (R = -0.228, P < 0.01). Logistic regression analysis selected high MUFA intake as an independent predictor of remission in the RA group with borderline boundary significance (odds ratio, 1.97; 95% CI, 0.98-3.98; P = 0.057). Changes in DAS28-ESR between 2010 and 2011 significantly correlated with MUFA/SFA intake after age adjustment (R = 0.180, P = 0.01).

CONCLUSIONS:

Daily MUFA intake, a component of the Mediterranean diet score, might suppress disease activity in RA patients.

KEYWORDS:

Diet therapy; Disease activity; Inflammation; Mediterranean diet; Nutrition; Rheumatoid arthritis

 

Human aging, finite lives and the idealization of clocks.

Baars J.

Biogerontology. 2016 Oct 22. [Epub ahead of print]

PMID: 27771833

https://link.springer.com/article/10.1007%2Fs10522-016-9664-6

Abstract

Aging and time are interconnected because aging is basically living seen in a temporal perspective. This makes 'time' an important concept in trying to explain aging. However, throughout modernity time has increasingly been identified as clock time: perfectly fit to measure 'age' as time since birth but failing to explain 'age' as an indicator of aging processes and even less adequate to grasp the lived time of human beings. Moreover, the clock as a cultural idol of instrumentalist perfection has led to approaching human aging in terms of maintenance and repair, inspiring a neglect and depreciation of human vulnerability. The instrumentalist culture of late modern society, including its health cure system, has difficulties to relate to the elusive but inevitable limitations of finite life. This tendency is supported by outspoken approaches in biogerontology indulging in perspectives of infinite human lives; a message that is eagerly consumed by the mass media. Moreover, as most people can be expected to survive into old age, thinking about finitude is easily postponed and reserved for those who are 'really old'. Instead of reducing aging to the opposite or mere continuation of vital adulthood, it should be seen as something with a potentially broad and deep significance: a process of learning to live a finite life.

KEYWORDS:

Finitude; Philosophy of aging; Time; Vulnerability

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I expect to be away from my computer from March 16 until about April 1.

 

The role of transplanted visceral fat from the long-lived growth hormone receptor knockout mice on insulin signaling

Mohammed T. BennisAugusto SchneiderBerta VictoriaAndrew DoDenise S. WiesenbornLina SpinelAdam GesingJohn J. KopchickShadab A. SiddiqiMichal M. Masternak

First Online: 18 January 2017

DOI: 10.1007/s11357-017-9957-y

GeroScience (2017) 39: 51-9. doi:10.1007/s11357-017-9957-y

http://sci-hub.cc/10.1007/s11357-017-9957-y

Abstract

Growth hormone receptor knockout mice (GHRKO) are characterized by high insulin sensitivity and extended lifespan. Interestingly, the secretory activity of visceral fat in GHRKO mice is altered, stimulating whole body insulin sensitivity. In this study, we transplanted normal (N) mice with visceral fat pads from GHRKO or N mice to determine the role of visceral fat on the insulin signaling. We found that the transplant of visceral fat from GHRKO mice to N mice (N-GHRKO) improved whole body insulin sensitivity when comparing with sham-operated mice (N-S) and with mice that received visceral fat from N mice (N-N). This was associated with increased hepatic insulin sensitivity as observed by the increased phosphorylated insulin receptor and increased hepatic expression of Pparα and Pparγ. In conclusion, we demonstrated that visceral fat transplant from GHRKO mice into normal mice enhanced insulin sensitivity and glucose tolerance. These results further confirm the differential physiological role played by visceral adipose tissue from GH receptor deficient mice, indicating that the increase of this fat depot can be associated with beneficial effects on insulin signaling and longevity.

Keywords

GHRKOGHRInsulin resistanceLongevityType 2 diabetes

 

The frailty index outperforms DNA methylation age and its derivatives as an indicator of biological age

Sangkyu Kim, Leann MyersJennifer WyckoffKatie E. CherryS. Michal Jazwinski

Open Access

First Online: 14 January 2017 DOI: 10.1007/s11357-017-9960-3

GeroScience (2017). pp 1–10 doi:10.1007/s11357-017-9960-3

Abstract

The measurement of biological age as opposed to chronological age is important to allow the study of factors that are responsible for the heterogeneity in the decline in health and function ability among individuals during aging. Various measures of biological aging have been proposed. Frailty indices based on health deficits in diverse body systems have been well studied, and we have documented the use of a frailty index (FI34) composed of 34 health items, for measuring biological age. A different approach is based on leukocyte DNA methylation. It has been termed DNA methylation age, and derivatives of this metric called age acceleration difference and age acceleration residual have also been employed. Any useful measure of biological age must predict survival better than chronological age does. Meta-analyses indicate that age acceleration difference and age acceleration residual are significant predictors of mortality, qualifying them as indicators of biological age. In this article, we compared the measures based on DNA methylation with FI34. Using a well-studied cohort, we assessed the efficiency of these measures side by side in predicting mortality. In the presence of chronological age as a covariate, FI34 was a significant predictor of mortality, whereas none of the DNA methylation age-based metrics were. The outperformance of FI34 over DNA methylation age measures was apparent when FI34 and each of the DNA methylation age measures were used together as explanatory variables, along with chronological age: FI34 remained significant but the DNA methylation measures did not. These results indicate that FI34 is a robust predictor of biological age, while these DNA methylation measures are largely a statistical reflection of the passage of chronological time.

Keywords

AgingBiological ageFrailtyDNA methylationMortality

 

Metabolic Effects of Inflammation on Vitamin A and Carotenoids in Humans and Animal Models

Lewis P Rubin, A Catharine Ross, Charles B Stephensen, Torsten Bohn, and Sherry A Tanumihardjo

Adv Nutr 2017; 8:197-212 doi:10.3945/an.116.014167

http://sci-hub.cc/doi/10.3945/an.116.014167

Abstract

The association between inflammation and vitamin A (VA) metabolism and status assessment has been documented in multiple studies with animals and humans. The relation between inflammation and carotenoid status is less clear. Nonetheless, it is well known that carotenoids are associated with certain health benefits. Understanding these relations is key to improving health outcomes and mortality risk in infants and young children. Hyporetinolemia, i.e., low serum retinol concentrations, occurs during inflammation, and this can lead to the misdiagnosis of VA deficiency. On the other hand, inflammation causes impaired VA absorption and urinary losses that can precipitate VA deficiency in at-risk groups of children. Many epidemiologic studies have suggested that high dietary carotenoid intake and elevated plasma concentrations are correlated with a decreased risk of several chronic diseases; however, large-scale carotenoid supplementation trials have been unable to confirm the health benefits and in some cases resulted in controversial results. However, it has been documented that dietary carotenoids and retinoids play important roles in innate and acquired immunity and in the body’s response to inflammation. Although animal models have been useful in investigating retinoid effects on developmental immunity, it is more challenging to tease out the effects of carotenoids because of differences in the absorption, kinetics, and metabolism between humans and animal models. The current understanding of the relations between inflammation and retinoid and carotenoid metabolism and status are the topics of this review.

Keywords:

biomarkers cytokines infection retinol retinol-binding protein sequestration urinary loss

 

Magnitude and Timing of the Postprandial Inflammatory Response to a High-Fat Meal in Healthy Adults: A Systematic Review

Sam R Emerson, Stephanie P Kurti, Craig A Harms, Mark D Haub, Tonatiuh Melgarejo, Cindy Logan, and Sara K Rosenkranz

Adv Nutr 2017; 8:213-225 doi:10.3945/an.116.014431

http://sci-hub.cc/doi/10.3945/an.116.014431

Abstract

Research findings over the past several decades have shown that inflammation is a prominent feature of many chronic diseases, with poor diet being one likely inflammatory stimulus. Specifically, a single high-fat meal (HFM) has been suggested to increase inflammation, although there is currently no consensus with regard to the specific changes in many of the proinflammatory markers that are frequently assessed after an HFM. The aim of this systematic review was to objectively describe the postprandial timing and magnitude of changes in 5 common inflammatory markers: interleukin (IL) 6, C-reactive protein (CRP), tumor necrosis factor (TNF) α, IL-1β, and IL-8. Ten relevant databases were searched, yielding 494 results, of which 47 articles met the pre-established inclusion criteria: 1) healthy men and women aged 18–60 y, 2) consuming a single HFM (≥30% fat, ≥500 kcal), and 3) assessing relevant inflammatory markers postmeal for ≥2 h. The only marker found to consistently change in the postprandial period was IL-6: on average, from a baseline of ∼1.4 pg/mL, it peaked at ∼2.9 pg/mL ∼6 h post-HFM (an average relative change of ∼100%). CRP, TNF-α, IL-1β, and IL-8 did not change significantly in 79% (23 of 29), 68% (19 of 28), 67% (2 of 3), and 75% (3 of 4) of included studies, respectively. We conclude that there is strong evidence that CRP and TNF-α are not responsive at the usual time scale observed in postprandial studies in healthy humans younger than age 60 y. However, future research should further investigate the role of IL-6 in the postprandial period, because it routinely increases even in healthy participants. We assert that the findings of this systematic review on markers of inflammation in the postprandial period will considerably aid in informing future research and advancing clinical knowledge.

Keywords:

cytokine interleukin C-reactive protein postmeal tumor necrosis factor

 

Effects of Dietary Flavonoids on Reverse Cholesterol Transport, HDL Metabolism, and HDL Function

Courtney L Millar, Quinn Duclos, and Christopher N Blesso

Adv Nutr 2017; 8:226-239 doi:10.3945/an.116.014050

http://sci-hub.cc/doi/10.3945/an.116.014050

Abstract

Strong experimental evidence confirms that HDL directly alleviates atherosclerosis. HDL particles display diverse atheroprotective functions in reverse cholesterol transport (RCT), antioxidant, anti-inflammatory, and antiapoptotic processes. In certain inflammatory disease states, however, HDL particles may become dysfunctional and proatherogenic. Flavonoids show the potential to improve HDL function through their well-documented effects on cellular antioxidant status and inflammation. The aim of this review is to summarize the basic science and clinical research examining the effects of dietary flavonoids on RCT and HDL function. Based on preclinical studies that used cell culture and rodent models, it appears that many flavonoids (e.g., anthocyanidins, flavonols, and flavone subclasses) influence RCT and HDL function beyond simple HDL cholesterol concentration by regulating cellular cholesterol efflux from macrophages and hepatic paraoxonase 1 expression and activity. In clinical studies, dietary anthocyanin intake is associated with beneficial changes in serum biomarkers related to HDL function in a variety of human populations (e.g., in those who are hyperlipidemic, hypertensive, or diabetic), including increased HDL cholesterol concentration, as well as HDL antioxidant and cholesterol efflux capacities. However, clinical research on HDL functionality is lacking for some flavonoid subclasses (e.g., flavanols, flavones, flavanones, and isoflavones). Although there has been a tremendous effort to develop HDL-targeted drug therapies, more research is warranted on how the intake of foods or specific nutrients affects HDL function.

Keywords:

flavonoids HDL polyphenols anthocyanins atherosclerosis

 

Optimizing Protein Intake in Adults: Interpretation and Application of the Recommended Dietary Allowance Compared with the Acceptable Macronutrient Distribution Range

Robert R Wolfe, Amy M Cifelli, Georgia Kostas, and Il-Young Kim

Adv Nutr 2017; 8:266-275 doi:10.3945/an.116.013821

OPEN ACCESS ARTICLE

http://advances.nutrition.org/content/8/2/266.full

Abstract

The adult RDA is defined as the average daily level of intake sufficient to meet the nutrient requirements of nearly all healthy people. The RDA for protein for adults ≥18 y of age (0.8 g/kg) has been essentially unchanged for >70 y. In practice, the RDA for protein was derived to estimate the minimum amount of protein that must be eaten to avoid a loss of body nitrogen. The Acceptable Macronutrient Distribution Range (AMDR) (10–35% of calories as protein) was developed to express dietary recommendations in the context of a complete diet. It is noteworthy that the lowest level of protein intake reflected in the AMDR is higher than that of the RDA. Furthermore, recent studies, particularly in older individuals, suggest specific health benefits at levels of protein intake that significantly exceed the RDA. Translation of protein intake recommendations for the general adult population into dietary guidance for individuals requires an understanding of the derivation and intended use of both the protein RDA and AMDR. The following discussion will describe limitations to the derivation and practical application of the RDA compared with the use of the AMDR to help maximize health benefits associated with higher protein intake by using flexible calories inherent in different dietary patterns.

Keywords:

protein nitrogen balance RDA AMDR dietary pattern

 

Thiamin

Jennifer C Kerns and Jean L Gutierrez

Adv Nutr 2017; 8:395-397 doi:10.3945/an.116.013979

http://sci-hub.cc/doi/10.3945/an.116.013979

"Because thiamin

must be obtained from the diet, is water soluble, and is not

stored in large amounts in the body, people who are thiamin

deficient (e.g., from calorie-restricted diets ..."

7. Vitamin B1 (thiamine) and dementia.

Gibson GE, Hirsch JA, Fonzetti P, Jordan BD, Cirio RT, Elder J.

Ann N Y Acad Sci. 2016 Mar;1367(1):21-30. doi: 10.1111/nyas.13031.

PMID: 26971083 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4846521/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4846521/pdf/nihms755605.pdf

Abstract

The earliest and perhaps best example of an interaction between nutrition and dementia is related to thiamine (vitamin B1). Throughout the last century, research showed that thiamine deficiency is associated with neurological problems, including cognitive deficits and encephalopathy. Multiple similarities exist between classical thiamine deficiency and Alzheimer's disease (AD) in that both are associated with cognitive deficits and reductions in brain glucose metabolism. Thiamine-dependent enzymes are critical components of glucose metabolism that are reduced in the brains of AD patients and by thiamine decline, and a decrease in their levels could account for the reduction in glucose metabolism. In preclinical models, reduced thiamine can drive AD-like abnormalities, including memory deficits, neuritic plaques, and hyperphosphorylation of tau. Furthermore, excess thiamine diminishes AD-like pathologies. In addition to dietary deficits, drugs or other manipulations that interfere with thiamine absorption can cause thiamine deficiency. Elucidating the reasons why the brains of AD patients are functionally thiamine deficient and determining the effects of thiamine restoration may provide critical information to help treat patients with AD.

KEYWORDS:

Alzheimer's disease; glucose metabolism; mitochondria; thiamine; vitamin B1

Edited by AlPater

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Rejuvenation by Therapeutic Elimination of Senescent Cells.

Krimpenfort P, Berns A.

Cell. 2017 Mar 23;169(1):3-5. doi: 10.1016/j.cell.2017.03.014.

PMID: 28340347

http://sci-hub.cc/10.1016/j.cell.2017.03.014

Abstract

In this issue of Cell, Baar et al. show how FOXO4 protects senescent cell viability by keeping p53 sequestered in nuclear bodies, preventing it from inducing apoptosis. Disrupting this interaction with an all-D amino acid peptide (FOXO4-DRI) restores p53's apoptotic role and ameliorates the consequences of senescence-associated loss of tissue homeostasis.

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

Targeted Apoptosis of Senescent Cells Restores Tissue Homeostasis in Response to Chemotoxicity and Aging.

Baar MP, Brandt RM, Putavet DA, Klein JD, Derks KW, Bourgeois BR, Stryeck S, Rijksen Y, van Willigenburg H, Feijtel DA, van der Pluijm I, Essers J, van Cappellen WA, van IJcken WF, Houtsmuller AB, Pothof J, de Bruin RW, Madl T, Hoeijmakers JH, Campisi J, de Keizer PL.

Cell. 2017 Mar 23;169(1):132-147.e16. doi: 10.1016/j.cell.2017.02.031.

PMID: 28340339

http://www.cell.com/fulltext/S0092-8674(17)30246-5

http://www.cell.com/cell/pdf/S0092-8674(17)30246-5.pdf

Abstract

The accumulation of irreparable cellular damage restricts healthspan after acute stress or natural aging. Senescent cells are thought to impair tissue function, and their genetic clearance can delay features of aging. Identifying how senescent cells avoid apoptosis allows for the prospective design of anti-senescence compounds to address whether homeostasis can also be restored. Here, we identify FOXO4 as a pivot in senescent cell viability. We designed a FOXO4 peptide that perturbs the FOXO4 interaction with p53. In senescent cells, this selectively causes p53 nuclear exclusion and cell-intrinsic apoptosis. Under conditions where it was well tolerated in vivo, this FOXO4 peptide neutralized doxorubicin-induced chemotoxicity. Moreover, it restored fitness, fur density, and renal function in both fast aging XpdTTD/TTD and naturally aged mice. Thus, therapeutic targeting of senescent cells is feasible under conditions where loss of health has already occurred, and in doing so tissue homeostasis can effectively be restored.

KEYWORDS:

FOXO4; IL6; LMNB1; Senescence; TP53; aging; apoptosis; cell-penetrating peptide; chemotherapy; tissue homeostasis

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Theoretical and Biological Evaluation of the Link between Low Exercise Capacity and Disease Risk.

Koch LG, Britton SL.

Cold Spring Harb Perspect Med. 2017 Apr 7. pii: a029868. doi: 10.1101/cshperspect.a029868. [Epub ahead of print]

PMID: 28389512

Abstract

Large-scale epidemiological studies show that low exercise capacity is the highest risk factor for all-cause morbidity and mortality relative to other conditions including diabetes, hypertension, and obesity. This led us to formulate the energy transfer hypothesis (ETH): Variation in capacity for energy transfer is the central mechanistic determinant of the divide between disease and health. As a test of this hypothesis, we predicted that two-way selective breeding of genetically heterogeneous rats for low and high intrinsic treadmill running capacity (a surrogate for energy transfer) would also produce rats that differ for disease risks. The lines are termed low-capacity runners (LCRs) and high-capacity runners (HCRs) and, after 36 generations of selection, they differ by more than eightfold in running capacity. Consistent with the ETH, the LCRs score high for developing disease risks, including metabolic syndrome, neurodegeneration, cognitive impairment, fatty liver disease, susceptibility to cancer, and reduced longevity. The HCRs are resistant to the development of these disease risks. Here we synthesize ideas on nonequilibrium thermodynamics and evolution from Ilya Prigogine, Hans Krebs, and Peter Mitchell to formulate theoretic explanations for the ETH. First, at every moment in time, the atoms and molecules of organisms are reorganizing to pursue avenues for energy transfer. Second, this continuous organization is navigating in a constantly changing environment such that "strategies" are perpetually in flux and do not leave a simple footprint (evolution). Third, as a consequence, human populations demonstrate a wide variation in capacity for energy transfer that mirrors mechanistically the divide between disease and health.

 

Hormetic efficacy of rutin to promote longevity in Drosophila melanogaster.

Chattopadhyay D, Chitnis A, Talekar A, Mulay P, Makkar M, James J, Thirumurugan K.

Biogerontology. 2017 Apr 7. doi: 10.1007/s10522-017-9700-1. [Epub ahead of print]

PMID: 28389882

Abstract

Hormetins are compounds that mediate hormesis by being beneficial at low doses but detrimental at high doses. Recent studies have highlighted that many compounds that extended lifespan in model organisms did so by mediating hormesis. Rutin is a glycosylate conjugate of quercetin and rutinose and is abundant in citrus fruits and buckwheat seeds. Rutin possess ROS scavenging, anti-cancer, cardio-protective, skin-regenerative and neuro-protective properties. Drosophila melanogaster is an attractive model organism for longevity studies owing to its homology of organ and cellular-pathways with mammals. In this study, we aimed to understand the effect of rutin on extending longevity in Drosophila melanogaster. Male and female flies were administered with a range of rutin doses (100-800 µM) to analyse whether rutin mediated lifespan-extension by hormesis. Effect of rutin on physiological parameters like food intake, fecundity, climbing activity, development and resistance to various stresses was also studied. Lifespan assays showed that rutin at 200 and 400 µM significantly extended median lifespan in both male and female flies beyond which flies exhibited drastically reduced longevity. Increase in survival at 400 µM was associated with reduced food intake and fecundity. Flies exhibited improved climbing capability with both 200 and 400 µM rutin. Flies fed with 100 and 200 µM rutin exhibited enhanced survival upon exposure to oxidative stress with 400 µM rutin exhibiting no improvement in median lifespan following oxidative stress. Analysis of endogenous peroxide upon treatment with rutin (100-400 µM) with or without 5% H2O2 showed elevated levels of endogenous peroxide with 400 µM rutin whereas no increase in hydrogen peroxide level was observed with rutin at 100 and 200 µM. Finally, gene expression studies in male flies revealed that rutin treatment at 200 and/or 400 µM elevated transcript levels of dFoxO, MnSod, Cat, dTsc1, dTsc2, Thor, dAtg1, dAtg5 and dAtg7 and reduced transcript levels of dTor. Collectively, rutin at 200 and 400 µM improved longevity in flies; 200 µM rutin acted as a mild stressor to prolong lifespan in flies by mediating hormesis whereas 400 µM, being a high dose for best positive effects.

KEYWORDS:

Drosophila melanogaster; Hormesis; Hormetin; Longevity; Rutin; Stress

 

Malnutrition is associated with increased mortality in older adults regardless of the cause of death.

Söderström L, Rosenblad A, Thors Adolfsson E, Bergkvist L.

Br J Nutr. 2017 Feb;117(4):532-540. doi: 10.1017/S0007114517000435. Epub 2017 Mar 14.

PMID: 28290264

Abstract

Malnutrition predicts preterm death, but whether this is valid irrespective of the cause of death is unknown. The aim of the present study was to determine whether malnutrition is associated with cause-specific mortality in older adults. This cohort study was conducted in Sweden and included 1767 individuals aged ≥65 years admitted to hospital in 2008-2009. On the basis of the Mini Nutritional Assessment instrument, nutritional risk was assessed as well nourished (score 24-30), at risk of malnutrition (score 17-23·5) or malnourished (score <17). Cause of death was classified according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, into twenty different causes of death. Data were analysed using Cox proportional hazards regression models. At baseline, 55·1 % were at risk of malnutrition, and 9·4 % of the participants were malnourished. During a median follow-up of 5·1 years, 839 participants (47·5 %) died. The multiple Cox regression model identified significant associations (hazard ratio (HR)) between malnutrition and risk of malnutrition, respectively, and death due to neoplasms (HR 2·43 and 1·32); mental or behavioural disorders (HR 5·73 and 5·44); diseases of the nervous (HR 4·39 and 2·08), circulatory (HR 1·95 and 1·57) or respiratory system (HR 2·19 and 1·49); and symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (HR 2·23 and 1·43). Malnutrition and risk of malnutrition are associated with increased mortality regardless of the cause of death, which emphasises the need for nutritional screening to identify older adults who may require nutritional support in order to avoid preterm death.

KEYWORDS:

10th Revision; HR hazard ratio; ICD-10 International Statistical Classification of Diseases and Related Health Problems; MNA Mini Nutritional Assessment; Cause-specific mortality; Cohort studies; Malnutrition; Older adults; Survival analyses

 

Hb level, iron intake and mortality in Chinese adults: a 10-year follow-up study.

Shi Z, Zhen S, Zhou Y, Taylor AW.

Br J Nutr. 2017 Feb;117(4):572-581. doi: 10.1017/S000711451700040X.

PMID: 28382896

Abstract

Anaemia is prevalent in developing countries and is commonly Fe deficiency related. We aimed to assess the association between Fe status, Fe intake and mortality among Chinese adults. We prospectively studied 8291 adults aged 20-98 years with a mean follow-up of 9·9 years. All participants were measured for Hb at baseline in 2002. Food intake, measured by 3-d weighed food record (n 2832), and fasting serum ferritin were measured. We documented 491 deaths (including 192 CVD and 165 cancer deaths) during 81 527 person-years of follow-up. There was a U-shaped association between Hb levels and all-cause mortality. Compared with the second quartile of Hb (121 g/l), the first (105) and fourth quartile (144) had hazard ratios (HR) of 2·29 (95 % CI 1·51, 3·48) and 2·31 (95 % CI 1·46, 3·64) for all-cause mortality in women. In men, compared with third quartile of Hb (143 g/l), first (122) and fourth quartiles (154) had 61 and 65 % increased risk of all-cause mortality. Anaemia was associated with an increased risk of all-cause and CVD mortality in men but not in women after adjusting for potential confounders. Low and high Fe intake as percentage of Chinese recommended nutrient intake (RNI) were positively associated with all-cause mortality in women but not in men. In women, across quartiles of relative Fe intake, HR for all-cause mortality were 2·55 (95 % CI 0·99, 6·57), 1·00, 3·12 (95 % CI 1·35, 7·18) and 2·78 (95 % CI 1·02, 7·58). Both low and high Hb levels are related to increased risk of all-cause mortality. Both low and high intake of Fe as percentage of RNI was positively associated with mortality in women.

KEYWORDS:

CDC Centre for Disease Control and Prevention; CKD chronic kidney disease; HR hazard ratio; RNI recommended nutrient intake; Chinese adults; Cohort studies; Hb; Iron; Mortality

 

Longitudinal study of diet quality and change in asthma symptoms in adults, according to smoking status.

Li Z, Kesse-Guyot E, Dumas O, Garcia-Aymerich J, Leynaert B, Pison C, Le Moual N, Romieu I, Siroux V, Camargo CA, Nadif R, Varraso R.

Br J Nutr. 2017 Feb;117(4):562-571. doi: 10.1017/S0007114517000368.

PMID: 28382891

Abstract

It has been hypothesised that increased asthma prevalence in westernised countries is associated with changes in lifestyle factors, including a poorer diet. However, little is known regarding the association between diet quality and asthma. In the diet-asthma association, the role of BMI as a potential mediator needs clarification; moreover, potential effect modification by non-diet sources of oxidants, such as smoking, merits investigation. We investigated the association between diet quality and change in asthma symptoms, as well as assessed effect modification by smoking, while accounting for BMI as a potential mediator. Using data from the French prospective Epidemiological study on the Genetics and Environment of Asthma study, we assessed diet quality using the Alternate Healthy Eating Index 2010 (AHEI-2010) at baseline and change in asthma symptoms (stable (reference), worsening, improved; mean follow-up time: 7 years). Mediation analysis was used to disentangle total and direct effects and the indirect effect mediated by BMI. The analyses included 969 adults (mean age 43 years; 49 % men; 42 % ever asthma). We observed a significant interaction between smoking and AHEI-2010 on change in asthma symptoms (P for interaction=0·04). Among never smokers (n 499), we observed a positive total effect (multivariable OR 1·39; 95 % CI 1·07, 1·80) and a positive direct effect (OR 1·41; 95 % CI 1·09, 1·80) of the AHEI-2010 (per ten-point increment) on improved symptoms. No indirect effect mediated through BMI was observed (OR 0·99; 95 % CI 0·91, 1·07). Among former and current smokers, all effects were statistically non-significant. Better diet quality was associated with improved asthma symptoms over time in never smokers, independently of BMI.

KEYWORDS:

AHEI-2010 Alternate Healthy Eating Index 2010; EGEA Epidemiological study on the Genetics and Environment of Asthma; SU.VI.MAX SUpplémentation en VItamines et Minéraux AntioXydants; Asthma; BMI; Diet scores; Mediation analysis; Smoking

 

Synergistic attenuation of ovariectomy-induced bone loss by combined use of fish oil and 17β-oestradiol.

Jin Y, Lee M, Park Y.

Br J Nutr. 2017 Feb;117(4):479-489. doi: 10.1017/S0007114517000344. Epub 2017 Mar 14.

PMID: 28290259

http://sci-hub.cc/10.1017/S0007114517000344

Abstract

Oestrogen and n-3 PUFA, especially EPA and DHA, have been reported to have beneficial effects on bone loss. Thus, the purpose of the present study was to investigate the synergistic bone-protective mechanism of combined treatments of EPA+DHA supplementation and oestrogen injection in ovariectomised rats. Rats were fed a modified American Institute of Nutrition-93G diet with 0 %, 1 % or 2 % n-3 PUFA (EPA+DHA) relative to the total energy intake for 12 weeks. Rats were surgically ovariectomised at week 8, and after a 1-week recovery period rats were injected with either 17β-oestradiol-3-benzoate (E2) or maize oil for the last 3 weeks. Combined use of n-3 PUFA and E2 synergistically increased femoral cortical bone volume, bone mineral content and the bone expression of runt-related transcription factor 2 (RUNX2), but decreased the bone expression of IL-1β. Both n-3 PUFA and E2 decreased the bone expressions of IL-7, TNF-α and PPAR-γ, and increased the bone expression of oestrogen receptor-α. n-3 PUFA in the presence of E2 and E2 alone significantly decreased the bone expressions of IL-1β and IL-6 and increased the bone expression of RUNX2. E2 significantly decreased the serum levels of bone turnover markers and the bone expression of receptor activator of NF-κB ligand, but decreased the bone expression of osteoprotegerin. The combined use of n-3 PUFA and E2 exerted synergistic bone-protective efficacy through up-regulation of RUNX2, an essential transcription factor for bone formation, as well as the suppression of bone-resorbing cytokine IL-1β.

KEYWORDS:

n-3 PUFA; BMC bone mineral content; BV bone volume; E2 17β-oestradiol-3-benzoate; ER-α oestrogen receptor-α; OPG osteoprotegerin; OVX ovariectomised; RANKL receptor activator of NF-κB ligand; RUNX2 runt-related transcription factor 2; 17β-Oestradiol-3-benzoate; Bone loss; IL-1β ; Runt-related transcription factor 2

 

Vitamin B<sub>12</sub>, homocysteine and depressive symptoms: a longitudinal study among older adults.

Elstgeest LE, Brouwer IA, Penninx BW, van Schoor NM, Visser M.

Eur J Clin Nutr. 2017 Apr;71(4):468-475. doi: 10.1038/ejcn.2016.224. Epub 2017 Feb 1.

PMID: 28145420

Abstract

BACKGROUND/OBJECTIVES:

The roles of vitamin B12 and homocysteine concentration in depression are not clear. We investigated cross-sectional and prospective associations of serum vitamin B12 and plasma homocysteine with depressive symptoms in Dutch older adults.

SUBJECTS/METHODS:

In the Longitudinal Aging Study Amsterdam (LASA), blood was collected in 1995/1996 among 1352 men and women aged ⩾65 years. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale (CES-D) six times from 1995/1996 to 2011/2012. Multiple linear regression and mixed models were used to assess whether vitamin B12 and homocysteine were associated with severity at baseline and course of depressive symptoms over 16 years. Cox regression analyses were performed for the associations with incidence of depression (CES-D ⩾16 and/or antidepressant use). All analyses were adjusted for sociodemographic characteristics and lifestyle factors.

RESULTS:

Vitamin B12 was neither cross-sectionally (n=1205) nor prospectively (n=1012) associated with depressive symptoms (adjusted β for CES-D over time, lowest versus highest quartile: -0.04 (95% confidence interval (CI): -0.15-0.06)). We also found no association with incident depression (n=853), except for a higher risk of depression over time in younger participants (aged 64.8-73.4 years; continuous vitamin B12, adjusted hazard ratio per s.d.: 1.38 (95% CI: 1.10-1.72)). For homocysteine, no associations were found, except for a lower risk of depression in younger participants.

CONCLUSIONS:

Our study did not confirm earlier shown associations of serum vitamin B12 and plasma homocysteine with severity and course of depressive symptoms and incidence of depression in older adults. Further research into the influence of homocysteine metabolism on mental health is needed.

 

Tea consumption and its interactions with tobacco smoking and alcohol drinking on oral cancer in southeast China.

Chen F, He BC, Yan LJ, Liu FP, Huang JF, Hu ZJ, Lin Z, Zheng XY, Lin LS, Zhang ZF, Cai L.

Eur J Clin Nutr. 2017 Apr;71(4):481-485. doi: 10.1038/ejcn.2016.208. Epub 2017 Feb 8.

PMID: 28176772

http://sci-hub.cc/10.1038/ejcn.2016.208

Abstract

BACKGROUND/OBJECTIVES:

Epidemiological results on the association between tea consumption and oral cancer remain controversial. We aimed to evaluate the exact relationship between tea consumption and oral cancer in Chinese population.

SUBJECTS/METHODS:

A large-scale case-control study was conducted on 586 oral cancer patients and 1024 controls frequency-matched by age and gender. Epidemiological data were collected through face-to-face interviews with a structure questionnaire. Unconditional logistic regression model was used to assess the effect of tea consumption on oral cancer stratified by smoking, alcohol drinking and demographics. Quantity of tea consumed (ml/day) was categorized into five subgroups based on quartiles and then its interactions was evaluated with tobacco smoking and alcohol drinking at each subgroup.

RESULTS:

Tea consumption showed an inverse association with oral cancer for non-smokers or non-alcohol drinkers (the odds ratios (ORs) were 0.610 (95% confidence interval (CI): 0.425-0.876) and 0.686 (95% CI: 0.503-0.934), respectively). For smokers or alcohol drinkers, decreased risk was only observed in those who consumed >800 ml/day. Furthermore, oolong tea consumption was associated with decreased risk of oral cancer in smokers or alcohol drinkers but not in non-smokers or non-alcohol drinkers. Tea consumption combined with smoking or/and alcohol drinking had a greater risk than tea consumption alone, but the risk was roughly reduced from zero to Q4 (>800 ml/day). Additionally, when stratified by demographics, the protective effect of tea was especially evident in females, urban residents, normal body mass index population (18.5-23.9), farmers, office workers and those aged <60 years.

CONCLUSIONS:

Tea consumption protects against oral cancer in non-smokers or non-alcohol drinkers, but this effect may be obscured in smokers or alcohol drinkers. Additionally, demographics may modify the association between tea consumption and oral cancer.

 

Criterion values for urine-specific gravity and urine color representing adequate water intake in healthy adults.

Perrier ET, Bottin JH, Vecchio M, Lemetais G.

Eur J Clin Nutr. 2017 Apr;71(4):561-563. doi: 10.1038/ejcn.2016.269. Epub 2017 Feb 1.

PMID: 28145416

Abstract

Growing evidence suggests a distinction between water intake necessary for maintaining a euhydrated state, and water intake considered to be adequate from a perspective of long-term health. Previously, we have proposed that maintaining a 24-h urine osmolality (UOsm) of ⩽500 mOsm/kg is a desirable target for urine concentration to ensure sufficient urinary output to reduce renal health risk and circulating vasopressin. In clinical practice and field monitoring, the measurement of UOsm is not practical. In this analysis, we calculate criterion values for urine-specific gravity (USG) and urine color (UCol), two measures which have broad applicability in clinical and field settings. A receiver operating characteristic curve analysis performed on 817 urine samples demonstrates that a USG ⩾1.013 detects UOsm>500 mOsm/kg with very high accuracy (AUC 0.984), whereas a subject-assessed UCol⩾4 offers high sensitivity and moderate specificity (AUC 0.831) for detecting UOsm >500 m Osm/kg.

 

Intake of vitamin C, vitamin E, selenium, zinc and polyunsaturated fatty acids and upper respiratory tract infection-a prospective cohort study.

Raposo SE, Fondell E, Ström P, Bälter O, Bonn SE, Nyrén O, Plymoth A, Bälter K.

Eur J Clin Nutr. 2017 Apr;71(4):450-457. doi: 10.1038/ejcn.2016.261. Epub 2017 Jan 11.

PMID: 28074891

http://sci-hub.cc/10.1038/ejcn.2016.261

Abstract

BACKGROUND/OBJECTIVES:

Antioxidants and polyunsaturated fatty acids (PUFAs) have a role in the human immune defense and may affect the susceptibility to upper respiratory tract infection (URTI). To examine dietary intake of vitamin C, vitamin E, selenium, zinc and PUFAs in relation to URTI incidence in a prospective cohort study.

SUBJECTS/METHODS:

A total of 1533 Swedish women and men aged 25-64 years were followed for nine months during 2011-2012. Information on dietary intake was assessed through a web-based food frequency questionnaire, and events of URTI were self-reported prospectively as they occurred. Cox proportional hazards regression was applied to obtain incidence rate ratios with 95% confidence intervals.

RESULTS:

The mean number of URTI events was 0.9 among all participants, 1.0 among women and 0.7 among men. In women, the incidence rate ratios (95% confidence interval) for high compared with low intake were 0.69 (0.55-0.88) for vitamin C, 0.77 (0.62-0.96) for vitamin E, 0.57 (0.39-0.83) for docosahexaenoic acid (DHA) and 0.80 (0.65-0.99) for arachidonic acid (AA). No association was found for selenium or zinc among women. In men, an increased URTI incidence was seen with medium vitamin E intake (1.42 (1.09-1.85)) and high zinc intake (1.50 (1.04-2.16)). No association was found for vitamin C, selenium or PUFAs among men.

CONCLUSIONS:

We found an inverse association of URTI incidence among women for vitamin C, vitamin E, DHA and AA intake and a positive association among men for vitamin E and zinc intake. The observed gender differences warrant further investigation.

 

http://www.the-scientist.com/?articles.view/articleNo/49006/title/Infographic--Circadian-Clock-Affects-Health-and-Disease/&utm_campaign=NEWSLETTER_TS_The-Scientist-Daily_2016&utm_source=hs_email&utm_medium=email&utm_content=50079564&_hsenc=p2ANqtz-_09MZrUxXao_dXlxOiXs_kYtbvksTX_W9PA8fTAaLhzLZ8YFeqoNBDmoXKuGM_D6v8AzIvDyhe0wIvMefCd4C5gXukrA&_hsmi=50079564

 

http://www.the-scientist.com/?articles.view/articleNo/48873/title/Cooking-Up-Cancer-/&utm_campaign=NEWSLETTER_TS_The-Scientist-Daily_2016&utm_source=hs_email&utm_medium=email&utm_content=49973237&_hsenc=p2ANqtz--P666yxm4RHHxbivxK0gaLuarCIfA_pWzmePsGzMlBLAc53PLFoQosj--WbfnB-LAfNx0aLBvd_ZkX-83i6mTSeKivuQ&_hsmi=49973237

 

http://www.the-scientist.com/?articles.view/articleNo/49147/title/Study--Microbes-from-Young-Fish-Extend-Older-Fish-s-Lives/&utm_campaign=NEWSLETTER_TS_The-Scientist-Daily_2016&utm_source=hs_email&utm_medium=email&utm_content=50079564&_hsenc=p2ANqtz-9dP0wsKgGQSYHY155VWfMPlD-SJmNYva8uto2TZ7RJyqenuU4HR2sVfpcY7v-C2_HdGck6gD6As9Y8kLi_zboT3vcvmA&_hsmi=50079564

http://biorxiv.org/content/biorxiv/early/2017/03/27/120980.full.pdf

Nevi, ambient ultraviolet radiation, and thyroid cancer risk: a French prospective study.

Mesrine S, Kvaskoff M, Bah T, Wald L, Clavel-Chapelon F, Boutron-Ruault MC.

Epidemiology. 2017 Apr 5. doi: 10.1097/EDE.0000000000000673. [Epub ahead of print]

PMID: 28383300

Abstract

BACKGROUND:

Incidence rates have increased considerably worldwide for both differentiated thyroid cancer and cutaneous melanoma, and two-way associations between these neoplasms have been described. Whether melanoma risk factors are associated with thyroid cancer risk remains unknown.

METHODS:

Using Cox regression modeling, we prospectively analyzed the relationship between self-reported pigmentary traits, baseline residential ultraviolet (UV) exposure, and thyroid cancer risk in 86,960 women from the E3N cohort, followed-up over 1990-2008 through biennial questionnaires. We assessed associations of pigmentary traits and UV exposure with personal history of benign thyroid diseases using logistic regression modeling. All statistical tests were two-sided.

RESULTS:

In models adjusted for age and thyroid cancer risk factors, number of nevi was positively associated with thyroid cancer risk ("very many" vs. "none": Hazards Ratio (HR)=1.7, 95% Confidence Interval (CI)=1.0-2.8;Ptrend=0.01), independently of residential UV exposure or iodine intake. Risk was inversely associated with latitude and positively associated with mean daily UV level at baseline (HRs for the fourth vs. first quartile of latitude and spring/summer UVB level =0.7, 95% CI=0.5-0.9;Ptrend=0.03, and HR=1.9, 95% CI=1.4-2.7;Ptrend=0.02, respectively); associations were restricted to women with dietary iodine below the median intake. Number of nevi and UV level were also associated with personal histories of dysthyroidism and of goiter/nodules, although more weakly so.

CONCLUSION:

Our results suggest that number of nevi and residential UV exposure are associated with the risks of thyroid cancer and benign conditions. They point to novel pathways in thyroid cancer or melanoma etiologies and warrant replication.

 

Weight History and All-Cause and Cause-Specific Mortality in Three Prospective Cohort Studies.

