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Do aspirin and other NSAIDs confer a survival benefit in men diagnosed with prostate cancer? A pooled analysis of NIH-AARP and PLCO cohorts.

Zhou CK, Daugherty SE, Liao LM, Freedman ND, Abnet CC, Pfeiffer R, Cook MB.

Cancer Prev Res (Phila). 2017 May 15. pii: canprevres.0033.2016. doi: 10.1158/1940-6207.CAPR-17-0033. [Epub ahead of print]

PMID: 28507039

Abstract

Prostate cancer is one of the leading causes of cancer death in US men. There is an unmet need to identify modifiable risk factors for prostate cancer survival. Experimental studies have suggested that nonsteroidal anti-inflammatory drugs (NSAIDs) may improve prostate cancer survival through anti-thrombotic and anti-inflammation mechanisms. Results from previous observational studies have been equivocal, and few have assessed whether an etiologically relevant time window of exposure exists. We sampled prostate cancer cases from two large US prospective cohorts-NIH-AARP Diet and Health Study and PLCO Cancer Screening Trial-to investigate whether pre- and post-diagnostic aspirin and non-aspirin NSAID use were associated with prostate cancer-specific and all-cause mortality. Cox proportional hazards regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs). Study-specific results were meta-analyzed using fixed-effects models. Pre- and post-diagnostic aspirin or non-aspirin NSAID use were not statistically significantly associated with prostate cancer-specific mortality. However, occasional (less than daily) and daily aspirin users five years or more before prostate cancer diagnosis had 18% (HR=0.82; 95%CI=0.75 to 0.90) and 15% (HR=0.85; 95%CI=0.77 to 0.94) reduced all-cause mortality versus nonusers. Similarly, post-diagnostic occasional and daily aspirin use were associated with 17% (HR=0.83; 95%CI=0.72 to 0.95) and 25% (HR=0.75; 95%CI=0.66 to 0.86) reduced all-cause mortality, independent of pre-diagnostic aspirin use. This study suggests that aspirin or non-aspirin NSAIDs are not associated with prostate cancer survival. However, aspirin use both before and after prostate cancer diagnosis was associated with longer overall survival, highlighting the importance of comorbidity prevention among prostate cancer survivors.

 

Ten-Year Changes in Healthy Eating Attitudes in the SUN Cohort.

Andrade L, Zazpe I, Santiago S, Carlos S, Bes-Rastrollo M, Martínez-González MA.

J Am Coll Nutr. 2017 May 16:1-11. doi: 10.1080/07315724.2016.1278566. [Epub ahead of print]

PMID: 28506187

Abstract

OBJECTIVE:

The objective of this study was to assess the within-subject longitudinal changes in self-perceived healthy eating attitudes after 10 years of follow-up and to identify predictors of long-term changes in a middle-aged adult cohort.

METHODS:

Four thousand five hundred seventy-two participants completed a validated food frequency questionnaire (FFQ) at baseline and after 10 years of follow-up. The FFQ was expanded with a brief 10-item questionnaire about eating attitudes with 2 possible answers: yes or no. A baseline score and a 10-year score were calculated with these 10 items (range from 0 to 10). Participants were categorized into 3 groups according to this score. Linear and logistic regressions were used to examine changes at follow-up and associations between baseline characteristics and improvement in the score.

RESULTS:

After 10 years of follow-up, a statistically significant favorable change (p < 0.001) was achieved in all questions about eating attitudes, particularly in these items: "Do you try to eat less sweets and pastries?" (12%), "Do you try to eat less meat?" (11.1%), and "Do you try to reduce your fat intake?" (10%). Being female (odds ratio [OR] = 1.19, 95% confidence interval [CI], 1.02-1.39), being 35-50 or ≥ 50 years old (OR = 1.24, 95% CI, 1.07-1.44 and OR = 1.74, 95% CI, 1.38-2.18, respectively), a high level of physical activity (OR for third vs first tertile = 1.20, 95% CI, 1.02-1.41), and a higher Mediterranean diet score (OR for second and third tertiles = 1.18, 95% CI, 1.01-1.37 and OR = 1.26, 95% CI, 1.04-1.52, respectively) were associated with a higher probability of improving the eating attitudes score, while a low body mass index (BMI; OR = 0.71, 95% CI, 0.51-1.00) and snacking between meals (OR = 0.84, 95% CI, 0.73-0.97) were associated with a lower probability of improving their score.

CONCLUSIONS:

The eating attitudes of the participants in the Seguimiento Universidad de Navarra (SUN) cohort became more favorable after 10 years of follow-up. Certain sociodemographic or clinical variables may predict a positive change.

KEYWORDS:

Attitudes; behaviors; brief questionnaire; cohort; eating habits; food consumption

 

Explaining the Obesity Paradox: The Association between Body Composition and Colorectal Cancer Survival (C-SCANS Study).

Caan BJ, Meyerhardt JA, Kroenke CH, Alexeeff S, Xiao J, Weltzien E, Feliciano EC, Castillo AL, Quesenberry CP, Kwan ML, Prado CM.

Cancer Epidemiol Biomarkers Prev. 2017 May 15. doi: 10.1158/1055-9965.EPI-17-0200. [Epub ahead of print]

PMID: 28506965

Abstract

Background: Body composition may partially explain the U-shaped association between body mass index (BMI) and colorectal cancer survival.Methods: Muscle and adiposity at colorectal cancer diagnosis and survival were examined in a retrospective cohort using Kaplan-Meier curves, multivariable Cox regression, and restricted cubic splines in 3,262 early-stage (I-III) male (50%) and female (50%) patients. Sarcopenia was defined using optimal stratification and sex- and BMI-specific cut points. High adiposity was defined as the highest tertile of sex-specific total adipose tissue (TAT). Primary outcomes were overall mortality and colorectal cancer-specific mortality (CRCsM).Results: Slightly over 42% patients were sarcopenic. During 5.8 years of follow-up, 788 deaths occurred, including 433 from colorectal cancer. Sarcopenic patients had a 27% [hr, 1.27; 95% confidence interval (CI), 1.09-1.48] higher risk of overall mortality than those who were not sarcopenic. Females with both low muscle and high adiposity had a 64% higher risk of overall mortality (HR, 1.64; 95% CI, 1.05-2.57) than females with adequate muscle and lower adiposity. The lowest risk of overall mortality was seen in patients with a BMI between 25 and <30 kg/m2, a range associated with the greatest number of patients (58.6%) who were not at increased risk of overall mortality due to either low muscle or high adiposity.Conclusions: Sarcopenia is prevalent among patients with non-metastatic colorectal cancer, and should, along with adiposity be a standard oncological marker.Impact: Our findings suggest a biologic explanation for the obesity paradox in colorectal cancer and refute the notion that the association between overweight and lower mortality is due solely to methodologic biases.