Yu E, Ley SH, Manson JE, Willett W, Satija A, Hu FB, Stokes A.

Ann Intern Med. 2017 Apr 4. doi: 10.7326/M16-1390. [Epub ahead of print]

PMID: 28384755

http://sci-hub.cc/10.7326/M16-1390

Abstract

BACKGROUND:

The relationship between body mass index (BMI) and mortality is controversial.

OBJECTIVE:

To investigate the relationship between maximum BMI over 16 years and subsequent mortality.

DESIGN:

3 prospective cohort studies.

SETTING:

Nurses' Health Study I and II and Health Professionals Follow-Up Study.

PARTICIPANTS:

225 072 men and women with 32 571 deaths observed over a mean of 12.3 years of follow-up.

MEASUREMENTS:

Maximum BMI over 16 years of weight history and all-cause and cause-specific mortality.

RESULTS:

Maximum BMIs in the overweight (25.0 to 29.9 kg/m2) (multivariate hazard ratio {HR}, 1.06 [95% CI, 1.03 to 1.08]), obese I (30.0 to 34.9 kg/m2) (HR, 1.24 [CI, 1.20 to 1.29]), and obese II (≥35.0 kg/m2) (HR, 1.73 [CI, 1.66 to 1.80]) categories were associated with increases in risk for all-cause death. The pattern of excess risk with a maximum BMI above normal weight was maintained across strata defined by smoking status, sex, and age, but the excess was greatest among those younger than 70 years and never-smokers. In contrast, a significant inverse association between overweight and mortality (HR, 0.96 [CI, 0.94 to 0.99]) was observed when BMI was defined using a single baseline measurement. Maximum overweight was also associated with increased cause-specific mortality, including death from cardiovascular disease and coronary heart disease.

LIMITATION:

Residual confounding and misclassification.

CONCLUSION:

The paradoxical association between overweight and mortality is reversed in analyses incorporating weight history. Maximum BMI may be a useful metric to minimize reverse causation bias associated with a single baseline BMI assessment.

 

Effect of Vitamin D and Calcium Supplementation on Cancer Incidence in Older Women: A Randomized Clinical Trial.

Lappe J, Watson P, Travers-Gustafson D, Recker R, Garland C, Gorham E, Baggerly K, McDonnell SL.

JAMA. 2017 Mar 28;317(12):1234-1243. doi: 10.1001/jama.2017.2115.

PMID: 28350929

http://sci-hub.cc/10.1001/jama.2017.2115

Abstract

IMPORTANCE:

Evidence suggests that low vitamin D status may increase the risk of cancer.

OBJECTIVE:

To determine if dietary supplementation with vitamin D3 and calcium reduces the risk of cancer among older women.

DESIGN, SETTING, AND PARTICIPANTS:

A 4-year, double-blind, placebo-controlled, population-based randomized clinical trial in 31 rural counties (June 24, 2009, to August 26, 2015-the final date of follow-up). A total of 2303 healthy postmenopausal women 55 years or older were randomized, 1156 to the treatment group and 1147 to the placebo group. Duration of treatment was 4 years.

INTERVENTIONS:

The treatment group (vitamin D3 + calcium group) received 2000 IU/d of vitamin D3 and 1500 mg/d of calcium; the placebo group received identical placebos.

MAIN OUTCOMES AND MEASURES:

The primary outcome was the incidence of all-type cancer (excluding nonmelanoma skin cancers), which was evaluated using Kaplan-Meier survival analysis and proportional hazards modeling.

RESULTS:

Among 2303 randomized women (mean age, 65.2 years [sD, 7.0]; mean baseline serum 25-hydroxyvitamin D level, 32.8 ng/mL [sD, 10.5]), 2064 (90%) completed the study. At year 1, serum 25-hydroxyvitamin D levels were 43.9 ng/mL in the vitamin D3 + calcium group and 31.6 ng/mL in the placebo group. A new diagnosis of cancer was confirmed in 109 participants, 45 (3.89%) in the vitamin D3 + calcium group and 64 (5.58%) in the placebo group (difference, 1.69% [95% CI, -0.06% to 3.46%]; P = .06). Kaplan-Meier incidence over 4 years was 0.042 (95% CI, 0.032 to 0.056) in the vitamin D3 + calcium group and 0.060 (95% CI, 0.048 to 0.076) in the placebo group; P = .06. In unadjusted Cox proportional hazards regression, the hazard ratio was 0.70 (95% CI, 0.47 to 1.02). Adverse events potentially related to the study included renal calculi (16 participants in the vitamin D3 + calcium group and 10 in the placebo group), and elevated serum calcium levels (6 in the vitamin D3 + calcium group and 2 in the placebo group).

CONCLUSIONS AND RELEVANCE:

Among healthy postmenopausal older women with a mean baseline serum 25-hydroxyvitamin D level of 32.8 ng/mL, supplementation with vitamin D3 and calcium compared with placebo did not result in a significantly lower risk of all-type cancer at 4 years. Further research is necessary to assess the possible role of vitamin D in cancer prevention.

>>>>>>>>>>>>>>>>>>>>>>>>>>>>

Comment in:

Vitamin D, Calcium, and Cancer: Approaching Daylight?

Manson JE, Bassuk SS, Buring JE.

JAMA. 2017 Mar 28;317(12):1217-1218. doi: 10.1001/jama.2017.2155. No abstract available.

PMID: 28350909

http://sci-hub.cc/10.1001/jama.2017.2155

 

Dietary rapeseed/canola-oil supplementation reduces serum lipids and liver enzymes and alters postprandial inflammatory responses in adipose tissue compared to olive-oil supplementation in obese men.

Kruse M, von Loeffelholz C, Hoffmann D, Pohlmann A, Seltmann AC, Osterhoff M, Hornemann S, Pivovarova O, Rohn S, Jahreis G, Pfeiffer AF.

Mol Nutr Food Res. 2015 Mar;59(3):507-19. doi: 10.1002/mnfr.201400446. Epub 2014 Dec 22.

PMID: 25403327

http://sci-hub.cc/10.1002/mnfr.201400446

Abstract

SCOPE:

Obesity is associated with hyperlipidemia, hepatic steatosis, and low-grade inflammation. Studies have shown that MUFA as well as PUFA have beneficial effects on blood lipids and the inflammatory state.

METHODS AND RESULTS:

This study investigates the effects of a daily supplementation of either 50 g of rapeseed/canola (RA) or olive (OL) oil over 4 wk on serum lipids, serum liver enzymes, and inflammatory gene expression in subcutaneous (s. c.) adipose tissue in obese men. Consuming RA resulted in increased serum n-3 fatty acids and a reduction in total cholesterol, LDL cholesterol, and serum aspartate aminotransferase compared to OL. In s. c. adipose tissue, gene expression of the pro-inflammatory cytokine IL6 was reduced in RA compared to OL. However, after 4 h after a test meal, containing the appropriate oil, white bread, and 400 mL of liquid diet drink (835 kcal in total), gene expression of IL6, IL1B, and EMR1 (egf-like module containing Mucin-like hormone receptor-like 1) was increased in RA and of monocyte chemoattractant protein-1 (CCL2) in both RA and OL.

CONCLUSION:

This demonstrates that consuming RA for 4 wk improves serum lipids, liver enzymes, and basal inflammation in s. c. adipose tissue, but it mediates an acute pro-inflammatory response in adipose tissue upon consuming a meal.

KEYWORDS:

Inflammation; Obesity; Olive oil; Rapeseed oil; Serum lipids

" The oils used in this study were commercially

available, cold-pressed extra virgin OL and refined RA."

 

Race, Serum Potassium, and Associations With ESRD and Mortality.

Chen Y, Sang Y, Ballew SH, Tin A, Chang AR, Matsushita K, Coresh J, Kalantar-Zadeh K, Molnar MZ, Grams ME.

Am J Kidney Dis. 2017 Mar 28. pii: S0272-6386(17)30535-8. doi: 10.1053/j.ajkd.2017.01.044. [Epub ahead of print]

PMID: 28363732

http://sci-hub.cc/10.1053/j.ajkd.2017.01.044

Abstract

BACKGROUND:

Recent studies suggest that potassium levels may differ by race. The basis for these differences and whether associations between potassium levels and adverse outcomes differ by race are unknown.

STUDY DESIGN:

Observational study.

SETTING & PARTICIPANTS:

Associations between race and potassium level and the interaction of race and potassium level with outcomes were investigated in the Racial and Cardiovascular Risk Anomalies in Chronic Kidney Disease (RCAV) Study, a cohort of US veterans (N=2,662,462). Associations between African ancestry and potassium level were investigated in African Americans in the Atherosclerosis Risk in Communities (ARIC) Study (N=3,450).

PREDICTORS:

Race (African American vs non-African American and percent African ancestry) for cross-sectional analysis; serum potassium level for longitudinal analysis.

OUTCOMES:

Potassium level for cross-sectional analysis; mortality and end-stage renal disease for longitudinal analysis.

RESULTS:

The RCAV cohort was 18% African American (N=470,985). Potassium levels on average were 0.162mmol/L lower in African Americans compared with non-African Americans, with differences persisting after adjustment for demographics, comorbid conditions, and potassium-altering medication use. In the ARIC Study, higher African ancestry was related to lower potassium levels (-0.027mmol/L per each 10% African ancestry). In both race groups, higher and lower potassium levels were associated with mortality. Compared to potassium level of 4.2mmol/L, mortality risk associated with lower potassium levels was lower in African Americans versus non-African Americans, whereas mortality risk associated with higher levels was slightly greater. Risk relationships between potassium and end-stage renal disease were weaker, with no difference by race.

LIMITATIONS:

No data for potassium intake.

CONCLUSIONS:

African Americans had slightly lower serum potassium levels than non-African Americans. Consistent associations between potassium levels and percent African ancestry may suggest a genetic component to these differences. Higher and lower serum potassium levels were associated with mortality in both racial groups.

KEYWORDS:

African American; African ancestry; Race; end-stage renal disease (ESRD); genetic risk factor; hyperkalemia; hypokalemia; kidney disease; mortality; racial differences; serum potassium

 

Dietary and Lifestyle Risk Factors Associated with Incident Kidney Stones in Men and Women.

Ferraro PM, Taylor EN, Gambaro G, Curhan GC.

J Urol. 2017 Mar 29. pii: S0022-5347(17)43809-2. doi: 10.1016/j.juro.2017.03.124. [Epub ahead of print]

PMID: 28365271

http://sci-hub.cc/10.1016/j.juro.2017.03.124

Abstract

PURPOSE:

Several dietary and lifestyle factors are associated with a higher risk of developing kidney stones. We estimated the population attributable fraction (PAF) and number needed to prevent (NNTP) for modifiable risk factors including body mass index (BMI), fluid intake, DASH-style diet, dietary calcium intake and intake of sugar-sweetened beverages.

MATERIALS AND METHODS:

We used data from the Health Professionals Follow-up Study (HPFS) and the Nurses' Health Studies (NHS) I and II cohorts. Information was obtained from validated questionnaires. Poisson regression models adjusted for potential confounders were used to estimate the association of each risk factor with development of incident kidney stones and to compute PAF and NNTP.

RESULTS:

The study included 192,126 participants who contributed a total of 3,259,313 person-years of follow-up, during which 6,449 participants developed an incident kidney stone. All the modifiable risk factors were independently associated with incident stones in each of the cohorts. The PAF ranged from 4.4% for higher sugar-sweetened beverages intake to 26.0% for lower fluid intake; the PAF for all the five risk factors combined was 57.0% in HPFS, 55.2% in NHS I and 55.1% in NHS II. NNTP over 10 years ranged from 67 for lower fluid intake to 556 for lower dietary calcium intake.

CONCLUSIONS:

Five modifiable risk factors accounted for more than 50% of incident kidney stones in three large prospective cohorts. Assuming a causal relation, our estimates suggest that preventive measures aimed at reducing those factors could substantially reduce the burden of kidney stones in the general population.

KEYWORDS:

attributable fraction; cohort studies; nutrition; obesity; urolithiasis

 

Green tea and the risk of prostate cancer: A systematic review and meta-analysis.

Guo Y, Zhi F, Chen P, Zhao K, Xiang H, Mao Q, Wang X, Zhang X.

Medicine (Baltimore). 2017 Mar;96(13):e6426. doi: 10.1097/MD.0000000000006426. Review.

PMID: 28353571 Free Article

Abstract

Prostate cancer (PCa) now remains the 2nd most frequently diagnosed cancer. In recent years, chemoprevention for PCa becomes a possible concept. Especially, many phytochemicals rich foods are suggested to lower the risk of cancer. Among these foods, green tea is considered as effective prevention for various cancers. However, clinical trials and previous meta-analyses on the relationship between green tea consumption and the risk of PCa have produced inconsistent outcomes. This study aims to determine the dose-response association of green tea intake with PCa risk and the preventive effect of green tea catechins on PCa risk. Seven observational studies and 3 randomized controlled trials were retrieved from Cochrane Library, PubMed, Sciencedirect Online, and hand searching. The STATA (version 12.0) was applied to analyze the data. The relative risks (RRs) and 95% confidence intervals were pooled by fixed or random effect modeling. Dose-response relations were evaluated with categories of green tea intake. Although there was no statistical significance in the comparison of the highest versus lowest category, there was a trend of reduced incidence of PCa with each 1 cup/day increase of green tea (P = 0.08). Our dose-response meta-analysis further demonstrated that higher green tea consumption was linearly associated with a reduced risk of PCa with more than 7 cups/day. In addition, green tea catechins were effective for preventing PCa with an RR of 0.38 (P = 0.02). In conclusion, our dose-response meta-analysis evaluated the association of green tea intake with PCa risk systematically and quantitatively. And this is the first meta-analysis of green tea catechins consumption and PCa incidence. Our novel data demonstrated that higher green tea consumption was linearly reduced PCa risk with more than 7 cups/day and green tea catechins were effective for preventing PCa. However, further studies are required to substantiate these conclusions.

 

Oral creatine supplements lower plasma homocysteine concentrations in humans.

Korzun WJ.

Clin Lab Sci. 2004 Spring;17(2):102-6.

PMID: 15168891

Abstract

OBJECTIVE:

To determine if oral creatine supplements will lower the concentration of total plasma homocysteine (tHcy).

SETTING/PARTICIPANTS:

Apparently healthy volunteers, at least 19 years old, were recruited from the University of South Alabama and surrounding community. DESIGN/INTERVENTION/MAIN OUTCOME: Participants took multi-vitamins daily for four weeks, then were randomly divided into two groups. The control group © continued to take multi-vitamins daily for an additional four weeks. The experimental group (EX) took multivitamins plus an amount of creatine each day equal to twice their daily creatinine excretion, for the additional four weeks. Total plasma homocysteine concentrations were measured in all participants at the beginning and at the end of the second four week interval.

RESULTS:

There were no statistically significant differences between the two groups in age, initial tHcy, serum folate, erythrocyte folate, serum vitamin B12, or creatinine excretion. After four weeks of creatine supplements, tHcy in EX changed by an average of -0.9 micromol/L (range: -1.8 to 0.0), compared to an average change of +0.2 micromol/L in C (range: -0.6 to 0.9) during the same four weeks. The difference in the changes in tHcy between the two groups was statistically significant (p < 0.01).

CONCLUSION:

Creatine supplements may be an effective adjunct to vitamin supplements for lowering tHcy.

 

Does caffeine and alcohol intake before pregnancy predict the occurrence of spontaneous abortion?

Tolstrup JS, Kjaer SK, Munk C, Madsen LB, Ottesen B, Bergholt T, Grønbaek M.

Hum Reprod. 2003 Dec;18(12):2704-10.

PMID: 14645195

Abstract

BACKGROUND:

Consumption of caffeine and alcohol is suspected to affect pregnancy outcome. Use of both stimulants is widespread and even minor effects on fetal viability are of public health interest.

METHODS:

We performed a nested case-control study using prospective data from a population-based cohort comprising 11088 women aged 20-29 years. From this cohort, women who experienced either a spontaneous abortion (n = 303) or who gave birth (n = 1381) during follow-up [mean time: 2.1 years (range: 1.6-3.4)] were selected. Associations between self-reported exposures to caffeine and/or alcohol at enrolment and spontaneous abortion were analysed by means of logistic regression.

RESULTS:

Compared with women with a pre-pregnancy intake of <75 mg caffeine per day, the adjusted odds ratio (95% confidence interval) for spontaneous abortion was 1.26 (0.77-2.06), 1.45 (0.87-2.41), 1.44 (0.87-2.37) and 1.72 (1.00-2.96) for a pre-pregnancy intake on 75-300, 301-500, 501-900 and >900 mg caffeine per day respectively (P = 0.05 for trend). A pre-pregnancy intake of alcohol was not a predictor for spontaneous abortion.

CONCLUSIONS:

A high intake of caffeine prior to pregnancy seems to be associated with an increased risk of spontaneous abortion, whereas a low-to-moderate alcohol intake does not influence the risk.

 

A prospective study of dietary lactose and ovarian cancer.

Fairfield KM, Hunter DJ, Colditz GA, Fuchs CS, Cramer DW, Speizer FE, Willett WC, Hankinson SE.

Int J Cancer. 2004 Jun 10;110(2):271-7.

PMID: 15069693 Free Article

http://onlinelibrary.wiley.com/doi/10.1002/ijc.20086/epdf

Abstract

The milk sugar lactose is an hypothesized risk factor for epithelial ovarian cancer because of possible direct toxic effects of its metabolites on oocytes or by compensatory gonadotropin stimulation. Women are presently encouraged to consume dairy products as a source of calcium to prevent osteoporosis. The objective of our study was to prospectively assess lactose, milk and milk product consumption in relation to ovarian cancer risk among 80326 participants in the Nurses' Health Study who had no history of cancer other than nonmelanoma skin cancer. Participants in the Nurses' Health Study reported on known and suspected ovarian cancer risk factors in questionnaires mailed biennially from 1976 to 1996. Food frequency questionnaires were included in the years 1980, 1984, 1986 and 1990. Newly reported ovarian cancer was documented by review of medical records. During 16 years of follow-up (1980-1996), 301 cases of invasive epithelial ovarian cancer were confirmed. Pooled logistic regression was used to control for age, body mass index (kg/m(2)), caffeine intake, oral contraceptive use, smoking history, parity and tubal ligation. For all subtypes of invasive ovarian cancer combined, we observed a nonsignificant 40% greater risk for women in the highest category of lactose consumption compared to the lowest (multivariate relative risk (RR) 1.40, 95% confidence interval (CI), 0.98-2.01). We observed a 2-fold higher risk of the serous ovarian cancer subtype among those in the highest category of lactose consumption compared to the lowest (RR 2.07, 95% CI, 1.27-3.40). For each 11-gram increase in lactose consumption (the approximate amount in one glass of milk), we observed a 20% increase in risk of serous cancers (RR 1.20, 95% CI, 1.04-1.39). Skim and low-fat milk were the largest contributors to dietary lactose. Women who consumed one or more servings of skim or low-fat milk daily had a 32% higher risk of any ovarian cancer (RR 1.32, 95% CI, 0.97-1.82) and a 69% higher risk of serous ovarian cancer (RR 1.69, 95% CI, 1.12-2.56) compared to women consuming 3 or less servings monthly. Controlling for fat intake did not change our findings. Our findings provide some support for the hypothesis that lactose intake increases risk of epithelial ovarian cancer. However, the observed excess risk appeared limited to the serous subtype of ovarian cancer in our study.

 

Mono-unsaturated fatty acids link H3K4me3 modifiers to C. elegans lifespan.

Han S, Schroeder EA, Silva-García CG, Hebestreit K, Mair WB, Brunet A.

Nature. 2017 Apr 5. doi: 10.1038/nature21686. [Epub ahead of print]

PMID: 28379943

Abstract

Chromatin and metabolic states both influence lifespan, but how they interact in lifespan regulation is largely unknown. The COMPASS chromatin complex, which trimethylates lysine 4 on histone H3 (H3K4me3), regulates lifespan in Caenorhabditis elegans. However, the mechanism by which H3K4me3 modifiers affect longevity, and whether this mechanism involves metabolic changes, remain unclear. Here we show that a deficiency in H3K4me3 methyltransferase, which extends lifespan, promotes fat accumulation in worms with a specific enrichment of mono-unsaturated fatty acids (MUFAs). This fat metabolism switch in H3K4me3 methyltransferase-deficient worms is mediated at least in part by the downregulation of germline targets, including S6 kinase, and by the activation of an intestinal transcriptional network that upregulates delta-9 fatty acid desaturases. Notably, the accumulation of MUFAs is necessary for the lifespan extension of H3K4me3 methyltransferase-deficient worms, and dietary MUFAs are sufficient to extend lifespan. Given the conservation of lipid metabolism, dietary or endogenous MUFAs could extend lifespan and healthspan in other species, including mammals.

 

New book explores 'Lagom' — the Swedish secret to a long life

Lagom, which means 'not too much and not too little', is the latest Scandinavian trend

By Brandie Weikle, CBC News Posted: Apr 09, 2017

http://www.cbc.ca/news/health/lagom-nordic-guide-swedish-live-10-years-longer-1.4026319

 

Long-term residential road traffic noise and NO2 exposure in relation to risk of incident myocardial infarction - A Danish cohort study.

Roswall N, Raaschou-Nielsen O, Ketzel M, Gammelmark A, Overvad K, Olsen A, Sørensen M.

Environ Res. 2017 Mar 20;156:80-86. doi: 10.1016/j.envres.2017.03.019. [Epub ahead of print]

PMID: 28334645

http://sci-hub.cc/10.1016/j.envres.2017.03.019

Abstract

BACKGROUND:

Road traffic is a source of both air pollution and noise; two environmental hazards both found to increase the risk of ischemic heart disease. Given the high correlation between these pollutants, it is important to investigate combined effects, in relation to myocardial infarction (MI).

METHODS:

Among 50,744 middle-aged Danes enrolled into the Diet, Cancer and Health cohort from 1993 to 97, we identified 2403 cases of incident MI during a median follow-up of 14.5 years. Present and historical residential addresses from 1987 to 2011 were found in national registries, and traffic noise (Lden) and air pollution (NO2) were modelled for all addresses. Analyses were performed using Cox proportional hazard models.

RESULTS:

Road traffic noise and NO2 were both individually associated with a higher risk of MI, with hazard ratios of 1.14 (1.07-1.21) and 1.08 (1.03-1.12) per inter-quartile range higher 10-year mean of road traffic noise and NO2, respectively. Mutual exposure adjustment reduced the association with 10-year NO2 exposure (1.02 (0.96-1.08)), whereas the association with road traffic noise remained: 1.12 (1.03-1.21). For fatal incident MI, the pattern was similar, but the associations for both pollutants were stronger. In analyses of tertiles across both pollutants, the strongest effects were seen for combined medium/high exposure, especially for fatal MI's.

CONCLUSION:

Both road traffic noise and NO2 were associated with a higher risk of MI in single-pollutant models. In two-pollutant models, mainly noise was associated with MI. Combined exposure to both pollutants was associated with the highest risk.

KEYWORDS:

Air pollution; Cohort study; Epidemiology; Myocardial infarction; Traffic noise

 

Multivitamin/mineral supplements: Rationale and safety.

Biesalski HK, Tinz J.

Nutrition. 2017 Apr;36:60-66. doi: 10.1016/j.nut.2016.06.003. Epub 2016 Jun 16. Review.

PMID: 28336109

Abstract

Multivitamin/mineral supplements (MVMs) are widely used in many populations. MVMs, together with iron and folic acid, are recommended for pregnant women to improve birth outcome and to reduce low-birthweight and rates of miscarriage. However, MVM use is common in the general population as well. The aim of the present review was to evaluate the safety of long-term use of these supplements. To examine the safety of MVM use, we performed a literature search for randomized controlled studies involving supplementation with a combination of at least nine vitamins and three minerals at a maximum concentration of 100% of the Recommended Dietary Allowance. We found nine studies evaluating the use and efficacy of MVMs in pregnant women and healthy adults and six studies in the elderly where adverse effects were explicitly addressed. Only minor adverse events (e.g., unspecific gastrointestinal symptoms) were reported in all studies. In particular, there were no significant differences between treatment and placebo groups. MVM use within the range of the Dietary Reference Intake will not result in excess intake, even when including the effect of food and fortified food, and does not increase mortality. Taken together, these findings indicate that MVMs can be safe for long-term use (>10 y).

KEYWORDS:

Long-term use; Minerals; Multivitamins; Randomized controlled trials; Safety; Supplements

 

Quantitative analysis of efficacy and associated factors of calcium intake on bone mineral density in postmenopausal women.

Wu J, Xu L, Lv Y, Dong L, Zheng Q, Li L.

Osteoporos Int. 2017 Mar 23. doi: 10.1007/s00198-017-3993-4. [Epub ahead of print]

PMID: 28337524

Abstract

A model-based meta-analysis method was performed to quantitatively analyze the efficacy characteristics of calcium intake in BMD increase among postmenopausal women. We found that age and calcium intake dose were key factors affecting the efficiency and onset of BMD change, and daily 1200 mg calcium was suggested to be a beneficial dosage.

INTRODUCTION:

This paper aims to quantify the efficacy of calcium intake in preventing bone mineral density (BMD) decrease among postmenopausal women and to investigate the factors that may affect the efficacy.

METHODS:

Comprehensive literature search was conducted in PubMed and EMBASE from January 2016. Placebo-controlled or no-treatment controlled randomized trials focused on calcium intake for the management of osteoporosis in postmenopausal women were included. The clinical and demographic characteristics of participants and efficacy data, defined as the mean percentage change of spine BMD (L2-L4) at each observation time point compared with that of baseline, were extracted from the studies. Model-based meta-analysis (MBMA) was used to describe the time course of BMD change by calcium intake and identify the related factors.

RESULTS:

This study includes 17 trials involving 2537 subjects. The results showed that a classic pharmacodynamic maximal effect (E max) model could describe the time course of BMD change by calcium intake. Using this model, we found that age and calcium intake dose were key factors affecting the efficiency and onset of BMD change. A 60-year-old woman administered with 800 mg/day calcium can achieve a maximum BMD increasing rate of 2.38%, and the time to reach 50% of this maximum (known as onset time) was 9.44 months. An increase of 0.0817% per year was noted in the maximal effect value for women aged between 50 and 83 years. For calcium dose interval from 250 to 2000 mg/day, the onset time was expressed as 9.44 × (dose/800)-1.33 months. Two-year calcium intake of 700, 1200, and 2000 mg/day resulted in a maximum efficacy of BMD of 68.0, 81.3, and 89.6%, respectively. This indicates that the final efficacy had already reached the plateau (>80% E max) under the 1200-mg/day dose.

CONCLUSION:

Calcium intake can effectively postpone the tendency of BMD decrease in postmenopausal women. An increased calcium dose contributes to the shortening of the onset time. Considering the drug-acting rate and safety into account, menopausal women can be administered with a rational dose of 1200 mg/day to reduce bone loss.

KEYWORDS:

Bone mineral density; Calcium intake; Postmenopausal women

 

Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality-a systematic review and dose-response meta-analysis of prospective studies.

Aune D, Giovannucci E, Boffetta P, Fadnes LT, Keum N, Norat T, Greenwood DC, Riboli E, Vatten LJ, Tonstad S.

Int J Epidemiol. 2017 Feb 22. doi: 10.1093/ije/dyw319. [Epub ahead of print]

PMID: 28338764

http://sci-hub.cc/10.1093/ije/dyw319

Abstract

BACKGROUND:

Questions remain about the strength and shape of the dose-response relationship between fruit and vegetable intake and risk of cardiovascular disease, cancer and mortality, and the effects of specific types of fruit and vegetables. We conducted a systematic review and meta-analysis to clarify these associations.

METHODS:

PubMed and Embase were searched up to 29 September 2016. Prospective studies of fruit and vegetable intake and cardiovascular disease, total cancer and all-cause mortality were included. Summary relative risks (RRs) were calculated using a random effects model, and the mortality burden globally was estimated; 95 studies (142 publications) were included.

RESULTS:

For fruits and vegetables combined, the summary RR per 200 g/day was 0.92 [95% confidence interval (CI): 0.90-0.94, I 2  = 0%, n  = 15] for coronary heart disease, 0.84 (95% CI: 0.76-0.92, I 2  = 73%, n  = 10) for stroke, 0.92 (95% CI: 0.90-0.95, I 2  = 31%, n  = 13) for cardiovascular disease, 0.97 (95% CI: 0.95-0.99, I 2  = 49%, n  = 12) for total cancer and 0.90 (95% CI: 0.87-0.93, I 2  = 83%, n  = 15) for all-cause mortality. Similar associations were observed for fruits and vegetables separately. Reductions in risk were observed up to 800 g/day for all outcomes except cancer (600 g/day). Inverse associations were observed between the intake of apples and pears, citrus fruits, green leafy vegetables, cruciferous vegetables, and salads and cardiovascular disease and all-cause mortality, and between the intake of green-yellow vegetables and cruciferous vegetables and total cancer risk. An estimated 5.6 and 7.8 million premature deaths worldwide in 2013 may be attributable to a fruit and vegetable intake below 500 and 800 g/day, respectively, if the observed associations are causal.

CONCLUSIONS:

Fruit and vegetable intakes were associated with reduced risk of cardiovascular disease, cancer and all-cause mortality. These results support public health recommendations to increase fruit and vegetable intake for the prevention of cardiovascular disease, cancer, and premature mortality.

KEYWORDS:

Fruit and vegetables; all-cause mortality; cancer; cardiovascular disease; cohort; diet; global assessment; nutrition

 

Change in Body Weight from Age 20 Years Is a Powerful Determinant of the Metabolic Syndrome.

Lind L, Elmståhl S, Ärnlöv J.

Metab Syndr Relat Disord. 2017 Apr;15(3):112-117. doi: 10.1089/met.2016.0121. Epub 2017 Feb 16.

PMID: 28339342

Abstract

BACKGROUND:

Higher body weight is a well-known determinant of the metabolic syndrome (MetS) and its components. It is however less well studied how the change in weight from age 20 years to middle age or old age affects MetS development.

METHODS:

In the community-based EpiHealth (n = 19,000, age range 45 to 75 years, 56% females) and PIVUS (n = 1000, all aged 70 years, 50% females) studies, the participants were asked about their body weight at age 20 years. Data were collected to determine MetS prevalence (NCEP ATP III criteria).

RESULTS:

In EpiHealth, the probability of having MetS increased fairly linearly with increasing weight from age 20 in the obese [odds ratios (OR) 1.04 per kg change in weight, 95% confidence interval (CI) 1.03-1.05, P < 0.0001], as well as in the overweight (OR 1.15, 95% CI 1.14-1.17, P < 0.0001) and normal-weight (OR 1.18, 95% CI 1.14-1.21, P < 0.0001), subjects after adjustment for age, sex, body mass index (BMI) at age 20, alcohol intake, smoking, education, and exercise habits. Also in the PIVUS study, the change in weight over 50 years was related to prevalent MetS (OR 1.08 per kg change in weight, 95% CI 1.06-1.10, P < 0.0001). In both studies, self-reported BMI at age 20 was related to prevalent MetS.

CONCLUSION:

Self-reported weight gain from age 20 was strongly and independently associated with prevalent MetS both in middle age or old age. Interestingly, this relationship was not restricted only to obese subjects. Our data provide additional support for the importance of maintaining a stable weight throughout life.

KEYWORDS:

body weight; epidemiology; longitudinal; metabolic syndrome; obesity

Edited by AlPater

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Dietary acrylamide and cancer risk: an updated meta-analysis.

Pelucchi C, Bosetti C, Galeone C, La Vecchia C.

Int J Cancer. 2015 Jun 15;136(12):2912-22. doi: 10.1002/ijc.29339. Epub 2014 Nov 26. Review.

PMID: 25403648 Free Article

http://onlinelibrary.wiley.com/doi/10.1002/ijc.29339/full

http://onlinelibrary.wiley.com/doi/10.1002/ijc.29339/epdf

Abstract

The debate on the potential carcinogenic effect of dietary acrylamide is open. In consideration of the recent findings from large prospective investigations, we conducted an updated meta-analysis on acrylamide intake and the risk of cancer at several sites. Up to July 2014, we identified 32 publications. We performed meta-analyses to calculate the summary relative risk (RR) of each cancer site for the highest versus lowest level of intake and for an increment of 10 µg/day of dietary acrylamide, through fixed-effects or random-effects models, depending on the heterogeneity test. Fourteen cancer sites could be examined. No meaningful associations were found for most cancers considered. The summary RRs for high versus low acrylamide intake were 0.87 for oral and pharyngeal, 1.14 for esophageal, 1.03 for stomach, 0.94 for colorectal, 0.93 for pancreatic, 1.10 for laryngeal, 0.88 for lung, 0.96 for breast, 1.06 for endometrial, 1.12 for ovarian, 1.00 for prostate, 0.93 for bladder and 1.13 for lymphoid malignancies. The RR was of borderline significance only for kidney cancer (RR = 1.20; 95% confidence interval, CI, 1.00-1.45). All the corresponding continuous estimates ranged between 0.95 and 1.03, and none of them was significant. Among never-smokers, borderline associations with dietary acrylamide emerged for endometrial (RR = 1.23; 95% CI, 1.00-1.51) and ovarian (RR = 1.39; 95% CI, 0.97-2.00) cancers. This systematic review and meta-analysis of epidemiological studies indicates that dietary acrylamide is not related to the risk of most common cancers. A modest association for kidney cancer, and for endometrial and ovarian cancers in never smokers only, cannot be excluded.

KEYWORDS:

acrylamide; epidemiologic studies; meta-analysis; neoplasms; review

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Interactions between dietary acrylamide intake and genes for ovarian cancer risk.

Hogervorst JG, van den Brandt PA, Godschalk RW, van Schooten FJ, Schouten LJ.

Eur J Epidemiol. 2017 Apr 8. doi: 10.1007/s10654-017-0244-0. [Epub ahead of print]

PMID: 28391539

http://sci-hub.cc/10.1007/s10654-017-0244-0

Abstract

Some epidemiological studies observed a positive association between dietary acrylamide intake and ovarian cancer risk but the causality needs to be substantiated. By analyzing gene-acrylamide interactions for ovarian cancer risk for the first time, we aimed to contribute to this. The prospective Netherlands Cohort Study on diet and cancer includes 62,573 women, aged 55-69 years. At baseline in 1986, a random subcohort of 2589 women was sampled from the total cohort for a case cohort analysis approach. Dietary acrylamide intake of subcohort members and ovarian cancer cases (n = 252, based on 20.3 years of follow-up) was assessed with a food frequency questionnaire. We selected single nucleotide polymorphisms (SNPs) in genes in acrylamide metabolism and in genes involved in the possible mechanisms of acrylamide-induced carcinogenesis (effects on sex steroid systems, oxidative stress and DNA damage). Genotyping was done on DNA from toenails through Agena's MassARRAY iPLEX platform. Multiplicative interaction between acrylamide intake and SNPs was assessed with Cox proportional hazards analysis. Among the results for 57 SNPs and 2 gene deletions, there were no statistically significant interactions between acrylamide and gene variants after adjustment for multiple testing. However, there were several nominally statistically significant interactions between acrylamide intake and SNPs in the HSD3B1/B2 gene cluster: (rs4659175 (p interaction = 0.04), rs10923823 (p interaction = 0.06) and its proxy rs7546652 (p interaction = 0.05), rs1047303 (p interaction = 0.005), and rs6428830 (p interaction = 0.05). Although in need of confirmation, results of this study suggest that acrylamide may cause ovarian cancer through effects on sex hormones.

KEYWORDS:

Dietary acrylamide; Ovarian cancer; Prospective cohort; Single nucleotide polymorphism

 

"1 tsp salt = 6 g salt ≈ 2,400 mg sodium = 104 mmol sodium = 104 mEq sodium"

"Sodium reduction ... cholesterol increased 5.59 mg/dL (2.9%); triglyceride increased 7.04 mg/dL (6.3%)."

Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride.

Graudal NA, Hubeck-Graudal T, Jurgens G.

Cochrane Database Syst Rev. 2017 Apr 9;4:CD004022. doi: 10.1002/14651858.CD004022.pub4. [Epub ahead of print] Review.

PMID: 28391629

http://sci-hub.cc/10.1002/14651858.CD004022.pub4

Abstract

BACKGROUND:

In spite of more than 100 years of investigations the question of whether a reduced sodium intake improves health is still unsolved.

OBJECTIVES:

To estimate the effects of low sodium intake versus high sodium intake on systolic and diastolic blood pressure (SBP and DBP), plasma or serum levels of renin, aldosterone, catecholamines, cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL) and triglycerides.

SEARCH METHODS:

The Cochrane Hypertension Information Specialist searched the following databases for randomized controlled trials up to March 2016: the Cochrane Hypertension Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (2016, Issue 3), MEDLINE (from 1946), Embase (from 1974), the World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov. We also searched the reference lists of relevant articles.

SELECTION CRITERIA:

Studies randomising persons to low-sodium and high-sodium diets were included if they evaluated at least one of the above outcome parameters.

DATA COLLECTION AND ANALYSIS:

Two review authors independently collected data, which were analysed with Review Manager 5.3.

MAIN RESULTS:

A total of 185 studies were included. The average sodium intake was reduced from 201 mmol/day (corresponding to high usual level) to 66 mmol/day (corresponding to the recommended level).The effect of sodium reduction on blood pressure (BP) was as follows: white people with normotension: SBP: mean difference (MD) -1.09 mmHg (95% confidence interval (CI): -1.63 to -0.56; P = 0.0001); 89 studies, 8569 participants; DBP: + 0.03 mmHg (MD 95% CI: -0.37 to 0.43; P = 0.89); 90 studies, 8833 participants. High-quality evidence. Black people with normotension: SBP: MD -4.02 mmHg (95% CI:-7.37 to -0.68; P = 0.002); seven studies, 506 participants; DBP: MD -2.01 mmHg (95% CI:-4.37 to 0.35; P = 0.09); seven studies, 506 participants. Moderate-quality evidence. Asian people with normotension: SBP: MD -0.72 mmHg (95% CI: -3.86 to 2.41; P = 0.65); DBP: MD -1.63 mmHg (95% CI:-3.35 to 0.08; P =0.06); three studies, 393 participants. Moderate-quality evidence.White people with hypertension: SBP: MD -5.51 mmHg (95% CI: -6.45 to -4.57; P < 0.00001); 84 studies, 5925 participants; DBP: MD -2.88 mmHg (95% CI: -3.44 to -2.32; P < 0.00001); 85 studies, 6001 participants. High-quality evidence. Black people with hypertension: SBP MD -6.64 mmHg (95% CI:-9.00 to -4.27; P = 0.00001); eight studies, 619 participants; DBP -2.91 mmHg (95% CI:-4.52, -1.30; P = 0.0004); eight studies, 619 participants. Moderate-quality evidence. Asian people with hypertension: SBP: MD -7.75 mmHg (95% CI:-11,44 to -4.07; P < 0.0001) nine studies, 501 participants; DBP: MD -2.68 mmHg (95% CI: -4.21 to -1.15; P = 0.0006). Moderate-quality evidence.In plasma or serum, there was a significant increase in renin (P < 0.00001), aldosterone (P < 0.00001), noradrenaline (P < 0.00001), adrenaline (P < 0.03), cholesterol (P < 0.0005) and triglyceride (P < 0.0006) with low sodium intake as compared with high sodium intake. All effects were stable in 125 study populations with a sodium intake below 250 mmol/day and a sodium reduction intervention of at least one week.

AUTHORS' CONCLUSIONS:

Sodium reduction from an average high usual sodium intake level (201 mmol/day) to an average level of 66 mmol/day, which is below the recommended upper level of 100 mmol/day (5.8 g salt), resulted in a decrease in SBP/DBP of 1/0 mmHg in white participants with normotension and a decrease in SBP/DBP of 5.5/2.9 mmHg in white participants with hypertension. A few studies showed that these effects in black and Asian populations were greater. The effects on hormones and lipids were similar in people with normotension and hypertension. Renin increased 1.60 ng/mL/hour (55%); aldosterone increased 97.81 pg/mL (127%); adrenalin increased 7.55 pg/mL (14%); noradrenalin increased 63.56 pg/mL: (27%); cholesterol increased 5.59 mg/dL (2.9%); triglyceride increased 7.04 mg/dL (6.3%).

 

Total volume and composition of fluid intake and mortality in older women: a cohort study.

Lim WH, Wong G, Lewis JR, Lok CE, Polkinghorne KR, Hodgson J, Lim EM, Prince RL.

BMJ Open. 2017 Mar 24;7(3):e011720. doi: 10.1136/bmjopen-2016-011720.

PMID: 28341683 Free Article

http://bmjopen.bmj.com/content/7/3/e011720.long

http://bmjopen.bmj.com/content/bmjopen/7/3/e011720.full.pdf

Abstract

OBJECTIVES:

The health benefits of 'drinking at least 8 glasses of water a day" in healthy individuals are largely unproven. We aimed to examine the relationship between total fluid and the sources of fluid consumption, risk of rapid renal decline, cardiovascular disease (CVD) mortality and all-cause mortality in elderly women.

DESIGN, SETTING AND PARTICIPANTS:

We conducted a longitudinal analysis of a population-based cohort study of 1055 women aged ≥70 years residing in Australia.

MAIN OUTCOME MEASURES:

The associations between total daily fluid intake (defined as total volume of beverage excluding alcohol and milk) and the types of fluid (water, black tea, coffee, milk and other fluids) measured as cups per day and rapid renal decline, CVD and all-cause mortality were assessed using adjusted logistic and Cox regression analyses.

RESULTS:

Over a follow-up period of 10 years, 70 (6.6%) experienced rapid renal decline and 362 (34.4%) died, of which 142 (13.5%) deaths were attributed to CVD. The median (IQR) intake of total fluid was 10.4 (8.5-12.5) cups per day, with water (median (IQR) 4 (2-6) cups per day) and black tea (median (IQR) 3 (1-4) cups per day) being the most frequent type of fluid consumed. Every cup per day higher intake of black tea was associated with adjusted HRs of 0.90 (95% CI 0.81 to 0.99) and 0.92 (95% CI 0.86 to 0.98) for CVD mortality and all-cause mortality, respectively. There were no associations between black tea intake and rapid renal decline, or between the quantity or type of other fluids, including water intake, and any clinical outcomes.

CONCLUSIONS:

Habitual higher intake of black tea may potentially improve long-term health outcomes, independent of treating traditional CVD risk factors, but validation of our study findings is essential.

KEYWORDS:

EPIDEMIOLOGY; elderly; fluid intake; mortality; tea

 

Comparison between the effect of 6 weeks of morning or evening aerobic exercise on appetite and anthropometric indices: a randomized controlled trial.

Alizadeh Z, Younespour S, Rajabian Tabesh M, Haghravan S.

Clin Obes. 2017 Mar 26. doi: 10.1111/cob.12187. [Epub ahead of print]

PMID: 28343364

Abstract

Several studies have shown that exercise is directly related to creating negative energy balance and changes in appetite. However, few studies have examined the effect of exercise time during the day on these factors. The aim of the present study was to demonstrate the effect of 6 weeks of morning and evening aerobic exercise on appetite and anthropometric indices. A total of 48 overweight females were recruited to this clinical trial. By the time of exercise, they were divided into two groups (morning or evening) and performed 6 weeks of exercise with a target heart rate on the ventilatory threshold. Appetite change, calorie intake and anthropometric indices were assessed. Consistent changes in appetite scores were not found during the 6 weeks (P > 0.05). Calorie consumption of the morning group decreased significantly more than that of the evening group (P = 0.02) during the 6 weeks. In addition, significant changes in body weight, body mass index, abdominal skin fold thickness and abdominal circumference were seen in the morning group. It appears that moderate- to high-intensity aerobic exercise in the morning could be considered a more effective programme than evening exercise on appetite control, calorie intake and weight loss in inactive overweight women. However, the limitations of the study, such as short-term duration, should be noticed.

KEYWORDS:

Overweight; aerobic; appetite; exercise

 

Lifestyles and Mortality in Taiwan.

Lin YH, Ku PW, Chou P.

Asia Pac J Public Health. 2017 Mar 1:1010539517699058. doi: 10.1177/1010539517699058. [Epub ahead of print]

PMID: 28343400

Abstract

The associations of modifiable lifestyle-related factors with cardiovascular and all-cause mortality were examined in a population-based sample of older Taiwanese people. A total of 4176 individuals aged 50 years and older, with 11 years of follow-up, were analyzed. Current and former smokers had a higher risk of all-cause mortality compared with never smokers ([hr 1.33; 95% CI 1.12, 1.58], [hr 1.39; 95% CI 1.16, 1.68]). Low intake of vegetables and fruits was associated with a significantly higher risk of 1.43 (95% CI = 1.13, 1.81) for cardiovascular mortality and 1.22 (95% CI = 1.09, 1.38) for all-cause mortality. The low physical activity group at baseline who became part of the low, moderate, and high physical activity groups during follow-up had the following risks of cardiovascular mortality: ([hr 2.89; 95% CI 1.91, 4.36], [hr 2.17; 95% CI 1.29, 3.63], [hr 1.59; 95% CI 0.90, 2.82]). Similarly, the moderate physical activity group at baseline who became part of the low, moderate, and high physical activity groups during follow-up had the following risks of cardiovascular mortality: ([hr 3.52; 95% CI 2.14, 5.80], [hr 2.25; 95% CI 1.34, 3.80], [hr 1.44; 95% CI 0.78, 2.66]). The same tendencies were found in all-cause mortality. Smoking, diet, and physical activity were significantly modifiable lifestyle-related factors for mortality.Besides, individuals who decreased their physical activity had a significantly higher risk, whereas those who increased their physical activity had a significantly lower risk.

KEYWORDS:

diet; lifestyles; mortality; physical activity; smoking

 

The Effect of a Breakfast Rich in Slowly Digestible Starch on Glucose Metabolism: A Statistical Meta-Analysis of Randomized Controlled Trials.

Vinoy S, Meynier A, Goux A, Jourdan-Salloum N, Normand S, Rabasa-Lhoret R, Brack O, Nazare JA, Péronnet F, Laville M.

Nutrients. 2017 Mar 23;9(4). pii: E318. doi: 10.3390/nu9040318. Review.

PMID: 28333086 Free Article

http://www.mdpi.com/2072-6643/9/4/318/htm

Abstract

Starch digestibility may have an effect on the postprandial blood glucose profile. The aim of this meta-analysis was to analyze the relationship between Slowly Digestible Starch (SDS) levels and plasma glucose appearance and disappearance rates, as well as other parameters of glucose metabolism, after healthy subjects consumed cereal products that differed in SDS content. Three randomized controlled clinical trials that included a total of 79 subjects were identified. Using binary classification for the variables (high versus low levels, more than 12 g of SDS per portion, and less than 1 g of SDS per portion, respectively), we found that there was a 15-fold higher chance of having a low rate of appearance of exogenous glucose (RaE) after consumption of a high-SDS product. A high SDS content was also associated with a 12-fold and 4-fold higher chance of having a low rate of disappearance of exogenous glucose (RdE) and rate of disappearance of total plasma glucose (RdT), respectively. The RaE kinetics were further analyzed by modeling the contribution of SDS content to the different phases of the RaE response. We show that the higher the SDS content per portion of cereal product, the higher its contribution to the incremental area under the curve (iAUC) of the RaE response after 165 min. Using the association rule technique, we found that glycemic iAUC and insulinemic iAUC values vary in the same direction. In conclusion, this meta-analysis confirms the effect of the SDS level in cereal products on the metabolic response, and shows for the first time that the degree to which SDS affects the RaE response differs depending on the SDS content of the food product, as well as the phase of the postprandial period.

KEYWORDS:

breakfast; exogenous glucose appearance rate (RaE); glycemic index (GI); glycemic response; insulin response; slowly digestible starch (SDS); starch digestibility

 

Effect of Life Events, Social Supports, and Personality on Mental Status in Later Life.

Lee K, Holst M, Martin P, Poon LW.

Int J Aging Hum Dev. 2017 Jan 1:91415017702905. doi: 10.1177/0091415017702905. [Epub ahead of print]

PMID: 28378616

http://sci-hub.cc/10.1177/0091415017702905

Abstract

The goal of this study was to explore the influences of proximal and distal life events on mental status in later life. Additionally, life events were categorized into positive and negative experiences. Data from 208 older adults over 80 years of age from the Georgia Centenarian Study were included in this study. Results from a series of blockwise regression analyses indicated that the number of distal negative life events that older adults had experienced was a predictor of older adults' better mental status. Oldest-old adults' age, education, social supports, and social provision were also associated with their cognition. Cumulative negative life events may protect people in cognitive function as implicated by our results.

KEYWORDS:

distal; life events; mental status; proximal; social support

 

Milk and dairy consumption and risk of cardiovascular diseases and all-cause mortality: dose-response meta-analysis of prospective cohort studies.

Guo J, Astrup A, Lovegrove JA, Gijsbers L, Givens DI, Soedamah-Muthu SS.

Eur J Epidemiol. 2017 Apr 3. doi: 10.1007/s10654-017-0243-1. [Epub ahead of print]

PMID: 28374228

Abstract

With a growing number of prospective cohort studies, an updated dose-response meta-analysis of milk and dairy products with all-cause mortality, coronary heart disease (CHD) or cardiovascular disease (CVD) have been conducted. PubMed, Embase and Scopus were searched for articles published up to September 2016. Random-effect meta-analyses with summarised dose-response data were performed for total (high-fat/low-fat) dairy, milk, fermented dairy, cheese and yogurt. Non-linear associations were investigated using the spine models and heterogeneity by subgroup analyses. A total of 29 cohort studies were available for meta-analysis, with 938,465 participants and 93,158 mortality, 28,419 CHD and 25,416 CVD cases. No associations were found for total (high-fat/low-fat) dairy, and milk with the health outcomes of mortality, CHD or CVD. Inverse associations were found between total fermented dairy (included sour milk products, cheese or yogurt; per 20 g/day) with mortality (RR 0.98, 95% CI 0.97-0.99; I2 = 94.4%) and CVD risk (RR 0.98, 95% CI 0.97-0.99; I2 = 87.5%). Further analyses of individual fermented dairy of cheese and yogurt showed cheese to have a 2% lower risk of CVD (RR 0.98, 95% CI 0.95-1.00; I2 = 82.6%) per 10 g/day, but not yogurt. All of these marginally inverse associations of totally fermented dairy and cheese were attenuated in sensitivity analyses by removing one large Swedish study. This meta-analysis combining data from 29 prospective cohort studies demonstrated neutral associations between dairy products and cardiovascular and all-cause mortality. For future studies it is important to investigate in more detail how dairy products can be replaced by other foods.

KEYWORDS:

All-cause mortality; Cardiovascular disease; Dairy; Dose–response meta-analysis; Fermented dairy; Milk

 

Consumption of Yogurt and the Incident Risk of Cardiovascular Disease: A Meta-Analysis of Nine Cohort Studies.

Wu L, Sun D.

Nutrients. 2017 Mar 22;9(3). pii: E315. doi: 10.3390/nu9030315. Review.

PMID: 28327514 Free Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372978/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372978/pdf/nutrients-09-00315.pdf

Abstract

Previous systematic reviews and meta-analyses have evaluated the association of dairy consumption and the risk of cardiovascular disease (CVD). However, the findings were inconsistent. No quantitative analysis has specifically assessed the effect of yogurt intake on the incident risk of CVD. We searched the PubMed and the Embase databases from inception to 10 January 2017. A generic inverse-variance method was used to pool the fully-adjusted relative risks (RRs) and the corresponding 95% confidence intervals (CIs) with a random-effects model. A generalized least squares trend estimation model was used to calculate the specific slopes in the dose-response analysis. The present systematic review and meta-analysis identified nine prospective cohort articles involving a total of 291,236 participants. Compared with the lowest category, highest category of yogurt consumption was not significantly related with the incident risk of CVD, and the RR (95% CI) was 1.01 (0.95, 1.08) with an evidence of significant heterogeneity (I² = 52%). However, intake of ≥200 g/day yogurt was significantly associated with a lower risk of CVD in the subgroup analysis. There was a trend that a higher level of yogurt consumption was associated with a lower incident risk of CVD in the dose-response analysis. A daily dose of ≥200 g yogurt intake might be associated with a lower incident risk of CVD. Further cohort studies and randomized controlled trials are still demanded to establish and confirm the observed association in populations with different characteristics.

KEYWORDS:

cardiovascular disease; coronary heart disease; meta-analysis; stroke; yogurt intake

 

The Relationship of Obesity to Hospice Use and Expenditures: A Cohort Study.

Harris JA, Byhoff E, Perumalswami CR, Langa KM, Wright AA, Griggs JJ.

Ann Intern Med. 2017 Mar 21;166(6):381-389. doi: 10.7326/M16-0749. Epub 2017 Feb 7.

PMID: 28166546

Abstract

BACKGROUND:

Obesity complicates medical, nursing, and informal care in severe illness, but its effect on hospice use and Medicare expenditures is unknown.

OBJECTIVE:

To describe the associations between body mass index (BMI) and hospice use and Medicare expenditures in the last 6 months of life.

DESIGN:

Retrospective cohort.

SETTING:

The HRS (Health and Retirement Study).

PARTICIPANTS:

5677 community-dwelling Medicare fee-for-service beneficiaries who died between 1998 and 2012.

MEASUREMENTS:

Hospice enrollment, days enrolled in hospice, in-home death, and total Medicare expenditures in the 6 months before death. Body mass index was modeled as a continuous variable with a quadratic functional form.

RESULTS:

For decedents with BMI of 20 kg/m2, the predicted probability of hospice enrollment was 38.3% (95% CI, 36.5% to 40.2%), hospice duration was 42.8 days (CI, 42.3 to 43.2 days), probability of in-home death was 61.3% (CI, 59.4% to 63.2%), and total Medicare expenditures were $42 803 (CI, $41 085 to $44 521). When BMI increased to 30 kg/m2, the predicted probability of hospice enrollment decreased by 6.7 percentage points (CI, -9.3 to -4.0 percentage points), hospice duration decreased by 3.8 days (CI, -4.4 to -3.1 days), probability of in-home death decreased by 3.2 percentage points (CI, -6.0 to -0.4 percentage points), and total Medicare expenditures increased by $3471 (CI, $955 to $5988). For morbidly obese decedents (BMI ≥40 kg/m2), the predicted probability of hospice enrollment decreased by 15.2 percentage points (CI, -19.6 to -10.9 percentage points), hospice duration decreased by 4.3 days (CI, -5.7 to -2.9 days), and in-home death decreased by 6.3 percentage points (CI, -11.2 to -1.5 percentage points) versus decedents with BMI of 20 kg/m2.

LIMITATION:

Baseline data were self-reported, and the interval between reported BMI and time of death varied.

CONCLUSION:

Among community-dwelling decedents in the HRS, increasing obesity was associated with reduced hospice use and in-home death and higher Medicare expenditures in the last 6 months of life.

 

Review: 1-time ultrasonography screening reduces abdominal aortic aneurysm-related mortality and rupture.

Hirsch C.

Ann Intern Med. 2017 Mar 21;166(6):JC27. doi: 10.7326/ACPJC-2017-166-6-027. No abstract available.

PMID: 28320001

http://sci-hub.cc/10.7326/ACPJC-2017-166-6-027

 

Change in lifestyle behaviors and diabetes risk: evidence from a population-based cohort study with 10 year follow-up.

Feldman AL, Long GH, Johansson I, Weinehall L, Fhärm E, Wennberg P, Norberg M, Griffin SJ, Rolandsson O.

Int J Behav Nutr Phys Act. 2017 Mar 29;14(1):39. doi: 10.1186/s12966-017-0489-8.

PMID: 28351358 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5371247/?report=classic

Abstract

BACKGROUND:

Promoting positive changes in lifestyle behavior in the whole population may be a feasible and effective approach to reducing type 2 diabetes burden, but the impact of population shifts of modifiable risk factors remains unclear. Currently most of the evidence on modifiable lifestyle behavior and type 2 diabetes risk on a population level comes from studies of between-individual differences. The objective of the study was to investigate the association and potential impact on disease burden for within-individual change in lifestyle behavior and diabetes risk.

METHODS:

Population-based prospective cohort study of 35,680 participants aged 30-50 at baseline in 1990-2003 in Västerbotten County, Sweden (follow-up until 2013). Five self-reported modifiable lifestyle behaviors (tobacco use, physical activity, alcohol intake, dietary fiber intake and dietary fat intake) were measured at baseline and 10 year follow-up. Lifestyle behaviors were studied separately, and combined in a score. Incident diabetes was detected by oral glucose tolerance tests. Multivariate logistic regression models and population attributable fractions (PAF) were used to analyze the association between change in lifestyle behavior between baseline and 10 year follow-up, and risk of incident diabetes.

RESULTS:

Incident diabetes was detected in 1,184 (3.3%) participants at 10 year follow-up. There was a reduced diabetes risk associated with increase in dietary fiber intake, odds ratio (OR) 0.79 (95% confidence interval (CI) 0.66, 0.96) for increase of at least one unit standard deviation (3.0 g/1,000 kcal) of the baseline distribution, PAF 16.0% (95% CI 4.2, 26.4%). Increase in the lifestyle behavior score was associated with reduced diabetes risk, OR 0.92 (95% CI 0.85, 0.99) per unit increase of the score.

CONCLUSIONS:

These results support a causal link between lifestyle behavior and type 2 diabetes incidence. A small shift in lifestyle behaviors, in particular intake of dietary fiber, has the potential to reduce diabetes burden in the population and might be a suitable target for public health intervention.

KEYWORDS:

Diabetes Mellitus; Epidemiology; Health Behaviour; Life Style; Public Health

 

The effect of omega-3 polyunsaturated fatty acids on arthritic pain: A systematic review

Mozghan Abdulrazaq, Jacqueline K. Innes, Philip C. Calder

Nutrtion

DOI: http://dx.doi.org/10.1016/j.nut.2016.12.003

Publication stage: In Press Accepted Manuscript

Published online: December 21, 2016

http://sci-hub.cc/10.1016/j.nut.2016.12.003

Highlights

•Eighteen RCTs published between 1985 and 2013 involving 1143 patients were included in a systematic review of omega-3 fatty acids and pain in rheumatoid arthritis (RA)

•Ten studies support the hypothesis that there is a reduction in patient or physician assessment of pain associated with RA after intake of omega-3 fatty acids

•Omega-3 fatty acids may have a therapeutic role in decreasing pain associated with RA, with doses of 3-6 g/d appearing to have a greater effect.

•More research is needed to investigate omega-3 fatty acids and pain in larger populations and over extended periods of time

Background & aims

Pain is a significant problem in rheumatoid arthritis (RA), and is associated with prostaglandins derived from the omega-6 polyunsaturated fatty acid (PUFA) arachidonic acid (AA). The omega-3 PUFAs eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been shown to reduce inflammation, with some studies observing clinical improvements in RA. The aim of this systematic review is to investigate the effect of omega-3 PUFAs on arthritic pain.

Method

A systematic literature review of omega-3 PUFAs and pain associated with RA was performed up to December 2015. Randomised controlled trials (RCTs) investigating the effect of omega-3 PUFAs (> 2 g/d) on patient and/or physician assessment of pain were included. The Cochrane Collaboration’s tool for assessing risk of bias was employed. Data for outcomes of interest were extracted and collated for interpretation.

Results

Eighteen RCTs published between 1985 and 2013 involving 1143 patients were included. Dosage of omega-3 PUFAs used was 2.1-9.1 g/day, with study durations of 12-52 weeks. Ten studies supported the hypothesis that there is a reduction in patient or physician assessment of pain associated with RA after intake of omega-3 PUFAs. Eight studies found no statistically significant effect of omega-3 PUFAs on arthritic pain.

Conclusions

Omega-3 PUFAs may have a therapeutic role in decreasing pain associated with RA, with doses of 3-6 g/d appearing to have a greater effect. Due to the limitations identified in studies included in this review, more research is needed to investigate omega-3 PUFAs in larger populations and over extended periods of time.

Keywords:

EPA, DHA, fish oil, rheumatoid arthritis, pain

 

High dose vitamin D may improve lower urinary tract symptoms in postmenopausal women.

Oberg J, Verelst M, Jorde R, Cashman K, Grimnes G.

J Steroid Biochem Mol Biol. 2017 Mar 18. pii: S0960-0760(17)30078-X. doi: 10.1016/j.jsbmb.2017.03.013. [Epub ahead of print]

PMID: 28323043

http://sci-hub.cc/10.1016/j.jsbmb.2017.03.013

Abstract

Lower urinary tract symptoms (LUTS) are common in postmenopausal women, and have been reported inversely associated with vitamin D intake and serum 25-hydroxyvitamin D (25(OH)D) levels. The aim of this study was to investigate if high dose vitamin D supplementation would affect LUTS in comparison to standard dose. In a randomized controlled study including 297 postmenopausal women with low bone mineral density, the participants were allocated to receive capsules of 20 000IU of vitamin D3 twice a week (high dose group) or similar looking placebo (standard dose group). In addition, all the participants received 1g of calcium and 800IU of vitamin D daily. A validated questionnaire regarding LUTS was filled in at baseline and after 12 months. At baseline, 76 women in the high dose group and 82 in the standard dose group reported any LUTS. Levels of serum 25(OH)D increased significantly more in the high dose group (from 64.7 to 164.1nmol/l compared to from 64.1 to 81.8nmol/l, p<0.01). No differences between the groups were seen regarding change in LUTS except for a statistically significant reduction in the reported severity of urine incontinence in the high dose group as compared to the standard dose group after one year (p<0.05). The results need confirmation in a study specifically designed for this purpose.

KEYWORDS:

Lower urinary tract symptoms; RCT; Urinary tract infection; Vitamin D

 

Randomized Controlled Trial of a MUFA or Fiber-rich diet on Hepatic fat in Pre-diabetes.

Errazuriz I, Dube S, Slama M, Visentin R, Nayar S, O'Connor H, Cobelli C, Das SK, Basu A, Kremers WK, Port J, Basu R.

J Clin Endocrinol Metab. 2017 Mar 6. doi: 10.1210/jc.2016-3722. [Epub ahead of print]

PMID: 28323952

Abstract

CONTEXT:

Increased prevalence of type 2 diabetes mellitus and prediabetes worldwide has been attributed, at least in part, to a modern lifestyle, in particular, to an unhealthy diet.

OBJECTIVE:

To evaluate whether 12 weeks of high MUFA or fiber-rich weight maintenance diet lowers hepatic fat and improves glucose tolerance in people with prediabetes.

DESIGN:

Subjects underwent a [6, 6-2H2] labeled 75 g oral glucose tolerance test to estimate hepatic insulin sensitivity (Siliver) along with measurement of liver fat fraction (LFF) using magnetic resonance spectroscopy before and after intervention.

SETTING:

Mayo Clinic Clinical Research Trials Unit.

PARTICIPANTS:

43 subjects with pre-diabetes.

INTERVENTION:

Subjects randomized into three isocaloric weight maintaining diets containing MUFA (olive oil), extra fiber, and standard American food (control-habitual diet).

OUTCOME MEASURES:

Liver fat fraction, glucose tolerance and indices of insulin action and secretion.

RESULTS:

Body weight was maintained constant in all groups during intervention. Baseline, 8 and 12 week weights recorded for MUFA (86.6 ± 3.7 vs. 86.7 ± 3.8 vs. 86.6 ± 3.6 kg), Fiber (85.1 ± 3.5 vs. 84.1 ± 3.6 vs. 84.8 ± 3.9 kg) and Control were (88.7 ± 4.0 vs. 90.6 ± 3.1vs. 90.6 ± 3.2 kg). Glucose and hormonal concentrations were similar in all groups before and unchanged after 12 weeks of intervention. LFF was significantly lower following intervention in the MUFA group (9.7 ± 2.8% vs. 8.0 ± 2.5%; p < 0.0003), but remained unchanged in the Fiber group (6.9 ± 1.1% vs. 6.3 ± 1.0%; p = 0.25) as well as the Control group (11.2 ± 2.5% vs. 11.9 ± 2.7%; p = 0.45). After 12 weeks, adjusting for baseline, LFF was significantly lower in the MUFA than the control group (p = 0.01), but fiber group did not differ from control (p = 0.41). Indices of insulin action and secretion were numerically but not significantly different between the MUFA vs. control following intervention (p ≥ 0.11) but within group comparison showed higher hepatic (p=0.01), and total insulin sensitivity (p<0.04) with MUFA diet.

CONCLUSIONS:

In the absence of weight loss, 12 weeks of a MUFA-rich diet decreases hepatic fat with improvement in both hepatic and total insulin sensitivity.

 

Chocolate consumption and risk of stroke among men and women: A large population-based, prospective cohort study.

Dong JY, Iso H, Yamagishi K, Sawada N, Tsugane S; Japan Public Health Center–based Prospective Study Group..

Atherosclerosis. 2017 Mar 4;260:8-12. doi: 10.1016/j.atherosclerosis.2017.03.004. [Epub ahead of print]

PMID: 28324761

Abstract

BACKGROUND AND AIMS:

Chocolate consumption may have a beneficial effect on cardiovascular health, but evidence from prospective cohort studies is still limited. We aimed to examine the prospective associations between chocolate consumption and risk of stroke among men and women in a large population-based cohort.

METHODS:

A total of 38,182 men and 46,415 women aged 44-76 years, and free of cardiovascular disease, diabetes, and cancer at baseline in 1995 and 1998, were followed up until the end of 2009 and 2010, respectively. We obtained data on chocolate consumption for each participant using a self-administrated food frequency questionnaire that included 138 food and beverage items. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) of stroke in relation to chocolate consumption.

RESULTS:

During a median follow-up of 12.9 years, we identified 3558 incident strokes cases (2146 cerebral infarctions and 1396 hemorrhagic strokes). After adjustment for age, body mass index, life styles, dietary intakes, and other risk factors, chocolate consumption was associated with a significant lower risk of stroke in women (HR = 0.84; 95% CI, 0.71-0.99). However, the association in men was not significant (HR = 0.94; 95% CI, 0.80-1.10). In addition, the association did not vary by stroke subtypes in either men or women.

CONCLUSIONS:

Findings from this large Japanese cohort supported a significant inverse association between chocolate consumption and risk of developing stroke in women. However, residual confounding could not be excluded as an alternative explanation for our findings.

KEYWORDS:

Chocolate; Prospective cohort study; Stroke

 

Impact of Resveratrol on Glucose Control, Hippocampal Structure and Connectivity, and Memory Performance in Patients with Mild Cognitive Impairment.

Köbe T, Witte AV, Schnelle A, Tesky VA, Pantel J, Schuchardt JP, Hahn A, Bohlken J, Grittner U, Flöel A.

Front Neurosci. 2017 Mar 7;11:105. doi: 10.3389/fnins.2017.00105. eCollection 2017.

PMID: 28326010 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5339301/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5339301/pdf/fnins-11-00105.pdf

Abstract

In healthy older adults, resveratrol supplementation has been shown to improve long-term glucose control, resting-state functional connectivity (RSFC) of the hippocampus, and memory function. Here, we aimed to investigate if these beneficial effects extend to individuals at high-risk for dementia, i.e., patients with mild cognitive impairment (MCI). In a randomized, double-blind interventional study, 40 well-characterized patients with MCI (21 females; 50-80 years) completed 26 weeks of resveratrol (200 mg/d; n = 18) or placebo (1,015 mg/d olive oil; n = 22) intake. Serum levels of glucose, glycated hemoglobin A1c and insulin were determined before and after intervention. Moreover, cerebral magnetic resonance imaging (MRI) (3T) (n = 14 vs. 16) was conducted to analyze hippocampus volume, microstructure and RSFC, and neuropsychological testing was conducted to assess learning and memory (primary endpoint) at both time points. In comparison to the control group, resveratrol supplementation resulted in lower glycated hemoglobin A1c concentration with a moderate effect size (ANOVARMp = 0.059, Cohen's d = 0.66), higher RSFC between right anterior hippocampus and right angular cortex (p < 0.001), and led to a moderate preservation of left anterior hippocampus volume (ANOVARMp = 0.061, Cohen's d = 0.68). No significant differences in memory performance emerged between groups. This proof-of-concept study indicates for the first-time that resveratrol intake may reduce glycated hemoglobin A1c, preserves hippocampus volume, and improves hippocampus RSFC in at-risk patients for dementia. Larger trials with longer intervention time should now determine if these benefits can be validated and extended to cognitive function.

KEYWORDS:

MCI; hippocampus; memory performance; resting-state functional connectivity; resveratrol

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Why Are So Many People Popping Vitamin D?

By GINA KOLATAAPRIL 10, 2017

https://www.nytimes.com/2017/04/10/health/vitamin-d-deficiency-supplements.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=mini-moth&region=top-stories-below&WT.nav=top-stories-below

>>>>>>>>>>>>>

http://www.longecity.org/forum/topic/54272-another-day-another-pill-2012-supplement-regimen/

"optimal concentrations ∼75-87.5 nmol/L. http://ajcn.nutrition.org/content/95/1/91.long "

 

Metabolic effects of aspartame in adulthood: a systematic review and meta-analysis of randomized clinical trials.

Santos NC, Araujo LM, De Luca Canto G, Guerra EN, Coelho MS, Borin MF.

Crit Rev Food Sci Nutr. 2017 Apr 10:0. doi: 10.1080/10408398.2017.1304358. [Epub ahead of print]

PMID: 28394643

Abstract

BACKGROUND:

Data about harms or benefits associated with the consumption of aspartame, a non-nutritive sweetener worldwide consumed, is still controversial. This systematic review and meta-analysis of randomized controlled clinical trials aimed to assess the effect of aspartame consumption on metabolic parameters related to diabetes and obesity.

METHODS:

The search was performed on Cochrane, LILACS, PubMed, SCOPUS, Web of Science databases and on a grey literature using Open Grey, Google Scholar and ProQuest Dissertations & Theses Global. Searches across all databases were conducted from the earliest available date up to April 13, 2016, without date and language restrictions. Pooled mean differences were calculated using a random or fixed-effects model for heterogeneous and homogenous studies, respectively.

RESULTS:

Twenty nine articles were included in qualitative synthesis and twelve, presenting numeric results, were used in meta-analysis. Fasting blood glucose (mmol/L), insulin levels (μU/mL), total cholesterol (mmol/L), triglycerides concentrations (mmol/L), high-density lipoprotein cholesterol (mmol/L), body weight (Kg) and energy intake (MJ) were considered as the main outcomes in subjects that consumed aspartame and results were presented as (mean difference; % Confidence Interval, range). Aspartame consumption was not associated with alterations on blood glucose levels compared to control (-0.03 mmol/L; 95% CI, -0.21 to 0.14) or to sucrose (0.31 mmol/L; 95% CI, -0.05 to 0.67) and on insulin levels compared to control (0.13 μU/mL; 95% CI, -0.69 to 0.95) or to sucrose (2.54 μU/mL; 95% CI, -6.29 to 11.37). Total cholesterol was not affected by aspartame consumption compared to control (-0.02 mmol/L; 95% CI, -0.31 to 0.27) or to sucrose (-0.24 mmol/L; 95% CI, -0.89 to 0.42). Triglycerides concentrations were not affected by aspartame consumption compared to control (0.00 mmol/L; 95% CI, -0.04 to 0.05) or to sucrose (0.00 mmol/L; 95% CI, -0.09 to 0.09). High-density lipoprotein cholesterol serum levels were higher on aspartame compared to control (-0.03 mmol/L; 95% CI, -0.06 to -0.01) and lower on aspartame compared to sucrose (0.05 mmol/L; 95% CI, 0.02 to 0.09). Body weight did not change after aspartame consumption compared to control (5.00 Kg; 95% CI, -1.56 to 11.56) or to sucrose (3.78 Kg; 95% CI, -2.18 to 9.74). Energy intake was not altered by aspartame consumption compared to control (-0.49 MJ; 95% CI, -1.21 to 0.22) or to sucrose (-0.17 MJ; 95% CI, -2.03 to 1.69).

CONCLUSIONS:

Data concerning effects of aspartame on main metabolic variables associated to diabetes and obesity do not support a beneficial related to its consumption.

KEYWORDS:

aspartame; blood glucose; energy intake; insulin; lipid profile; meta-analyze; systematic review

 

Aging With Purpose.

Irving J, Davis S, Collier A.

Int J Aging Hum Dev. 2017 Jan 1:91415017702908. doi: 10.1177/0091415017702908. [Epub ahead of print]

PMID: 28391702

Abstract

Purpose can provide a sense of intentionality, guide behavior to achieve personal aims and living objectives, and may offer insight into how and why certain people remain healthy over time. A review of the literature sought to identify contemporary research pertaining to purpose and older adults. Thirty-one studies were selected for evaluation based on inclusion criteria. Research outcomes suggest that greater reported purpose is related to a range of better health and well-being outcomes for older adults. With few exceptions, the literature demonstrates that purpose declines with age. Nevertheless, the potential to experience purpose persists across the life span, by providing opportunities for older adults to continue contributing roles, participate in meaningful activities, and sustain their social value and sense of relevance. Further research could explore how purpose is experienced by the oldest-old age-group, those living within noncommunity settings, and people with age-related cognitive impairment such as dementia.

KEYWORDS:

ageing; aging; older adults; purpose; purpose in life; sense of purpose

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Effectiveness of meaningful occupation interventions for people living with dementia in residential aged care: a systematic review.

Travers C, Brooks D, Hines S, O'Reilly M, McMaster M, He W, MacAndrew M, Fielding E, Karlsson L, Beattie E.

JBI Database System Rev Implement Rep. 2016 Dec;14(12):163-225. doi: 10.11124/JBISRIR-2016-003230.

PMID: 28009676

Abstract

BACKGROUND:

The ability to participate in valued activities, whether for work, leisure or family, is an important aspect of personal identity. In dementia, progressive memory loss means that abilities developed over a lifetime begin to be lost as well, contributing to the loss of self and identity. Some studies have reported that activities or interventions tailored to be meaningful to the person with dementia (defined as any activity important to the individual) are more effective in addressing behavioral and psychological symptoms of dementia (BPSD) and improving quality of life (QoL) than those that are not so tailored. However, the effectiveness of individualizing interventions or activities for this population is not known.

OBJECTIVES:

In response to consumer feedback by the Consumer Dementia Research Network that this question ought to be addressed, this review was undertaken, the aim of which was to determine the effectiveness of meaningful occupation interventions for people living with dementia in residential aged care facilities (RACFs).

INCLUSION CRITERIA:

People living with dementia in RACFs (nursing homes).Any intervention that was individualized to be meaningful to the participant, versus any active control condition or usual care.Experimental and observational studies.

TYPES OF OUTCOMES:

Quality of life, BPSD (such as agitation, aggression, depression, wandering and apathy), mood, function, cognition and sleep.

SEARCH STRATEGY:

The search strategy aimed to identify both published and unpublished studies, with the following 12 databases extensively searched: PubMed, CINAHL, PsycINFO, ISI Web of Science, OTSeeker, Embase, Cochrane CENTRAL, clinicaltrials.gov, Mednar, OpenSIGLE, New York Academy of Medicine Library Gray Literature Report, ProQuest Dissertations and Theses. The search strategy was limited to papers published in English between 2004 and January 31, 2015.

METHODOLOGICAL QUALITY:

All studies were assessed independently by two reviewers for relevance, eligibility and methodological quality.

DATA EXTRACTION:

Data from included papers were extracted using a standard data extraction tool.

DATA SYNTHESIS:

Where possible, study results were pooled in statistical meta-analysis. Alternatively, results are presented in narrative and tabular form.

RESULTS:

A total of 5274 citations were identified; after removal of duplicates, assessment for relevance and eligibility, 61 studies underwent critical appraisal. Thirty-four studies met the quality criteria and were included in a quantitative synthesis. A wide range of interventions were evaluated including individualized recreational activities (13 studies), reminiscence therapy (RT) (seven studies), music therapy interventions (six studies), training staff to develop individual care plans using person-centered care (PCC) or similar approaches (three studies), animal-assisted therapy (two studies), multi-sensory interventions (MSIs) (two studies) and social interaction (one study), all of which measured a number of different outcomes. Overall, and in spite of most studies being small-scale and of relatively brief duration, all interventions with the exception of Snoezelen therapy (a MSI) reported some benefits for people with dementia living in RACFs. The most frequently reported benefits were reductions in agitation (the most frequently assessed outcome), passivity and depression, improved QoL and increases in pleasure and interest. However, the majority of studies generally implemented the intervention, whether it was individualized activities, music or RT or other, in conjunction with one-to-one social interaction, and the relative importance of the intervention in comparison to one-to-one social contact for effectiveness cannot be determined from this review.

CONCLUSION:

Providing meaningful or individualized tailored activities for people with dementia living in RACFs appears to be effective for a range of behavioral and psychological symptoms. The strongest evidence was for individualized activities/recreational interventions for a range of BPSD; preferred music for agitation, depression and anxiety; and RT for mood and cognitive functioning. Insufficient evidence precluded making recommendations regarding animal-assisted (dog) therapy and training staff to develop individual care plans using PCC or similar approaches, while there was no good quality evidence to show that Snoezelen was effective for any outcome. What remains unclear, however, is whether any of these interventions is more effective than the provision of one-to-one social interaction.

 

Red blood cell polyunsaturated fatty acids and mortality in the Women's Health Initiative Memory Study.

Harris WS, Luo J, Pottala JV, Espeland MA, Margolis KL, Manson JE, Wang L, Brasky TM, Robinson JG.

J Clin Lipidol. 2017 Jan - Feb;11(1):250-259.e5. doi: 10.1016/j.jacl.2016.12.013. Epub 2017 Jan 12.

PMID: 28391893

Abstract

BACKGROUND:

The prognostic value of circulating polyunsaturated fatty acid (PUFA) levels is unclear.

OBJECTIVES:

To determine the associations between red blood cell (RBC) PUFA levels and risk for death.

METHODS:

This prospective cohort study included 6501 women aged 65 to 80 years who participated in the Women's Health Initiative Memory Study (enrolment began 1996). RBC PUFA levels were measured at baseline and expressed as a percent of total RBC PUFAs. PUFAs of primary interest were the n-3 PUFAs eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and their sum (the Omega-3 Index). PUFAs of secondary interest included the 2 major n-6 PUFAs, linoleic acid and arachidonic acid, and the PUFA factor score (a calculated variable including 6 PUFAs that accounts for their intercorrelations). The primary outcome was total mortality through August 2014.

RESULTS:

After a median of 14.9 years of follow-up, 1851 women (28.5%) had died. RBC levels of EPA and DHA were higher in the survivors (P < .002 for each). In the fully adjusted models, the hazard ratios (99% confidence intervals) for mortality associated with a 1 standard deviation PUFA increase for total mortality were 0.92 (0.85, 0.98) for the Omega-3 Index, 0.89 (0.82, 0.96) for EPA, 0.93 (0.87, 1.0) for DHA, and 0.76 (0.64, 0.90) for the PUFA factor score. There were no significant associations of alpha-linolenic acid, arachidonic acid or linoleic acid with total mortality.

CONCLUSIONS:

Higher RBC levels of marine n-3 PUFAs were associated with reduced risk for all-cause mortality. These findings support the beneficial relationship between the Omega-3 Index and health outcomes.

KEYWORDS:

Docosahexaenoic acid; Eicosapentaenoic acid; Epidemiology; Omega-3 fatty acids; Omega-6 fatty acids; Prospective cohort study

 

Kefir drink causes a significant yet similar improvement in serum lipid profile, compared with low-fat milk, in a dairy-rich diet in overweight or obese premenopausal women: A randomized controlled trial.

Fathi Y, Ghodrati N, Zibaeenezhad MJ, Faghih S.

J Clin Lipidol. 2017 Jan - Feb;11(1):136-146. doi: 10.1016/j.jacl.2016.10.016. Epub 2016 Nov 9.

PMID: 28391880

Abstract

BACKGROUND:

Controversy exists as to whether the lipid-lowering properties of kefir drink (a fermented probiotic dairy product) in animal models could be replicated in humans.

OBJECTIVE:

To assess and compare the potential lipid-lowering effects of kefir drink with low-fat milk in a dairy-rich diet in overweight or obese premenopausal women.

METHODS:

In this 8-week, single-center, multiarm, parallel-group, outpatient, randomized controlled trial, 75 eligible Iranian women aged 25 to 45 years were randomly allocated to kefir, milk, or control groups. Women in the control group received a weight-maintenance diet containing 2 servings/d of low-fat dairy products, whereas subjects in the milk and kefir groups received a similar diet containing 2 additional servings/d (a total of 4 servings/d) of dairy products from low-fat milk or kefir drink, respectively. At baseline and study end point, serum levels/ratios of total cholesterol (TC), low- and high-density lipoprotein cholesterol (LDLC and HDLC), triglyceride, Non-HDLC, TC/HDLC, LDLC/HDLC, and triglyceride/LDLC were measured as outcome measures.