 

Nutritional determinants of frailty in older adults: A systematic review.

Lorenzo-López L, Maseda A, de Labra C, Regueiro-Folgueira L, Rodríguez-Villamil JL, Millán-Calenti JC.

BMC Geriatr. 2017 May 15;17(1):108. doi: 10.1186/s12877-017-0496-2.

PMID: 28506216

Abstract

BACKGROUND:

Frailty is a geriatric syndrome that affects multiple domains of human functioning. A variety of problems contributes to the development of this syndrome; poor nutritional status is an important determinant of this condition. The purpose of this systematic review was to examine recent evidence regarding the association between nutritional status and frailty syndrome in older adults.

METHODS:

PubMed, Web of Science, and Scopus electronic databases were searched using specific key words, for observational papers that were published during the period from 2005 to February 2017 and that studied the association or relationship between nutritional status and frailty in older adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement was followed to assess the quality of the included articles.

RESULTS:

Of the 2042 studies found, nineteen met the inclusion criteria. Of these studies, five provided data on micronutrients and frailty, and reported that frailty syndrome is associated with low intakes of specific micronutrients. Five studies provided data on macronutrients and frailty, and among those studies, four revealed that a higher protein intake was associated with a lower risk of frailty. Three studies examined the relationship between diet quality and frailty, and showed that the quality of the diet is inversely associated with the risk of being frail. Two studies provided data on the antioxidant capacity of the diet and frailty, and reported that a high dietary antioxidant capacity is associated with a lower risk of developing frailty. Finally, seven studies evaluated the relationship between scores on both the Mini Nutritional Assessment (MNA) and the MNA-SF (Short Form) and frailty, and revealed an association between malnutrition and/or the risk of malnutrition and frailty.

CONCLUSIONS:

This systematic review confirms the importance of both quantitative (energy intake) and qualitative (nutrient quality) factors of nutrition in the development of frailty syndrome in older adults. However, more longitudinal studies on this topic are required to further understand the potential role of nutrition in the prevention, postponement, or even reversion of frailty syndrome.

KEYWORDS:

Frail elderly; Macronutrients; Micronutrients; Nutritional status; Protein

 

Cardiovascular Mortality Differences-Place Matters.

Mensah GA, Goff DC, Gibbons GH.

JAMA. 2017 May 16;317(19):1955-1957. doi: 10.1001/jama.2017.4168. No abstract available.

PMID: 28510660

http://sci-hub.cc/10.1001/jama.2017.4168

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Trends and Patterns of Geographic Variation in Cardiovascular Mortality Among US Counties, 1980-2014.

Roth GA, Dwyer-Lindgren L, Bertozzi-Villa A, Stubbs RW, Morozoff C, Naghavi M, Mokdad AH, Murray CJL.

JAMA. 2017 May 16;317(19):1976-1992. doi: 10.1001/jama.2017.4150.

PMID: 28510678

Abstract

IMPORTANCE:

In the United States, regional variation in cardiovascular mortality is well-known but county-level estimates for all major cardiovascular conditions have not been produced.

OBJECTIVE:

To estimate age-standardized mortality rates from cardiovascular diseases by county.

DESIGN AND SETTING:

Deidentified death records from the National Center for Health Statistics and population counts from the US Census Bureau, the National Center for Health Statistics, and the Human Mortality Database from 1980 through 2014 were used. Validated small area estimation models were used to estimate county-level mortality rates from all cardiovascular diseases, including ischemic heart disease, cerebrovascular disease, ischemic stroke, hemorrhagic stroke, hypertensive heart disease, cardiomyopathy, atrial fibrillation and flutter, rheumatic heart disease, aortic aneurysm, peripheral arterial disease, endocarditis, and all other cardiovascular diseases combined.

EXPOSURES:

The 3110 counties of residence.

MAIN OUTCOMES AND MEASURES:

Age-standardized cardiovascular disease mortality rates by county, year, sex, and cause.

RESULTS:

From 1980 to 2014, cardiovascular diseases were the leading cause of death in the United States, although the mortality rate declined from 507.4 deaths per 100 000 persons in 1980 to 252.7 deaths per 100 000 persons in 2014, a relative decline of 50.2% (95% uncertainty interval [uI], 49.5%-50.8%). In 2014, cardiovascular diseases accounted for more than 846 000 deaths (95% UI, 827-865 thousand deaths) and 11.7 million years of life lost (95% UI, 11.6-11.9 million years of life lost). The gap in age-standardized cardiovascular disease mortality rates between counties at the 10th and 90th percentile declined 14.6% from 172.1 deaths per 100 000 persons in 1980 to 147.0 deaths per 100 000 persons in 2014 (posterior probability of decline >99.9%). In 2014, the ratio between counties at the 90th and 10th percentile was 2.0 for ischemic heart disease (119.1 vs 235.7 deaths per 100 000 persons) and 1.7 for cerebrovascular disease (40.3 vs 68.1 deaths per 100 000 persons). For other cardiovascular disease causes, the ratio ranged from 1.4 (aortic aneurysm: 3.5 vs 5.1 deaths per 100 000 persons) to 4.2 (hypertensive heart disease: 4.3 vs 17.9 deaths per 100 000 persons). The largest concentration of counties with high cardiovascular disease mortality extended from southeastern Oklahoma along the Mississippi River Valley to eastern Kentucky. Several cardiovascular disease conditions were clustered substantially outside the South, including atrial fibrillation (Northwest), aortic aneurysm (Midwest), and endocarditis (Mountain West and Alaska). The lowest cardiovascular mortality rates were found in the counties surrounding San Francisco, California, central Colorado, northern Nebraska, central Minnesota, northeastern Virginia, and southern Florida.

CONCLUSIONS AND RELEVANCE:

Substantial differences exist between county ischemic heart disease and stroke mortality rates. Smaller differences exist for diseases of the myocardium, atrial fibrillation, aortic and peripheral arterial disease, rheumatic heart disease, and endocarditis.

 

Bystander Efforts and 1-Year Outcomes in Out-of-Hospital Cardiac Arrest.

Kragholm K, Wissenberg M, Mortensen RN, Hansen SM, Malta Hansen C, Thorsteinsson K, Rajan S, Lippert F, Folke F, Gislason G, Køber L, Fonager K, Jensen SE, Gerds TA, Torp-Pedersen C, Rasmussen BS.

N Engl J Med. 2017 May 4;376(18):1737-1747. doi: 10.1056/NEJMoa1601891.

PMID: 28467879

Abstract

BACKGROUND:

The effect of bystander interventions on long-term functional outcomes among survivors of out-of-hospital cardiac arrest has not been extensively studied.