RESULTS:

After 8 weeks, subjects in the kefir group had significantly lower serum levels/ratios of lipoproteins than those in the control group (mean between-group differences were -10.4 mg/dL, -9.7 mg/dL, -11.5 mg/dL, -0.4, and -0.3 for TC, LDLC, non-HDLC, TC/HDLC, and LDLC/HDLC, respectively; all P < .05). Similar results were observed in the milk group. However, no such significant differences were found between the kefir and milk groups.

CONCLUSION:

Kefir drink causes a significant yet similar improvement in serum lipid profile, compared with low-fat milk, in a dairy-rich diet in overweight or obese premenopausal women.

KEYWORDS:

Dairy products; Kefir; Lipoproteins; Milk; Obesity; Overweight; Premenopause; Randomized controlled trial

 

The effect of dietary protein source on serum lipids: Secondary data analysis from a randomized clinical trial.

Gonciulea AR, Sellmeyer DE.

J Clin Lipidol. 2017 Jan - Feb;11(1):46-54. doi: 10.1016/j.jacl.2016.09.014. Epub 2016 Oct 3.

PMID: 28391910

Abstract

BACKGROUND:

Plant-based diets can lower serum lipids. Whether soy foods offer additional benefits remains controversial.

OBJECTIVE:

To determine the effect of different protein sources on serum lipids and glucose metabolism, emphasizing comparisons between soy and nonsoy plant-based diets.

METHODS:

Secondary data analysis. A total of 173 postmenopausal women were randomized to 1 of 4 weighed metabolic diets for 6 weeks. Diets were equivalent in energy, protein, and fat with at least 80% of protein from either nondairy animal, dairy, nonsoy plant, or soy foods. At baseline and week 6, total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, glucose, and insulin were measured. Changes in variables during the diet period were compared within and among groups using t tests and analysis of variance.

RESULTS:

TC decreased 38.8 mg/dL in soy group (P < .001 vs dairy and animal) and 30.5 mg/dL in nonsoy plant group (P = .003 vs dairy, .03 vs animal). LDL decreased 28.3 mg/dL in soy group (P < .001 vs dairy and animal) and 20.6 mg/dL in nonsoy plant group (P = .005 vs dairy, .06 vs animal). HDL decreased 12 mg/dL in soy group (P = .003 vs dairy, .0008 vs animal) and 10 mg/dL in nonsoy plant group (P = .05 vs dairy, .04 vs animal). There were no significant differences in lipid changes between soy and nonsoy plant-based diets. No differences among groups in changes in triglycerides, glucose, or insulin were seen.

CONCLUSIONS:

Soy and nonsoy plant-based diets reduced TC and LDL with no significant difference between them. Further studies are needed to determine the specific lipid-lowering components of both soy and nonsoy plant foods.

KEYWORDS:

Cholesterol; Glucose; HDL; HOMA-IR; Insulin; Isoflavone; LDL; Lipoproteins; Soy

 

Legume consumption is inversely associated with type 2 diabetes incidence in adults: A prospective assessment from the PREDIMED study.

Becerra-Tomás N, Díaz-López A, Rosique-Esteban N, Ros E, Buil-Cosiales P, Corella D, Estruch R, Fitó M, Serra-Majem L, Arós F, Lamuela-Raventós RM, Fiol M, Santos-Lozano JM, Díez-Espino J, Portoles O, Salas-Salvadó J; PREDIMED Study Investigators..

Clin Nutr. 2017 Mar 24. pii: S0261-5614(17)30106-1. doi: 10.1016/j.clnu.2017.03.015. [Epub ahead of print]

PMID: 28392166

Abstract

BACKGROUND & AIMS:

Legumes, a low-energy, nutrient-dense and low glycemic index food, have shown beneficial effects on glycemic control and adiposity. As such, legumes are widely recommended in diabetic diets, even though there is little evidence that their consumption protects against type 2 diabetes. Therefore the aim of the present study was to examine the associations between consumption of total legumes and specific subtypes, and type 2 diabetes risk. We also investigated the effect of theoretically substituting legumes for other protein- or carbohydrate-rich foods.

METHODS:

Prospective assessment of 3349 participants in the PREvención con DIeta MEDiterránea (PREDIMED) study without type 2 diabetes at baseline. Dietary information was assessed at baseline and yearly during follow-up. We used Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for type-2 diabetes incidence according to quartiles of cumulative average consumption of total legumes, lentils, chickpeas, dry beans and fresh peas.

RESULTS:

During a median follow-up of 4.3 years, 266 new cases of type 2 diabetes occurred. Individuals in the highest quartile of total legume and lentil consumption had a lower risk of diabetes than those in the lowest quartile (HR: 0.65; 95% CI: 0.43, 0.96; P-trend = 0.04; and HR: 0.67; 95% CI: 0.46-0.98; P-trend = 0.05, respectively). A borderline significant association was also observed for chickpeas consumption (HR 0.68; 95% CI: 0.46, 1.00; P-trend = 0.06). Substitutions of half a serving/day of legumes for similar servings of eggs, bread, rice or baked potato was associated with lower risk of diabetes incidence.

CONCLUSIONS:

A frequent consumption of legumes, particularly lentils, in the context of a Mediterranean diet, may provide benefits on type 2 diabetes prevention in older adults at high cardiovascular risk.

KEYWORDS:

Legumes; Lentils; PREDIMED-study; Type 2 diabetes

 

Chromium Exposure and Risk of Cardiovascular Disease in High Cardiovascular Risk Subjects - Nested Case-Control Study in the Prevention With Mediterranean Diet (PREDIMED) Study.

Gutiérrez-Bedmar M, Martínez-González MÁ, Muñoz-Bravo C, Ruiz-Canela M, Mariscal A, Salas-Salvadó J, Estruch R, Corella D, Arós F, Fito M, Lapetra J, Serra-Majem L, Pintó X, Alonso-Gómez Á, Portoles O, Fiol M, Bulló M, Castañer O, Ros E, Gómez-Gracia E.

Circ J. 2017 Apr 8. doi: 10.1253/circj.CJ-17-0032. [Epub ahead of print]

PMID: 28392547

Abstract

BACKGROUND:

Epidemiological data on chromium (Cr) exposure and the risk of cardiovascular disease (CVD) are still limited. Toenail Cr level (TCL) provides a time-integrated measure reflecting long-term Cr exposure. We measured TCL to assess the hypothesis that long-term Cr exposure was inversely associated with incident CVD in a population at high risk for CVD.

Methods and Results:The associations between TCL and CVD were evaluated in a case-control study nested within the "PREvención con DIeta MEDiterránea" (PREDIMED) trial. We randomly selected 147 of the 288 patients diagnosed with CVD during follow-up and matched them on age and sex to 271 controls. Instrumental neutron activation analysis was used to assess TCL. In-person interviews, medical record reviews, and validated questionnaires were used to assess covariates. The fully adjusted OR for the highest vs. lowest quartile of toenail Cr was 0.54 (95% CI: 0.26-1.14; Ptrend=0.189) for the nested case-control study. On stratification for diabetes mellitus (DM), OR was 1.37 (95% CI: 0.54-3.46; Ptrend=0.364) for the DM group, and 0.25 (95% CI: 0.08-0.80; Ptrend=0.030) for the non-DM group (P for interaction=0.078).

CONCLUSIONS:

The present findings, although not statistically significant, are consistent with previously reported inverse associations between TCL and CVD. These results, especially for non-DM patients, increase the limited epidemiological knowledge about the possible protective role of Cr against CVD.

 

Short and sweet: Associations between self-reported sleep duration and sugar-sweetened beverage consumption among adults in the United States.

Prather AA, Leung C, Adler NE, Ritchie L, Laraia B, Epel ES.

Sleep Health. 2016 Dec;2(4):272-276. doi: 10.1016/j.sleh.2016.09.007.

PMID: 28393097

Abstract

OBJECTIVES:

Sugar sweetened beverages (SSBs) are a major factor in the development of obesity and cardiometabolic disease. Shortened sleep duration has also been linked to increased appetite and obesity. Here, we examined whether there was an association between self-reported sleep duration and SSB consumption among adults aged 18 years and older.

METHODS:

Using data from 2005-12 NHANES we examined self- reported sleep duration and beverage intake (types of SSBs, juice, water, coffee, tea) from two 24-hour dietary recalls among 18,779 adults. Adults who slept 7-8 hours/night were considered the reference group. Generalized linear models were computed adjusting for sociodemographics and health characteristics as well as total energy intake.

RESULTS:

Thirteen percent slept 5 or fewer hours per night. In fully adjusted models, those who slept 5 hours or less had 21% higher SSB consumption, (RD = 1.21, 95% CI 1.11-1.32). When broken down by beverage type this was due to caffeinated sugary beverages. Longer sleepers (≥9 hour sleepers) consumed fewer servings of coffee and water. There were no associations between self-reported sleep duration and consumption of 100% juice, tea, or diet drinks.

CONCLUSIONS:

Short sleep is associated with greater intake of sugared caffeinated sodas, a relationship which may have important, though unrecognized, implications for physical health. Directionality of this relationship cannot be determined from this study. While caffeinated drinks could account for impaired sleep, it is possible that short sleep could influence one's appetitive drive for sugared caffeine drinks. Further examination of this relationship using prospective designs is warranted.

KEYWORDS:

NHANES; diet; sleep; sugar-sweetened beverage

 

Olive oil in the prevention and management of type 2 diabetes mellitus: a systematic review and meta-analysis of cohort studies and intervention trials.

Schwingshackl L, Lampousi AM, Portillo MP, Romaguera D, Hoffmann G, Boeing H.

Nutr Diabetes. 2017 Apr 10;7(4):e262. doi: 10.1038/nutd.2017.12.

PMID: 28394365

http://sci-hub.cc/10.1038/nutd.2017.12

Abstract

BACKGROUND/OBJECTIVES:

Olive oil (OO) as food is composed mainly of fatty acids and bioactive compounds depending from the extraction method. Both had been discussed as health promoting with still open questions. Thus, we conducted a meta-analysis to illustrate the impact of this food on type 2 diabetes (T2D) by investigating the association between OO intake and risk of T2D, and the effect of OO intake in the management of T2D.

SUBJECTS/METHODS:

Searches were performed in PubMed, Cochrane Library and google scholar. First, we conducted a random effect meta-analysis of prospective cohort studies and trials investigating the association between OO and risk of T2D. Second, a meta-analysis was performed to detect the effects of olive oil on glycemic control in patients with T2D.

RESULTS:

Four cohort studies including 15 784 T2D cases and 29 trials were included in the meta-analysis. The highest OO intake category showed a 16% reduced risk of T2D (RR: 0.84; 95% CI: 0.77, 0.92) compared with the lowest. However, we observed evidence for a nonlinear relationship. In T2D patients OO supplementation resulted in a significantly more pronounced reduction in HbA1c (MD: -0.27%; 95% CI: -0.37, -0.17) and fasting plasma glucose (MD: -0.44 mmol l-1; 95% CI -0.66, -0.22) as compared with the control groups.

CONCLUSIONS:

This meta-analysis provides evidence that the intake of OO could be beneficial for the prevention and management of T2D. This conclusion regards OO as food, and might not been valid for single components comprising this food.

 

Is salt a culprit or an innocent bystander in hypertension? A hypothesis challenging the ancient paradigm.

DiNicolantonio JJ, Mehta V, O'Keefe JH.

Am J Med. 2017 Mar 31. pii: S0002-9343(17)30326-1. doi: 10.1016/j.amjmed.2017.03.011. [Epub ahead of print] Review.

PMID: 28373112

http://sci-hub.cc/10.1016/j.amjmed.2017.03.011

Abstract

For decades the notion that an excessive consumption of salt (NaCl) leads to hypertension has persisted. However, this idea is based on opinion not scientific proof. Despite this, every health organisation, agency and clinicians around the world have been advising salt restriction especially to hypertensive patients. The present review article suggests that the consumption of a high salt diet is not the cause of hypertension and that there are other factors, such as added sugars, which are causative for inducing hypertension and cardiovascular disease.

KEYWORDS:

Diet; Hypertension; Salt; Sugar

 

History of Periodontitis Diagnosis and Edentulism as Predictors of Cardiovascular Disease, Stroke, and Mortality in Postmenopausal Women.

LaMonte MJ, Genco RJ, Hovey KM, Wallace RB, Freudenheim JL, Michaud DS, Mai X, Tinker LF, Salazar CR, Andrews CA, Li W, Eaton CB, Martin LW, Wactawski-Wende J.

J Am Heart Assoc. 2017 Mar 29;6(4). pii: e004518. doi: 10.1161/JAHA.116.004518.

PMID: 28356279

http://jaha.ahajournals.org/content/6/4/e004518.long

Abstract

BACKGROUND:

Few studies have reported associations between periodontitis and cardiovascular disease (CVD) risk in older women, which is the objective of the present investigation.

METHODS AND RESULTS:

Participants were 57 001 postmenopausal women ages 55 to 89 years (mean 68 years; >85% 60 and older) who were enrolled (1993-1998) in the Women's Health Initiative Observational Study, and were without known CVD when history of periodontitis and edentulism was assessed by questionnaire at study Year-5 (1998-2003). There were 3589 incident CVD events and 3816 total deaths during a mean follow-up of 6.7 years. In multivariable analysis, periodontitis was not associated with CVD events, but was associated with higher total mortality (hazard ratio (HR)=1.12, 95% CI: 1.05-1.21). Edentulism was associated with higher age- and smoking-adjusted risks of CVD (HR=1.42, 95% CI: 1.27-1.59) and mortality (HR=1.47, 95% CI: 1.32-1.63). Further adjustment eliminated the association with CVD, but mortality remained significantly increased (HR=1.17, 95% CI: 1.02-1.33). Stratification on age, race-ethnicity, smoking, and diabetes mellitus yielded comparable results; however, edentulism was more strongly associated with CVD in women reporting ≥1 dental visit (HR=1.57) compared with <1 visit (HR 1.03, interaction P=0.004) annually.

CONCLUSIONS:

In community-dwelling older women, edentulism was associated with increased risks of CVD and total mortality, and presence of periodontitis, which is more prevalent than edentulism, was associated with 17% higher mortality rate. These findings suggest that improving periodontal condition of the general population could reduce overall mortality.

KEYWORDS:

cardiovascular disease; epidemiology; mortality; periodontal disease; women's health Free Article

 

An Appraisal of Methods Recently Recommended for Testing Salt Sensitivity of Blood Pressure.

Kurtz TW, DiCarlo SE, Pravenec M, Morris RC Jr.

J Am Heart Assoc. 2017 Apr 1;6(4). pii: e005653. doi: 10.1161/JAHA.117.005653. Review. No abstract available.

PMID: 28365569

http://jaha.ahajournals.org/content/6/4/e005653

"Introduction

According to a recent Scientific Statement of the American Heart Association (AHA), salt sensitivity of blood pressure (BP) is a trait in which BP “changes parallel to changes in salt intake.”1 It is said that salt sensitivity is “a risk factor for cardiovascular mortality and morbidity, independent of and as powerful as BP.”1 Although the criteria for identifying salt sensitivity are not standardized, it has been estimated that 30% to 50% of hypertensive humans are salt sensitive and ≈25% of normotensive humans are salt sensitive.2, 3 According to the AHA Scientific Statement, salt sensitivity of BP has become “an issue of clinical importance because the phenotype carries prognostic implications potentially as strong as those of traditional cardiovascular risk factors.”1 Various methods of testing for salt sensitivity have been applied in research settings; however, tests for salt sensitivity that are useful in routine clinical practice have yet to be identified.

Advances in understanding of the mechanisms and clinical significance of salt sensitivity have long been hampered by the lack of standardization in the methods used for assessing salt sensitivity.4 In this analysis, we discuss the main research methods of testing for salt sensitivity and present current views on how best to assess this complex phenotype, including many views that were not addressed by the recent AHA Scientific Statement. To broaden the scientific consideration, we also present alternative perspectives on the contention that salt sensitivity is a risk factor for cardiovascular mortality “independent of and as powerful as BP.”1

Is There a Scientifically Superior Method of Testing for Salt Sensitivity? Consideration of the AHA View

The AHA provides some brief recommendations1 on how to assess salt sensitivity with 2 different types of short‐term protocols: (1) “outpatient dietary protocols” requiring a total time of ≈2 weeks to directly measure BP responses to changes in dietary intake of salt and (2) an “inpatient acute protocol,” which might be viewed as an indirect test of salt sensitivity, requiring a total time of only ≈3 days to measure BP responses to furosemide and simultaneous dietary salt restriction in subjects who have been intravenously and orally administered salt beforehand.5, 6"

...

 

Sex-Specific Relationship Between Serum Uric Acid and Risk of Stroke: A Dose-Response Meta-Analysis of Prospective Studies.

Zhong C, Zhong X, Xu T, Xu T, Zhang Y.

J Am Heart Assoc. 2017 Mar 29;6(4). pii: e005042. doi: 10.1161/JAHA.116.005042. Review.

PMID: 28356280 Free Article

http://jaha.ahajournals.org/content/6/4/e005042.long

Abstract

BACKGROUND:

Conflicting findings of the association between serum uric acid (UA) and stroke have been reported in both men and women, and it is unclear whether this association was different between men and women. We preformed this meta-analysis to assess the sex-specific effect of serum UA on the risk of stroke and its subtypes.

METHODS AND RESULTS:

Prospective studies that reported sex-specific association of UA levels with stroke or reported in a certain sex were included. Dose-response relationships were assessed by the generalized least squares trend estimation, and summary effect estimates were evaluated with random-effect models. Subgroup and sensitivity analyses were performed to assess the potential sources of heterogeneity and the robustness of the pooled estimation. Altogether, 13 prospective studies were identified in this study. The summary of relative risks (95% CIs) of stroke for a 1-mg/dL increase in serum UA levels were 1.10 (1.05-1.14) for men and 1.11 (1.09-1.13) for women. There is no significant difference in the effect of UA on future stroke risk between men and women (Pinteraction=0.736). Subgroup analyses showed that the significant associations persisted in most stratifications, and sensitivity analyses according to various inclusion criteria yielded similar results. A nonlinear relationship was observed in men (Pnon-linearity<0.001), with risk increasing significantly from a UA of 6 mg/dL and more steeply at higher UA levels.

CONCLUSIONS:

Elevated serum UA levels were significantly associated with modestly increased risk of stroke in both men and women and have similar adverse effects on development of stroke in both sexes.

KEYWORDS:

meta‐analysis; prospective studies; sex difference; stroke; uric acid

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Deep Biomarkers Of Human Aging

How old by basic blood test

My physiological age estimate @ http://aging.ai/= 59 years, 2016

 

Prognostic impact of physical activity prior to myocardial infarction: Case fatality and subsequent risk of heart failure and death.

Ejlersen H, Andersen ZJ, von Euler-Chelpin MC, Johansen PP, Schnohr P, Prescott E.

Eur J Prev Cardiol. 2017 Jan 1:2047487317702046. doi: 10.1177/2047487317702046. [Epub ahead of print]

PMID: 28399634

Abstract

Background Animal studies indicate that exercise reduces myocardial damage during myocardial infarction by ischaemic preconditioning. Aim To determine from a prospective cohort study whether the level of leisure time physical activity (LTPA) in humans prior to myocardial infarction could modify the course of myocardial infarction by reducing case fatality and the subsequent risk of heart failure and mortality. Methods A total of 14,223 participants in the Copenhagen City Heart Study were assessed at baseline in 1976-1978; 1,664 later developed myocardial infarction (mean age at myocardial infarction 70.9 years) and were followed through registries until 2013. We explored the association of LTPA assessed before myocardial infarction with the risk of fatal myocardial infarction, heart failure and all-cause mortality after myocardial infarction. Odds ratios (ORs) and hazard ratios (HRs) were estimated by logistic and Cox proportional hazards regression models, adjusted for age at myocardial infarction and other potential confounders. Results A total of 425 (25.5%) myocardial infarctions were fatal. Higher levels of LTPA prior to myocardial infarction were associated with lower case fatality: adjusted ORs (95% confidence interval), with reference to sedentary LTPA were 0.68 (0.51-0.89) for light LTPA and 0.53 (0.38-0.74) for moderate/high LTPA. A total of 360 (29.1%) of the 1,239 myocardial infarction survivors developed heart failure and 1,033 (83.4%) died during follow-up. There was no association between LTPA levels prior to myocardial infarction and the risk of heart failure or all-cause mortality after non-fatal myocardial infarction: adjusted HRs for moderate/high versus sedentary LTPA were 1.06 (0.78-1.45) and 0.90 (0.74-1.08), respectively. Conclusion Individuals who were physically active had lower case fatality of myocardial infarction, but survivors were not protected against subsequent heart failure or mortality.

KEYWORDS:

Physical activity; exercise training; heart failure; ischaemic preconditioning; myocardial infarction; prospective study

 

Food groups and risk of type 2 diabetes mellitus: a systematic review and meta-analysis of prospective studies.

Schwingshackl L, Hoffmann G, Lampousi AM, Knüppel S, Iqbal K, Schwedhelm C, Bechthold A, Schlesinger S, Boeing H.

Eur J Epidemiol. 2017 Apr 10. doi: 10.1007/s10654-017-0246-y. [Epub ahead of print]

PMID: 28397016

http://sci-hub.cc/10.1007/s10654-017-0246-y

Abstract

The aim of this systematic review and meta-analysis was to synthesize the knowledge about the relation between intake of 12 major food groups and risk of type 2 diabetes (T2D). We conducted a systematic search in PubMed, Embase, Medline (Ovid), Cochrane Central, and Google Scholar for prospective studies investigating the association between whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages (SSB) on risk of T2D. Summary relative risks were estimated using a random effects model by contrasting categories, and for linear and non-linear dose-response relationships. Six out of the 12 food-groups showed a significant relation with risk of T2D, three of them a decrease of risk with increasing consumption (whole grains, fruits, and dairy), and three an increase of risk with increasing consumption (red meat, processed meat, and SSB) in the linear dose-response meta-analysis. There was evidence of a non-linear relationship between fruits, vegetables, processed meat, whole grains, and SSB and T2D risk. Optimal consumption of risk-decreasing foods resulted in a 42% reduction, and consumption of risk-increasing foods was associated with a threefold T2D risk, compared to non-consumption. The meta-evidence was graded "low" for legumes and nuts; "moderate" for refined grains, vegetables, fruit, eggs, dairy, and fish; and "high" for processed meat, red meat, whole grains, and SSB. Among the investigated food groups, selecting specific optimal intakes can lead to a considerable change in risk of T2D.

KEYWORDS:

Diet; Dose–response; Food; Meta-analysis; Type 2 diabetes

 

Modifiable Environmental Factors in Inflammatory Bowel Disease.

Burke KE, Boumitri C, Ananthakrishnan AN.

Curr Gastroenterol Rep. 2017 May;19(5):21. doi: 10.1007/s11894-017-0562-0. Review.

PMID: 28397132

10.1007/s11894-017-0562-0

Abstract

PURPOSE OF REVIEW:

Environmental factors may influence predisposition to develop inflammatory bowel diseases (Crohn's disease, ulcerative colitis) or alter its natural history by modification of both the host immune response and intestinal microbial composition. The purpose of this review is to translate such evidence into clinical practice by a focus on interventional studies that have modified such environmental influences to improve disease outcomes.

RECENT FINDINGS:

Several environmental influences have been identified in the recent literature including tobacco use, diet, antibiotics, vitamin D deficiency, stress, appendectomy, and oral contraceptive use. Some risk factors have similar influences on both Crohn's disease and ulcerative colitis while others are disease-specific or have divergent effects. Emerging epidemiologic evidence has confirmed the association of many of these factors with incident disease using prospective data. In addition, laboratory data has supported their mechanistic plausibility and relevance to intestinal inflammation.

KEYWORDS:

Crohn’s disease; Diet; Environment; Smoking; Ulcerative colitis

 

https://en.wikipedia.org/wiki/3-Indolepropionic_acid

Indolepropionic acid and novel lipid metabolites are associated with a lower risk of type 2 diabetes in the Finnish Diabetes Prevention Study.

de Mello VD, Paananen J, Lindström J, Lankinen MA, Shi L, Kuusisto J, Pihlajamäki J, Auriola S, Lehtonen M, Rolandsson O, Bergdahl IA, Nordin E, Ilanne-Parikka P, Keinänen-Kiukaanniemi S, Landberg R, Eriksson JG, Tuomilehto J, Hanhineva K, Uusitupa M.

Sci Rep. 2017 Apr 11;7:46337. doi: 10.1038/srep46337.

PMID: 28397877

https://www.nature.com/articles/srep46337

Abstract

Wide-scale profiling technologies including metabolomics broaden the possibility of novel discoveries related to the pathogenesis of type 2 diabetes (T2D). By applying non-targeted metabolomics approach, we investigated here whether serum metabolite profile predicts T2D in a well-characterized study population with impaired glucose tolerance by examining two groups of individuals who took part in the Finnish Diabetes Prevention Study (DPS); those who either early developed T2D (n = 96) or did not convert to T2D within the 15-year follow-up (n = 104). Several novel metabolites were associated with lower likelihood of developing T2D, including indole and lipid related metabolites. Higher indolepropionic acid was associated with reduced likelihood of T2D in the DPS. Interestingly, in those who remained free of T2D, indolepropionic acid and various lipid species were associated with better insulin secretion and sensitivity, respectively. Furthermore, these metabolites were negatively correlated with low-grade inflammation. We replicated the association between indolepropionic acid and T2D risk in one Finnish and one Swedish population. We suggest that indolepropionic acid, a gut microbiota-produced metabolite, is a potential biomarker for the development of T2D that may mediate its protective effect by preservation of β-cell function. Novel lipid metabolites associated with T2D may exert their effects partly through enhancing insulin sensitivity.

 

Fresh fruit consumption in relation to incident diabetes and diabetic vascular complications: A 7-y prospective study of 0.5 million Chinese adults.

Du H, Li L, Bennett D, Guo Y, Turnbull I, Yang L, Bragg F, Bian Z, Chen Y, Chen J, Millwood IY, Sansome S, Ma L, Huang Y, Zhang N, Zheng X, Sun Q, Key TJ, Collins R, Peto R, Chen Z; China Kadoorie Biobank study..

PLoS Med. 2017 Apr 11;14(4):e1002279. doi: 10.1371/journal.pmed.1002279. eCollection 2017 Apr.

PMID: 28399126

Abstract

BACKGROUND:

Despite the well-recognised health benefits of fresh fruit consumption, substantial uncertainties remain about its potential effects on incident diabetes and, among those with diabetes, on risks of death and major vascular complications.

METHODS AND FINDINGS:

Between June 2004 and July 2008, the nationwide China Kadoorie Biobank study recruited 0.5 million adults aged 30-79 (mean 51) y from ten diverse localities across China. During ~7 y of follow-up, 9,504 new diabetes cases were recorded among 482,591 participants without prevalent (previously diagnosed or screen-detected) diabetes at baseline, with an overall incidence rate of 2.8 per 1,000 person-years. Among 30,300 (5.9%) participants who had diabetes at baseline, 3,389 deaths occurred (overall mortality rate 16.5 per 1,000), along with 9,746 cases of macrovascular disease and 1,345 cases of microvascular disease. Cox regression yielded adjusted hazard ratios (HRs) associating each disease outcome with self-reported fresh fruit consumption, adjusting for potential confounders such as age, sex, region, socio-economic status, other lifestyle factors, body mass index, and family history of diabetes. Overall, 18.8% of participants reported consuming fresh fruit daily, and 6.4% never/rarely (non-consumers), with the proportion of non-consumers about three times higher in individuals with previously diagnosed diabetes (18.9%) than in those with screen-detected diabetes (6.7%) or no diabetes (6.0%). Among those without diabetes at baseline, higher fruit consumption was associated with significantly lower risk of developing diabetes (adjusted HR = 0.88 [95% CI 0.83-0.93] for daily versus non-consumers, p < 0.001, corresponding to a 0.2% difference in 5-y absolute risk), with a clear dose-response relationship. Among those with baseline diabetes, higher fruit consumption was associated with lower risks of all-cause mortality (adjusted HR = 0.83 [95% CI 0.74-0.93] per 100 g/d) and microvascular (0.72 [0.61-0.87]) and macrovascular (0.87 [0.82-0.93]) complications (p < 0.001), with similar HRs in individuals with previously diagnosed and screen-detected diabetes; estimated differences in 5-y absolute risk between daily and non-consumers were 1.9%, 1.1%, and 5.4%, respectively. The main limitation of this study was that, owing to its observational nature, we could not fully exclude the effects of residual confounding.

CONCLUSION:

In this large epidemiological study in Chinese adults, higher fresh fruit consumption was associated with significantly lower risk of diabetes and, among diabetic individuals, lower risks of death and development of major vascular complications.

 

Dietary Patterns and 10-year (2002-2012) Incidence of Type 2 Diabetes: Results from the ATTICA Cohort Study.

Koloverou E, Panagiotakos DB, Georgousopoulou EN, Grekas A, Christou A, Chatzigeorgiou M, Chrysohoou C, Tousoulis D, Stefanadis C, Pitsavos C; ATTICA Study Group..

Rev Diabet Stud. 2016 Winter;13(4):246-256. doi: 10.1900/RDS.2016.13.246. Epub 2017 Feb 10.

PMID: 28394951

Abstract

AIM:

To identify dietary patterns among apparently healthy individuals and to determine their long-term effect on diabetes incidence.

METHODS:

During 2001-2002, a random sample of 3,042 men and women (18-89 years old), living in greater Athens, was randomly selected to participate in the study. During 2011-2012, the 10-year follow-up was performed in 2,583 participants (15% drop-out rate). After excluding participants with diabetes at baseline and those for whom no information on diabetes status was available at follow-up, the working sample consisted of 1,485 participants. Dietary habits were assessed by means of a validated semi-quantitative, food frequency questionnaire. Factor analysis was performed to extract dietary patterns from 18 food groups.

RESULTS:

Diabetes diagnosis at follow-up was made in 191 participants, yielding an incidence rate of 12.9%. Six factors (i.e. dietary patterns) were identified that explained 54% of the variation in consumption. After adjusting for major confounders, and stratification by age-group, logistic regression revealed that the most healthful pattern consisted of the consumption of fruits, vegetables, legumes, bread, rusk, and pasta which reduced the 10-year diabetes risk by 40%, among participants aged 45-55 years. The association reached marginal statistical significance (95% CI: 0.34, 1.07), while no significant association was observed for the other age-groups. When the analysis was additionally adjusted for carbohydrate percentage, statistical significance was lost completely, suggesting a possibly mediating effect of this macronutrient.

CONCLUSIONS:

The results confirm the potentially protective effect of a plant-based dietary pattern in the primary prevention of diabetes, in particular among middle-aged people. Carbohydrate content may be a specific factor in this relationship; other micronutrients found in plant-based food groups may also play a role.

 

Joint Association of Low Vitamin D and Vitamin K Status With Blood Pressure and Hypertension.

van Ballegooijen AJ, Cepelis A, Visser M, Brouwer IA, van Schoor NM, Beulens JW.

Hypertension. 2017 Apr 10. pii: HYPERTENSIONAHA.116.08869. doi: 10.1161/HYPERTENSIONAHA.116.08869. [Epub ahead of print]

PMID: 28396533

Abstract

Low vitamin D and K status are both associated with an increased cardiovascular risk. New evidence from experimental studies on bone health suggest an interaction between vitamin D and K; however, a joint association with vascular health outcomes is largely unknown. To prospectively investigate whether the combination of low vitamin D and K status is associated with higher systolic and diastolic blood pressure in 402 participants and with incident hypertension in 231 participants free of hypertension at baseline. We used data from a subsample of the Longitudinal Aging Study Amsterdam, a population-based cohort of Dutch participants aged 55 to 65 years. Vitamin D and K status were assessed by 25-hydroxyvitamin D and dp-ucMGP (dephosphorylated uncarboxylated matrix gla protein) concentrations (high dp-ucMGP is indicative for low vitamin K status) in stored samples from 2002 to 2003. Vitamin D and K status were categorized into 25-hydroxyvitamin D <50/≥50 mmol/L and median dp-ucMGP <323/≥323 pmol/L. During a median follow-up of 6.4 years, 62% of the participants (n=143) developed hypertension. The combination of low vitamin D and K status was associated with increased systolic 4.8 mm Hg (95% confidence interval, 0.1-9.5) and diastolic 3.1 mm Hg (95% confidence interval, 0.5-5.7) blood pressure compared with high vitamin D and K status (P for interaction =0.013 for systolic blood pressure and 0.068 for diastolic blood pressure). A similar trend was seen for incident hypertension: hazard ratio=1.62 (95% confidence interval, 0.96-2.73) for the low vitamin D and K group. The combination of low vitamin D and K status was associated with increased blood pressure and a trend for greater hypertension risk.

KEYWORDS:

25-hydroxyvitamin D; blood pressure; epidemiology; incident hypertension; vitamin K status

 

Egg Consumption and Incidence of Heart Failure: A Meta-Analysis of Prospective Cohort Studies.

Khawaja O, Singh H, Luni F, Kabour A, Ali SS, Taleb M, Ahmed H, Gaziano JM, Djoussé L.

Front Nutr. 2017 Mar 27;4:10. doi: 10.3389/fnut.2017.00010. eCollection 2017.

PMID: 28396858

Abstract

INTRODUCTION:

Heart failure (HF) remains a major health problem affecting 5.7 million adults in USA. Data on the association of egg consumption with incident HF have been inconsistent. We, therefore, conducted this meta-analysis of prospective cohort studies to assess the relation of egg consumption with incident HF in the general population.

METHODS:

Using extensive online search, we conducted a meta-analysis of new onset HF following exposure to egg consumption. A random effects model was used and between studies heterogeneity was estimated with I2. Publication bias was assessed graphically using a funnel plot. All analyses were performed with Comprehensive Meta-Analysis (version 2.2.064).

RESULTS:

We identified four prospective cohorts for a total of 105,999 subjects and 5,059 cases of new onset HF. When comparing the highest (≥1/day) to the lowest category of egg consumption, pooled relative risk of HF was 1.25 (95% confidence interval = 1.12-1.39; p = 0.00). There was no evidence for heterogeneity (I2 = 0%) nor publication bias. On sensitivity analysis, stratification by gender differences, follow-up duration, and region where study was conducted did not alter the main conclusion.

CONCLUSION:

Our meta-analysis suggests an elevated risk of incident HF with frequent egg consumption.

KEYWORDS:

diet; eggs; epidemiology; heart failure; nutrition

 

A Ketone Ester Drink Increases Postexercise Muscle Glycogen Synthesis in Humans.

Holdsworth DA, Cox PJ, Kirk T, Stradling H, Impey SG, Clarke K.

Med Sci Sports Exerc. 2017 Apr 10. doi: 10.1249/MSS.0000000000001292. [Epub ahead of print]

PMID: 28398950

Abstract

INTRODUCTION:

Physical endurance can be limited by muscle glycogen stores, in that glycogen depletion markedly reduces external work. During carbohydrate restriction, the liver synthesises the ketone bodies, D-β-hydroxybutyrate and acetoacetate, from fatty acids. In animals and in the presence of glucose, D-β-hydroxybutyrate promotes insulin secretion and increases glycogen synthesis. Here we determined whether a dietary ketone ester, combined with plentiful glucose, can increase post-exercise glycogen synthesis in human skeletal muscle.

METHODS:

Following an interval-based glycogen-depletion exercise protocol, 12 well-trained male athletes completed a randomized, 3-arm, blinded crossover recovery study that consisted of consumption of either a taste-matched, zero-calorie control or a ketone monoester drink, followed by a 10 mM glucose clamp or saline infusion for two hours. The three post-exercise conditions were; control drink then saline infusion, control drink then hyperglycemic clamp or ketone ester drink then hyperglycemic clamp. Skeletal muscle glycogen content was determined in muscle biopsies of vastus lateralis taken before and after the two-hour clamps.

RESULTS:

The ketone ester drink increased blood D-β-hydroxybutyrate concentrations to a maximum of 5.3 vs. 0.7 mM for the control drink (p < 0.0001). During the two-hour glucose clamps, insulin levels were two-fold higher (31 vs. 16 mU/l, p < 0.01) and glucose uptake 32% faster (1.66 vs. 1.26 g/kg, p<0.001). The ketone drink increased by 61 g the total glucose infused over 2 h, from 197 g to 258 g, and muscle glycogen was 50% higher (246 vs.164 mmoles glycosyl units/kg dry weight, p < 0.05) than after the control drink.

CONCLUSION:

In the presence of constant high glucose concentrations, a ketone ester drink increased endogenous insulin levels, glucose uptake and muscle glycogen synthesis.

 

The Role of Diet in Inflammatory Bowel Disease.

Shivashankar R, Lewis JD.

Curr Gastroenterol Rep. 2017 May;19(5):22. doi: 10.1007/s11894-017-0563-z. Review.

PMID: 28397133

http://sci-hub.cc/10.1007/s11894-017-0563-z

Abstract

PURPOSE OF REVIEW:

Diet may play both a causal and therapeutic role for inflammatory bowel disease (IBD). Physicians caring for patients with IBD are often asked to make dietary recommendations. However, there are no well-established guidelines on the use of diet as a treatment of IBD. In this review, we describe the evidence supporting diet as a potential cause for IBD, patient-perceived symptoms based on diet, current research on various diets as a treatment for IBD, and areas of future research.

RECENT FINDINGS:

New studies in murine models suggest that dietary emulsifiers may trigger the gut inflammatory cascade. New studies of restriction diets in patients have shown a relationship between dietary intake, symptoms, and bowel inflammation. Until several ongoing clinical trials are completed, a reasonable approach to dietary recommendations for patients with IBD is to propose a well-balanced, healthy (low-fat, low-sugar) diet prepared from fresh ingredients, such as the Mediterranean diet, with exclusions of self-identified foods that worsen or trigger IBD-related symptoms.

KEYWORDS:

Diet; IBD pathogenesis; IBD therapy; Inflammatory bowel disease

 

Creatine supplementation reduces sleep need and homeostatic sleep pressure in rats.

Dworak M, Kim T, Mccarley RW, Basheer R.

J Sleep Res. 2017 Apr 11. doi: 10.1111/jsr.12523. [Epub ahead of print]

PMID: 28397310

Abstract

Sleep has been postulated to promote brain energy restoration. It is as yet unknown if increasing the energy availability within the brain reduces sleep need. The guanidine amino acid creatine (Cr) is a well-known energy booster in cellular energy homeostasis. Oral Cr-monohydrate supplementation (CS) increases exercise performance and has been shown to have substantial effects on cognitive performance, neuroprotection and circadian rhythms. The effect of CS on cellular high-energy molecules and sleep-wake behaviour is unclear. Here, we examined the sleep-wake behaviour and brain energy metabolism before and after 4-week-long oral administration of CS in the rat. CS decreased total sleep time and non-rapid eye movement (NREM) sleep significantly during the light (inactive) but not during the dark (active) period. NREM sleep and NREM delta activity were decreased significantly in CS rats after 6 h of sleep deprivation. Biochemical analysis of brain energy metabolites showed a tendency to increase in phosphocreatine after CS, while cellular adenosine triphosphate (ATP) level decreased. Microdialysis analysis showed that the sleep deprivation-induced increase in extracellular adenosine was attenuated after CS. These results suggest that CS reduces sleep need and homeostatic sleep pressure in rats, thereby indicating its potential in the treatment of sleep-related disorders.

KEYWORDS:

creatine; energy metabolism; sleep deprivation; sleep homeostasis

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The Scientist » Multimedia » Infographics

Infographic: Circadian Clock Affects Health and Disease

The body's rhythms could affect numerous ailments as well as how people respond to treatments.

By Jyoti Madhusoodanan | April 1, 2017

http://www.the-scientist.com/?articles.view/articleNo/49006/title/Infographic--Circadian-Clock-Affects-Health-and-Disease/&utm_campaign=NEWSLETTER_TS_The-Scientist-Daily_2016&utm_source=hs_email&utm_medium=email&utm_content=50495832&_hsenc=p2ANqtz-8FtIMrvNoj1PaLlr6EDDStWItPUe66iWiPojpyxLlE3Bm7rDEhk1WCnDFa_u2s046Mn5I6oRkO_KGoSeQp0_qtViHodA&_hsmi=50495832

>>>>>>>>>>>>>>>>>>>>>>>>>>>

The Scientist » April 2017 Issue » Features

Circadian Rhythms Influence Treatment Effects

Across many diseases, taking medication at specific times of day may make the therapy more effective.

By Jyoti Madhusoodanan | April 1, 2017

http://www.the-scientist.com/?articles.view/articleNo/49003/title/Circadian-Rhythms-Influence-Treatment-Effects/&utm_campaign=NEWSLETTER_TS_The-Scientist-Daily_2016&utm_source=hs_email&utm_medium=email&utm_content=50495832&_hsenc=p2ANqtz--riWB_3v1jC89UCyRhKPLJwb0jXmRHcgW8kHdnC3p7U5XU2OmNrImTg7cu6pGYOXr5peAWc0xz1YPBuDEWydJJYDft1Q&_hsmi=50495832

 

Vitamin D Status, Muscle Strength and Physical Performance Decline in Very Old Adults: A Prospective Study.

Granic A, Hill TR, Davies K, Jagger C, Adamson A, Siervo M, Kirkwood TB, Mathers JC, Sayer AA.

Nutrients. 2017 Apr 13;9(4). pii: E379. doi: 10.3390/nu9040379.

PMID: 28406464

Abstract

Mixed reports exist about the role of 25-hydroxyvitamin D (25(OH)D) in muscle ageing and there are few prospective studies involving the very old (aged ≥ 85) who are at highest risk of low 25(OH)D, loss of muscle mass and strength, and physical performance decline. In the Newcastle 85+ Study (n = 845), we aimed to determine the association between 25(OH)D season-specific quartiles (hereafter SQ1-SQ4), grip strength (GS) and physical performance decline (Timed Up-and-Go Test, TUG) over 5 years using mixed models. In the time-only models with linear and quadratic slopes, SQ1 and SQ4 of 25(OH)D were associated with weaker GS initially in men (SQ1: β (SE) = -2.56 (0.96); SQ4: -2.16 (1.06)) and women (SQ1: -1.10 (0.52); SQ4: -1.28 (0.50)) (all p ≤ 0.04). In the fully adjusted models, only men in SQ1 had a significant annual decline in GS of 1.41 kg which accelerated over time (-0.40 (0.1)), (both p ≤ 0.003) compared with those in combined middle quartiles. Only women in SQ1 and SQ4 of 25(OH)D had worse TUG times initially, but the rate of TUG decline was not affected. Low baseline 25(OH)D may contribute to muscle strength decline in the very old and particularly in men.

KEYWORDS:

25(OH)D; Timed Up-and-Go Test; grip strength; muscle strength; physical performance; very old adults

 

A prospective study of low fasting glucose with cardiovascular disease events and all-cause mortality: The Women's Health Initiative.

Mongraw-Chaffin M, LaCroix AZ, Sears DD, Garcia L, Phillips LS, Salmoirago-Blotcher E, Zaslavsky O, Anderson CA.

Metabolism. 2017 May;70:116-124. doi: 10.1016/j.metabol.2017.02.010. Epub 2017 Feb 16.

PMID: 28403935

Abstract

BACKGROUND:

While there is increasing recognition of the risks associated with hypoglycemia in patients with diabetes, few studies have investigated incident cause-specific cardiovascular outcomes with regard to low fasting glucose in the general population.

OBJECTIVE:

We hypothesized that low fasting glucose would be associated with cardiovascular disease risk and all-cause mortality in postmenopausal women.

METHODS:

To test our hypothesis, we used both continuous incidence rates and Cox proportional hazards models in 17,287 participants from the Women's Health Initiative with fasting glucose measured at baseline. Participants were separated into groups based on fasting glucose level: low (<80mg/dL), normal/reference (80-99mg/dL), impaired (100-125mg/dL), and diabetic (≥126mg/dL).

RESULTS:

Participants were free of cardiovascular disease at enrollment, had mean age of 62years, and were 52% Caucasian, 24% African American, 8% Asian, and 12% Hispanic. Median follow-up was 15years. Graphs of continuous incidence rates compared to fasting glucose distribution exhibited evidence of a weak J-shaped association with heart failure and mortality that was predominantly due to participants with treated diabetes. Impaired and diabetic fasting glucose were positively associated with all outcomes. Associations for low fasting glucose differed, with coronary heart disease (HR=0.64 (0.42, 0.98)) significantly inverse; stroke (0.73 (0.48, 1.13)), combined cardiovascular disease (0.91 (0.73, 1.14)), and all-cause mortality (0.97 (0.79, 1.20)) null or inverse and not significant; and heart failure (1.27 (0.80, 2.02)) positive and not significant.

CONCLUSIONS:

Fasting glucose at the upper range, but not the lower range, was significantly associated with incident cardiovascular disease and all-cause mortality.

KEYWORDS:

Cardiovascular disease; Epidemiology; Fasting glucose; Heart failure

 

Prevention of metabolic diseases: fruits (including fruit sugars) vs. vegetables.

Kuzma JN, Schmidt KA, Kratz M.

Curr Opin Clin Nutr Metab Care. 2017 Apr 11. doi: 10.1097/MCO.0000000000000378. [Epub ahead of print]

PMID: 28403010

Abstract

PURPOSE OF REVIEW:

To discuss recent evidence from observational and intervention studies on the relationship between fruit and vegetable (F&V) consumption and metabolic disease.

RECENT FINDINGS:

Observational studies have consistently demonstrated a modest inverse association between the intake of fruit and leafy green vegetables, but not total vegetables, and biomarkers of metabolic disease as well as incident type 2 diabetes mellitus. This is in contrast to limited evidence from recently published randomized controlled dietary intervention trials, which - in sum - suggests little to no impact of increased F&V consumption on biomarkers of metabolic disease.

SUMMARY:

Evidence from observational studies that fruit and leafy green vegetable intake is associated with lower type 2 diabetes risk and better metabolic health could not be confirmed by dietary intervention trials. It is unclear whether this discrepancy is because of limitations inherent in observational studies (e.g., subjective dietary assessment methods, residual confounding) or due to limitations in the few available intervention studies (e.g., short duration of follow-up, interventions combining whole fruit and fruit juice, or lack of compliance). Future studies that attempt to address these limitations are needed to provide more conclusive insight into the impact of F&V consumption on metabolic health.

 

Physical Activity on Prescription (PAP), in patients with metabolic risk factors. A 6-month follow-up study in primary health care.

Lundqvist S, Börjesson M, Larsson ME, Hagberg L, Cider Å.

PLoS One. 2017 Apr 12;12(4):e0175190. doi: 10.1371/journal.pone.0175190. eCollection 2017.

PMID: 28403151

Abstract

There is strong evidence that inadequate physical activity (PA) leads to an increased risk of lifestyle-related diseases and premature mortality. Physical activity on prescription (PAP) is a method to increase the level of PA of patients in primary care, but needs further evaluation. The aim of this observational study was to explore the association between PAP-treatment and the PA level of patients with metabolic risk factors and the relationship between changes in the PA level and health outcomes at the 6 month follow-up. This study included 444 patients in primary care, aged 27-85 years (56% females), who were physically inactive with at least one component of metabolic syndrome. The PAP-treatment model included: individualized dialogue concerning PA, prescribed PA, and a structured follow-up. A total of 368 patients (83%) completed the 6 months of follow-up. Of these patients, 73% increased their PA level and 42% moved from an inadequate PA level to sufficient, according to public health recommendations. There were significant improvements (p≤ 0.05) in the following metabolic risk factors: body mass index, waist circumference, systolic blood pressure, fasting plasma glucose, cholesterol, and low density lipoprotein. There were also significant improvements regarding health-related quality of life, assessed by the Short Form 36, in: general health, vitality, social function, mental health, role limitation-physical/emotional, mental component summary, and physical component summary. Regression analysis showed a significant association between changes in the PA level and health outcomes. During the first 6-month period, the caregiver provided PAP support 1-2 times. This study indicates that an individual-based model of PAP-treatment has the potential to change people's PA behavior with improved metabolic risk factors and self-reported quality of life at the 6 month follow-up. Thus, PAP seems to be feasible in a clinical primary care practice, with minimum effort from healthcare professionals.

 

Fruit consumption and physical activity in relation to all-cause and cardiovascular mortality among 70,000 Chinese adults with pre-existing vascular disease.

Tian X, Du H, Li L, Bennett D, Gao R, Li S, Wang S, Guo Y, Bian Z, Yang L, Chen Y, Chen J, Gao Y, Weng M, Pang Z, Jiang B, Chen Z; China Kadoorie Biobank study..

PLoS One. 2017 Apr 12;12(4):e0173054. doi: 10.1371/journal.pone.0173054. eCollection 2017.

PMID: 28403155

Abstract

OBJECTIVES:

To assess the associations of fresh fruit consumption and total physical activity with all-cause and cardiovascular mortality among Chinese adults who have been diagnosed with cardiovascular disease (CVD) or hypertension.

METHODS:

During 2004-08, the China Kadoorie Biobank study recruited 70,047 adults, aged 30-79 years, with physician-diagnosed stroke or transient ischaemic attack, ischemic heart disease, or hypertension. Information on diet and physical activity was collected using an interviewer-administered electronic questionnaire. Cox regression was used to yield hazard ratios (HRs) for the independent and joint associations of fresh fruit consumption and total physical activity with mortality.

RESULTS:

At baseline, 32.9% of participants consumed fresh fruit regularly (i.e. >3 days/week) and the mean total physical activity were 15.8 (SD = 11.8) MET-hr/day. During ~7-years follow-up, 6569 deaths occurred with 3563 from CVD. Compared to participants with <1 day/week fruit consumption, regular consumers had HR (95% CI) of 0.84 (0.79-0.89) for all-cause mortality and 0.79 (0.73-0.86) for CVD mortality. The HRs for the top vs bottom tertile of physical activity were 0.68 (0.64-0.72) and 0.65 (0.60-0.71), respectively, with no clear evidence of reverse causality. After correcting for regression dilution, each 100 g/day usual consumption of fresh fruit or 10 MET-hr/day usual levels of physical activity was associated with 23-29% lower mortality. The combination of regular fruit consumption with top 3rd of physical activity (>16.53 MET-hr/day) was associated with about 40% lower mortality.

CONCLUSION:

Among Chinese adults with pre-existing vascular disease, higher physical activity and fruit consumption were both independently and jointly associated with lower mortality.

 

Dietary acid load, trabecular bone integrity, and mineral density in an ageing population: the Rotterdam study.

de Jonge EA, Koromani F, Hofman A, Uitterlinden AG, Franco OH, Rivadeneira F, Kiefte-de Jong JC.

Osteoporos Int. 2017 Apr 12. doi: 10.1007/s00198-017-4037-9. [Epub ahead of print]

PMID: 28405729

Abstract

We studied the relation between a diet that is high in acid-forming nutrients (e.g. proteins) and low in base-forming nutrients (e.g. potassium) and bone structure. We showed a negative relation, which was more prominent if proteins were of animal rather than of vegetable origin and if intake of dietary fibre was high.

INTRODUCTION:

Studies on dietary acid load (DAL) and fractures have shown inconsistent results. Associations between DAL, bone mineral density (BMD) and trabecular bone integrity might play a role in these inconsistencies and might be influenced by renal function and dietary fibre intake. Therefore, our aim was to study (1) associations of DAL with BMD and with the trabecular bone score (TBS) and (2) the potential influence of renal function and dietary fibre in these associations.

METHODS:

Dutch individuals aged 45 years and over (n = 4672) participating in the prospective cohort of the Rotterdam study were included. Based on food frequency questionnaires, three indices of DAL were calculated: the net endogenous acid production (NEAP) and the ratios of vegetable or animal protein and potassium (VegPro/K and AnPro/K). Data on lumbar spinal TBS and BMD were derived from dual-energy X-ray absorptiometry measurements.

RESULTS:

Independent of confounders, NEAP and AnPro/K, but not VegPro/K, were associated with low TBS (standardized β (95%) = -0.04 (-0.07, -0.01) and -0.08 (-0.11, -0.04)) but not with BMD. Associations of AnPro/K and VegPro/K with TBS were non-linear and differently shaped. Unfavourable associations between NEAP, BMD and TBS were mainly present in subgroups with high fibre intake.

CONCLUSIONS:

High NEAP was associated with low TBS. Associations of AnPro/K and VegPro/K and TBS were non-linear and differently shaped. No significant associations of DAL with BMD were observed, nor was there any significant interaction between DAL and renal function. Mainly in participants with high intake of dietary fibre, DAL might be detrimental to bone.

KEYWORDS:

BMD; Dietary acid load; Dietary fibre; Renal function; Trabecular bone score

 

Low serum magnesium levels are associated with increased risk of fractures: a long-term prospective cohort study.

Kunutsor SK, Whitehouse MR, Blom AW, Laukkanen JA.

Eur J Epidemiol. 2017 Apr 12. doi: 10.1007/s10654-017-0242-2. [Epub ahead of print]

PMID: 28405867

Abstract

Magnesium, which is an essential trace element that plays a key role in several cellular processes, is a major component of bone; however, its relationship with risk of major bone fractures is uncertain. We aimed to investigate the association of baseline serum magnesium concentrations with risk of incident fractures. We analyzed data on 2245 men aged 42-61 years in the Kuopio Ischemic Heart Disease prospective cohort study, with the assessment of serum magnesium measurements and dietary intakes made at baseline. Hazard ratios [95% confidence intervals (CI)] for incident total (femoral, humeral, and forearm) and femoral fractures were assessed. During a median follow-up of 25.6 years, 123 total fractures were recorded. Serum magnesium was non-linearly associated with risk of total fractures. In age-adjusted Cox regression analysis, the hazard ratio (HR) (95% CIs) for total fractures in a comparison of the bottom quartile versus top quartile of magnesium concentrations was 2.10 (1.30-3.41), which persisted on adjustment for several established risk factors 1.99 (1.23-3.24). The association remained consistent on further adjustment for renal function, socioeconomic status, total energy intake, and several trace elements 1.80 (1.10-2.94). The corresponding adjusted HRs for femoral fractures were 2.56 (1.38-4.76), 2.43 (1.30-4.53) and 2.13 (1.13-3.99) respectively. There was no evidence of an association of dietary magnesium intake with risk of any fractures. In middle-aged Caucasian men, low serum magnesium is strongly and independently associated with an increased risk of fractures. Further research is needed to assess the potential relevance of serum magnesium in the prevention of fractures.

KEYWORDS:

Cohort study; Fracture; Magnesium; Risk factor

 

Interaction of iron status with single nucleotide polymorphisms on incidence of type 2 diabetes.

Kim J, Kim MK, Jung S, Lim JE, Shin MH, Kim YJ, Oh B.

PLoS One. 2017 Apr 13;12(4):e0175681. doi: 10.1371/journal.pone.0175681. eCollection 2017.

PMID: 28406950

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0175681

http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0175681&type=printable

Abstract

The objective of this study is to find single nucleotide polymorphisms (SNPs) associated with a risk of Type 2 diabetes (T2D) in Korean adults and to investigate the longitudinal association between these SNPs and T2D and the interaction effects of iron intake and average hemoglobin level. Data from the KoGES_Ansan and Ansung Study were used. Gene-iron interaction analysis was conducted using a two-step approach. To select candidate SNPs associated with T2D, a total of 7,935 adults at baseline were included in genome-wide association analysis (step one). After excluding T2D prevalent cases, prospective analyses were conducted with 7,024 adults aged 40-69 (step two). The association of selected SNPs and iron status with T2D and their interaction were determined using a Cox proportional hazard model. A total of 3 SNPs [rs9465871 (CDKAL1), rs10761745 (JMJD1C), and rs163177 (KCNQ1)] were selected as candidate SNPs related to T2D. Among them, rs10761745 (JMJD1C) and rs163177 (KCNQ1) were prospectively associated with T2D. High iron intake was also prospectively associated with the risk of T2D after adjusting for covariates. Average hemoglobin level was positively associated with T2D after adjusting for covariates in women. We also found significant interaction effects between rs10761745 (JMJD1C) and average hemoglobin levels on the risk of T2D among women with normal inflammation and without anemia at baseline. In conclusion, KCNQ1 and JMJD1C may prospectively contribute to the risk of T2D incidence among adults over the age of 40 and JMJD1C, but CDKAL1 may not, and iron status may interactively contribute to T2D incidence in women.

 

Foods and beverages and colorectal cancer risk: a systematic review and meta-analysis of cohort studies, an update of the evidence of the WCRF-AICR Continuous Update Project.

Vieira AR, Abar L, Chan D, Vingeliene S, Polemiti E, Stevens C, Greenwood D, Norat T.

Ann Oncol. 2017 Apr 12. doi: 10.1093/annonc/mdx171. [Epub ahead of print]

PMID: 28407090

Abstract

OBJECTIVE:

As part of the World Cancer Research Fund International Continuous Update Project, we updated the systematic review and meta-analysis of prospective studies to quantify the dose-response between foods and beverages intake and colorectal cancer risk.

DATA SOURCES:

PubMed and several databases up to May 31 st 2015.

STUDY SELECTION:

Prospective studies reporting adjusted relative risk estimates for the association of specific food groups and beverages and risk of colorectal, colon and rectal cancer.

DATA SYNTHESIS:

Dose-response meta-analyses using random effect models to estimate summary relative risks (RRs).

RESULTS:

Results: 400 individual study estimates from 111 unique cohort studies were included. Overall, the risk increase of colorectal cancer is 12% for each 100g/day increase of red and processed meat intake (95%CI=4-21%, I2 =70%, pheterogeneity (ph)<0.01) and 7% for 10 g/day increase of ethanol intake in alcoholic drinks (95%CI=5-9%, I2 =25%, ph =  0.21). Colorectal cancer risk decrease in 17% for each 90g/day increase of whole grains (95%CI=11-21%, I2 =0%, ph =  0.30, 6 studies). For each 400 g/day increase of dairy products intake (95%CI=10-17%, I2 =18%, ph =  0.27, 10 studies). Inverse associations were also observed for vegetables intake (RR per 100 g/day =0.98 (95%CI=0.96-0.99, I2 =0%, ph =  0.48, 11 studies) and for fish intake (RR for 100g/day=0.89(95%CI=0.80-0.99, I2 =0%, ph =  0.52, 11 studies), that were weak for vegetables and driven by one study for fish. Intakes of fruits, coffee, tea, cheese, poultry and legumes were not associated with colorectal cancer risk.

CONCLUSIONS:

Our results reinforce the evidence that high intake of red and processed meat and alcohol increase the risk of colorectal cancer. Milk and whole grains may have a protective role against colorectal cancer. The evidence for vegetables and fish was less convincing.

KEYWORDS:

Alcohol; Colorectal Cancer; Dairy; Meat; Meta-analysis; Review; Summary of the evidence; Wholegrains

 

Fruit and vegetable intake and breast cancer prognosis: a meta-analysis of prospective cohort studies.

Peng C, Luo WP, Zhang CX.

Br J Nutr. 2017 Mar;117(5):737-749. doi: 10.1017/S0007114517000423. Epub 2017 Apr 3.

PMID: 28366183

Abstract

The effect of fruit and vegetable intake on breast cancer prognosis is controversial. Thus, a meta-analysis was carried out to explore their associations. A comprehensive search was conducted in PubMed, Web of Science, OVID, ProQuest and Chinese databases from inception to April 2016. The summary hazard ratios (HR) and 95 % CI were estimated using a random effects model if substantial heterogeneity existed and using a fixed effects model if not. Subgroup analyses and sensitivity analyses were also performed. In total, twelve studies comprising 41 185 participants were included in the meta-analysis. Comparing the highest with the lowest, the summary HR for all-cause mortality were 1·01 (95 % CI 0·72, 1·42) for fruits and vegetables combined, 0·96 (95 % CI 0·83, 1·12) for total vegetable intake, 0·99 (95 % CI 0·89, 1·11) for cruciferous vegetable intake and 0·88 (95 % CI 0·74, 1·05) for fruit intake; those for breast cancer-specific mortality were 1·05 (95 % CI 0·77, 1·43) for total vegetable intake and 0·94 (95 % CI 0·69, 1·26) for fruit intake; and those for breast cancer recurrence were 0·89 (95 % CI 0·53, 1·50) for total vegetable intake and 0·98 (95 % CI 0·76, 1·26) for cruciferous vegetable intake. This meta-analysis found no significant associations between fruit and vegetable intake and breast cancer prognosis.

KEYWORDS:

HR hazard ratio; Breast cancer; Fruits and vegetables; Meta-analyses; Mortality; Recurrence

 

Banning trans fats in New York led to fewer heart attacks, strokes

Both the U.S. FDA and Health Canada have moved to place restrictions on use of partially hydrogenated oils

CBC News Posted: Apr 12, 2017

http://www.cbc.ca/news/health/trans-fat-ban-ny-1.4068142

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

Hospital Admissions for Myocardial Infarction and Stroke Before and After the Trans-Fatty Acid Restrictions in New York.

Brandt EJ, Myerson R, Perraillon MC, Polonsky TS.

JAMA Cardiol. 2017 Apr 12. doi: 10.1001/jamacardio.2017.0491. [Epub ahead of print]

PMID: 28403435

Abstract

IMPORTANCE:

Trans-fatty acids (TFAs) have deleterious cardiovascular effects. Restrictions on their use were initiated in 11 New York State (NYS) counties between 2007 and 2011. The US Food and Drug Administration plans a nationwide restriction in 2018. Public health implications of TFA restrictions are not well understood.

OBJECTIVE:

To determine whether TFA restrictions in NYS counties were associated with fewer hospital admissions for myocardial infarction (MI) and stroke compared with NYS counties without restrictions.

DESIGN, SETTING, AND PARTICIPANTS:

We conducted a retrospective observational pre-post study of residents in counties with TFA restrictions vs counties without restrictions from 2002 to 2013 using NYS Department of Health's Statewide Planning and Research Cooperative System and census population estimates. In this natural experiment, we included those residents who were hospitalized for MI or stroke. The data analysis was conducted from December 2014 through July 2016.

EXPOSURE:

Residing in a county where TFAs were restricted.

MAIN OUTCOMES AND MEASURES:

The primary outcome was a composite of MI and stroke events based on primary discharge diagnostic codes from hospital admissions in NYS. Admission rates were calculated by year, age, sex, and county of residence. A difference-in-differences regression design was used to compare admission rates in populations with and without TFA restrictions. Restrictions were only implemented in highly urban counties, based on US Department of Agriculture Economic Research Service Urban Influence Codes. Nonrestriction counties of similar urbanicity were chosen to make a comparison population. Temporal trends and county characteristics were accounted for using fixed effects by county and year, as well as linear time trends by county. We adjusted for age, sex, and commuting between restriction and nonrestriction counties.

RESULTS:

In 2006, the year before the first restrictions were implemented, there were 8.4 million adults (53.6% female) in highly urban counties with TFA restrictions and 3.3 million adults (52.3% female) in highly urban counties without restrictions. Twenty-five counties were included in the nonrestriction population and 11 in the restriction population. Three or more years after restriction implementation, the population with TFA restrictions experienced significant additional decline beyond temporal trends in MI and stroke events combined (-6.2%; 95% CI, -9.2% to -3.2%; P < .001) and MI (-7.8%; 95% CI, -12.7% to -2.8%; P = .002) and a nonsignificant decline in stroke (-3.6%; 95% CI, -7.6% to 0.4%; P = .08) compared with the nonrestriction populations.

CONCLUSIONS AND RELEVANCE:

The NYS populations with TFA restrictions experienced fewer cardiovascular events, beyond temporal trends, compared with those without restrictions.

 

Vitamin D is not associated with incident dementia or cognitive impairment: an 18-y follow-up study in community-living old men.

Olsson E, Byberg L, Karlström B, Cederholm T, Melhus H, Sjögren P, Kilander L.

Am J Clin Nutr. 2017 Feb 15. pii: ajcn141531. doi: 10.3945/ajcn.116.141531. [Epub ahead of print]

PMID: 28202477

Abstract

Background: Vitamin D has been implicated as being important for maintaining cognitive function in old age. Results from longitudinal studies examining the association of vitamin D with incident dementia and cognitive impairment have been inconsistent.Objective: We investigated the relation between vitamin D, assessed in 3 different ways, and the risk of dementia.Design: We measured plasma 25-hydroxyvitamin D [25(OH)D] with the use of high-performance liquid chromatography-mass spectrometry, assessed dietary vitamin D intake with the use of 7-d dietary records, and created a vitamin D-synthesis genetic risk score (GRS) at baseline (1991-1995) in a cohort of 1182 Swedish men (mean age: 71 y). In a maximum of 18 y (median: 12 y) of follow-up, 116 men developed Alzheimer disease, 64 men developed vascular dementia, and 250 men developed all-cause dementia. An additional 80 men declined in cognitive function as assessed with the use of the Mini-Mental State Examination. Adjusted HRs and ORs were calculated with the use of Cox and logistic regressions.

Results: The mean ± SD plasma 25(OH)D concentration was 68.7 ± 19.1 nmol/L. Plasma 25(OH)D, dietary vitamin D intake, and vitamin D-synthesis GRS were not associated with any cognitive outcomes (crude and adjusted HRs and ORs were ∼1.0 for all continuous exposures). The adjusted HR for all-cause dementia was 0.88 (95% CI: 0.59, 1.31) in men with plasma 25(OH)D concentrations ≤50 compared with >75 nmol/L. The adjusted HR for all-cause dementia was 0.92 (95% CI: 0.63, 1.32) for the lowest compared with highest tertiles of vitamin D intake. The adjusted HR for the continuous GRS for all-cause dementia was 1.04 (95% CI: 0.91, 1.19).

Conclusion: In this cohort study, we show that there is no association between baseline vitamin D status and long-term risk of dementia or cognitive impairment over an 18-y period of time.

KEYWORDS:

25-hydroxyvitamin D; Alzheimer disease; Mendelian randomization; cognitive impairment; cohort; dementia; vascular dementia; vitamin D

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Effects of Sesame (Sesamum indicum L.) Supplementation on Creatine Kinase, Lactate Dehydrogenase, Oxidative Stress Markers, and Aerobic Capacity in Semi-Professional Soccer Players.

Barbosa CV, Silva AS, de Oliveira CV, Massa NM, de Sousa YR, da Costa WK, Silva AC, Delatorre P, Carvalho R, Braga VA, Magnani M.

Front Physiol. 2017 Mar 31;8:196. doi: 10.3389/fphys.2017.00196. eCollection 2017.

PMID: 28408889

Abstract

Nutritional intervention with antioxidants rich foods has been considered a strategy to minimize the effects of overtraining in athletes. This experimental, randomized, and placebo-controlled study evaluated the effects of consumption of sesame (Sesamum indicum L.) on muscle damage markers, oxidative stress, systemic inflammation, and aerobic performance in male semi-professional soccer players. Twenty athletes were randomly assigned to groups that received 40 g (two tablespoons) per day of sesame or a placebo during 28 days of regular training (exposed to routine training that includes loads of heavy training in the final half of the season). Before and after intervention, creatine kinase (CK), lactate dehydrogenase (LDH), malondialdehyde (MDA), superoxide dismutase (SOD), C-reactive protein (hs-CRP), and aerobic capacity were evaluated. Before intervention, a physiologic imbalance was noted in both groups related to CK and LDH levels. Sesame intake caused a reduction of CK (19%, p < 0.05), LDH (37%, p < 0.05), MDA (55%, p < 0.05) and hs-CRP (53%, p < 0.05) and increased SOD (14%, p < 0.05), vitamin A (25%, p < 0.05), and vitamin E (65%, p < 0.05) in the experimental group. These phenomena were accompanied by increased aerobic capacity (17%, p < 0.05). The placebo group showed an increase in CK (5%, p < 0.05) and no significant change in LDH, SOD or vitamin A. MDA levels decreased (21%, p < 0.05) and vitamin E increased (14%, p < 0.05) in the placebo group, but to a much lesser extent than in the experimental group. These results show that sesame consumption may reduce muscle damage and oxidative stress while improving the aerobic capacity in soccer players.

KEYWORDS:

athletes; functional food; inflammation; muscle damage; oxidative stress

 

Oral contraceptive use and fracture risk-a retrospective study of 12,970 women in the UK.

Dombrowski S, Jacob L, Hadji P, Kostev K.

Osteoporos Int. 2017 Apr 13. doi: 10.1007/s00198-017-4036-x. [Epub ahead of print]

PMID: 28409216

Abstract

In the present retrospective case-control study, we compared 6485 women with fractures and 6485 women without fractures from 135 general practitioner offices in the UK. Women without bone fractures were statistically more likely to have been exposed to oral contraception, depending on their age and therapy duration.

INTRODUCTION:

The aim of this analysis was to compare the risk of bone fracture in women using hormonal contraception with that in women who have never used hormonal contraception.

METHODS:

A total of 6485 women (mean age 37.8 years) with an initial diagnosis of fracture between January 2010 and December 2015 were identified in 135 doctors' offices in the UK Disease Analyzer database. In this nested case-control study, each case with a fracture was matched (1:1) to a control without a fracture for age, index year, and follow-up time. In total, 12,970 individuals were available for analysis. The main outcome of the study was the risk of fracture as a function of combined oral contraceptive (OC) therapy. Multivariate logistic regression models were used to determine the effect of OC therapy and its duration on the risk of fracture in the entire population and in four age-specific subgroups.

RESULTS:

Women without bone fractures were significantly more likely to have used oral contraception (OR 0.81). The usage of oral contraception was associated with a significantly lower risk of bone fracture (OR 0.81, 95% CI 0.74-0.90). This effect was strongest in the age groups 18-25 and 26-35 and in patients with an OC treatment duration of more than 1 year.

CONCLUSIONS:

The present study revealed that women without bone fractures were significantly more likely to have had exposure to combined oral contraception, especially where the duration of intake was at least 5 years.

KEYWORDS:

Fracture risk; Oral contraceptives; UK; Women

 

Moderate alcohol consumption is associated with lower chronic disease burden expressed in disability-adjusted life years: a prospective cohort study.

Beulens JW, Fransen HP, Struijk EA, Boer JM, de Wit GA, Onland-Moret NC, Hoekstra J, Bueno-de-Mesquita HB, Peeters PH, May AM.

Eur J Epidemiol. 2017 Apr 13. doi: 10.1007/s10654-017-0247-x. [Epub ahead of print]

PMID: 28409278

Abstract

The relation of alcohol consumption with disease burden remains debated partly due to opposite associations with cardiovascular disease (CVD) and cancer. The relation of alcohol consumption with disease burden expressed in disability-adjusted life years (DALYs) summarizes opposing associations of alcohol consumption on chronic diseases. This study aimed to investigate the association of alcohol consumption with chronic disease burden expressed in DALYs based on individual-participant data. The study was a prospective study among 33,066 men and women from the EPIC-NL cohort. At baseline, alcohol consumption was assessed with a validated food-frequency questionnaire. Participants were followed for occurrence of and mortality from chronic diseases and DALYs were calculated. After 12.4 years follow-up, 6647 disease incidences and 1482 deaths were documented, resulting in 68,225 healthy years of life lost (6225 DALYs). Moderate drinkers (women 5-14.9 g/day, men 5-29.9 g/day) had a lower chronic disease burden (mean DALYs -0.27; 95% CI -0.43; -0.11) than light drinkers (0-4.9 g/day), driven by a lower disease burden due to CVD (-0.18: -0.29; -0.06) but not cancer (-0.05: -0.16; 0.06). The associations were most pronounced among older participants (≥50 years; -0.32; -0.53; -0.10) and not observed among younger women (-0.08; -0.43; 0.35), albeit non-significant (pinteraction > 0.14). Substantial drinking (women 15-29.9 g/day, men 30-59.9 g/day) compared to light drinking was not associated with chronic disease burden. Our results show that moderate compared to light alcohol consumption was associated with living approximately 3 months longer in good health. These results were mainly observed among older participants and not seen among younger women.

KEYWORDS:

Alcohol consumption; Cancer; Cardiovascular disease; Chronic disease burden; Disability-adjusted life years

 

Paleolithic and Mediterranean Diet Pattern Scores Are Inversely Associated with All-Cause and Cause-Specific Mortality in Adults.

Whalen KA, Judd S, McCullough ML, Flanders WD, Hartman TJ, Bostick RM.

J Nutr. 2017 Feb 8. pii: jn241919. doi: 10.3945/jn.116.241919. [Epub ahead of print]

PMID: 28179490

http://sci-hub.cc/10.3945/jn.116.241919

Abstract

Background: Poor diet quality is associated with a higher risk of many chronic diseases that are among the leading causes of death in the United States. It has been hypothesized that evolutionary discordance may account for some of the higher incidence and mortality from these diseases.Objective: We investigated associations of 2 diet pattern scores, the Paleolithic and the Mediterranean, with all-cause and cause-specific mortality in the REGARDS (REasons for Geographic and Racial Differences in Stroke) study, a longitudinal cohort of black and white men and women ≥45 y of age.Methods: Participants completed questionnaires, including a Block food-frequency questionnaire (FFQ), at baseline and were contacted every 6 mo to determine their health status. Of the analytic cohort (n = 21,423), a total of 2513 participants died during a median follow-up of 6.25 y. We created diet scores from FFQ responses and assessed their associations with mortality using multivariable Cox proportional hazards regression models adjusting for major risk factors.Results: For those in the highest relative to the lowest quintiles of the Paleolithic and Mediterranean diet scores, the multivariable adjusted HRs for all-cause mortality were, respectively, 0.77 (95% CI: 0.67, 0.89; P-trend < 0.01) and 0.63 (95% CI: 0.54, 0.73; P-trend < 0.01). The corresponding HRs for all-cancer mortality were 0.72 (95% CI: 0.55, 0.95; P-trend = 0.03) and 0.64 (95% CI: 0.48, 0.84; P-trend = 0.01), and for all-cardiovascular disease mortality they were 0.78 (95% CI: 0.61, 1.00; P-trend = 0.06) and HR: 0.68 (95% CI: 0.53, 0.88; P-trend = 0.01).Conclusions: Findings from this biracial prospective study suggest that diets closer to Paleolithic or Mediterranean diet patterns may be inversely associated with all-cause and cause-specific mortality.

KEYWORDS:

Mediterranean diet; Paleolithic diet; cohort study; diet patterns; mortality

 

Dairy Intake Is Protective against Bone Loss in Older Vitamin D Supplement Users: The Framingham Study.

Sahni S, Mangano KM, Kiel DP, Tucker KL, Hannan MT.

J Nutr. 2017 Mar 1. pii: jn240390. doi: 10.3945/jn.116.240390. [Epub ahead of print]

PMID: 28250192

Abstract

Background: Previous studies showed beneficial effects of specific dairy foods on bone health in middle-aged adults.Objective: We examined the association of milk, yogurt, cheese, cream, fluid dairy (milk + yogurt), and milk + yogurt + cheese intakes with bone mineral density (BMD) and 4-y percentage of change in BMD [▵%BMD; femoral neck, trochanter, and lumbar spine (LS)]. We further assessed whether these associations were modified by vitamin D supplement use in this cohort of older adults.Methods: Food-frequency questionnaire responses, baseline BMD (hip and spine, n = 862 in 1988-1989), and follow-up BMD (n = 628 in 1992-1993) were measured in the Framingham study, a prospective cohort study of older Caucasian men and women aged 67-93 y. Outcomes included baseline BMD and ▵%BMD. Dairy-food intakes (servings per week) were converted to energy-adjusted residuals, and linear regression was used, adjusting for covariates. These associations were further examined by vitamin D supplement use.Results: The mean age of the participants was 75 y. In the full sample, dairy-food items were not associated with BMD (P = 0.11-0.99) or with ▵%BMD (P = 0.29-0.96). Among vitamin D supplement users, but not among nonusers, higher milk, fluid dairy, and milk + yogurt + cheese intakes were associated with higher LS BMD (P = 0.011-0.009). Among vitamin D supplement users, but not among nonusers, higher milk + yogurt + cheese intakes were protective against trochanter BMD loss (P = 0.009).Conclusions: In this population of older adults, higher intakes of milk, fluid dairy, and milk + yogurt + cheese were associated with higher LS BMD, and a higher intake of milk + yogurt + cheese was protective against trochanter BMD loss among vitamin D supplement users but not among nonusers. These findings underscore that the benefits of dairy intake on the skeleton may be dependent on vitamin D intake.

KEYWORDS:

bone loss; bone mineral density; dairy food; milk; observational studies; older adults; osteoporosis; vitamin D

 

Lower likelihood of falling at age 90+ is associated with daily exercise a quarter of a century earlier: The 90+ Study.

Paganini-Hill A, Greenia DE, Perry S, Sajjadi SA, Kawas CH, Corrada MM.

Age Ageing. 2017 Mar 21:1-6. doi: 10.1093/ageing/afx039. [Epub ahead of print]

PMID: 28369185

Abstract

OBJECTIVE:

to explore the relationship between risk of falling at age 90+ and prior physical activity at age 60-70s.

DESIGN:

population-based cohort study (The 90+ Study).

SETTING:

California retirement community.

PARTICIPANTS:

of 1596 cohort members, 1536 had both falls and prior activity data. Mean age = 94 years; 78% female; 99% Caucasian.

METHODS:

time spent in active physical activity was self-reported in 1980s; medical history, medication, assistive devices, residence type, and falls (outcome) was collected in 2000s. Activity/fall relationships were assessed using logistic regression.

RESULTS:

falls were reported by 52% of participants, recurrent falls by 32%, and severe injury by 21% of fallers. In univariate analyses risk of falling at age 90+ was significantly related to medical history (heart disease, TIA/stroke, arthritis, vision disease, depression, dementia), medication use (hypnotics, anti-psychotics, anti-depressants), use of assistive devices (cane, walker, wheelchair), residence type (living with relatives, sheltered living), and source of information (self-report vs informant). Risks of falling and recurrent falls at age 90+ were 35-45% lower in those reporting 30+ minutes/day of active physical activity at age 60-70s compared with no activity. The odds ratio of falling was 0.65 (95% CI = 0.44-0.97) for 30-45 minutes/day and 0.64 (0.44-0.94) for 1+ hour/day adjusting for age, sex, medical history (stroke/TIA, vision disease, depression), use of assistive devices, and source of information.

CONCLUSIONS AND RELEVANCE:

falls are extremely common among the oldest-old and a significant proportion lead to severe injury. This work is the first to show an association between exercise at age 60-70s and lower risk of falling at age 90+.

KEYWORDS:

Falls; cohort; exercise; older people; oldest-old; risk factors

 

Favorable ecological circumstances promote life expectancy in chimpanzees similar to that of human hunter-gatherers.

Wood BM, Watts DP, Mitani JC, Langergraber KE.

J Hum Evol. 2017 Apr;105:41-56. doi: 10.1016/j.jhevol.2017.01.003. Epub 2017 Mar 17.

PMID: 28366199

Abstract

Demographic data on wild chimpanzees are crucial for understanding the evolution of chimpanzee and hominin life histories, but most data come from populations affected by disease outbreaks and anthropogenic disturbance. We present survivorship data from a relatively undisturbed and exceptionally large community of eastern chimpanzees (Pan troglodytes schweinfurthii) at Ngogo, Kibale National Park, Uganda. We monitored births, deaths, immigrations, and emigrations in the community between 1995 and 2016. Using known and estimated ages, we calculated survivorship curves for the whole community, for males and females separately, and for individuals ≤2 years old when identified. We used a novel method to address age estimation error by calculating stochastic survivorship curves. We compared Ngogo life expectancy, survivorship, and mortality rates to those from other chimpanzee communities and human hunter-gatherers. Life expectancy at birth for both sexes combined was 32.8 years, far exceeding estimates of chimpanzee life expectancy in other communities, and falling within the range of human hunter-gatherers (i.e., 27-37 years). Overall, the pattern of survivorship at Ngogo was more similar to that of human hunter-gatherers than to other chimpanzee communities. Maximum lifespan for the Ngogo chimpanzees, however, was similar to that reported at other chimpanzee research sites and was less than that of human-hunter gatherers. The absence of predation by large carnivores may contribute to some of the higher survivorship at Ngogo, but this cannot explain the much higher survivorship at Ngogo than at Kanyawara, another chimpanzee community in the same forest, which also lacks large carnivores. Higher survivorship at Ngogo appears to be an adaptive response to a food supply that is more abundant and varies less than that of Kanyawara. Future analyses of hominin life history evolution should take these results into account.

KEYWORDS:

Chimpanzees; Demography; Hunter-gatherers; Life-expectancy; Mortality; Ngogo

 

Consumption of Fruit or Fiber-Fruit Decreases the Risk of Cardiovascular Disease in a Mediterranean Young Cohort.

Buil-Cosiales P, Martinez-Gonzalez MA, Ruiz-Canela M, Díez-Espino J, García-Arellano A, Toledo E.

Nutrients. 2017 Mar 17;9(3). pii: E295. doi: 10.3390/nu9030295.