METHODS:

We linked nationwide data on out-of-hospital cardiac arrests in Denmark to functional outcome data and reported the 1-year risks of anoxic brain damage or nursing home admission and of death from any cause among patients who survived to day 30 after an out-of-hospital cardiac arrest. We analyzed risks according to whether bystander cardiopulmonary resuscitation (CPR) or defibrillation was performed and evaluated temporal changes in bystander interventions and outcomes.

RESULTS:

Among the 2855 patients who were 30-day survivors of an out-of-hospital cardiac arrest during the period from 2001 through 2012, a total of 10.5% had brain damage or were admitted to a nursing home and 9.7% died during the 1-year follow-up period. During the study period, among the 2084 patients who had cardiac arrests that were not witnessed by emergency medical services (EMS) personnel, the rate of bystander CPR increased from 66.7% to 80.6% (P<0.001), the rate of bystander defibrillation increased from 2.1% to 16.8% (P<0.001), the rate of brain damage or nursing home admission decreased from 10.0% to 7.6% (P<0.001), and all-cause mortality decreased from 18.0% to 7.9% (P=0.002). In adjusted analyses, bystander CPR was associated with a risk of brain damage or nursing home admission that was significantly lower than that associated with no bystander resuscitation (hazard ratio, 0.62; 95% confidence interval [CI], 0.47 to 0.82), as well as a lower risk of death from any cause (hazard ratio, 0.70; 95% CI, 0.50 to 0.99) and a lower risk of the composite end point of brain damage, nursing home admission, or death (hazard ratio, 0.67; 95% CI, 0.53 to 0.84). The risks of these outcomes were even lower among patients who received bystander defibrillation as compared with no bystander resuscitation.

CONCLUSIONS:

In our study, we found that bystander CPR and defibrillation were associated with risks of brain damage or nursing home admission and of death from any cause that were significantly lower than those associated with no bystander resuscitation.

 

The US Preventive Services Task Force 2017 Draft Recommendation Statement on Screening for Prostate Cancer: An Invitation to Review and Comment.

Bibbins-Domingo K, Grossman DC, Curry SJ.

JAMA. 2017 May 16;317(19):1949-1950. doi: 10.1001/jama.2017.4413. No abstract available.

PMID: 28397958

http://sci-hub.cc/10.1001/jama.2017.4413

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Effect of moderate weight loss on ovarian function assessed by salivary progesterone measurements.

Lager C, Ellison PT.

Am J Hum Biol. 1990;2(3):303-312. doi: 10.1002/ajhb.1310020312.

PMID: 28520285

Abstract

The effects of moderate, voluntary weight loss on ovarian function are studied by monitoring the daily levels of salivary progesterone in 8 dieting women (18 cycles) and 9 age-matched controls (19 cycles). Both groups of women were within normal standards of weight for height, though the dieters were significantly heavier than the controls. Dieters lost weight at an average rate of 1.9 ± 0.3 kg/mo during the study. Dieters' cycles during periods of weight loss (weight loss cycles) have significantly lower peak levels of luteal progesterone (controls 655 ± 46 pmol/L, weight loss 461 ± 67 pmol/L; P < 0.005) and lower average levels of luteal progesterone (controls 287 ± 30 pmol/L, weight loss 214 ± 23 pmol/L; P < 0.005) than do controls. All control cycles were classified as ovulatory by virtue of at least one salivary progesterone reading ≥ 300 pmol/L. Only 62% of the weight loss cycles were classified as ovulatory by this criterion. Where longitudinal weight data are available both the magnitude and duration of progesterone elevation correlates significantly with net weight change during the preceding cycle and show no significant correlation with net weight change during the current cycle. Examination of individual profiles confirms that the most profound suppression of luteal activity usually occurs during post-loss rather than weight loss cycles, even if weight is stable or increasing during the post-loss cycle itself. These results, together with field studies of African horticultural populations, suggest that human ovarian function may be adapted to modulate waiting time to conception in response to trends in energetic balance.

 

Associations of visceral fat area and physical activity levels with the risk of metabolic syndrome in postmenopausal women.

Zając-Gawlak I, Kłapcińska B, Kroemeke A, Pośpiech D, Pelclová J, Přidalová M.

Biogerontology. 2017 Jun;18(3):357-366. doi: 10.1007/s10522-017-9693-9. Epub 2017 Mar 18.

PMID: 28316012

https://link.springer.com/article/10.1007/s10522-017-9693-9/fulltext.html?wt_mc=alerts.TOCjournals

Abstract

This study was aimed at the evaluation of relationship between visceral fat area (VFA) and physical activity (PA) with the metabolic syndrome (MetS) risk in the physically active postmenopausal women. A total of 85 attendants of the University of the Third Age (U3A) aged 62.8 ± 5.9 years (median time since menopause 11.8 y), participated in this study. VFA was assessed by bioimpedance method using InBody 720 analyzer. PA was assessed using the ActiGraph GT1 M accelerometer. Fasting levels of serum lipids (TG, HDL), serum glucose, waist circumference (WC) and blood pressure were measured to diagnose MetS according to NCEP-ATP III criteria. In 73 out of 85 participants the VFA exceeded the upper normal level of 100 cm2, however, in almost a half of this group (n = 36) with elevated VFA (139.5 ± 26.1 cm2 on average), only 2 out of 5 criteria for MetS diagnosis were met. Participants were physically active, making on average 10,919 ± 3435 steps/day. The risk of MetS occurrence in women with VFA > 100 cm2 was twelve times higher (OR 12.33; CI 95% [1.5; 99.8]) than in the group with VFA < 100 cm2. The participants from the group with the highest PA level (≥12,500 steps/day) were at almost 4 times lower risk for MetS, than their less active counterparts (OR 3.84; CI 95% [1.27;11.64]). Increased level of VFA is a strong risk factor for the MetS in postmenopausal women, however high level of regular PA above the threshold of 12,500 steps/day may substantially reduce it.

KEYWORDS:

Metabolic syndrome; Physical activity; Visceral fat; Women

 

Protective Effect of Dietary Calcium Intake on Esophageal Cancer Risk: A Meta-Analysis of Observational Studies.

Li Q, Cui L, Tian Y, Cui H, Li L, Dou W, Li H, Wang L.

Nutrients. 2017 May 18;9(5). pii: E510. doi: 10.3390/nu9050510.

PMID: 28524093

http://www.mdpi.com/2072-6643/9/5/510/htm

Abstract

Although several epidemiological studies have investigated the association between dietary calcium intake and the risk of esophageal cancer, the results are inconsistent. This study aimed to make a comprehensive evaluation regarding the association between calcium intake and risk of esophageal cancer through a meta-analysis approach. We searched for all relevant articles from the inception to April 2017, using PUBMED, EMBASE, and Web of Knowledge. The pooled odds ratio (ORs) with the 95% confidence interval (95% CI) for the highest versus the lowest categories of calcium intake was calculated using a Mantel-Haenszel fixed-effect model. In total, 15 articles reporting 17 studies including 3396 esophageal cancer cases and 346,815 controls were selected for the meta-analysis. By comparing the highest vs. the lowest levels of dietary calcium intake, we found that dietary calcium intake was inversely associated with the risk of esophageal cancer (OR = 0.80, 95% CI: 0.71-0.91, I² = 33.6%). The subgroup analysis indicated that the protective function of dietary calcium intake were observed in esophageal squamous cell cancer, but not in esophageal adenocarcinoma in the studies conducted in Asia, but not those in Europe and America. In conclusion, our results suggest that higher dietary calcium intake is associated with a lower risk of esophageal cancer-especially esophageal squamous cell cancer-in Asian populations, though more data from prospective cohort studies are needed.

KEYWORDS:

dietary calcium; esophageal cancer; meta-analysis

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Orange juice allied to a reduced-calorie diet results in weight loss and ameliorates obesity-related biomarkers: A randomized controlled trial.

Ribeiro C, Dourado G, Cesar T.

Nutrition. 2017 Jun;38:13-19. doi: 10.1016/j.nut.2016.12.020. Epub 2017 Jan 7.

PMID: 28526377

http://sci-hub.cc/10.1016/j.nut.2016.12.020

Abstract

OBJECTIVE:

Assumptions have linked orange juice (OJ) consumption with weight gain and adverse effects on health due to its sugar content; however, epidemiologic studies have not shown increased risk for overweight or obesity with the consumption of 100% OJ. The aim of this study was to verify whether the combination of a reduced-calorie diet (RCD) and 100% OJ contribute to weight loss, promote changes in glucose and lipid metabolism, and improve diet quality in obese individuals.

METHODS:

A randomized controlled trial with 78 obese patients (age 36 ± 1 y, body mass index [bMI] 33 ± 3 kg/m2) were enrolled in two groups: Individuals in the OJ group submitted to an RCD that included OJ (500 mL/d), and individuals in the control group submitted to an RCD without OJ. Body composition, biochemical biomarkers, and dietary intake were analyzed over a 12-wk period.

RESULTS:

Both treatments had similar outcomes regarding body weight (-6.5 kg; P = 0.363), BMI (-2.5 kg/m2; P = 0.34), lean mass (-1 kg; P = 0.29), fat mass (-5 kg; P = 0.58), body fat (-3%; P = 0.15), and waist-to-hip ratio (-0.1; P = 0.79). Insulin levels in the OJ group decreased by 18% (P = 0.05), homeostasis model assessment-insulin resistance by 33% (P = 0.04), total cholesterol by 24% (P = 0.004), low-density lipoprotein cholesterol by 24% (P ≤ 0.001), and high-sensitivity C-reactive protein levels by 33% (P = 0.001) compared with the control group. Consumption of energy and nutrients was similar between the two groups, but vitamin C and folate increased by 62% (P ≤ 0.015) and 39% (P = 0.033), respectively, after OJ intervention.

CONCLUSION:

When consumed concomitantly with an RCD, OJ does not inhibit weight loss; ameliorate the insulin sensitivity, lipid profile, or inflammatory status, or contribute nutritionally to the quality of the diet.

KEYWORDS:

Biochemical biomarkers; Body composition; Obese; Orange juice; Randomized-controlled trial; Reduced-calorie diet

"CitrusBr has funded this work. The authors thank the financial

301 support of “Programa de Apoio ao Desenvolvimento Científico da Faculdade de

302 Ciencias Farmaceuticas, UNESP (PADC/FCFAr)” and Citrosuco S.A."

 

The effects of folic acid and pyridoxine supplementation on characteristics of migraine attacks in migraine patients with aura: A double-blind, randomized placebo-controlled, clinical trial.

Askari G, Nasiri M, Mozaffari-Khosravi H, Rezaie M, Bagheri-Bidakhavidi M, Sadeghi O.

Nutrition. 2017 Jun;38:74-79. doi: 10.1016/j.nut.2017.01.007. Epub 2017 Feb 2.

PMID: 28526386

Abstract

OBJECTIVE:

The aim of this study was to assess the effects of folic acid alone and in combination with pyridoxine on characteristics of migraine attacks in adult migraine patients with aura.

METHODS:

This double-blind, randomized placebo-controlled, clinical trial was conducted on 95 migraine patients with aura (age range 18-65 y) in Isfahan, Islamic Republic of Iran, in 2014. Patients were randomly allocated to receive folic acid (5 mg/d) plus pyridoxine (80 mg/d) or folic acid alone (5 mg/d) or placebo (lactose) for 3 mo. Characteristics of migraine attacks including headache severity, attacks frequency, duration, and headache diary results (HDRs) were obtained for each patient at baseline and at the end of the study.

RESULTS:

Folic acid plus pyridoxine intake resulted in a significant decrease compared with placebo in headache severity (-2.71 ± 0.08 versus -2.19 ± 0.05; P < 0.001), attack frequency (-3.35 ± 0.09 versus -2.73 ± 0.05; P < 0.001), duration (-7.25 ± 0.17 versus -6.5 ± 0.07; P < 0.001), and HDR (-74.15 ± 0.2 versus -72.73 ± 0.1; P < 0.001). Additionally, the reduction in these characteristics of migraine attacks in the folic acid plus pyridoxine group was significant compared with the group given folic acid alone (P < 0.001). However, these beneficial effects of the combined supplement became nonsignificant for attack duration compared with the folic acid-only and placebo groups after controlling for confounders. Folic acid intake without pyridoxine did not lead to a significant decrease in characteristics of migraine attacks compared with placebo group.

CONCLUSIONS:

Supplementation of folic acid with pyridoxine could decrease the characteristics of migraine attacks including headache severity, attack frequency, and HDR; however, further studies are needed to shed light on the findings of the present study.

KEYWORDS:

Folic acid; Headache; Migraine; Pyridoxine

 

Ketogenic diet in migraine: rationale, findings and perspectives.

Barbanti P, Fofi L, Aurilia C, Egeo G, Caprio M.

Neurol Sci. 2017 May;38(Suppl 1):111-115. doi: 10.1007/s10072-017-2889-6.

PMID: 28527061

Abstract

Ketogenic diet (KD) is an established treatment for refractory pediatric epilepsy and a promising therapy for diverse neurological diseases. Clinical data on KD in migraine-obtained from 150 patients investigated in case reports and prospective studies-suggest that KD may be a rapid onset effective prophylaxis for episodic and chronic migraine. KD would contribute to restore brain excitability and metabolism and to counteract neuroinflammation in migraine, although its precise mechanism is still unclear. Randomized controlled studies are needed to confirm the usefulness of KD in migraine and to investigate its optimal duration, repeatability, feasibility in normal weight subjects, efficacy in pediatric population and association to conventional migraine prophylaxis.