PMID: 28304346 Free Article

http://www.mdpi.com/2072-6643/9/3/295/htm

Abstract

Fiber and fiber-rich foods have been inversely associated with cardiovascular disease (CVD), but the evidence is scarce in young and Mediterranean cohorts. We used Cox regression models to assess the association between quintiles of total fiber and fiber from different sources, and the risk of CVD adjusted for the principal confounding factors in a Mediterranean cohort of young adults, the SUN (Seguimiento Universidad de Navarra, Follow-up) cohort. After a median follow-up of 10.3 years, we observed 112 cases of CVD among 17,007 participants (61% female, mean age 38 years). We observed an inverse association between fiber intake and CVD events (p for trend = 0.024) and also between the highest quintile of fruit consumption (hazard ratio (HR) 0.51, 95% confidence interval (CI) 0.27-0.95) or whole grains consumption (HR 0.43 95% CI 0.20-0.93) and CVD compared to the lowest quintile, and also a HR of 0.58 (95% CI 0.37-0.90) for the participants who ate at least 175 g/day of fruit. Only the participants in the highest quintile of fruit-derived fiber intake had a significantly lower risk of CVD (HR 0.52, 95% CI 0.28-0.97). The participants who ate at least one serving per week of cruciferous vegetables had a lower risk than those who did not (HR 0.52, 95% CI 0.30-0.89). In conclusion, high fruit consumption, whole grain consumption, or consumption of at least one serving/week of cruciferous vegetables may be protective against CVD in young Mediterranean populations.

KEYWORDS:

cardiovascular disease; fiber; fruit; legumes; vegetables; whole grains

 

[Animal protein, but not vegetable protein, was protective.]

Protein Intake and Mobility Limitation in Community-Dwelling Older Adults: the Health ABC Study.

Houston DK, Tooze JA, Garcia K, Visser M, Rubin S, Harris TB, Newman AB, Kritchevsky SB; Health ABC Study..

J Am Geriatr Soc. 2017 Mar 17. doi: 10.1111/jgs.14856. [Epub ahead of print]

PMID: 28306154

http://sci-hub.cc/10.1111/jgs.14856

Abstract

OBJECTIVES:

The current Recommended Dietary Allowance (RDA) for protein is based on short-term nitrogen balance studies in young adults and may underestimate the amount needed to optimally preserve physical function in older adults. We examined the association between protein intake and the onset of mobility limitation over 6 years of follow-up in older adults in the Health ABC study.

DESIGN:

Prospective cohort study.

SETTING:

Memphis, Tennessee and Pittsburgh, Pennsylvania.

PARTICIPANTS:

Community-dwelling, initially well-functioning adults aged 70-79 years (n = 1998).

MEASUREMENTS:

Protein intake (g/kg body weight/d) was calculated using an interviewer-administered 108-item food frequency questionnaire at baseline. Mobility limitation was assessed semi-annually and defined as reporting any difficulty walking one-quarter of a mile or climbing 10 steps on 2 consecutive 6-month contacts. The association between protein intake and incident mobility limitation was examined using Cox proportional hazard regression models adjusting for demographics, behavioral characteristics, chronic conditions, total energy intake, and height.

RESULTS:

Mean (SD) protein intake was 0.91 (0.38) g/kg body weight/d, with 43% reporting intakes less than the RDA (0.8 g/kg body weight/d). During 6 years of follow-up, 705 participants (35.3%) developed mobility limitations. Compared to participants in the upper tertile of protein intake (≥1.0 g/kg body weight/d), participants in the lower two tertiles of protein intake (<0.7 and 0.7 -<1.0 g/kg body weight/d) were at greater risk of developing mobility limitation over 6 years of follow-up (RR (95% CI): 1.86 (1.41-2.44) and 1.49 (1.20-1.84), respectively).

CONCLUSION:

Lower protein intake was associated with increased risk of mobility limitation in community-dwelling, initially well-functioning older adults. These results suggest that protein intakes of ≥1.0 g/kg body weight/d may be optimal for maintaining physical function in older adults.

KEYWORDS:

aging; mobility limitation; protein

 

Dairy intake and risk of type 2 diabetes.

Talaei M, Pan A, Yuan JM, Koh WP.

Clin Nutr. 2017 Mar 8. pii: S0261-5614(17)30094-8. doi: 10.1016/j.clnu.2017.02.022. [Epub ahead of print]

PMID: 28318689

http://sci-hub.cc/10.1016/j.clnu.2017.02.022

Abstract

BACKGROUND & AIMS:

The effect of total dairy products, milk, and calcium intake on risk of type 2 diabetes (T2D) is uncertain, particularly in the Chinese population.

METHODS:

The present study was based on a prospective cohort of 63,257 Chinese men and women aged 45-74 years during enrollment (1993-1998) in Singapore. Dietary information was obtained using a validated 165-item semi-quantitative food-frequency questionnaire. Information about newly diagnosed T2D was collected by self-report during two follow-up interviews in 1999-2004 and 2006-2010. Cox proportional hazard regression method was used to estimate hazard ratios (HRs) and their 95% confidence intervals (CIs) in 45,411 eligible participants.

RESULTS:

Incidence rate (95% CI) of T2D was 10.5 (10.2-10.8) per 1000 person-years. Intake of dairy food was significantly associated with reduced T2D risk; compared with the lowest quartile, HRs (95% CI) for the second, third and fourth quartiles of dairy intake were 0.98 (0.91-1.06), 0.96 (0.89-1.03) and 0.90 (0.83-0.98), respectively, after adjustment for potential confounders at baseline (P-trend = 0.01). Daily drinkers of milk had a significant 12% reduction in T2D risk compared with non-drinkers. While dairy calcium was associated with a decreased risk of T2D (HR comparing extreme quartiles 0.84; 95% CI 0.76-0.93; P-trend = 0.001), no association was found for non-dairy calcium (HR 1.02; 95% CI 0.92-1.14; P-trend = 0.61).

CONCLUSIONS:

In this large cohort study of Chinese adults, dairy product intake and daily milk consumption was associated with a statistically significant, although modest, decrease in risk of developing T2D, which may be independent of its calcium content.

KEYWORDS:

Calcium; Chinese; Dairy products; Milk; Prospective cohort study; Type 2 diabetes

 

Allium vegetable intakes and the incidence of cardiovascular disease, hypertension, chronic kidney disease, and type 2 diabetes in adults: a longitudinal follow-up study.

Bahadoran Z, Mirmiran P, Momenan AA, Azizi F.

J Hypertens. 2017 Mar 17. doi: 10.1097/HJH.0000000000001356. [Epub ahead of print]

PMID: 28319598

http://sci-hub.cc/10.1097/HJH.0000000000001356

Abstract

OBJECTIVES:

This study investigated the association between habitual consumption of allium vegetables (garlic and onion) and the incidence of cardiovascular disease (CVD) outcomes, hypertension (HTN), chronic kidney disease (CKD), and type 2 diabetes (T2D).

METHODS:

Adult men and women, participated in the Tehran Lipid and Glucose Study (2006-2008 to 2012-2014), were recruited. Habitual dietary intakes were assessed using a validated semiquantitative food frequency questionnaire. Demographics, anthropometrics, blood pressure, and biochemical variables were evaluated at baseline and during follow-up examinations. Multivariate Cox proportional hazard regression models adjusted for potential confounders were used to estimate the development of CVD outcomes, HTN, CKD, and T2D in relation to allium vegetable intakes.

RESULTS:

Mean age of participants (44.2% men) was 40.3 ± 14.3 years, at baseline. During an average of 6 years of follow-up, the incidence rate of CVD outcomes, HTN, CKD, and T2D were 3.3, 15.5, 17.9, and 6.7%, respectively. A higher habitual intake of allium vegetables was associated with a 64% reduced risk of CVD outcomes (hazard ratio = 0.36, 95% confidence interval, CI = 0.18-0.71; P for trend = 0.011), 32% lower incidence of CKD (hazard ratio = 0.69, 95% CI = 0.46-0.98; P for trend = 0.11), and 26% decreased HTN development (hazard ratio = 0.74, 95% CI = 0.54-1.00; P for trend = 0.06). No significant association was observed between allium vegetable intakes and the risk of T2D. Allium vegetable intake was related to 6 years' changes of triglyceride levels (β = -0.81, P = 0.01) and creatinine clearance (β = 0.56, P = 0.01).

CONCLUSION:

Data of the current study support the available mechanistic findings regarding cardiorenal protective properties of allium vegetables.

 

[The first below paper is not pdf-availed.]

Effects of Capsaicin on Older Patients with Oropharyngeal Dysphagia: A Double-Blind, Placebo-Controlled, Crossover Study.

Nakato R, Manabe N, Shimizu S, Hanayama K, Shiotani A, Hata J, Haruma K.

Digestion. 2017 Mar 21;95(3):210-220. doi: 10.1159/000463382. [Epub ahead of print]

PMID: 28319947

Abstract

BACKGROUND/AIMS:

The standard of care for older patients with oropharyngeal dysphagia (OD) is poor. Stimulation of transient receptor potential vanilloid 1 might become a pharmacological strategy for these patients. This study aimed to compare the therapeutic effect of film food containing 0.75 µg of capsaicin in these patients.

METHODS:

In a crossover, randomized trial, 49 patients with OD were provided capsaicin or identical placebo at least 7 days apart. Patients' reported symptoms during repeated swallowing, the volume, pH and substance P (SP) concentrations in saliva, and cervical esophageal wall motion evaluated by ultrasonographic tissue Doppler imaging were obtained before and after capsaicin or placebo administration.

RESULTS:

Significantly more patients with OD who took capsaicin experienced improvement in symptoms than those who took placebo. Salivary SP levels were significantly increased after capsaicin administration compared with placebo in the effective group. The duration of cervical esophageal wall opening was significantly shorter in capsaicin administration in the effective group. Furthermore, a significant negative correlation was found between the duration of cervical esophageal wall opening and salivary SP levels.

CONCLUSION:

Elevated salivary SP concentrations stimulated by capsaicin greatly improve the safety and efficacy of swallowing, and shorten the swallow response in older patients with OD.

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Natural capsaicinoids improve swallow response in older patients with oropharyngeal dysphagia.

Rofes L, Arreola V, Martin A, Clavé P.

Gut. 2013 Sep;62(9):1280-7. doi: 10.1136/gutjnl-2011-300753. Epub 2012 Jun 21.

PMID: 22722616

http://sci-hub.cc/10.1136/gutjnl-2011-300753

Abstract

OBJECTIVE:

There is no pharmacological treatment for oropharyngeal dysphagia (OD). The aim of this study was to compare the therapeutic effect of stimulation of oropharyngeal transient receptor potential vanilloid type 1 (TRPV1) with that of thickeners in older patients with OD.

DESIGN:

A clinical videofluoroscopic non-randomised study was performed to assess the signs of safety and efficacy of swallow and the swallow response in (1) 33 patients with OD (75.94 ± 1.88 years) while swallowing 5, 10 and 20 ml of liquid (20.4 mPa.s), nectar (274.4 mPa.s), and pudding (3930 mPa.s) boluses; (2) 33 patients with OD (73.94 ± 2.23 years) while swallowing 5, 10 and 20 ml nectar boluses, and two series of nectar boluses with 150 μM capsaicinoids and (3) 8 older controls (76.88 ± 1.51 years) while swallowing 5, 10 and 20 ml nectar boluses.

RESULTS:

Increasing bolus viscosity reduced the prevalence of laryngeal penetrations by 72.03% (p < 0.05), increased pharyngeal residue by 41.37% (p < 0.05), delayed the upper esophageal sphincter opening time and the larynx movement and did not affect the laryngeal vestibule closure time and maximal hyoid displacement. Treatment with capsaicinoids reduced both, penetrations by 50.% (p < 0.05) and pharyngeal residue by 50.% (p < 0.05), and shortened the time of laryngeal vestibule closure (p < 0.001), upper esophageal sphincter opening (p < 0.05) and maximal hyoid and laryngeal displacement.

CONCLUSION:

Stimulation of TRPV1 by capsaicinoids strongly improved safety and efficacy of swallow and shortened the swallow response in older patients with OD. Stimulation of TRPV1 might become a pharmacologic strategy to treat OD.

KEYWORDS:

TRPV1; deglutition; dysphagia; gastro-oesophageal reflux disease; gastrointestinal physiology; motility disorders; nerve–gut interactions; neurogenic dysphagia; oropharyngeal dysphagia; sensory input; swallowing center

 

Serum 25-hydroxyvitamin D and the risk of cardiovascular disease: dose-response meta-analysis of prospective studies.

Zhang R, Li B, Gao X, Tian R, Pan Y, Jiang Y, Gu H, Wang Y, Wang Y, Liu G.

Am J Clin Nutr. 2017 Mar 1. pii: ajcn140392. doi: 10.3945/ajcn.116.140392. [Epub ahead of print]

PMID: 28251933

http://sci-hub.cc/10.3945/ajcn.116.140392

Abstract

Background: During the past decade, an increasing number of prospective studies have focused on the association between vitamin D and cardiovascular disease (CVD). However, the evidence on the relation between serum 25-hydroxyvitamin D [25(OH)D] and the risk of overt CVD is inconclusive.Objective: We performed a dose-response meta-analysis to summarize and prospectively quantify the RR of low serum 25(OH)D concentration and total CVD (events and mortality).Design: We identified relevant studies by searching PubMed and EMBASE up to December 2015 and by hand-searching reference lists. Prospective studies based on the general population and reported RRs and 95% CIs were included. A random-effects model was used to calculate the pooled RRs. Nonlinear association was assessed by using restricted cubic spline analyses.Results: A total of 34 publications with 180,667 participants were eligible for the meta-analysis. We included 32 publications (27 independent studies) for total CVD events and 17 publications (17 independent studies) for CVD mortality. We observed an inverse association between serum 25(OH)D and total CVD events and CVD mortality, and the pooled RRs per 10-ng/mL increment were 0.90 (95% CI: 0.86, 0.94) for total CVD events and 0.88 (95% CI: 0.80, 0.96) for CVD mortality. A nonlinear association was detected for total CVD events (P-nonlinear < 0.001) and CVD mortality (P-nonlinear = 0.022).Conclusion: Serum 25(OH)D concentration was inversely associated with total CVD events and CVD mortality from the observed studies.

KEYWORDS:

25-hydroxyvitamin D; CVD mortality; cardiovascular disease; dose-response; meta-analysis

 

Dietary intake is independently associated with the maximal capacity for fat oxidation during exercise.

Fletcher G, Eves FF, Glover EI, Robinson SL, Vernooij CA, Thompson JL, Wallis GA.

Am J Clin Nutr. 2017 Mar 1. pii: ajcn133520. doi: 10.3945/ajcn.116.133520. [Epub ahead of print]

PMID: 28251936 Free Article

http://ajcn.nutrition.org/content/105/4/864.long

http://ajcn.nutrition.org/content/105/4/864.full.pdf+html

Abstract

Background: Substantial interindividual variability exists in the maximal rate of fat oxidation (MFO) during exercise with potential implications for metabolic health. Although the diet can affect the metabolic response to exercise, the contribution of a self-selected diet to the interindividual variability in the MFO requires further clarification.Objective: We sought to identify whether recent, self-selected dietary intake independently predicts the MFO in healthy men and women.Design: The MFO and maximal oxygen uptake (V̇O2 max) were determined with the use of indirect calorimetry in 305 healthy volunteers [150 men and 155 women; mean ± SD age: 25 ± 6 y; body mass index (BMI; in kg/m2): 23 ± 2]. Dual-energy X-ray absorptiometry was used to assess body composition with the self-reported physical activity level (SRPAL) and dietary intake determined in the 4 d before exercise testing. To minimize potential confounding with typically observed sex-related differences (e.g., body composition), predictor variables were mean-centered by sex. In the analyses, hierarchical multiple linear regressions were used to quantify each variable's influence on the MFO.Results: The mean absolute MFO was 0.55 ± 0.19 g/min (range: 0.19-1.13 g/min). A total of 44.4% of the interindividual variability in the MFO was explained by the V̇O2 max, sex, and SRPAL with dietary carbohydrate (carbohydrate; negative association with the MFO) and fat intake (positive association) associated with an additional 3.2% of the variance. When expressed relative to fat-free mass (FFM), the MFO was 10.8 ± 3.2 mg · kg FFM-1 · min-1 (range: 3.5-20.7 mg · kg FFM-1 · min-1) with 16.6% of the variability explained by the V̇O2 max, sex, and SRPAL; dietary carbohydrate and fat intakes together explained an additional 2.6% of the variability. Biological sex was an independent determinant of the MFO with women showing a higher MFO [men: 10.3 ± 3.1 mg · kg FFM-1 · min-1 (3.5-19.9 mg · kg FFM-1 · min-1); women: 11.2 ± 3.3 mg · kg FFM-1 · min-1 (4.6-20.7 mg · kg FFM-1 · min-1); P < 0.05].Conclusion: Considered alongside other robust determinants, dietary carbohydrate and fat intake make modest but independent contributions to the interindividual variability in the capacity to oxidize fat during exercise.

KEYWORDS:

health; metabolism; nutrition; physical activity; substrate oxidation

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Fibroblast growth factor 23 as a predictor of cardiovascular and all-cause mortality in prospective studies.

Qin Z, Liu X, Song M, Zhou Q, Yu J, Zhou B, Wu Y, He Y, Huang L.

Atherosclerosis. 2017 Apr 1;261:1-11. doi: 10.1016/j.atherosclerosis.2017.03.042. [Epub ahead of print]

PMID: 28411494

Abstract

BACKGROUND AND AIMS:

The prognostic value of fibroblast growth factor 23 (FGF23) for mortality remains controversial. We performed a meta-analysis of cohort studies to examine the controversial relationship between FGF23 and mortality.

METHODS:

PubMed, EMBASE, the Cochrane Library databases and reference bibliographies were searched through September 2016 to identify prospective cohort studies with relative risks (RRs) and 95% confidence intervals (CIs) for FGF23 and mortality. A random effects model was used to pool the risk estimates. A dose-response analysis of the risk for all-cause mortality associated with FGF23 was conducted using the generalized least squares trend estimation method.

RESULTS:

Nineteen prospective cohort studies were eligible for inclusion in this meta-analysis, of which 16 reported all-cause mortality and 9 reported cardiovascular mortality. During the follow-up periods ranging from 1 to 18.6 years, 5606 deaths occurred among 22,805 participants and 2458 cardiovascular deaths occurred among 28,845 participants. Elevated FGF23 was associated with an increased risk of all-cause mortality (RR 1.68; 95% CI 1.48-1.92) and cardiovascular mortality (RR 1.68; 95% CI 1.38-2.04) with moderate heterogeneity. These associations were not markedly modified by the geographic location, follow-up length, patient predisposition, FGF23 measurement or study quality. A sensitivity analysis yielded a similar effect on the pooled risk estimate. Evidence of a nonlinear relationship between FGF23 and all-cause mortality was observed in the dose-response analysis, with the risk gradually increasing as FGF23 increased.

CONCLUSIONS:

This meta-analysis showed that individuals with increased plasma FGF23 levels might suffer a higher risk of all-cause mortality and cardiovascular mortality.

KEYWORDS:

Biomarker; Fibroblast growth factor 23; Mortality; Prognosis

 

Development of Nephrolithiasis in Asymptomatic Hyperuricemia: A Cohort Study.

Kim S, Chang Y, Yun KE, Jung HS, Lee SJ, Shin H, Ryu S.

Am J Kidney Dis. 2017 Apr 12. pii: S0272-6386(17)30548-6. doi: 10.1053/j.ajkd.2017.01.053. [Epub ahead of print]

PMID: 28410765

Abstract

BACKGROUND:

Although the association between gout and nephrolithiasis is well known, the relationship between asymptomatic hyperuricemia and the development of nephrolithiasis is largely unknown.

STUDY DESIGN:

Cohort study.

SETTING & PARTICIPANTS:

239,331 Korean adults who underwent a health checkup examination during January 2002 to December 2014 and were followed up annually or biennially through December 2014.

PREDICTOR:

Baseline serum uric acid levels of participants.

OUTCOME:

The development of nephrolithiasis during follow-up.

MEASUREMENTS:

Nephrolithiasis is determined based on ultrasonographic findings. A parametric Cox model was used to estimate the adjusted HRs of nephrolithiasis according to serum uric acid level.

RESULTS:

During 1,184,653.8 person-years of follow-up, 18,777 participants developed nephrolithiasis (incidence rate, 1.6/100 person-years). Elevated uric acid level was significantly associated with increased risk for nephrolithiasis in a dose-response manner (P for trend < 0.001) in men. This dose-response association was not observed in women. In male participants, multivariable-adjusted HRs for incident nephrolithiasis comparing uric acid levels of 6.0 to 6.9, 7.0 to 7.9, 8.0 to 8.9, 9.0 to 9.9, and ≥10.0mg/dL with uric acid levels < 6.0mg/dL were 1.06 (95% CI, 1.02-1.11), 1.11 (95% CI, 1.05-1.16), 1.21 (95% CI, 1.13-1.29), 1.31 (95% CI, 1.17-1.46), and 1.72 (95% CI, 1.44-2.06), respectively. This association was observed in all clinically relevant subgroups and persisted even after adjustment for homeostasis model assessment of insulin resistance and high-sensitivity C-reactive protein level.

LIMITATIONS:

Dietary information and computed tomographic diagnosis of nephrolithiasis were unavailable.

CONCLUSIONS:

In this large cohort study, increased serum uric acid level was modestly and independently associated with increased risk for the development of nephrolithiasis in a dose-response manner in apparently healthy men.

KEYWORDS:

Korea; Nephrolithiasis; abdominal ultrasound; cohort study; hyperuricemia; kidney stone; risk factor; sex differences; uric acid; urinary stones

 

Folic acid: the solution for treating asymptomatic hyperuricemia?

Scheepers LE.

Am J Clin Nutr. 2017 Mar 15. pii: ajcn154294. doi: 10.3945/ajcn.117.154294. [Epub ahead of print] No abstract available.

PMID: 28298395

http://sci-hub.cc/10.3945/ajcn.117.154294

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Folic acid therapy reduces serum uric acid in hypertensive patients: a substudy of the China Stroke Primary Prevention Trial (CSPPT).

Qin X, Li Y, He M, Tang G, Yin D, Liang M, Wang B, Nie J, Huo Y, Xu X, Hou FF.

Am J Clin Nutr. 2017 Feb 1. pii: ajcn143131. doi: 10.3945/ajcn.116.143131. [Epub ahead of print]

PMID: 28148501

Abstract

BACKGROUND:

The effect of folic acid supplementation on uric acid (UA) concentrations is still inconclusive.

OBJECTIVE:

We aimed to test the efficacy of folic acid therapy in reducing serum UA in hypertensive patients.

DESIGN:

A total of 15,364 hypertensive patients were randomly assigned to a double-blind daily treatment with a single tablet that contained 10 mg enalapril and 0.8 mg folic acid (n = 7685) or 10 mg enalapril alone (n = 7679). The main outcome was the change in serum UA, which was defined as UA at the exit visit minus that at baseline. Secondary outcomes were as follows: 1) controlled hyperuricemia (UA concentration <357 μmol/L after treatment) and 2) new-onset hyperuricemia in participants with normal UA concentrations (<357 μmol/L).

RESULTS:

After a median of 4.4 y of treatment, the mean ± SD UA concentration increased by 34.7 ± 72.5 μmol/L in the enalapril-alone group and by 30.7 ± 71.8 μmol/L in the enalapril-folic acid group, which resulted in a mean group difference of -4.0 μmol/L (95% CI: -6.5, -1.6 μmol/L; P = 0.001). Furthermore, compared with enalapril alone, enalapril-folic acid treatment showed an increase in controlled hyperuricemia (30.3% compared with 25.6%; OR: 1.31; 95% CI: 1.01, 1.70) and a decrease in new-onset hyperuricemia (15.0% compared with 16.3%; OR: 0.89; 95% CI: 0.79, 0.99). A greater beneficial effect was observed in subjects with hyperuricemia (P-interaction = 0.07) or higher concentrations of total homocysteine (tHcy) (P-interaction = 0.02) at baseline. Furthermore, there was a significant inverse relation (P < 0.001) between the reduction of tHcy and the change in UA concentrations.

CONCLUSIONS:

Enalapril-folic acid therapy, compared with enalapril alone, can significantly reduce the magnitude of the increase of UA concentrations in hypertensive adults.

KEYWORDS:

controlled hyperuricemia; folic acid supplementation; new-onset hyperuricemia; total homocysteine; uric acid concentrations

 

Vitamin B-6 and colorectal cancer risk: a prospective population-based study using 3 distinct plasma markers of vitamin B-6 status.

Gylling B, Myte R, Schneede J, Hallmans G, Häggström J, Johansson I, Ulvik A, Ueland PM, Van Guelpen B, Palmqvist R.

Am J Clin Nutr. 2017 Mar 8. pii: ajcn139337. doi: 10.3945/ajcn.116.139337. [Epub ahead of print]

PMID: 28275126

Abstract

Background: Higher plasma concentrations of the vitamin B-6 marker pyridoxal 5'-phosphate (PLP) have been associated with reduced colorectal cancer (CRC) risk. Inflammatory processes, including vitamin B-6 catabolism, could explain such findings.Objective: We investigated 3 biomarkers of vitamin B-6 status in relation to CRC risk.Design: This was a prospective case-control study of 613 CRC cases and 1190 matched controls nested within the Northern Sweden Health and Disease Study (n = 114,679). Participants were followed from 1985 to 2009, and the median follow-up from baseline to CRC diagnosis was 8.2 y. PLP, pyridoxal, pyridoxic acid (PA), 3-hydroxykynurenine, and xanthurenic acids (XAs) were measured in plasma with the use of liquid chromatography-tandem mass spectrometry. We calculated relative and absolute risks of CRC for PLP and the ratios 3-hydroxykynurenine:XA (HK:XA), an inverse marker of functional vitamin B-6 status, and PA:(PLP + pyridoxal) (PAr), a marker of inflammation and oxidative stress and an inverse marker of vitamin B-6 status.Results: Plasma PLP concentrations were associated with a reduced CRC risk for the third compared with the first quartile and for PLP sufficiency compared with deficiency [OR: 0.60 (95% CI: 0.44, 0.81) and OR: 0.55 (95% CI: 0.37, 0.81), respectively]. HK:XA and PAr were both associated with increased CRC risk [OR: 1.48 (95% CI: 1.08, 2.02) and OR: 1.50 (95% CI: 1.10, 2.04), respectively] for the fourth compared with the first quartile. For HK:XA and PAr, the findings were mainly observed in study participants with <10.5 y of follow-up between sampling and diagnosis.Conclusions: Vitamin B-6 deficiency as measured by plasma PLP is associated with a clear increase in CRC risk. Furthermore, our analyses of novel markers of functional vitamin B-6 status and vitamin B-6-associated oxidative stress and inflammation suggest a role in tumor progression rather than initiation.

KEYWORDS:

biomarkers; colorectal cancer; inflammation; metabolite ratios; vitamin B-6

 

Longitudinal study of alcohol consumption and HDL concentrations: a community-based study.

Huang S, Li J, Shearer GC, Lichtenstein AH, Zheng X, Wu Y, Jin C, Wu S, Gao X.

Am J Clin Nutr. 2017 Mar 1. pii: ajcn144832. doi: 10.3945/ajcn.116.144832. [Epub ahead of print]

PMID: 28251934

http://sci-hub.cc/10.3945/ajcn.116.144832

Abstract

Background: In cross-sectional studies and short-term clinical trials, it has been suggested that there is a positive dose-response relation between alcohol consumption and HDL concentrations. However, prospective data have been limited.Objective: We sought to determine the association between total alcohol intake, the type of alcohol-containing beverage, and the 6-y (2006-2012) longitudinal change in HDL-cholesterol concentrations in a community-based cohort.Design: A total of 71,379 Chinese adults (mean age: 50 y) who were free of cardiovascular diseases and cancer and did not use cholesterol-lowering agents during follow-up were included in the study. Alcohol intake was assessed via a questionnaire in 2006 (baseline), and participants were classified into the following categories of alcohol consumption: never, past, light (women: 0-0.4 servings/d; men: 0-0.9 servings/d), moderate (women: 0.5-1.0 servings/d; men: 1-2 servings/d), and heavy (women: >1.0 servings/d; men: >2 servings/d). HDL-cholesterol concentrations were measured in 2006, 2008, 2010, and 2012. We used generalized estimating equation models to examine the associations between baseline alcohol intake and the change in HDL-cholesterol concentrations with adjustment for age, sex, smoking, physical activity, obesity, hypertension, diabetes, liver function, and C-reactive protein concentrations.Results: An umbrella-shaped association was observed between total alcohol consumption and changes in HDL-cholesterol concentrations. Compared with never drinkers, past, light, moderate, and heavy drinkers experienced slower decreases in HDL cholesterol of 0.012 mmol · L-1 · y-1 (95% CI: 0.008, 0.016 mmol · L-1 · y-1), 0.013 mmol · L-1 · y-1 (95% CI: 0.010, 0.016 mmol · L-1 · y-1), 0.017 mmol · L-1 · y-1 (95% CI: 0.009, 0.025 mmol · L-1 · y-1), and 0.008 mmol · L-1 · y-1 (95% CI: 0.005, 0.011 mmol · L-1 · y-1), respectively (P < 0.0001 for all), after adjustment for potential confounders. Moderate alcohol consumption was associated with the slowest increase in total-cholesterol:HDL-cholesterol and triglyceride:HDL-cholesterol ratios. We observed a similar association between hard-liquor consumption and the HDL-cholesterol change. In contrast, greater beer consumption was associated with slower HDL-cholesterol decreases in a dose-response manner.Conclusion: Moderate alcohol consumption was associated with slower HDL-cholesterol decreases; however, the type of alcoholic beverage had differential effects on the change in the HDL-cholesterol concentration.

KEYWORDS:

HDL; alcohol; cardiovascular disease risk; epidemiology; lipids; prospective cohort; triglyceride

 

Effect of macronutrients and fiber on postprandial glycemic responses and meal glycemic index and glycemic load value determinations.

Meng H, Matthan NR, Ausman LM, Lichtenstein AH.

Am J Clin Nutr. 2017 Feb 15. pii: ajcn144162. doi: 10.3945/ajcn.116.144162. [Epub ahead of print]

PMID: 28202475

http://sci-hub.cc/10.3945/ajcn.116.144162

Abstract

Background: The potential confounding effect of different amounts and proportions of macronutrients across eating patterns on meal or dietary glycemic index (GI) and glycemic load (GL) value determinations has remained partially unaddressed.Objective: The study aimed to determine the effects of different amounts of macronutrients and fiber on measured meal GI and GL values.Design: Four studies were conducted during which participants [n = 20-22; women: 50%; age: 50-80 y; body mass index (in kg/m2): 25-30)] received food challenges containing different amounts of the variable nutrient in a random order. Added to the standard 50 g available carbohydrate from white bread was 12.5, 25, or 50 g carbohydrate; 12.5, 25, or 50 g protein; and 5.6, 11.1, or 22.2 g fat from rice cereal, tuna, and unsalted butter, respectively, and 4.8 or 9.6 g fiber from oat cereal. Arterialized venous blood was sampled for 2 h, and measured meal GI and GL and insulin index (II) values were calculated by using the incremental area under the curve (AUCi) method.

Results: Adding carbohydrate to the standard white-bread challenge increased glucose AUCi (P < 0.0001), measured meal GI (P = 0.0066), and mean GL (P < 0.0001). Adding protein (50 g only) decreased glucose AUCi (P = 0.0026), measured meal GI (P = 0.0139), and meal GL (P = 0.0140). Adding fat or fiber had no significant effect on these variables. Adding carbohydrate (50 g), protein (50 g), and fat (11.1 g) increased the insulin AUCi or II; fiber had no effect.Conclusions: These data indicate that uncertainty in the determination of meal GI and GL values is introduced when carbohydrate-containing foods are consumed concurrently with protein (equal amount of carbohydrate challenge) but not with carbohydrate-, fat-, or fiber-containing foods. Future studies are needed to evaluate whether this uncertainty also influences the prediction of average dietary GI and GL values for eating patterns.

KEYWORDS:

glycemic index; glycemic load; healthy participants; macronutrients and fiber; variability

 

Association of Cardiovascular Health With Subclinical Disease and Incident Events: The Multi-Ethnic Study of Atherosclerosis.

Polonsky TS, Ning H, Daviglus ML, Liu K, Burke GL, Cushman M, Eng J, Folsom AR, Lutsey PL, Nettleton JA, Post WS, Sacco RL, Szklo M, Lloyd-Jones DM.

J Am Heart Assoc. 2017 Mar 20;6(3). pii: e004894. doi: 10.1161/JAHA.116.004894.

PMID: 28320747 Free Article

http://jaha.ahajournals.org/content/6/3/e004894.long

Abstract

BACKGROUND:

Few adults have ideal cardiovascular health (CVH). We studied associations of an overall CVH score with subclinical cardiovascular disease and events. We assessed whether associations varied by race/ethnicity.

METHODS AND RESULTS:

Among 5961 participants in the Multi-Ethnic Study of Atherosclerosis, components of CVH were measured at baseline, 2000-2002: systolic blood pressure, total cholesterol, fasting glucose, smoking, physical activity, diet, and body mass index. Levels were classified as ideal (2 points), intermediate (1 point), and poor (0 points) according to American Heart Association definitions. Points were summed to produce a CVH score (0-7 low, 8-11 moderate, 12-14 high). Coronary artery calcium, carotid intima-media thickness, and left ventricular mass were measured at baseline. Cardiovascular disease was defined as myocardial infarction, coronary heart disease death, resuscitated cardiac arrest, stroke, heart failure, or peripheral artery disease. Follow-up was 10.3 years. Regression models were used to examine associations of the CVH score with subclinical disease and events, adjusting for age, sex, and education. Analyses were stratified by race/ethnicity. Adults with high or moderate CVH scores had significantly lower odds of coronary artery calcium and lower carotid intima-media thickness and left ventricular mass than adults with low CVH scores. Adults with high or moderate CVH scores were 67% (95%CI 41% to 82%) and 37% (95%CI 22% to 49%) less likely, respectively, to experience a cardiovascular disease event than adults with low scores. There was no interaction with race/ethnicity.

CONCLUSIONS:

There is a graded inverse association between CVH scores and measures of subclinical and overt cardiovascular disease that is similar across race/ethnic groups.

KEYWORDS:

cardiovascular disease prevention; disparities; subclinical atherosclerosis risk factor

 

Editorial: No Trp, no B: surprising connectivity of diet, microbiome, aging, and adaptive immunity.

Maldonado-Contreras A, Gerstein RM.

J Leukoc Biol. 2017 Apr;101(4):807-809. doi: 10.1189/jlb.1CE0916-402R. No abstract available.

PMID: 28366880

http://sci-hub.cc/10.1189/jlb.1CE0916-402R

Frontline Science: Tryptophan restriction arrests B cell development and enhances microbial diversity in WT and prematurely aging <i>Ercc1<sup>-/Δ7</sup></i> mice.

van Beek AA, Hugenholtz F, Meijer B, Sovran B, Perdijk O, Vermeij WP, Brandt RM, Barnhoorn S, Hoeijmakers JH, de Vos P, Leenen PJ, Hendriks RW, Savelkoul HF.

J Leukoc Biol. 2017 Apr;101(4):811-821. doi: 10.1189/jlb.1HI0216-062RR. Epub 2016 Jul 14.

PMID: 27418353

Abstract

With aging, tryptophan metabolism is affected. Tryptophan has a crucial role in the induction of immune tolerance and the maintenance of gut microbiota. We, therefore, studied the effect of dietary tryptophan restriction in young wild-type (WT) mice (118-wk life span) and in DNA-repair deficient, premature-aged (Ercc1-/Δ7 ) mice (20-wk life span). First, we found that the effect of aging on the distribution of B and T cells in bone marrow (BM) and in the periphery of 16-wk-old Ercc1-/Δ7 mice was comparable to that in 18-mo-old WT mice. Dietary tryptophan restriction caused an arrest of B cell development in the BM, accompanied by diminished B cell frequencies in the periphery. In general, old Ercc1-/Δ7 mice showed similar responses to tryptophan restriction compared with young WT mice, indicative of age-independent effects. Dietary tryptophan restriction increased microbial diversity and made the gut microbiota composition of old Ercc1-/Δ7 mice more similar to that of young WT mice. The decreased abundances of Alistipes and Akkermansia spp. after dietary tryptophan restriction correlated significantly with decreased B cell precursor numbers. In conclusion, we report that dietary tryptophan restriction arrests B cell development and concomitantly changes gut microbiota composition. Our study suggests a beneficial interplay between dietary tryptophan, B cell development, and gut microbial composition on several aspects of age-induced changes.

KEYWORDS:

bone marrow; gut microbiota; hematopoiesis; proliferation

 

Health Canada proposes trans fat ban

http://www.cbc.ca/news/health/trans-fats-1.4061489

Health Canada introduces a regulatory proposal to prohibit the use of partially hydrogenated oils (PHOs), the main source of industrially produced trans fats in our food.

Apr. 7, 2017 4:57 PM ET

 

[The below paper is pdf-availed.]

Higher Meat Intakes Are Positively Associated With Higher Risks of Developing Pancreatic Cancer in an Age-Dependent Manner and Are Modified by Plasma Antioxidants: A Prospective Cohort Study (EPIC-Norfolk) Using Data From Food Diaries.

Beaney AJ, Banim PJ, Luben R, Lentjes MA, Khaw KT, Hart AR.

Pancreas. 2017 Apr 4. doi: 10.1097/MPA.0000000000000819. [Epub ahead of print]

PMID: 28375948

Abstract

OBJECTIVE:

Carcinogens in meat may be involved in pancreatic carcinogenesis. Meat intake was investigated using 7-day food diaries and according to factors potentially influencing carcinogenesis: age, cooking method, and antioxidants.

METHODS:

Twenty-three thousand one hundred thirty-three participants in the European Prospective Investigation of Cancer-Norfolk cohort study completed 7-day food diaries and were followed up. Meat intakes were compared with controls and hazard ratios (HRs) calculated.

RESULTS:

Eighty-six participants developed pancreatic cancer. If younger than 60 years at recruitment, all quintiles of red meat (Q1 vs Q5; HR, 4.62; 95% confidence interval [CI], 0.96-22.30; P = 0.06) and processed meat (Q1 vs Q5; HR, 3.73; 95% CI, 0.95-14.66; P = 0.06) were nonsignificantly positively associated, with significant trends across quintiles (HRtrend, 1.33; 95% CI, 1.01-1.77 and HRtrend, 1.37; 95% CI, 1.04-1.82, respectively). Red meat's effect was attenuated by higher, but not lower, plasma vitamin C (HR, 1.06; 95% CI, 0.69-1.63 vs HR, 1.84; 95% CI, 1.09-3.14) and for processed meat (HR, 1.07; 95% CI, 0.71-1.63 vs HR, 1.80; 95% CI, 1.10-2.96). A nonstatistically significant risk was observed for high-temperature cooking methods in younger people (HR, 4.68; 95% CI, 0.63-34.70; P = 0.13).

CONCLUSIONS:

Red and processed meats may be involved in pancreatic carcinogenesis.

 

Vitamin B6 and Cancer Risk: A Field Synopsis and Meta-Analysis.

Mocellin S, Briarava M, Pilati P.

J Natl Cancer Inst. 2017 Mar 1;109(3):1-9. doi: 10.1093/jnci/djw230.

PMID: 28376200

http://sci-hub.cc/10.1093/jnci/djw230

Abstract

BACKGROUND:

: Vitamin B6 is involved in many biochemical reactions and might play a role in carcinogenesis. We summarized the evidence linking vitamin B6 to cancer risk.

METHODS:

We conducted a systematic review of both observational and intervention studies investigating the relationship between vitamin B6 intake or blood levels of its bioactive form pyridoxal-5'-phosphate (PLP) and the risk of any type of cancer. Random-effects meta-analysis was used to calculate pooled relative risks (RRs) and their 95% confidence intervals (CIs) across studies for high vs low categories of vitamin intake or PLP levels. We also performed a random-effects dose-response meta-analysis.