KEYWORDS:

Disability; Ketogenic diet; Migraine; Prevention; Treatment

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Association Between Teaching Status and Mortality in US Hospitals

Laura G. Burke, MD, MPH; Austin B. Frakt, PhD; Dhruv Khullar, MD, MPP; et al.

Abstract Full Text

JAMA. 2017;317(20):2105-2113. doi:10.1001/jama.2017.5702

This study uses national Medicare data to compare 30-day mortality among patients hospitalized or undergoing surgical procedures in teaching vs nonteaching hospitals between 2012 and 2014.

Key Points

Question Is there a difference in mortality rates at US teaching hospitals compared with other hospitals?

Findings In an observational study of approximately 21 million hospitalizations of Medicare beneficiaries, adjusted 30-day mortality rates were significantly lower at 250 major teaching hospitals compared with 894 minor teaching and 3339 nonteaching hospitals overall (8.3% vs 9.2% and 9.5%) as well as for several individual common medical and surgical conditions.

Meaning Major teaching hospital status was associated with lower mortality rates for common conditions.

Abstract

Importance Few studies have analyzed contemporary data on outcomes at US teaching hospitals vs nonteaching hospitals.

Objective To examine risk-adjusted outcomes for patients admitted to teaching vs nonteaching hospitals across a broad range of medical and surgical conditions.

Design, Setting, and Participants Use of national Medicare data to compare mortality rates in US teaching and nonteaching hospitals for all hospitalizations and for common medical and surgical conditions among Medicare beneficiaries 65 years and older.

Exposures Hospital teaching status: major teaching hospitals (members of the Council of Teaching Hospitals), minor teaching hospitals (other hospitals with medical school affiliation), and nonteaching hospitals (remaining hospitals).

Main Outcomes and Measures Primary outcome was 30-day mortality rate for all hospitalizations and for 15 common medical and 6 surgical conditions. Secondary outcomes included 30-day mortality stratified by hospital size and 7-day mortality and 90-day mortality for all hospitalizations as well as for individual medical and surgical conditions.

Results The sample consisted of 21 451 824 total hospitalizations at 4483 hospitals, of which 250 (5.6%) were major teaching, 894 (19.9%) were minor teaching, and 3339 (74.3%) were nonteaching hospitals. Unadjusted 30-day mortality was 8.1% at major teaching hospitals, 9.2% at minor teaching hospitals, and 9.6% at nonteaching hospitals, with a 1.5% (95% CI, 1.3%-1.7%; P < .001) mortality difference between major teaching hospitals and nonteaching hospitals. After adjusting for patient and hospital characteristics, the same pattern persisted (8.3% mortality at major teaching vs 9.2% at minor teaching and 9.5% at nonteaching), but the difference in mortality between major and nonteaching hospitals was smaller (1.2% [95% CI, 1.0%-1.4%]; P < .001). After stratifying by hospital size, 187 large (≥400 beds) major teaching hospitals had lower adjusted overall 30-day mortality relative to 76 large nonteaching hospitals (8.1% vs 9.4%; 1.2% difference [95% CI, 0.9%-1.5%]; P < .001). This same pattern of lower overall 30-day mortality at teaching hospitals was observed for medium-sized (100-399 beds) hospitals (8.6% vs 9.3% and 9.4%; 0.8% difference between 61 major and 1207 nonteaching hospitals [95% CI, 0.4%-1.3%]; P = .003). Among small (≤99 beds) hospitals, 187 minor teaching hospitals had lower overall 30-day mortality relative to 2056 nonteaching hospitals (9.5% vs 9.9%; 0.4% difference [95% CI, 0.1%-0.7%]; P = .01).

Conclusions and Relevance Among hospitalizations for US Medicare beneficiaries, major teaching hospital status was associated with lower mortality rates for common conditions compared with nonteaching hospitals. Further study is needed to understand the reasons for these differences.

 

Clinical Trials Update

May 23/30, 2017

Vitamin E and Selenium Fail to Prevent Dementia in Men

Anita Slomski, MA

JAMA. 2017;317(20):2054. doi:10.1001/jama.2017.6078

Antioxidant supplementation with vitamin E and selenium, taken alone or in combination, was not associated with a decreased incidence of dementia in asymptomatic older men, according to a study published by JAMA Neurology. Oxidative stress has been implicated as an important mechanism in Alzheimer disease, spurring interest in the use of antioxidants to modify risk of cognitive decline and dementia.

The Prevention of Alzheimer Disease by Vitamin E and Selenium (PREADViSE) trial began as ancillary to a randomized controlled trial for prostate cancer prevention, which ended prematurely due to lack of efficacy. PREADViSE initially enrolled 7540 older men who were randomized to receive selenium (200 µg daily), vitamin E (400 IU daily), vitamin E and selenium, or placebo for an average of 5.4 years. A subset of 3786 men were observed and evaluated with at least 1 memory screen for an additional 6 years without taking the supplements in a cohort study. The incidence of dementia (4.4%) did not differ among the four study groups at the end of the observational period.

The authors cautioned that the study had significant limitations, such as the loss of about half of the participants to long-term follow-up during the transition from a randomized clinical trial to a cohort study, and the refusal of many participants to see clinicians for definitive testing for dementia. The relatively young age (mean 67.5 years) and the high level of education of participants at baseline likely contributed to the low incidence of dementia, which may have made it difficult to detect any positive effect of the interventions.

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Association of Antioxidant Supplement Use and Dementia in the Prevention of Alzheimer's Disease by Vitamin E and Selenium Trial (PREADViSE).

Kryscio RJ, Abner EL, Caban-Holt A, Lovell M, Goodman P, Darke AK, Yee M, Crowley J, Schmitt FA.

JAMA Neurol. 2017 May 1;74(5):567-573. doi: 10.1001/jamaneurol.2016.5778.

http://sci-hub.cc/10.1001/jamaneurol.2016.5778

PMID: 28319243

Abstract

IMPORTANCE:

Oxidative stress is an established dementia pathway, but it is unknown if the use of antioxidant supplements can prevent dementia.

OBJECTIVE:

To determine if antioxidant supplements (vitamin E or selenium) used alone or in combination can prevent dementia in asymptomatic older men.

DESIGN, SETTING, AND PARTICIPANTS:

The Prevention of Alzheimer's Disease by Vitamin E and Selenium (PREADViSE) trial began as a double-blind randomized clinical trial in May 2002, which transformed into a cohort study from September 2009 to May 2015. The PREADViSE trial was ancillary to the Selenium and Vitamin E Cancer Prevention Trial (SELECT), a randomized clinical trial of the same antioxidant supplements for preventing prostate cancer, which closed in 2009 owing to findings from a futility analysis. The PREADViSE trial recruited 7540 men, of whom 3786 continued into the cohort study. Participants were at least 60 years old at study entry and were enrolled at 130 SELECT sites, and Cox proportional hazards models were used in a modified intent-to-treat analysis to compare hazard rates among the study arms.

INTERVENTIONS:

Participants were randomized to vitamin E, selenium, vitamin E and selenium, or placebo. While taking study supplements, enrolled men visited their SELECT site and were evaluated for dementia using a 2-stage screen. During the cohort study, men were contacted by telephone and assessed using an enhanced 2-stage cognitive screen. In both phases, men were encouraged to visit their physician if the screen results indicated possible cognitive impairment.

MAIN OUTCOMES AND MEASURES:

Dementia case ascertainment relied on a consensus review of the cognitive screens and medical records for men with suspected dementia who visited their physician for an evaluation or by review of all available information, including a functional assessment screen.

RESULTS:

The mean (SD) baseline age of the 7540 participants was 67.5 (5.3) years, with 3936 (52.2%) reporting a college education or better, 754 (10.0%) reporting black race, and 505 (6.7%) reporting Hispanic ethnicity. Dementia incidence (325 of 7338 men [4.4%]) was not different among the 4 study arms. A Cox model, which adjusted incidence for participant demographic information and baseline self-reported comorbidities, yielded hazard ratios of 0.88 (95% CI, 0.64-1.20) for vitamin E, 0.83 (0.60-1.13) for selenium, and 1.00 (0.75-1.35) for the combination compared with placebo.

CONCLUSIONS AND RELEVANCE:

Neither supplement prevented dementia. To our knowledge, this is the first study to investigate the long-term association of antioxidant supplement use and dementia incidence among asymptomatic men.

 

Health Agencies Update

May 23/30, 2017

Increase in Diabetes Cases Among Young People

Jennifer Abbasi

A new report finds diabetes is increasing among young people.

JAMA. 2017;317(20):2053. doi:10.1001/jama.2017.5774

The incidence of both type 1 and type 2 diabetes in US youth younger than 20 years increased between 2002 and 2012, according to a new analysis from the ongoing SEARCH for Diabetes in Youth study, which is funded by the Centers for Disease Control and Prevention and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) at the National Institutes of Health.

Based on data from patients at 5 clinical centers in California, Colorado, Ohio, South Carolina, and Washington, the SEARCH investigators reported that during the study period, the relative annual increase in the incidence of type 1 diabetes among youth was 1.8% and that of type 2 diabetes was 4.8%, after adjusting for age, sex, and race or ethnic group.

The estimated annual incidence of type 1 diabetes in youths 0 to 19 years old increased from 15 900 cases in the 2002-2003 period to 17 900 cases in the 2011-2012 period. At the same time, the estimated annual incidence of type 2 diabetes in 10- to 19-year-olds increased from 3800 to 5300 cases.

Hispanic youth had the greatest increase in annual incidence of type 1 diabetes (4.2%), while the rate of type 2 diabetes increased most in Native Americans (8.9%) and Asian Americans/Pacific Islanders (8.5%). For both types of diabetes, whites had the smallest increases in annual incidence—1.2% for type 1 diabetes and 0.6% for type 2 diabetes—over the study period. New cases of type 2 diabetes increased more in females (6.2%) than in males (3.7%).

“Physicians need to especially think about type 2 diabetes, which can be asymptomatic,” Barbara Linder, MD, PhD, senior advisor for childhood diabetes research at the NIDDK, told JAMA. She encouraged screening young people who are obese and have a family history of type 2 diabetes and emphasized the importance of screening at-risk youth from racial or ethnic minority groups. “It is important to make the diagnosis of type 2 diabetes as early as possible, and to promote lifestyle changes and good glycemic control, as these can prevent long-term vascular complications from occurring,” she said.

 

Health Agencies Update

May 23/30, 2017

Cancer Death Rates Decrease in Men, Women, and Children

Jennifer Abbasi

JAMA. 2017;317(20):2053. doi:10.1001/jama.2017.6139

Overall death rates from cancer are decreasing in the United States, according to the “Annual Report to the Nation on the Status of Cancer” issued by the Centers for Disease Control and Prevention, the National Cancer Institute, the American Cancer Society, and the North American Association of Central Cancer Registries.

The 2017 report found that cancer mortality decreased 1.8% per year in men, 1.4% per year in women, and 1.6% per year in children between 2010 and 2014. During this time frame, death rates decreased for lung, colorectal, female breast, and prostate cancers, among others, but increased for liver cancer in men and women, pancreas and brain cancers in men, and uterine cancer.

The report also included a special section on survival. For 18 of 20 types of cancer, patients diagnosed in 2006-2012 had increased 5-year survival rates compared with those diagnosed in 1975-1977, with the greatest increases in absolute survival rates reported for prostate cancer, leukemia, non-Hodgkin lymphoma, myeloma, and kidney cancer. Survival rates did not increase for cancers of the cervix and the uterus. Cancers of the brain, stomach, esophagus, lung, liver, and pancreas diagnosed in 2006-2012 had the lowest 5-year relative survival rates.

Racial differences in survival also were reported: Compared with white people, the adjusted relative risk of death for all cancers was 51% higher among American Indians and Alaska Natives and 33% higher in black people.

Overall, new cancer cases decreased 2.3% per year for men between 2009 and 2013 but were stable for women. However, the report noted a 0.4% annual increase during this 5-year time period in the incidence of breast cancer, the most common cancer among women.

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Annual Report to the Nation on the Status of Cancer, 1975-2014, Featuring Survival.

Jemal A, Ward EM, Johnson CJ, Cronin KA, Ma J, Ryerson B, Mariotto A, Lake AJ, Wilson R, Sherman RL, Anderson RN, Henley SJ, Kohler BA, Penberthy L, Feuer EJ, Weir HK.

J Natl Cancer Inst. 2017 Sep 1;109(9). doi: 10.1093/jnci/djx030.

PMID: 28376154 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5409140/

Abstract

BACKGROUND:

The American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) collaborate to provide annual updates on cancer occurrence and trends in the United States. This Annual Report highlights survival rates. Data were from the CDC- and NCI-funded population-based cancer registry programs and compiled by NAACCR. Trends in age-standardized incidence and death rates for all cancers combined and for the leading cancer types by sex were estimated by joinpoint analysis and expressed as annual percent change. We used relative survival ratios and adjusted relative risk of death after a diagnosis of cancer (hazard ratios [hrs]) using Cox regression model to examine changes or differences in survival over time and by sociodemographic factors.