RESULTS:

We identified 121 observational studies (participants, n = 1 924 506; cases, n = 96 , 436) and nine randomized controlled trials (RCTs; participants, n = 34 911; cases, n = 2539) considering 19 tumor sites. High intake of dietary (food only) vitamin B6 was statistically significantly associated with lower risk of all cancers (relative risk [RR] = 0.78, 95% CI = 0.73 to 0.84) and specific tumors, with special regard to gastrointestinal carcinomas (RR = 0.68, 95% CI = 0.61 to 0.75). An inverse association was also observed between high PLP levels and the risk of all cancers (RR = 0.66, 95% CI = 0.58 to 0.76) and single tumor sites, the most consistent results being those for gastrointestinal tumors (RR = 0.56, 95% CI = 0.48 to 0.65). There was a statistically significant inverse linear relationship between cancer risk and both vitamin B6 dietary intake and PLP levels. When total (food and supplements) intake was considered, the associations were weaker or null. Findings from RCTs did not support a protective effect of vitamin B6 against cancer, although this evidence was graded as low level.

CONCLUSIONS:

Epidemiological evidence supports the potential of vitamin B6 as a cancer risk reduction agent and the role of PLP as a cancer screening biomarker, especially for gastrointestinal tumors. However, inconsistent findings from total intake and intervention studies suggest that vitamin B6 might also be an indicator of other dietary protective micronutrients.

 

Multivitamin use and adverse birth outcomes in high-income countries: a systematic review and meta-analysis.

Wolf HT, Hegaard HK, Huusom LD, Pinborg AB.

Am J Obstet Gynecol. 2017 Apr 1. pii: S0002-9378(17)30467-2. doi: 10.1016/j.ajog.2017.03.029. [Epub ahead of print] Review.

PMID: 28377269

Abstract

BACKGROUND:

In high-income countries (HIC), a healthy diet is widely accessible. However, a change towards a poor quality diet with a low nutritional value in HIC has led to an inadequate vitamin intake during pregnancy.

OBJECTIVE:

We conducted a systematic review and meta-analysis to evaluate the association between multivitamin use among women in HIC and the risk of adverse birth outcomes (preterm birth (PTB) (primary outcome), low birth weight, small-for-gestational age (SGA), stillbirth, neonatal death, perinatal mortality and congenital anomalies without further specification).

STUDY DESIGN:

We searched electronic databases (MEDLINE, Embase, Cochrane, Scopus and CINAHL) from inception to 17 June 2016 using synonyms of "pregnancy", "study/trial type" and "multivitamins". Eligible studies were all studies in HIC investigating the association between multivitamin use (three or more vitamins or minerals in tablets or capsules) and adverse birth outcomes. We evaluated randomized, controlled trials using the Cochrane Collaboration tool. Observational studies were evaluated using the Newcastle-Ottawa Scale. Meta-analyses were applied on raw data for outcomes with data for at least two studies and were conducted using RevMan (version 5.3). Outcomes were pooled using the random-effect model. The quality of evidence was assessed using the GRADE approach.

RESULTS:

We identified 35 eligible studies including 98,926 women. None of the studies compared the use of folic acid and iron versus use of multivitamins. Use of multivitamin did not change the risk of the primary outcome PTB RR 0.84 (95% CI 0.69-1.03). However, the risk of SGA RR 0.77 (95% CI 0.63-0.93), neural tube defects (NTD) RR 0.67 (95% CI 0.52-0.87), cardiovascular defects RR 0.83 (95% CI 0.70-0.98), urine tract defects RR 0.60 (95% CI 0.46-0.78), and limb deficiencies RR 0.68 (95% CI 0.52-0.89) was decreased. Of the 35 identified studies, only four were RCTs. The degree of clinical evidence according to the GRADE system was low or very low for all outcomes except for recurrence of NTD where a moderate degree of clinical evidence was found.

CONCLUSION:

Routine multivitamin use in HIC can be recommended, but with caution due to the low quality of evidence. RCTs or well-performed, large prospective cohort studies are needed.

KEYWORDS:

Multivitamin; adverse birth outcome; congenital birth defects; meta-analysis; pregnancy; systematic review

 

The role of vitamin D in maintaining bone health in older people.

Hill TR, Aspray TJ.

Ther Adv Musculoskelet Dis. 2017 Apr;9(4):89-95. doi: 10.1177/1759720X17692502. Epub 2017 Feb 14. Review.

PMID: 28382112

Abstract

This review summarises aspects of vitamin D metabolism, the consequences of vitamin D deficiency, and the impact of vitamin D supplementation on musculoskeletal health in older age. With age, changes in vitamin D exposure, cutaneous vitamin D synthesis and behavioural factors (including physical activity, diet and sun exposure) are compounded by changes in calcium and vitamin D pathophysiology with altered calcium absorption, decreased 25-OH vitamin D [25(OH)D] hydroxylation, lower renal fractional calcium reabsorption and a rise in parathyroid hormone. Hypovitaminosis D is common and associated with a risk of osteomalacia, particularly in older adults, where rates of vitamin D deficiency range from 10-66%, depending on the threshold of circulating 25(OH)D used, population studied and season. The relationship between vitamin D status and osteoporosis is less clear. While circulating 25(OH)D has a linear relationship with bone mineral density (BMD) in some epidemiological studies, this is not consistent across all racial groups. The results of randomized controlled trials of vitamin D supplementation on BMD are also inconsistent, and some studies may be less relevant to the older population, as, for example, half of participants in the most robust meta-analysis were aged under 60 years. The impact on BMD of treating vitamin D deficiency (and osteomalacia) is also rarely considered in such intervention studies. When considering osteoporosis, fracture risk is our main concern, but vitamin D therapy has no consistent fracture-prevention effect, except in studies where calcium is coprescribed (particularly in frail populations living in care homes). As a J-shaped effect on falls and fracture risk is becoming evident with vitamin D interventions, we should target those at greatest risk who may benefit from vitamin D supplementation to decrease falls and fractures, although the optimum dose is still unclear.

KEYWORDS:

Vitamin D; bone health; older people; osteomalacia; osteoporosis

 

Effect of Baseline Nutritional Status on Long-term Multivitamin Use and Cardiovascular Disease Risk: A Secondary Analysis of the Physicians' Health Study II Randomized Clinical Trial.

Rautiainen S, Gaziano JM, Christen WG, Bubes V, Kotler G, Glynn RJ, Manson JE, Buring JE, Sesso HD.

JAMA Cardiol. 2017 Apr 5. doi: 10.1001/jamacardio.2017.0176. [Epub ahead of print]

PMID: 28384735

http://sci-hub.cc/10.1001/jamacardio.2017.0176

Abstract

IMPORTANCE:

Long-term multivitamin use had no effect on risk of cardiovascular disease (CVD) in the Physicians' Health Study II. Baseline nutritional status may have modified the lack of effect.

OBJECTIVE:

To investigate effect modification by various baseline dietary factors on CVD risk in the Physicians' Health Study II.

DESIGN, SETTING, AND PARTICIPANTS:

The Physicians' Health Study II was a randomized, double-blind, placebo-controlled trial testing multivitamin use (multivitamin [Centrum Silver] or placebo daily) among US male physicians. The Physicians' Health Study II included 14 641 male physicians 50 years or older, 13 316 of whom (91.0%) completed a baseline 116-item semiquantitative food frequency questionnaire and were included in the analyses. This study examined effect modification by baseline intake of key foods, individual nutrients, dietary patterns (Alternate Healthy Eating Index and Alternate Mediterranean Diet Score), and dietary supplement use. The study began in 1997, with continued treatment and follow-up through June 1, 2011.

INTERVENTIONS:

Multivitamin or placebo daily.

MAIN OUTCOMES AND MEASURES:

Major cardiovascular events, including nonfatal myocardial infarction, nonfatal stroke, and CVD mortality. Secondary outcomes included myocardial infarction, total stroke, CVD mortality, and total mortality individually.

RESULTS:

In total, 13 316 male physicians (mean [sD] age at randomization, 64.0 [9.0] years in those receiving the active multivitamin and 64.0 [9.1] years in those receiving the placebo) were observed for a mean (SD) follow-up of 11.4 (2.3) years. There was no consistent evidence of effect modification by various foods, nutrients, dietary patterns, or baseline supplement use on the effect of multivitamin use on CVD end points. Statistically significant interaction effects were observed between multivitamin use and vitamin B6 intake on myocardial infarction, between multivitamin use and vitamin D intake on CVD mortality, and between multivitamin use and vitamin B12 intake on CVD mortality and total mortality. However, there were inconsistent patterns in hazard ratios across tertiles of each dietary factor that are likely explained by multiple testing.

CONCLUSIONS AND RELEVANCE:

The results suggest that baseline nutritional status does not influence the effect of randomized long-term multivitamin use on major CVD events. Future studies are needed to investigate the role of baseline nutritional biomarkers on the effect of multivitamin use on CVD and other outcomes.

 

Higher uric acid serum levels are associated with better muscle function in the oldest old: Results from the Mugello Study.

Molino-Lova R, Sofi F, Pasquini G, Vannetti F, Del Ry S, Vassalle C, Clerici M, Sorbi S, Macchi C.

Eur J Intern Med. 2017 Mar 22. pii: S0953-6205(17)30118-8. doi: 10.1016/j.ejim.2017.03.014. [Epub ahead of print]

PMID: 28342714

http://sci-hub.cc/10.1016/j.ejim.2017.03.014

Abstract

BACKGROUND:

Sarcopenia is the progressive loss of muscle mass and strength that occurs with advancing age and plays a pivotal role in the causal pathway leading to frailty, disability and, eventually, to death among older persons. As oxidative damage of muscle proteins has been shown to be a relevant contributory factor, in this study we hypothesized that uric acid (UA), a powerful endogenous antioxidant, might exert a protective effect on muscle function in the oldest old and we tested our hypothesis in a group of nonagenarians who participated in the Mugello Study.

METHODS:

239 subjects, 73 men and 166 women, mean age 92.8years±SD 3.1, underwent the assessment of UA serum level and isometric handgrip strength, a widely used clinical measure of sarcopenia.

RESULTS:

Mean UA serum level was 5.69mg/dL±SD 1.70 and mean handgrip strength was 15.0kg±SD 6.9. After adjusting for relevant confounders, higher UA serum levels remained independent positive predictors of isometric handgrip strength (β 1.24±SE(β) 0.43, p=0.005).

CONCLUSION:

Our results show that higher UA serum levels are associated with better muscle function in the oldest old and, accordingly, might slow down the progression of sarcopenia.

KEYWORDS:

Antioxidants; Muscle strength; Oldest old; Sarcopenia; Uric acid

 

Perceived swallowing problems and mortality risk in very elderly people ≥85 years old: Results of the Tokyo Oldest Old Survey on Total Health study.

Iinuma T, Hirata T, Arai Y, Takayama M, Abe Y, Fukumoto M, Fukui Y, Gionhaku N.

Gerodontology. 2017 Mar 28. doi: 10.1111/ger.12265. [Epub ahead of print]

PMID: 28349594

http://sci-hub.cc/10.1111/ger.12265

Abstract

OBJECTIVE:

The aim of this study was to clarify whether perceived swallowing problems affect the life expectancy of very elderly individuals.

BACKGROUND:

In an ageing society, oral function affects health status. In particular, a decline in swallowing function may increase the risk of various diseases, morbidity and malnutrition.

MATERIALS AND METHODS:

We evaluated 526 elderly individuals aged ≥85 years. All participants completed a questionnaire and underwent oral, physical and mental health examinations. The comprehensive oral health assessment comprised a face-to-face interview that included a questionnaire on swallowing function. We estimated hazard ratios and 95% confidence intervals using the Cox proportional hazards model, adjusting for potential confounders between perceived swallowing problems and all-cause mortality over a 3-year period.

RESULTS:

Over a 3-year follow-up period, 88 of 526 participants died and 68 participants complained of perceived swallowing problems. Perceived swallowing problems had statistically significant associations with physical status and function and nutrition. In the univariate analysis, perceived swallowing problems had statistically significant associations with an approximately 1.9-fold higher risk of all-cause mortality during the 3-year period (HR: 1.89, 95% CI: 1.14-3.14). In the multivariate analysis, the statistically significant association between perceived swallowing problems and all-cause mortality remained after adjusting for various confounding factors (HR: 1.73, 95% CI: 1.03-2.92).

CONCLUSION:

Perceived swallowing disorders should be verified by a clinical examination, as they are associated with other health outcomes and increased all-cause mortality.

KEYWORDS:

elderly; mortality; oral function; oral health

 

Improved skeletal muscle mass and strength after heavy strength training in very old individuals.

Bechshøft RL, Malmgaard-Clausen NM, Gliese B, Beyer N, Mackey AL, Andersen JL, Kjær M, Holm L.

Exp Gerontol. 2017 Mar 28. pii: S0531-5565(16)30494-6. doi: 10.1016/j.exger.2017.03.014. [Epub ahead of print]

PMID: 28363433

Abstract

Age-related loss of muscle mass and function represents personal and socioeconomic challenges. The purpose of this study was to determine the adaptation of skeletal musculature in very old individuals (83+ years) performing 12weeks of heavy resistance training (3×/week) (HRT) compared to a non-training control group (CON). Both groups received similar protein supplementations. We studied 26 participants (86.9±3.2 (SD) (83-94, range) years old) per-protocol. Quadriceps cross-sectional area (CSA) differed between groups at post-test (P<0.05) and increased 1.5±0.7cm2 (3.4%) (P<0.05) in HRT only. The relative increase in CSA correlated inversely with the baseline level of CSA (R2=0.43, P<0.02). Thigh muscle isometric strength, isokinetic peak torque and power increased significantly only in HRT by 10-15%, whereas knee extension one-repetition maximum (1 RM) improved by 91%. Physical functional tests, muscle fiber type distribution and size did not differ significantly between groups. We conclude that in protein supplemented very old individuals, heavy resistance training can increase muscle mass and strength, and that the relative improvement in mass is more pronounced when initial muscle mass is low.

KEYWORDS:

Elderly; Protein; Resistance training; Skeletal muscle

 

Use of Dietary Supplements Improved Diet Quality But Not Cardiovascular and Nutritional Biomarkers in Socioeconomically Diverse African American and White Adults.

Kuczmarski MF, Beydoun MA, Stave Shupe E, Pohlig RT, Zonderman AB, Evans MK.

J Nutr Gerontol Geriatr. 2017 Mar 24:1-19. doi: 10.1080/21551197.2017.1299659. [Epub ahead of print]

PMID: 28339339

http://sci-hub.cc/10.1080/21551197.2017.1299659

Abstract

Knowledge of the contribution of supplements to overall nutritional health is limited. The research objectives were to describe motivations for use of dietary supplements by African Americans and Whites examined in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study and to determine if supplements provided beneficial effects to micronutrient diet quality and nutritional and cardiovascular biomarkers. The majority of the HANDLS study population were smokers, overweight or obese, and self-reported their health as poor to good. The top two reasons for their supplement use were to supplement the diet and to improve overall health. Micronutrient intake was calculated from two 24-hour recalls and a supplement questionnaire. Diet quality was assessed by the Mean Adequacy Ratio (MAR) [Maximum score = 100] derived from the Nutrient Adequacy Ratio (NAR) for 17 micronutrients. The MAR score for nonusers was 73.12, for supplement users based on diet alone was 74.89, and for food and supplements was 86.61. Dietary supplements significantly increased each NAR score and MAR score. However, there were no significant differences between the population proportions with inadequate or excessive blood levels for any biomarkers examined. Nutrition education programs and intervention strategies addressing dietary supplement intake might lead to healthier food choices and may improve the health of this population.

KEYWORDS:

Diet quality; dietary supplements; supplement use

 

Cardiovascular Protective Effects and Clinical Applications of Resveratrol.

Cho S, Namkoong K, Shin M, Park J, Yang E, Ihm J, Thu VT, Kim HK, Han J.

J Med Food. 2017 Mar 27. doi: 10.1089/jmf.2016.3856. [Epub ahead of print]

PMID: 28346848

Abstract

Resveratrol is a naturally occurring phenol that is generated by plant species following injury or attack by bacterial and fungal pathogens. This compound was first described as the French Paradox in 1992. Later in 2003, resveratrol was reported to activate sirtuins in yeast cells. Recent experimental studies have found that resveratrol offers a variety of benefits that include both anticarcinogenic and anti-inflammatory effects in addition to the ability to reverse obesity, attenuate hyperglycemia and hyperinsulinemia, protect heart and endothelial function, and increase the life span. Multiple molecular targets are associated with the cardioprotective capabilities of resveratrol, and therefore, resveratrol has potential for a wide range of new therapeutic strategies for atherosclerosis, ischemia/reperfusion, metabolic syndrome, cardiac failure, and inflammatory alterations during aging. Expectations for application in human patients, however, suffer from a lack of sufficient clinical evidence in support of these beneficial effects. This article reviews recently reported basic research results that describe the beneficial effects of resveratrol in an attempt to condense the evidence observed in clinical trials and provide support for the future development of novel clinical therapeutics in patients with cardiovascular diseases.

KEYWORDS:

cardiovascular disease; clinical application; resveratrol

 

Hs-CRP and all-cause, cardiovascular, and cancer mortality risk: A meta-analysis.

Li Y, Zhong X, Cheng G, Zhao C, Zhang L, Hong Y, Wan Q, He R, Wang Z.

Atherosclerosis. 2017 Feb 9;259:75-82. doi: 10.1016/j.atherosclerosis.2017.02.003. [Epub ahead of print]

PMID: 28327451

Abstract

BACKGROUND AND AIMS:

Inconsistent findings have been reported on the association between high-sensitivity C-reactive protein (hs-CRP) and mortality risk. The objective of this meta-analysis was to investigate the association of elevated baseline hs-CRP levels with all-cause, cardiovascular, and cancer mortality risk in the general population.

METHODS:

PubMed and Embase were systematically searched for studies published from inception to October 2016. Prospective observational studies were eligible if they reported the effects of elevated baseline hs-CRP levels on cancer-related, cardiovascular or all-cause mortality in the general population. The pooled adjusted risk ratio (RR) with 95% confidence interval (CI) comparing the highest to the lowest category of hs-CRP levels was used as association measures.

RESULTS:

A total of 83,995 participants from 14 studies were identified. When comparing the highest to the lowest category of hs-CRP levels, the pooled RR was 1.25 (95% CI 1.13-1.38) for cancer-related mortality, 2.03 (95% CI 1.65-2.50) for cardiovascular mortality, and 1.75 (1.55-1.98) for all-cause mortality, respectively. Subgroup analysis showed that the effect of elevated hs-CRP levels on cancer-related mortality was observed in men (RR 1.26; 95% CI 1.11-1.43) but not in women (RR 1.03; 95% CI 0.83-1.27).

CONCLUSIONS:

Elevated hs-CRP levels can independently predict risk of all-cause, cardiovascular mortality in the general population. However, the gender differences in the predictive role of hs-CRP on cancer mortality should to be further investigated.

KEYWORDS:

All-cause mortality; Cardiovascular mortality; High-sensitivity C-reactive protein; Meta-analysis

 

Physical activity is independently associated with reduced mortality: 15-years follow-up of the Hordaland Health Study (HUSK).

Kopperstad Ø, Skogen JC, Sivertsen B, Tell GS, Sæther SM.

PLoS One. 2017 Mar 22;12(3):e0172932. doi: 10.1371/journal.pone.0172932. eCollection 2017.

PMID: 28328994 Free Article

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0172932

http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0172932&type=printable

Abstract

BACKGROUND:

Physical activity (PA) is associated with lower risk for non-communicable diseases and mortality. We aimed to investigate the prospective association between PA and all-cause and cause-specific mortality, and the impact of other potentially contributing factors.

METHOD:

Data from the community-based Hordaland Health Study (HUSK, 1997-99) were linked to the Norwegian Cause of Death Registry. The study included 20,506 individuals born 1950-1957 and 2,225 born in 1925-1927 (baseline age 40-49 and 70-74). Based on self-report, individuals were grouped as habitually performing low intensity, short duration, low intensity, longer duration or high intensity PA. The hazard ratios (HR) for all-cause and cause-specific mortality during follow-up were calculated. Measures of socioeconomic status, physical health, mental health, smoking and alcohol consumption were added separately and cumulatively to the model.

RESULTS:

PA was associated with lower all-cause mortality in both older (HR 0.75 (95% CI 0.67-0.84)) and younger individuals (HR 0.82 (95% CI 0.72-0.92)) (crude models, HR: risk associated with moving from low intensity, short duration to low intensity, longer duration PA, and from low intensity, longer duration to high intensity). Smoking, education, somatic diagnoses and mental health accounted for some of the association between physical activity and mortality, but a separate protective effect of PA remained in fully adjusted models for cardiovascular (HR 0.78 (95% CI 0.66-0.92)) and respiratory (HR 0.45 (95% CI 0.32-0.63) mortality (both age-groups together), as well as all-cause mortality in the older age group (HR 0.74, 95%CI 0.66-0.83).

CONCLUSION:

Low intensity, longer duration and high intensity physical activity was associated with reduced all-cause, respiratory and cardiovascular mortality, indicating that physical activity is beneficial also among older individuals, and that a moderate increase in PA can be beneficial.

 

Incident Cardiovascular Events and Death in Individuals with Restless Legs Syndrome or Periodic Limb Movements in Sleep: A Systematic Review.

Kendzerska T, Kamra M, Murray BJ, Boulos MI.

Sleep. 2017 Feb 9. doi: 10.1093/sleep/zsx013. [Epub ahead of print]

PMID: 28329227

http://sci-hub.cc/10.1093/sleep/zsx013

Abstract

STUDY OBJECTIVES:

To systematically review the current evidence examining restless legs syndrome (RLS) and periodic limb movements (PLMS) as prognostic factors for all-cause mortality and incident cardiovascular events (CVE) in longitudinal studies published in the adult population.

METHODS:

All English language studies (from 1947 to 2016) found through Medline and Embase, as well as bibliographies of identified articles, were considered eligible. Quality was evaluated using published guidelines.

RESULTS:

Among 18 cohorts (reported in 13 manuscripts), 15 evaluated the association between RLS and incident CVE and/or all-cause mortality, and three between PLMS and CV events and mortality. The follow-up periods ranged from 2 to 20 years. A significant relationship between RLS and CVE was reported in four cohorts with a greater risk suggested for severe RLS with longer duration and secondary forms of RLS. Although a significant association between RLS and all-cause mortality was reported in three cohorts, a meta-analysis we conducted of the four studies of highest quality found no association (pooled HR = 1.09, 95%CI: 0.80-1.78). A positive association between PLMS and CV events and/or mortality was demonstrated in all included studies with a greater risk attributed to PLMS with arousals.

CONCLUSIONS:

The available evidence on RLS as a prognostic factor for incident CVE and all-cause mortality was limited and inconclusive; RLS duration, severity and secondary manifestations may be important in understanding a possible relationship. Although very limited, the current evidence suggests that PLMS may be a prognostic factor for incident CVE and mortality.

KEYWORDS:

PLMS.; RLS; cardiovascular diseases; mortality; systematic review

"The evidence for an association between PLMS and CVE and

mortality was based on one study of moderate58 and one study of

high quality56; both studies demonstrated a significant association

between PLMS and our outcomes of interest. After adjusting for

confounders, an increase in the frequency of PLMS in sleep, with

or without related arousals, was associated with a 5–26% increased

hazard for the composite CV outcome56,58 and a 5% increased risk

of all-cause mortality.58 The effect of a periodic limb movement

arousal index ≥5 was comparable with that of a PLM index ≥30.56"

 

Mean platelet volume is associated with lower risk of overall and non-vascular mortality in a general population. Results from the Moli-sani study.

Bonaccio M, Di Castelnuovo A, Costanzo S, de Curtis A, Persichillo M, Cerletti C, Donati MB, de Gaetano G, Iacoviello L; MOLI-SANI study Investigators..

Thromb Haemost. 2017 Mar 30. doi: 10.1160/TH16-12-0974. [Epub ahead of print]

PMID: 28357442

Abstract

Larger mean platelet volume (MPV) has been associated with adverse health outcomes in high-risk populations or patients with cardiovascular disease (CVD). We tested the association of MPV with mortality in a prospective cohort study including 17,402 subjects randomly recruited from an adult general population within the Moli-sani study (2005-2010). Two distinct subgroups (with or without CVD at baseline) were subsequently analysed. Hazard ratios (HR) were calculated using multivariable Cox-proportional hazard models. Over a median follow up of eight years (137,547 person-years), 925 all-cause deaths occurred (330 vascular, 351 cancer and 244 other deaths). In a multivariable model, the highest MPV quintile (mean MPV=10.0 fL), as compared to the lowest one, was associated with reduced risk of overall mortality (HR=0.79; 95 % confidence interval 0.64-0.98), cancer death (HR=0.70; 0.49-1.00) and death from other non- vascular/non cancer causes (HR=0.55; 0.36-0.84) but not with vascular mortality. The inverse association with overall death appeared even stronger in the subgroup without CVD at baseline (HR=0.64; 0.50-0.81). In contrast, within 920 subjects reporting a previous CVD event, larger MPV was associated with higher risk of total mortality (HR=1.69; 1.05-2.72; p for interaction=0.048) and with a trend of risk for other cause-specific deaths. In conclusion, larger MPV is associated with lower risk of overall and non-vascular death in subjects apparently free from CVD, but appears to be a predictive marker of death in patients with CVD history. The latter is a likely effect modifier of the association between MPV and death.

KEYWORDS:

Mean platelet volume; cardiovascular disease; cerebrovascular disease; epidemiology; mortality

 

Quality of life independently predicts long-term mortality but not vascular events: the Northern Manhattan Study.

Liang JW, Cheung YK, Willey JZ, Moon YP, Sacco RL, Elkind MS, Dhamoon MS.

Qual Life Res. 2017 Mar 29. doi: 10.1007/s11136-017-1567-8. [Epub ahead of print]

PMID: 28357682

Abstract

PURPOSE:

Cardiovascular disease is a major contributor to morbidity and mortality, and prevention relies on accurate identification of those at risk. Studies of the association between quality of life (QOL) and mortality and vascular events incompletely accounted for depression, cognitive status, social support, and functional status, all of which have an impact on vascular outcomes. We hypothesized that baseline QOL is independently associated with long-term mortality in a large, multi-ethnic urban cohort.

METHODS:

In the prospective, population-based Northern Manhattan Study, Spitzer QOL index (SQI, range 0-10, with ten signifying the highest QOL) was assessed at baseline. Participants were followed over a median 11 years for stroke, myocardial infarction (MI), and vascular and non-vascular death. Multivariable Cox proportional hazards regression estimated hazard ratio and 95% confidence interval (HR, 95% CI) for each outcome, with SQI as the main predictor, dichotomized at 10, adjusting for baseline demographics, vascular risk factors, history of cancer, social support, cognitive status, depression, and functional status.

RESULTS:

Among 3298 participants, mean age was 69.7 + 10.3 years; 1795 (54.5%) had SQI of 10. In fully adjusted models, SQI of 10 (compared to SQI <10) was associated with reduced risk of all-cause mortality (HR 0.80, 95% CI 0.72-0.90), vascular death (0.81, 0.69-0.97), non-vascular death (0.78, 0.67-0.91), and stroke or MI or death (0.82, 0.74-0.91). In fully adjusted competing risk models, there was no association with stroke (0.93, 0.74-1.17), MI (0.98, 0.75-1.28), and stroke or MI (1.03, 0.86-1.24). Results were consistent when SQI was analyzed continuously.

CONCLUSION:

In this large population-based cohort, highest QOL was inversely associated with long-term mortality, vascular and non-vascular, independently of baseline primary vascular risk factors, social support, cognition, depression, and functional status. QOL was not associated with non-fatal vascular events.

KEYWORDS:

Cohort; Patient-centered outcomes; Prospective; Quality of life; Vascular outcomes

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THE CURRENT ENCORE: Hate the gym? History explains why the treadmill can feel like torture

http://www.cbc.ca/radio/thecurrent/the-current-for-april-17-2017-1.4071273/encore-hate-the-gym-history-explains-why-the-treadmill-can-feel-like-torture-1.4071310

 

If you dread the gym, it might not surprise you the treadmill was originally a device used to punish prison inmates. But how far have we really moved away from the idea of exercise as punishment?

http://www.cbc.ca/radio/thecurrent/the-current-for-february-22-2017-1.3992510/february-22-2017-full-episode-transcript-1.3994742#segment3

 

AMT: Hello. I'm Anna Maria Tremonti and you're listening to The Current.

 

[Music: The Disruptors theme]

 

AMT: This season on The Current, we're looking at disruptors—people, objects, ideas that have changed how we look at the world. And today we are at the gym.

 

SOUNDCLIP

 

[sound: Treadmill]

 

VOICE 1: Just warming up right now. I’m starting with 3.0 and then I go every two minute, up and up until I hit 12.

 

VOICE 2: Kilometres an hour?

 

VOICE 1: Yeah. Yes.

 

VOICE 2: That’s fast.

 

VOICE 1: It is. I do three times a week. I love it.

 

VOICE 3: I’m blowing up steam. I was up early. Drove my kid to basketball practice. Made my other kid’s lunch. I tend to be a solo runner mostly, so this works for me. I just lock it and go and I’ll feel so much better during the day having done this.

 

VOICE 4: I’m working on the couch to 5K program. So trying to work up to running for 30 minutes.

 

VOICE 2: Is the treadmill your thing or do you run outside normally or?

 

VOICE 4: Not when it's negative 11. This is where it goes on. Yeah. It does feel awful.

 

VOICE 2: You don't love it?

 

VOICE 4: No. No. It’s the other parts I love. Stopping. I love stopping.

 

[sound: Treadmill]

 

AMT: Okay. Can you relate? Treadmill enthusiasts bright and early at the downtown Toronto YMCA. Although enthusiasts may be the wrong word for some of them—perhaps sufferer is more apt. This year the treadmill celebrates its 200th anniversary. It's become a mainstay of the modern gym but the treadmill’s origins are downright torturous. As part of our project The Disruptors, we're looking at how the treadmill and the gym have disrupted how we look at health and fitness and we'll start this exploration with Vybarr Cregan-Reid. He teaches English at the University of Kent. More to the point, he's the author of Footnotes: How Running Makes Us Human. And he joins us from London. Hello.

 

VYBARR CREGAN-REID: Hello, Anna Maria.

 

AMT: Well, we just heard that woman there not enjoying her treadmill time. She may be on to something though. What was the original purpose of the treadmill 200 years ago?

 

VYBARR CREGAN-REID: In the UK in the late 18th century, there was lots of penal reform and it was felt that many of the crimes that were given the death penalty should be given something short of the death penalty. And the idea of hard labour was invented. The idea of hard labour was that it should punish the prisoners’ hearts and souls. It wasn't that they would be given labour to do that was fruitful or restorative. It was thought that something pointless should be done. An inventor called William Cubitt came up with his idea of the treadwheel, which we know today as the treadmill. And it became something that people were sentenced to.

 

AMT: That explains a lot. What did it look like?

 

VYBARR CREGAN-REID: Initially it started off as a sort of huge cylinder, like a water wheel that the men—because it was men—would all walk on together, a bit like a giant cylindrical Stairmaster. The wheels beneath them so that they are effectively on a floor is in motion but with small steps on it. By the time that Oscar Wilde was infamously imprisoned in 1895, prisoners then would walk the treadmill for about up to five to six hours a day. It was really serious punishment. And instead of being able to talk to one another, they were put into a sort of separated booths so that they had no sensory stimulation of any kind. It was terrifying.

 

AMT: So it really was hard physical labour. It was punishment. That is staggering.

 

VYBARR CREGAN-REID: Yeah, it is.

 

AMT: And so how does it evolve? Because at some point child labour comes into this.

 

VYBARR CREGAN-REID: It was a beginning of a movement that was recognizing that people were beginning to become more sedentary. And there was a patent called the gymnastican, which was basically a sort of cross-trainer that could be given to students or men of leisure who weren't getting appropriate amounts of exercise and they would climb inside this machine and then they would work the machine with their feet. But the gymnastican also had a huge wheel with a handle on the side and the patent explains that the reason for this is that [chuckles]—it's not funny—a child could be employed to work the wheel if the gentleman didn't want to have to go you know make the efforts of working the machine himself.

 

AMT: Wow. As you went through this history, what were you thinking?

 

VYBARR CREGAN-REID: Well, it was wondrous really. The gymnastican was not a commercial success. Only with electricity does it become workable. But the gymnastican, when you see the picture of it, whenever I show it at a talk or something, everybody in the room just breaks into laughter. It looks so ridiculous. But it's a lovely moment where we can see the beginnings of ourselves really in this history. It’s something that starts with the beginning of the industrial revolution, this recognition that modes of labour are changing so drastically that we now have to find other ways of moving our bodies.

 

AMT: So it goes from punishment perspiring because you're under punishment to perspiring for pleasure. When does the treadmill take on what we see today in our gyms?

 

VYBARR CREGAN-REID: The treadmill sort of disappears in the early 20th century and is forgotten about for a generation and then a cardiologist at the University of Washington in the 1950s wants to assess the fitness levels of his heart patients. He puts a treadmill together that looks a lot more like the treadmill that we would know today. And then it's not until the jogging revolution of the sixties and seventies that it becomes a sort of consumer commodity. And now I think the business is worth around $15 billion.

 

AMT: But this is not the treadmill that you would like to see, the treadmill of the future. What would you like to see?

 

VYBARR CREGAN-REID: Anything that gets people moving and exercising is great and there are things that people like about the mechanical treadmill now, like the fact that they can just punch in a number like 30 minutes into a treadmill or a speed. They have outsourced their responsibility for their exercise to the machine. But one of the things that's perfect about running is it stimulates us on so many levels that we're not aware of. But once you start stripping away the experience of an outdoor run in a green space and putting it onto a rubber belt in a gym, it might seem like you're doing the same thing, but actually lots of the things that you would have been doing have been lost in the translation. So the things that might create empathy between yourself and other people or yourself and a place, the things that might decrease stress, the things that might make you a better friend or a partner or a spouse or in preview or exam results or even make you less likely to commit a crime, these things are all lost on the treadmill. Our senses get stimulated in so many ways that they have very subtle effects on our psychology that aren’t always very easy to trace.

 

AMT: So you're saying we're not out in nature.

 

VYBARR CREGAN-REID: Basically, yeah. We're not out in nature and we're missing out on a great deal by being so. So to get back to your original question of what needs to be on the treadmill, basically the answer is more of nature. So things like treadmills with big screens that will allow us to feel like we're running in natural spaces. We need treadmills that are silent so that we can listen to nature sounds as well.

 

AMT: And where would the nature sounds come from?

 

VYBARR CREGAN-REID: Speakers or headphones. God, this is going to be a very complicated machine because it has to release smells as well.

 

AMT: Oh, okay. But that is your optimum treadmill, one that releases smells and sounds.

 

VYBARR CREGAN-REID: That would get as close to the outdoor running experience as possible. And the effects on the runner would be almost the same.

 

AMT: So I have to ask, if that's what it should incorporate, why don't we just run outside?

 

VYBARR CREGAN-REID: That's a very good question, isn't it? You know I'm obviously a very committed outdoor runner myself and I like this idea of the perfect treadmill that has bits of grass growing out of it. Hopefully it might encourage runners to see a little bit more of what it is that they're losing when they translate the runs from analog to digital.

 

AMT: What do you think of those people, like some of the people we heard earlier, who just love running on a treadmill?

 

VYBARR CREGAN-REID: I'd love to maybe sneak a few more of the benefits of outdoor running into their treadmill experience. But you know to hear people speaking so positively about any form of exercise, I think that's just great.

 

AMT: It's come a long way in 200 years.

 

VYBARR CREGAN-REID: Indeed, it has. It's got a long way to go as well.

 

AMT: Okay. Well, Vybarr Cregan-Reid, thank you for your time. Thank you for having me on. Vybarr Cregan-Reid teaches English at the University of Kent. He is the author of Footnotes: How Running Makes Us Human. He's in London, England.

 

SOUNDCLIP

 

[sound: Treadmill]

 

VOICE 1: Do you like the treadmill?

 

VOICE 2: Don't like it as much but it's nice to see everyone come in and you know the activity in the place. It’s very stationary. I can listen to a podcast. I can zone out. It's great.

 

AMT: Well, these days it is standard protocol for indoor runners to get into the zone. Ear buds in, screen on, heartbeat measured and eyes straight ahead. But the gym was not always like this. For that matter, the gym wasn't always just about exercise and health. For more on that, I'm joined by Eric Chaline. He is the author of The Temple of Perfection: A History of the Gym and he's also in London, England. Hello.

 

ERIC CHALINE: Hi.

 

AMT: What would we have seen if we'd walked into one of the very earliest of gyms back in ancient Greece?

 

ERIC CHALINE: What you would have seen is something completely different from a modern gym. You would have been in a large open air space set in parklands. Everybody trained naked and then they would be very little actual equipment because what was practiced were the six Olympic sports.

 

AMT: Everybody trained naked. They were all men.

 

ERIC CHALINE: They were all men, of course. Yeah.

 

AMT: And it wasn't solely a place to train for sport. It became more like a school and even military training, did it not?

 

ERIC CHALINE: The social functions of the classical gym much greater than that of the modern gym, certainly. It was also the only thing that the ancient Greeks had as a primary school or secondary school and even a university. For example, Plato taught at the Academy gym on the outskirts of Athens.

 

AMT: Let's skip ahead many, many centuries. What do the Napoleonic wars have to do with the emergence of the gym in Prussia?

 

ERIC CHALINE: The first modern institution devoted to physical exercise re-appears in 1811, in Prussia and it started by a Prussian teacher who wanted to build the German race up after Prussia's defeat by Napoleon, who were considered the major military power in Europe. So his take on exercise was to restore Prussia to its ancient virility which had been taken away by civilization, industrialization. After the mid-century, states started to realize that if they wanted fit soldiers and stronger workers, exercise was a good way of attaining that.

 

AMT: How does the advent of photography play into the changing image of fitness and then the gym?

 

ERIC CHALINE: Some of the first people who use it are strong men. One of the most famous at the time is a German called Eugen Sandow and he is the first recognizably modern fitness entrepreneur. He starts a chain of gyms. He has a fitness mail order business for all kinds of home equipment and he uses photography of his own rather extraordinary physique to promote his fitness enterprise. And the middle classes realized that they needed to start to do exercise to regain some kind of health and also attractiveness, I think, was a very important aspect of going to the gym then.

 

AMT: Right and we start to see more of this issue of the body beautiful, don't we? And as we keep moving forward and you go from Europe to America, where does the idea of the modern fitness club spring up?

 

ERIC CHALINE: Yes. The modern fitness club appears first in Southern California on and around Muscle Beach, which was quite a famous place in the 1930s and forties, where young people who obviously had good bodies because they went to the beach, would come and show off. They would do weight training. They would do Olympic lifting. They would do acrobatics. To cater to them and that hedonistic lifestyle, gyms started to open in the area. You have the first chains opening up and then gradually spreading nationwide and ultimately worldwide.

 

AMT: When did the gym start being primarily a boys club?

 

ERIC CHALINE: With the aerobics revolution, so you’re talking Jane Fonda. No pain, no gain.

 

AMT: That's right. She would do the videos, right? She had the leotard.

 

ERIC CHALINE: Well, she started with the book and then it was, the video was the one that really made it. I think it’s still the biggest selling exercise video of all time. For those people who are too young, you can go to YouTube and there she is, in leotards. Splendidly.

 

AMT: So how much is going to the gym actually about health? What other factors have driven us to the gym over its history?

 

ERIC CHALINE: Quite honestly, I'd say health was very low down on the scale of the reasons why people would want to go. In ancient Greece, people went because they trained to be warriors and they went because they wanted to be more attractive. The cult of the body beautiful starts with the ancient Greeks.

 

AMT: Well, you actually point out that there was real erotica there as well, right? There was a lot of same sex.

 

ERIC CHALINE: Exactly. It was the focus of classical Greek same-sex culture. That's where older men met younger men.

 

AMT: And you draw the line to gay liberation in modern times to gyms.

 

ERIC CHALINE: The gym plays a very important part in contemporary gay culture. Lots of gay men are very body conscious and as a result will go to the gym. And in fact, it's influenced straight culture. Younger straight men go to the gym. Maybe they don't realize that they owe their participation to gay men originally.

 

AMT: But this type of exercise was not always seen as medically healthy. It was actually seen as detrimental, was it not at one point?

 

ERIC CHALINE: That's right. In the 1930s, people definitely thought that women shouldn't weight train, that they would become over masculine. But they also thought that athletes shouldn't weight train because it would actually damage their bodies. Doctors discouraged weight training.

 

AMT: And so how is the concept and popularity of the gym affected how we think about health now?

 

ERIC CHALINE: If your aim is purely to improve your health, you don't have to go to a gym. Going to a gym is reshaping your body in a certain way.

 

AMT: In fact, you say that in many ways it's become a place of almost worship.

 

ERIC CHALINE: In a slightly lighthearted way, I suggested that the gym has taken over from the church. People in past generations used to be avid churchgoers and now we’re avid gym goers.