RESULTS:

Overall cancer death rates from 2010 to 2014 decreased by 1.8% (95% confidence interval [CI] = -1.8 to -1.8) per year in men, by 1.4% (95% CI = -1.4 to -1.3) per year in women, and by 1.6% (95% CI = -2.0 to -1.3) per year in children. Death rates decreased for 11 of the 16 most common cancer types in men and for 13 of the 18 most common cancer types in women, including lung, colorectal, female breast, and prostate, whereas death rates increased for liver (men and women), pancreas (men), brain (men), and uterine cancers. In contrast, overall incidence rates from 2009 to 2013 decreased by 2.3% (95% CI = -3.1 to -1.4) per year in men but stabilized in women. For several but not all cancer types, survival statistically significantly improved over time for both early and late-stage diseases. Between 1975 and 1977, and 2006 and 2012, for example, five-year relative survival for distant-stage disease statistically significantly increased from 18.7% (95% CI = 16.9% to 20.6%) to 33.6% (95% CI = 32.2% to 35.0%) for female breast cancer but not for liver cancer (from 1.1%, 95% CI = 0.3% to 2.9%, to 2.3%, 95% CI = 1.6% to 3.2%). Survival varied by race/ethnicity and state. For example, the adjusted relative risk of death for all cancers combined was 33% (HR = 1.33, 95% CI = 1.32 to 1.34) higher in non-Hispanic blacks and 51% (HR = 1.51, 95% CI = 1.46 to 1.56) higher in non-Hispanic American Indian/Alaska Native compared with non-Hispanic whites.

CONCLUSIONS:

Cancer death rates continue to decrease in the United States. However, progress in reducing death rates and improving survival is limited for several cancer types, underscoring the need for intensified efforts to discover new strategies for prevention, early detection, and treatment and to apply proven preventive measures broadly and equitably.

 

A cluster-randomized trial to reduce caesarean delivery rates in Quebec: cost-effectiveness analysis.

Johri M, Ng ESW, Bermudez-Tamayo C, Hoch JS, Ducruet T, Chaillet N.

BMC Med. 2017 May 22;15(1):96. doi: 10.1186/s12916-017-0859-8.

PMID: 28528578

Abstract

BACKGROUND:

Widespread increases in caesarean section (CS) rates have sparked concerns about risks to mothers and infants and rising healthcare costs. A multicentre, two-arm, cluster-randomized trial in Quebec, Canada assessed whether an audit and feedback intervention targeting health professionals would reduce CS rates for pregnant women compared to usual care, and concluded that it reduced CS rates without adverse effects on maternal or neonatal health. The effect was statistically significant but clinically small. We assessed cost-effectiveness to inform scale-up decisions.

METHODS:

A prospective economic evaluation was undertaken using individual patient data from the Quality of Care, Obstetrics Risk Management, and Mode of Delivery (QUARISMA) trial (April 2008 to October 2011). Analyses took a healthcare payer perspective. The time horizon captured hospital-based costs and clinical events for mothers and neonates from labour onset to 3 months postpartum. Resource use was identified and measured from patient charts and valued using standardized government sources. We estimated the changes in CS rates and costs for the intervention group (versus controls) between the baseline and post-intervention periods. We examined heterogeneity between clinical subgroups of high-risk versus low-risk pregnancies and estimated the joint uncertainty in cost-effectiveness over 20,000 trial simulations. We decomposed costs to identify drivers of change.

RESULTS:

The intervention group experienced per-patient reductions of 0.005 CS (95% confidence interval (CI): -0.015 to 0.004, P = 0.09) and $180 (95% CI: -$277 to - $83, P < 0.001). Women with low-risk pregnancies experienced statistically significant reductions in CS rates and costs; changes for the high-risk subgroup were not significant. The intervention was "dominant" (effective in reducing CS and less costly than usual care) in 86.08% of simulations. It reduced costs in 99.99% of simulations. Cost reductions were driven by lower rates of neonatal complications in the intervention group (-$190, 95% CI: -$255 to - $125, P < 0.001). Given 88,000 annual provincial births, a similar intervention could save $15.8 million (range: $7.3 to $24.4 million) in Quebec annually.

CONCLUSIONS:

From a healthcare payer perspective, a multifaceted intervention involving audits and feedback resulted in a small reduction in caesarean deliveries and important cost savings. Cost reductions are consistent with improved quality of care in intervention group hospitals.

KEYWORDS:

Adolescent; Adult; Caesarean section/utilization; Cost-benefit analysis; Female; Guideline adherence; Infant; Medical audit; Multilevel analysis; Newborn; Pregnancy outcomes; Randomized controlled trial

 

Risk factors for cervical intraepithelial neoplasia and cervical cancer in Chinese women: large study in Jiexiu, Shanxi Province, China.

Wang Z, Wang J, Fan J, Zhao W, Yang X, Wu L, Li D, Ding L, Wang W, Xu J, Stram M, Zhao C, Hao M.

J Cancer. 2017 Mar 12;8(6):924-932. doi: 10.7150/jca.17416. eCollection 2017.

PMID: 28529603

Abstract

We aimed to investigate the risk factors for cervical intraepithelial neoplasia (CIN) in Jiexiu, Shanxi Province, China. Twenty thousand eligible married women (age: 18-65 years) were administered with a questionnaire on potential risk factors for CIN and underwent liquid based Pap test. All women with abnormal cytological results underwent colposcopy with biopsy. Based on the biopsy pathology results, women were then assigned to either study group (with CIN) or control group (negative for histological results and volunteered to participate in the follow up study). The women in both study group and control group underwent vaginal microflora detection and dietary survey. The potential risk factors were analyzed by using ordinal logistic regression. Among the 20,000 women ne 1,438 women (7.19%) had cytologic abnormalities and 410 (2.05%) women were diagnosed histologically with CIN lesions, including 317 (1.58%) with CIN1, 93 (0.50%) with CIN2/3and 11 (55/100,000) with squamous cell carcinoma (SCC). The average daily dietary folate intake was significantly lower in the study group (344.61±153.07μg) than in the control group (371.50±166.58μg; P<0.001). Multivariate analysis demonstrated that age of 56-65 years, farming as the husband's occupation, unwashing the vulva after sexual intercourse, and low self-reported folate intake were positively associated with CIN development and might have contribution to the increased CIN incidence in this population. These findings may provide help to develop the strategies to reduce the risk of cervical cancer in China.

KEYWORDS:

CIN; China; cervical cancer; folate; risk factors

 

Effect of citrus-based products on urine profile: A systematic review and meta-analysis.

Rahman F, Birowo P, Widyahening IS, Rasyid N.

F1000Res. 2017 Mar 6;6:220. doi: 10.12688/f1000research.10976.1. eCollection 2017.