 

AMT: And we have special clothes. We have special rituals.

 

ERIC CHALINE: Special clothes. Special food. You know we eat our protein bars and have our protein shakes afterwards. We have all kinds of rituals connected to going to the gym.

 

AMT: And that's where we get the title too, eh? The Temple of Perfect.

 

[Crosstalk]

 

ERIC CHALINE: The Temple of Perfect. Yes.

 

AMT: Eric Chaline, thank you. Very interesting to follow that history all the way back. Thank you.

 

ERIC CHALINE: Thank you very much.

 

AMT: Eric Chaline, Eric Chaline, author of The Temple of Perfection: A History of the Gym. He's in London, England.

 

SOUNDCLIP

 

VOICE 1: What are you up to now?

 

VOICE 2: Now it is 12 for two minutes. See, I start to feel it, but a little bit hard is okay.

 

VOICE 3: When I hold these, it tells me how much my heart rate is going. I have like a history of like heart disease and stuff in my family. I'm just trying to nip it in the bud, I guess a little bit. It seems to me like the bare minimum I guess I could do. Yeah, initially I wasn’t sure if I would make it a regular thing or not. It's one of those things where you just keep going even though you don't want to and it gets better, I guess. I have so many of my friends telling me that running is like maybe one of the worst things you could be doing but it's the only thing I can find myself kind of motivated to do.

 

VOICE 2: Ooh. Oh yeah. A little bit slow down. Oof. [exhale] It’s good.

 

AMT: What is it about hearing other people working out if you're not? Some of those YMCA treadmill runners still going, hoping among other things to add years to their lives. But before you feel guilty, those who study people who live to be very old are discovering exercise is not part of the formula.

 

AMT: This is what you call natural movement.

 

DAN BUETTNER: Yes. Moving naturally.

 

AMT: So their daily routines, are they going for long walks?

 

DAN BUETTNER: Not intentionally. So walking is a form of transportation. So they'll live in places where every time you want to go to a friend's house, it occasions a walk or it's something people look forward to. In Okinawa, we studied these moais, these committed circles of friends and their way of winding down the day was to get together and take a walk and talk about the issues of their lives. And it's a big paradigm shift in the way we heard from our previous guest—treadmills being a punishment. Indeed for these people, walking was something they look forward to so they’d actually do it for 100 years. It was fun. Makes a big difference when it comes to longevity.

 

AMT: So but you're describing people whose lifestyles are different from those that most of us in urban areas lead. If you're living in an urban area, you're working a sedentary job. Is it possible to have all that natural movement at a level that would keep us healthy?

 

DAN BUETTNER: You can have an enormous impact with how you design the built environment. If you clean up parks, you make sure there are sidewalks without dangerous cracks in there. There's bike lanes. You can raise the physical activity level of a city by about 30 per cent. You know this also requires that you make driving slightly more inconvenient and walking more convenient and it's amazing how it drives people out from behind the steering wheel onto their feet. So we spend all this money lurching after physical activity when we really should be focusing on shaping our environments so that walking or movement is the default rather than something we race to after we're done sitting in our offices for eight or nine hours a day.

 

AMT: So beyond city planning and lobbying city hall, can you give us some specific examples of how those of us outside blue zones can get more movement into our lives?

 

DAN BUETTNER: Well, the first and most powerful would be to move to a walkable neighbourhood.

 

AMT: So pack up and move, you're saying.

 

DAN BUETTNER: The average adult moves about 10 times in their lives so you have 10 chances to move. Secondly, I would investigate how to get to work by public transportation. We know that people who just take the bus to work get about 19 minutes of physical activity spread out during the day and their chances of cardiovascular disease drops by a bottle of per cent. Also making sure you have comfortable shoes and a bicycle that works. And the third and most important one is to buy a dog or adopt a dog. We know that dog owners have about half the rate of obesity is non-dog owners and that's probably because the dog needs to get walked every day. So therefore too, the human gets walked as well.

 

AMT: And are there other ways that we should make life less convenient for ourselves even inside our homes?

 

DAN BUETTNER: Well, if you live in a multi-storey house, I would argue to put your TV on the top floor. So if you want to get a snack at occasions, at least going up and down those stairs. Every instance when you can have a hand tool instead of an electric tool, move it to hand. Take out garage door openers. All of these things provide dozens of little nudges throughout the day to get us to move and that adds up a lot more than we think.

 

AMT: So physiologically, how does moving naturally make those blue zone residents live so long?

 

DAN BUETTNER: They get enough movement in their twenties and thirties and forties and fifties. And actually, when you get into your sixties and above, you want to think about exercise differently. It's not just about you know cardiovascular or lifting weights. It's also about avoiding accidents. The beauty of moving naturally, i.e. walking and gardening, is they’re low impact. You're less likely to fall down and break a hip. Setting up your life so you're nudged into general physical activity every day is a strategy for your entire life from age 10 to 100. So in none of these places were you meeting spry 100 year olds who can stand on their head or waterski. Did they ever say at age 50, well, goddarnit. I'm going to get on that longevity diet or buy a treadmill or call an 800 number and order supplements. They just lived their lives in environments where they were nudged to move all day long. Fruits and vegetables were the cheapest and most accessible foods. Their kitchens were set up so it was easy for them to cook those foods or social networks were such that they reinforce those behaviours.

 

AMT: So should we stop going to the gym?

 

DAN BUETTNER: Well, for a tiny slice of people, the gym and the treadmill is a good idea. But the problem is we spend so much effort in marketing messaging, deluding people into thinking if you get on your treadmill or you go to the gym, that's what you need. People who join a gym, the vast majority of them have quit within nine months and almost all of them have quit within two years. So if it's a longevity strategy, does not work.

 

AMT: So you're telling me maybe we should walk to the gym, touch the front door and walk home. [laughs]

 

DAN BUETTNER: Yeah. Well, I'd rather see you move to a neighbourhood where there's a cafe that you like. You have neighbours who share your interests. And see, these are periods of movement you're going to do all day long mindlessly. I'm not going to use up your self-control. I think we need to think about our physical activity as a reward, as something enjoyable and something we look forward to doing, not something that we regard as self-flogging.

 

AMT: Dan Buettner, thanks for your thoughts. Really interesting.

 

DAN BUETTNER: [Chuckles] I loved it. Thank you.

 

AMT: Dan Buettner, National Geographic fellow and the author of The Blue Zones: 9 Lessons for Living Longer from the People Who've Lived the Longest. That's among other books on the Blue Zones that he's written. He is in Minneapolis and we do want to hear from you on this. What are your views on exercise? Pleasure or punishment? I see some people are already getting on Twitter and saying that explains a lot—the treadmill was an instrument of punishment in prisons. Is activity built naturally into your everyday life or do you have to pencil exercise into your schedule in a gym? Let us know. You can tweet us @thecurrentCBC, post on this segment on our Facebook page or e-mail us by clicking on contact at www.cbc.ca/thecurrent. And while you're there you can enjoy a video compilation of treadmill fails—a reminder that the treadmill remains a torture instrument for anyone who has ever tripped at full speed. That's our program for today. Stay with Radio One for q. Tom Power speaks with Toronto-born photographer Chris Buck about his new book of celebrity portraits. That book is called Uneasy. Now a reminder about our Facebook Live conversation: it comes up later today in advance of our public forum on missing and murdered Indigenous women. This is our fourth public forum. It is going to be held in Toronto. It will focus on children and youth. We have already handed out the tickets for this event tonight but you can join me and two of my guests on Facebook—3 p.m. Eastern, noon Pacific—to ask my guests questions. CBC Thunder Bay reporter Jody Porter and Rebecca Benson, a member of the two-spirit community. Find us at www.facebook.com/cbcthecurrent. Now, we’ll leave you with some more thoughts. We were talking about why there's good reason exercise can sometimes feel like punishment. Since music tends to make sweating it up and sweating up a storm more enjoyable, we are going to leave you today with one of the most popular songs to work out to, according to the digital music service, Spotify. This is Kanye West with “Power”. I'm Anna Maria Tremonti. Thank you for The Current.

 

[Music: “Power” – Kanye West]

Edited by AlPater

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Fasting regulates EGR1 and protects from glucose- and dexamethasone-dependent sensitization to chemotherapy.

Di Biase S, Shim HS, Kim KH, Vinciguerra M, Rappa F, Wei M, Brandhorst S, Cappello F, Mirzaei H, Lee C, Longo VD.

PLoS Biol. 2017 Mar 30;15(3):e2001951. doi: 10.1371/journal.pbio.2001951. eCollection 2017 Mar.

PMID: 28358805 Free Article

http://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.2001951

http://journals.plos.org/plosbiology/article/file?id=10.1371/journal.pbio.2001951&type=printable

Abstract

Fasting reduces glucose levels and protects mice against chemotoxicity, yet drugs that promote hyperglycemia are widely used in cancer treatment. Here, we show that dexamethasone (Dexa) and rapamycin (Rapa), commonly administered to cancer patients, elevate glucose and sensitize cardiomyocytes and mice to the cancer drug doxorubicin (DXR). Such toxicity can be reversed by reducing circulating glucose levels by fasting or insulin. Furthermore, glucose injections alone reversed the fasting-dependent protection against DXR in mice, indicating that elevated glucose mediates, at least in part, the sensitizing effects of rapamycin and dexamethasone. In yeast, glucose activates protein kinase A (PKA) to accelerate aging by inhibiting transcription factors Msn2/4. Here, we show that fasting or glucose restriction (GR) regulate PKA and AMP-activated protein kinase (AMPK) to protect against DXR in part by activating the mammalian Msn2/4 ortholog early growth response protein 1 (EGR1). Increased expression of the EGR1-regulated cardioprotective peptides atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) in heart tissue may also contribute to DXR resistance. Our findings suggest the existence of a glucose-PKA pathway that inactivates conserved zinc finger stress-resistance transcription factors to sensitize cells to toxins conserved from yeast to mammals. Our findings also describe a toxic role for drugs widely used in cancer treatment that promote hyperglycemia and identify dietary interventions that reverse these effects.

 

Long-term care is increasingly concentrated in the last years of life: a change from 2000 to 2011.

Forma L, Aaltonen M, Pulkki J, Raitanen J, Rissanen P, Jylhä M.

Eur J Public Health. 2017 Feb 23. doi: 10.1093/eurpub/ckw260. [Epub ahead of print]

PMID: 28339763

Abstract

BACKGROUND:

The use of long-term care (LTC) is common in very old age and in the last years of life. It is not known how the use pattern is changing as death is being postponed to increasingly old age. The aim is to analyze the association between the use of LTC and approaching death among old people and the change in this association from 2000 to 2011. The data were derived from national registers. The study population consists of 315 458 case-control pairs. Cases (decedents) were those who died between 2000 and 2011 at the age of 70 years or over in Finland. The matched controls (survivors) lived at least 2 years longer. Use of LTC was studied for the last 730 days for decedents and for the same calendar days for survivors. Conditional logistic regression analyses were performed to test the association of LTC use with decedent status and year. The difference in LTC use between decedents and survivors was smallest among the oldest (OR 9.91 among youngest, 4.96 among oldest). The difference widened from 2000 to 2011 (OR of interaction of LTC use and year increased): use increased or held steady among decedents, but decreased among survivors. The use of LTC became increasingly concentrated in the last years of life during the study period. The use of LTC is also common among the oldest survivors. As more people live to very old age, the demand for LTC will increase.

 

Worldwide demography of centenarians.

Robine JM, Cubaynes S.

Mech Ageing Dev. 2017 Mar 15. pii: S0047-6374(16)30254-8. doi: 10.1016/j.mad.2017.03.004. [Epub ahead of print] Review.

PMID: 28315698

http://sci-hub.cc/10.1016/j.mad.2017.03.004

Abstract

The global number of centenarians should strongly increase during the 21 st century. According to the Population Division of the United Nations it should reach more than 25 million people in 2100. To better understand the dynamics of the emergence and growth of the centenarian population, we focused on four European countries having long chronological series and high quality data about centenarians, Denmark, France, Sweden, and Switzerland, and Japan which has had the highest life expectancy at birth for several years. we analysed the emergence of the centenarian populations and their pace of growth in the wider context of the adult longevity revolution, as well as the trends in mortality level among these new populations. We found that out of the 5 countries studied, the decrease in mortality at age 100 for females who are leading the adult longevity revolution, seems to be interrupted in 4 countries, including in Japan. These results are in favour of the scenario of "compression of mortality", possibly limiting the future number of centenarians. However, previous studies have shown that demographic transitions are not linear and, after periods of interruption, trends can resume towards an always greater longevity.

 

Obesity accelerates epigenetic aging in middle-aged but not in elderly individuals.

Nevalainen T, Kananen L, Marttila S, Jylhävä J, Mononen N, Kähönen M, Raitakari OT, Hervonen A, Jylhä M, Lehtimäki T, Hurme M.

Clin Epigenetics. 2017 Feb 14;9:20. doi: 10.1186/s13148-016-0301-7. eCollection 2017 Feb 14.

PMID: 28289477 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5310016/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5310016/pdf/13148_2016_Article_301.pdf

Abstract

BACKGROUND:

Human aging is associated with profound changes in one of the major epigenetic mechanisms, DNA methylation. Some of these changes occur in a clock-like fashion, i.e., correlating with the calendar age of an individual, thus providing a new aging biomarker. Some reports have identified factors associated with the acceleration of the epigenetic age. However, it is also important to analyze the temporal changes in the epigenetic age, i.e., the duration of the observed acceleration, and the effects of the possible therapeutic and lifestyle modifications.

METHODS:

To address this issue, we determined the epigenetic age for a cohort of 183 healthy individuals using blood samples derived from two time points that were 25 years apart (between 15-24 and 40-49 years of age). Additionally, we also determined the epigenetic ages of 119 individuals in a cohort consisting of 90-year-old participants (nonagenarians). These were determined by using the Horvath algorithm based on the methylation level of 353 CpG sites. The data are indicated as the deviation of the epigenetic age from the calendar age (calendar age minus epigenetic age = delta age, ΔAGE). As obesity is often associated with accelerating aging and degenerative phenotypes, the correlation of the body mass index (BMI) with the ΔAGE was analyzed in the following three age groups: young adults, middle-aged, and nonagenarian.

RESULTS:

The data showed that BMI is associated with decreased ΔAGE, i.e., increased epigenetic age, in middle-aged individuals. This effect is also seen during the 25-year period from early adulthood to middle age, in which an increase in the BMI is significantly associated with a decrease in the ΔAGE. We also analyzed the association between BMI and epigenetic age in young and elderly individuals, but these associations were not significant.

CONCLUSION:

Taken together, the main finding on this report suggests that association between increased BMI and accelerated epigenetic aging in the blood cells of middle-aged individuals can be observed, and this effect is also detectable if the BMI has increased in adulthood. The fact that the association between BMI and epigenetic age can only be observed in the middle-aged group does not exclude the possibility that this association could be present throughout the human lifespan; it might just be masked by confounding factors in young adults and nonagenarian individuals.

 

The establishment and evaluation of a new model for the prediction of prostate cancer.

Wang Q, Li YF, Jiang J, Zhang Y, Liu XD, Li K.

Medicine (Baltimore). 2017 Mar;96(11):e6138. doi: 10.1097/MD.0000000000006138.

PMID: 28296726 Free Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5369881/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5369881/pdf/medi-96-e6138.pdf

Abstract

To develop a new prostate cancer predictor (PCP) model using the combination of total prostate-specific antigen (tPSA), free PSA (fPSA), and complexed PSA (cPSA).The diagnoses of all the included patients were confirmed pathologically in Daping Hospital between December 1, 2011 and December 1, 2014. There were 54 PCa cases and 579 benign prostatic hyperplasia (BPH) cases with tPSA levels of 2 to 10 ng/mL, and 48 PCa cases and 147 BPH cases with tPSA levels of 10 to 20 ng/mL. Logistic regression and receiver operating characteristic curve (ROC) analyses were employed to compare the value of PCP (PCP = tPSA / fPSA × √cPSA) with tPSA, fPSA, the ratio of fPSA to tPSA (%fPSA), and cPSA for the differential diagnosis of PCa and BPH. Meanwhile, bootstrapping analysis was used to calculate the distribution and confidence intervals (CIs) for the area under the curve (AUC), and Hosmer-Lemeshow tests were used to calculate P values.When tPSA levels were 2 to 10 ng/mL, the AUC of PCP (0.680) was significantly higher than that of tPSA (0.588), fPSA (0.571), %fPSA (0.675), and cPSA (0.613). When the sensitivity for the diagnosis of PCa was 90.7%, the specificity of PCP (22.8%) was higher than that of tPSA (11.1%), fPSA (11.2%), %fPSA (17.4%), and cPSA (15.5%). When tPSA levels were 10 to 20 ng/mL, the AUC of PCP (0.686) was significantly higher than that of tPSA (0.603), fPSA (0.643), %fPSA (0.679), and cPSA (0.647). When the sensitivity for the diagnosis of PCa was 91.7%, the specificity of PCP (29.3%) was higher than that of tPSA (10.9%), fPSA (10.2%), %fPSA (23.1%), and cPSA (18.4%).PCP is a novel model for the prediction of PCa; it has more predictive value than tPSA, fPSA, %fPSA, and cPSA when tPSA levels are 2 to 20 ng/mL.

 

Vitamin D, bones and muscle: myth versus reality.

Duque G, Daly RM, Sanders K, Kiel DP.

Australas J Ageing. 2017 Mar;36 Suppl 1:8-13. doi: 10.1111/ajag.12408. Review.

PMID: 28297132

Abstract

OBJECTIVES:

Evidence regarding the efficacy and dosing of vitamin D on fall and fracture prevention, with or without calcium, is characterised by uncertainty.

METHODS:

A panel of experts was organised at the First Australasian Conference on Sarcopenia and Frailty in Melbourne, Australia, in November 2016 to provide an interpretation of the current evidence and to give their opinions regarding the supplementation of vitamin D in three hypothetical cases.

RESULTS AND CONCLUSION:

The authors conclude that (i) target serum 25(OH)D concentration should be 50 to 60 nmol/L year round, with a conservative upper limit <100 nmol/L; (ii) change in serum concentrations at any given dose is highly variable among individuals; (iii) dosing interval may need to be <2 months to have a continuous benefit; (iv) a loading dose can raise levels to target quickly, but there is no evidence yet that this has any positive effect on falls or fracture outcomes; and (v) a maintenance dose of 1000 IU/day, or given as an equivalent dose weekly or monthly, is sufficient for most individuals.

KEYWORDS:

falls; fractures; osteoporosis; sarcopenia; vitamin D

 

The DrugAge database of aging-related drugs.

Barardo D, Thornton D, Thoppil H, Walsh M, Sharifi S, Ferreira S, Anžič A, Fernandes M, Monteiro P, Grum T, Cordeiro R, De-Souza EA, Budovsky A, Araujo N, Gruber J, Petrascheck M, Fraifeld VE, Zhavoronkov A, Moskalev A, de Magalhães JP.

Aging Cell. 2017 Mar 16. doi: 10.1111/acel.12585. [Epub ahead of print]

PMID: 28299908 Free Article

Abstract

Aging is a major worldwide medical challenge. Not surprisingly, identifying drugs and compounds that extend lifespan in model organisms is a growing research area. Here, we present DrugAge (http://genomics.senescence.info/drugs/), a curated database of lifespan-extending drugs and compounds. At the time of writing, DrugAge contains 1316 entries featuring 418 different compounds from studies across 27 model organisms, including worms, flies, yeast and mice. Data were manually curated from 324 publications. Using drug-gene interaction data, we also performed a functional enrichment analysis of targets of lifespan-extending drugs. Enriched terms include various functional categories related to glutathione and antioxidant activity, ion transport and metabolic processes. In addition, we found a modest but significant overlap between targets of lifespan-extending drugs and known aging-related genes, suggesting that some but not most aging-related pathways have been targeted pharmacologically in longevity studies. DrugAge is freely available online for the scientific community and will be an important resource for biogerontologists.

KEYWORDS:

bioinformatics; compound; functional genomics; lifespan; longevity; pharmacology

 

The role of the TOR pathway in mediating the link between nutrition and longevity.

Lushchak O, Strilbytska O, Piskovatska V, Storey KB, Koliada A, Vaiserman A.

Mech Ageing Dev. 2017 Mar 16. pii: S0047-6374(16)30228-7. doi: 10.1016/j.mad.2017.03.005. [Epub ahead of print] Review.

PMID: 28315697

Abstract

The target of rapamycin (TOR) pathway integrates signals from extracellular and intracellular agents, such as growth factors, nutrients, mediators of energy balance, oxygen availability and other environmental cues. It allows the regulation of multiple cellular processes including protein and lipid synthesis, ribosome biogenesis, autophagy and metabolic processes. Being conserved across different phyla, TOR regulates longevity of various organisms in response to dietary conditions. In this review we described the main components of the TOR pathway and its upstream effectors and downstream processes in relation to aging. The potential contribution of the TOR pathway in lifespan-extending effects of varied dietary interventions, and the anti-aging drugs rapamycin and metformin direct or indirect regulation of TOR activity in yeasts, worms, flies and mammals are also discussed.

KEYWORDS:

Aging; Lifespan; Nutrition; Rapamycin; TOR signaling pathway

 

Protein intake distribution pattern does not affect anabolic response, lean body mass, muscle strength or function over 8 weeks in older adults: A randomized-controlled trial.

Kim IY, Schutzler S, Schrader AM, Spencer HJ, Azhar G, Wolfe RR, Ferrando AA.

Clin Nutr. 2017 Mar 3. pii: S0261-5614(17)30086-9. doi: 10.1016/j.clnu.2017.02.020. [Epub ahead of print]

PMID: 28318687

Abstract

BACKGROUND & AIMS:

In our recent acute metabolic study, we found no differences in the anabolic response to differing patterns of dietary protein intake. To confirm this in a chronic study, we investigated the effects of protein distribution pattern on functional outcomes and protein kinetics in older adults over 8 weeks.

METHODS:

To determine chronic effects of protein intake pattern at 1.1 g protein/kg/day in mixed meals on lean body mass (LBM), functional outcomes, whole body protein kinetics and muscle protein fractional synthesis rate (MPS) over 8-week respective dietary intervention, fourteen older subjects were randomly divided into either EVEN or UNVEN group. The UNEVEN group (n = 7) consumed the majority of dietary protein with dinner (UNEVEN, 15/20/65%; breakfast, lunch, dinner), while the EVEN group (n = 7) consumed dietary protein evenly throughout the day (EVEN: 33/33/33%).

RESULTS:

We found no significant differences in LBM, muscle strength, and other functional outcomes between EVEN and UNEVEN before and after 8-week intervention. Consistent with these functional outcomes, we did not find significant differences in the 20-h integrated whole body protein kinetics [net protein balance (NB), protein synthesis (PS), and breakdown (PB)] above basal states and MPS between EVEN and UNEVEN intake patterns.

CONCLUSIONS:

We conclude that over an 8-week intervention period, the protein intake distribution pattern in mixed meals does not play an important role in determining anabolic response, muscle strength, or functional outcomes.

KEYWORDS:

Aging; Essential amino acids; Protein turnover; Sarcopenia; Stable isotope tracer

 

Daily salt intake is an independent risk factor for pollakiuria and nocturia.

Matsuo T, Miyata Y, Sakai H.

Int J Urol. 2017 Mar 14. doi: 10.1111/iju.13321. [Epub ahead of print]

PMID: 28295650

http://sci-hub.cc/10.1111/iju.13321

Abstract

OBJECTIVE:

To clarify the relationships between daily salt intake and lower urinary tract symptoms.

METHODS:

A cross-sectional clinical study was carried out with 728 patients. Spot urine samples were collected to evaluate estimated daily salt intake. The patients were divided into two groups based on mean salt intake (9.2 g/day). Their urinary condition was evaluated using the Core Lower Urinary Tract Symptoms score and 3-day frequency volume charts. The influence of salt intake on lower urinary tract symptoms was investigated using multivariate logistic regression analysis.

RESULTS:

Daytime frequency (Q1) and nocturia (Q2) in the high salt intake group (H-salt group) were higher compared with those in the low salt intake group (L-salt group); P < 0.001). The quality of life scores and nocturnal polyuria index in the H-salt group were worse than those in the L-salt group (P < 0.001). Multivariate analyses showed daily salt intake is an independent worsening factor for high daytime frequency (odds ratio 2.32, 95% confidential interval 1.66-3.25, P < 0.001) and nocturia (odds ratio 3.05, 95% confidential interval 2.08-4.52, P < 0.001). Similarly, hypertension was identified as the independent variable for these symptoms. A limitation of the present study was that we recruited only patients with mild or no comorbidity.

CONCLUSIONS:

Excessive daily salt intake negatively affects pollakiuria and nocturia. The presence of hypertension can also represent a worsening factor for these symptoms. Although not shown by prospective study, the appropriate control of salt intake and blood pressure might be important for the treatment of pollakiuria and nocturia.

KEYWORDS:

hypertension; nocturia; pollakiuria; quality of life; salt intake

 

Epidemiology of uterine fibroids: a systematic review.

Stewart EA, Cookson C, Gandolfo RA, Schulze-Rath R.

BJOG. 2017 Mar 14. doi: 10.1111/1471-0528.14640. [Epub ahead of print] Review.

PMID: 28296146

Abstract

BACKGROUND:

Uterine fibroids (UFs) are the most common neoplasm affecting women that can cause significant morbidity and may adversely impact fertility.

OBJECTIVES:

To examine UF epidemiology and to evaluate the relative strengths of putative risk factors.

SEARCH STRATEGY:

MEDLINE and Embase were searched for studies published in English between January 1995 and April 2015.

SELECTION CRITERIA:

Publications reporting relevant data from registries and other observational studies with over 1000 patients and single-centre studies with over 100 patients were selected.

DATA COLLECTION AND ANALYSIS:

Data on UF incidence, prevalence and associated risk factors were extracted from 60 publications.

MAIN RESULTS:

Wide ranges were reported in both UF incidence (217-3745 cases per 100 000 women-years) and prevalence (4.5-68.6%), depending on study populations and diagnostic methods. Black race was the only factor that was recurrently reported to increase UF risk, by 2-3-fold compared with white race. Eleven other factors affected UF risk to a magnitude similar to or greater than race. Age, premenopausal state, hypertension, family history, time since last birth, and food additive and soybean milk consumption increased UF risk; use of oral contraceptives or the injectable contraceptive depot medroxyprogesterone acetate, smoking in women with low body mass index and parity reduced UF risk.

CONCLUSIONS:

We identified twelve risk factors that play an important role in UF epidemiology. The UF risk factor with the strongest evidence is black race. High-quality prospective observational data are needed to improve our understanding of UF epidemiology, and thus its aetiology and optimal management.

KEYWORDS:

Uterine fibroids; epidemiology; incidence; leiomyoma; prevalence; race; risk factors

 

Longitudinal associations between body mass index, physical activity, and healthy dietary behaviors in adults: A parallel latent growth curve modeling approach.

Kim Y, Lee JM, Kim J, Dhurandhar E, Soliman G, Wehbi NK, Canedy J.

PLoS One. 2017 Mar 15;12(3):e0173986. doi: 10.1371/journal.pone.0173986. eCollection 2017 Mar 15.

PMID: 28296945 Free Article

Abstract

BACKGROUND:

Physical activity (PA) and healthy dietary behaviors (HDB) are two well-documented lifestyle factors influencing body mass index (BMI). This study examined 7-year longitudinal associations between changes in PA, HDB, and BMI among adults using a parallel latent growth curve modeling (LGCM).

METHODS:

We used prospective cohort data collected by a private company (SimplyWell LLC, Omaha, NE, USA) implementing a workplace health screening program. Data from a total of 2,579 adults who provided valid BMI, PA, and HDB information for at least 5 out of 7 follow-up years from the time they entered the program were analyzed. PA and HDB were subjectively measured during an annual online health survey. Height and weight measured during an annual onsite health screening were used to calculate BMI (kg·m2). The parallel LGCMs stratified by gender and baseline weight status (normal: BMI<25, overweight BMI 25-29.9, and obese: BMI>30) were fitted to examine the longitudinal associations of changes in PA and HDB with change in BMI over years.

RESULTS:

On average, BMI gradually increased over years, at rates ranging from 0.06 to 0.20 kg·m2·year, with larger increases observed among those of normal baseline weight status across genders. The increases in PA and HDB were independently associated with a smaller increase in BMI for obese males (b = -1.70 and -1.98, respectively), and overweight females (b = -1.85 and -2.46, respectively) and obese females (b = -2.78 and -3.08, respectively). However, no significant associations of baseline PA and HDB with changes in BMI were observed.

CONCLUSIONS:

Our study suggests that gradual increases in PA and HDB are independently associated with smaller increases in BMI in overweight and obese adults, but not in normal weight individuals. Further study is warranted to address factors that check increases in BMI in normal weight adults.

 

Fruit and vegetable consumption and psychological distress: cross-sectional and longitudinal analyses based on a large Australian sample.

Nguyen B, Ding D, Mihrshahi S.

BMJ Open. 2017 Mar 15;7(3):e014201. doi: 10.1136/bmjopen-2016-014201.

PMID: 28298322 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5353310/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5353310/pdf/bmjopen-2016-014201.pdf

Abstract

OBJECTIVES:

Growing evidence suggests a link between diet and mental health. This study aimed to investigate the association between fruit and vegetable consumption and the prevalence and incidence of psychological distress in middle-aged and older Australians.

DESIGN:

Cross-sectional and prospective.

SETTING:

New South Wales, Australia.

METHODS:

A sample of 60 404 adults aged ≥45 years completed baseline (2006-2008) and follow-up (2010) questionnaires. Psychological distress was assessed at baseline and follow-up using the validated Kessler Psychological Distress Scale (K10), a 10-item questionnaire measuring general anxiety and depression. Psychological distress was defined as the presence of high-to-very high levels of distress (K10 score ≥22). Usual fruit and vegetable consumption was assessed using short validated questions. The association between baseline fruit and vegetable consumption and the prevalence or incidence of psychological distress was examined using logistic regression models.

RESULTS:

At baseline, 5.6% reported psychological distress. After a mean 2.7 years of follow-up, 4.0% of those who did not report distress at baseline reported distress at follow-up. Baseline fruit and vegetable consumption considered separately or combined, was associated with a lower prevalence of psychological distress even after adjustment for sociodemographic characteristics and lifestyle risk factors. Baseline fruit and vegetable consumption, measured separately or combined, was associated with a lower incidence of psychological distress in minimally adjusted models. Most of these associations remained significant at medium levels of intake but were no longer significant at the highest intake levels in fully adjusted models.

CONCLUSIONS:

Increasing fruit and vegetable consumption may help reduce psychological distress in middle-aged and older adults. However, the association of fruit and vegetable consumption with the incidence of psychological distress requires further investigation, including the possibility of a threshold effect between medium and higher consumption levels.

KEYWORDS:

MENTAL HEALTH; NUTRITION & DIETETICS

 

The Association between Dehydroepiandrosterone Sulfate (DHEA-S) and Bone Mineral Density in Korean Men and Women.

Park SG, Hwang S, Kim JS, Park KC, Kwon Y, Kim KC.

J Bone Metab. 2017 Feb;24(1):31-36. doi: 10.11005/jbm.2017.24.1.31. Epub 2017 Feb 28.

PMID: 28326299 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5357610/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5357610/pdf/jbm-24-31.pdf

Abstract

BACKGROUND:

The relationship between dehydroepiandrosterone sulfate (DHEA-S) and bone mineral density (BMD) is controversial. And findings of most studies that have investigated this relationship are restricted to postmenopausal women. In this study, we investigated the relationship between serum DHEA-S and BMD in both men and women.

METHODS:

This cross-sectional study evaluated a total of 294 healthy Korean participants through a medical examination program. And a subgroup of 154 participants was subjected to a longitudinal analysis. We measured BMD by dual energy X-ray absorptiometry and assayed DHEA-S by a chemiluminescent immunoassay.

RESULTS:

We evaluated the association between serum DHEA-S concentration and BMD at the femur trochanter after adjusting for cofounders such as age, body mass index, lifestyle factors, serum cortisol level, serum insulin-like growth factor 1 (IGF-1) level, and sex. Through our longitudinal study, we found that the changes in BMD at the total spine, at the femur neck, and at the femur trochanter were all smaller in the ΔDHEA-S <0 group than in the ΔDHEA-S >0 group.

CONCLUSIONS:

We found that there was a positive correlation between serum DHEA-S and femur BMD, which suggests that controlling serum DHEA-S levels may retard age-related BMD reduction in Koreans.

KEYWORDS:

Aging; Bone density; Dehydroepiandrosterone sulfate; Osteoporosis

 

Additive value of interleukin-6 and C-reactive protein in risk prediction for all-cause and cardiovascular mortality among a representative adult cohort in Taiwan.

Lin YH, Glei D, Weinstein M, Wu SI, Chien KL.

J Formos Med Assoc. 2017 Mar 11. pii: S0929-6646(17)30096-7. doi: 10.1016/j.jfma.2017.02.002. [Epub ahead of print]

PMID: 28292623 Free Article

http://www.jfma-online.com/article/S0929-6646(17)30096-7/fulltext

http://www.jfma-online.com/article/S0929-6646(17)30096-7/pdf

Abstract

BACKGROUND/PURPOSE:

Interleukin-6 (IL-6) and C-reactive protein (CRP) are inflammatory makers of potential interest in all-cause and cardiovascular death risk prediction, but their additive explanatory value to established risk factors is not well documented among nonwestern populations.

METHODS:

We investigated the additive value of IL-6 and CRP to the Framingham risk score and lifestyle factors in predicting all-cause and cardiovascular mortality among a population-representative sample of 1023 adults aged 54 years and above in Taiwan.

RESULTS:

A total of 351 deaths and 82 cardiovascular deaths were identified (median follow-up = 11.2 years). After adjustment for established risk factors, elevated IL-6 and CRP levels were associated with a higher risk of all-cause death: the hazard ratios for the highest risk quartile compared with the lowest quartile were 3.64 (95% confidence interval, 2.44-5.44) for IL-6 and 2.31 (95% confidence interval, 1.62-3.29) for CRP. IL-6 was also significantly associated with cardiovascular mortality. For both all-cause and cardiovascular mortality, IL-6 yielded a substantial and significant increase in the area under the receiver operator characteristic curve (change in the area under the receiver operator characteristic curve = 0.036 and 0.024, respectively), but CRP did not (change in the area under the receiver operator characteristic curve = 0.004 and 0.009, respectively).

CONCLUSION:

Although both IL-6 and CRP were significantly associated with all-cause mortality, only IL-6 provided a substantial improvement in discrimination. Similarly, IL-6 demonstrated a notable prognostic value for predicting cardiovascular mortality, but not CRP. These findings provide further support for the role of inflammation in the deterioration of health at older ages among a nonwestern population.

KEYWORDS:

C-reactive protein; cardiovascular disease; inflammation; interleukin-6; mortality

 

Lycopene and risk of cardiovascular diseases: A meta-analysis of observational studies.

Song B, Liu K, Gao Y, Zhao L, Fang H, Li Y, Pei L, Xu Y.

Mol Nutr Food Res. 2017 Mar 20. doi: 10.1002/mnfr.201601009. [Epub ahead of print]

PMID: 28318092

http://sci-hub.cc/10.1002/mnfr.201601009

Abstract

SCOPE:

The aim of current meta-analysis was to investigate the relation between lycopene and risk of cardiovascular diseases (CVD).

METHODS AND RESULTS:

Studies concerning about the association between lycopene and risk of CVD were searched on Pubmed, Embase, and Web of Science from inception to October 2016. A total of 14 eligible studies were identified. A significantly inverse association with a pooled risk ratio (RR) of 0.83 (95% CI: 0.76-0.90) was shown between lycopene exposure and risk of CVD. Findings were similar restricting to dietary studies (RR = 0.87, 95% CI = 0.79-0.96) and biomarker studies (RR = 0.74, 95% CI = 0. 62-0.87).Dietary lycopene intake was statistically significant for coronary heart disease (CHD) (RR: 0.87; 95% CI: 0.76-0.98) and stroke (RR: 0.83; 95% CI: 0.69-0.96).The pooled risk estimate was generally similar for lycopene biomarker concentrations, but the association was only statistically significant for stroke (RR: 0.65; 95% CI: 0.42-0.87).Subgroup analyses showed that retrospective and low quality studies were statistically significant sources of heterogeneity.

CONCLUSION:

Higher lycopene exposure is inversely associated with a lower risk of CVD. Further well-designed randomized clinical trials are required to assess the role of lycopene on CVD.

KEYWORDS:

Coronary Heart Disease; Epidemiologic study; Lycopene; Meta-analysis; Stroke

 

Systematic review and meta-analysis of dietary carbohydrate restriction in patients with type 2 diabetes.

Snorgaard O, Poulsen GM, Andersen HK, Astrup A.

BMJ Open Diabetes Res Care. 2017 Feb 23;5(1):e000354. doi: 10.1136/bmjdrc-2016-000354. eCollection 2017 Feb 23.

PMID: 28316796 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5337734/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5337734/pdf/bmjdrc-2016-000354.pdf

Abstract

OBJECTIVE:

Nutrition therapy is an integral part of self-management education in patients with type 2 diabetes. Carbohydrates with a low glycemic index are recommended, but the ideal amount of carbohydrate in the diet is unclear. We performed a meta-analysis comparing diets containing low to moderate amounts of carbohydrate (LCD) (energy percentage below 45%) to diets containing high amounts of carbohydrate (HCD) in subjects with type 2 diabetes.

RESEARCH DESIGN AND METHODS:

We systematically reviewed Cochrane library databases, EMBASE, and MEDLINE in the period 2004-2014 for guidelines, meta-analyses, and randomized trials assessing the outcomes HbA1c, BMI, weight, LDL cholesterol, quality of life (QoL), and attrition.

RESULTS:

We identified 10 randomized trials comprising 1376 participants in total. In the first year of intervention, LCD was followed by a 0.34% lower HbA1c (3.7 mmol/mol) compared with HCD (95% CI 0.06 (0.7 mmol/mol), 0.63 (6.9 mmol/mol)). The greater the carbohydrate restriction, the greater the glucose-lowering effect (R=-0.85, p<0.01). At 1 year or later, however, HbA1c was similar in the 2 diet groups. The effect of the 2 types of diet on BMI/body weight, LDL cholesterol, QoL, and attrition rate was similar throughout interventions.

LIMITATIONS:

Glucose-lowering medication, the nutrition therapy, the amount of carbohydrate in the diet, glycemic index, fat and protein intake, baseline HbA1c, and adherence to the prescribed diets could all have affected the outcomes.

CONCLUSIONS:

Low to moderate carbohydrate diets have greater effect on glycemic control in type 2 diabetes compared with high-carbohydrate diets in the first year of intervention. The greater the carbohydrate restriction, the greater glucose lowering, a relationship that has not been demonstrated earlier. Apart from this lowering of HbA1c over the short term, there is no superiority of low-carbohydrate diets in terms of glycemic control, weight, or LDL cholesterol.

KEYWORDS:

Carbohydrate(s); Dietary Intervention; Glycemic Control; Type 2 Diabetes

 

Metabolism plays the key roles in Th cells differentiation.

Hosseinzadeh A, Soukhtehzari S, Ghaedi M, Mansouri R.

Reumatismo. 2016 Dec 31;68(4):176-182. doi: 10.4081/reumatismo.2016.919.

PMID: 28299915 Free Article

http://reumatismo.org/index.php/reuma/article/view/919/734

Abstract

The increasing rate of autoimmunity in recent decades cannot be related to only genetic instabilities and disorders. Diet can directly influence our health. Studies have shown that there is a relationship between nutritional elements and alteration in the immune system. Among immune cells, the function of T lymphocyte is important in directing immune response. T CD4+ cells lead other immune cells to respond to pathogens by secreting cytokines. HIV+ patients, who have largely lost their T CD4+ cells, are susceptible to opportunistic infections, which do not normally affect healthy people. It seems that the metabolism of T cells is critical for their differentiation and their consequent functions. After activation, T cells need to undergo clonal expansion, which is a high energy- consuming process. Studies have shown that specific metabolites deprivation or their excess supply affects T CD4+cells subsets differentiation. Abnormal induction of subsets of T CD4+ cells causes some autoimmunity reactions and hyper-sensitivity as well, which may result from imbalance of diet uptake. In this mini-review, we describe the findings about fatty acids, glucose, amino acids, and vitamins, which are effective in determining the fates of T CD4+ cells. These findings may help us uncover the role of diet in autoimmune diseases.

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