PMID: 28529700

Abstract

Background. Urolithiasis is a disease with high recurrence rate, 30-50% within 5 years. The aim of the present study was to learn the effects of citrus-based products on the urine profile in healthy persons and people with urolithiasis compared to control diet and potassium citrate. Methods. A systematic review was performed, which included interventional, prospective observational and retrospective studies, comparing citrus-based therapy with standard diet therapy, mineral water, or potassium citrate. A literature search was conducted using PUBMED, COCHRANE, and Google Scholar with "citrus or lemonade or orange or grapefruit or lime or juice" and "urolithiasis" as search terms. For statistical analysis, a fixed-effects model was conducted when p > 0.05, and random-effects model was conducted when p < 0.05. Results. In total, 135 citations were found through database searching with 10 studies found to be consistent with our selection criteria. However, only 8 studies were included in quantitative analysis, due to data availability. The present study showed a higher increased in urine pH for citrus-based products (mean difference, 0.16; 95% CI 0.01-0.32) and urinary citrate (mean difference, 124.49; 95% CI 80.24-168.74) compared with a control group. However, no differences were found in urine volume, urinary calcium, urinary oxalate, and urinary uric acid. From subgroup analysis, we found that citrus-based products consistently increased urinary citrate level higher than controls in both healthy and urolithiasis populations. Furthermore, there was lower urinary calcium level among people with urolithiasis. Conclusions. Citrus-based products could increase urinary citrate level significantly higher than control. These results should encourage further research to explore citrus-based products as a urolithiasis treatment.

KEYWORDS:

Citrus; citrate; potassium citrate; urine profile; urolithiasis

 

The effects of lutein on respiratory health across the life course: A systematic review.

Melo van Lent D, Leermakers ETM, Darweesh SKL, Moreira EM, Tielemans MJ, Muka T, Vitezova A, Chowdhury R, Bramer WM, Brusselle GG, Felix JF, Kiefte-de Jong JC, Franco OH.

Clin Nutr ESPEN. 2016 Jun;13:e1-e7. doi: 10.1016/j.clnesp.2016.02.096. Epub 2016 Mar 26. Review.

PMID: 28531562

Abstract

BACKGROUND:

Lutein, a fat-soluble carotenoid present in green leafy vegetables and eggs, has strong antioxidant properties and could therefore be important for respiratory health.

DESIGN:

We systematically reviewed the literature for articles that evaluated associations of lutein (intake, supplements or blood levels) with respiratory outcomes, published in Medline, Embase, Cochrane Central, PubMed, Web of Science and Google Scholar, up to August 2014.

RESULTS:

We identified one Randomized Control Trial (RCT), two longitudinal, four prospective and six cross-sectional studies. The individual studies obtained a Quality Score ranging between 3 and 9. Six studies were performed in children, which examined bronchopulmonary dysplasia (BPD), asthma and wheezing. In adults, 7 studies investigated asthma, respiratory function and respiratory mortality. The RCT found a borderline significant effect of lutein/zeaxanthin supplementation in neonates on the risk of BPD (OR 0.43 (95% CI 0.15; 1.17). No association was found between lutein intake or levels and respiratory outcomes in children. A case-control study in adults showed lower lutein levels in asthma cases. Three studies, with a prospective or longitudinal study design, in adults found a small but a significant positive association between lutein intake or levels and respiratory function. No association was found in the other two studies. In relation to respiratory mortality, one longitudinal study showed that higher lutein blood levels were associated with a decreased mortality (HR 0.77 (95% CI 0.60; 0.99), per SD increase in lutein).

CONCLUSION:

The published literature suggests a possible positive association between lutein and respiratory health. However, the literature is scarce and most studies are of observational nature.

KEYWORDS:

Antioxidant; Asthma; Carotenoid; Life course; Lung function; Lutein; Systematic review

 

Adherence to Mediterranean diet has a mediating effect inflammation as regards cardiovascular disease risk: The 10-year (2002-12) follow-up of ATTICA study.

Georgoysopoulou EN, Panagiotakos DB, Pitsavos C, Kalogeropoulou A, Ntertimani M, Pitaraki E, Chrysohoou C, Skoumas I, Tousoulis D, Stefanadis C.

Clin Nutr ESPEN. 2016 Jun;13:e67. doi: 10.1016/j.clnesp.2016.03.051. Epub 2016 May 20. No abstract available.

PMID: 28531616

http://sci-hub.cc/10.1016/j.clnesp.2016.03.051

Introduction: Mediterranean diet has been associated with lower allcause

and cardiovascular disease (CVD) morbidity and mortality, but the

clinical and pathway has not been well understood and appreciated.

Aim: The aim of this work was to explore the path between adherence to a

Mediterranean-type diet, lifestyle behaviors, clinical status and 10-year

incidence of CVD.

Materials and methods: the ATTICA study was carried out in the Athens

area during 2001-2002 and included 3042 participants free of CVD at

baseline (49.8% men, aged 18-89). Adherence to Mediterranean diet was

assessed using the MedDietScore (range 0-55). During 2011-2012, 2583

out of the 3042 baseline participants attended the 10-year follow-up of the

Attica study (15% lost-to-follow-up).

Results: Adherence to Mediterranean diet decreased CVD risk (Relative

Risk (RR) per 1/55 unit ¼0.96, 95%, CI: 0.93-1.00), independently of various

socio-demographic, lifestyle and clinical factors. Path analysis revealed

that adherence to Mediterranean diet decreases C-reactive protein’s levels

and interleukin-6 levels, but also has an independent protective role on

CVD risk per se (total effect of the MedDietScore on CVD¼-0.003, 95%CI:

-0.005-0.000).

Conclusions: adherence to Mediterranean diet confers a considerable

reduction on CVD risk, independently of various factors. Therefore, even

subjects with unhealthy lifestyle behaviors may benefit from adherence to

this diet, suggesting another dimension on prevention strategies.

 

The effects of Mediterranean Diet on cognitive function and dementia: Systematic review of the evidence.

Petersson S, Philippou E.

Clin Nutr ESPEN. 2016 Jun;13:e67. doi: 10.1016/j.clnesp.2016.03.052. Epub 2016 May 20. No abstract available.

PMID: 28531617

http://sci-hub.cc/10.1016/j.clnesp.2016.03.051

Introduction: There is a growing body of evidence suggesting that

adherence to the Mediterranean Diet (MD) may protect against cognitive

decline and dementia although the evidence is still inconsistent.

Aim: The aim of this systematic review is to update the current knowledge

on the effects of MD on cognitive function and/or cognitive impairment

(CI) and/or Alzheimer’s disease (AD) and/or all-type dementia.

Materials and methods: Five databases were searched: PubMed, CINAHL,

CENTRAL and PsychINFO (date 1806 to 25th May, 2015), using pre-specified

criteria. Human studies, published in English, without any restriction in

study type, population assessed, intervention period, follow-up time, or

publication date, examining the association between adherence to the MD

and cognitive function or dementia symptoms (as measured by cognitive

function tests) were included. Only primary publication types were included.

Results: 32 studies, including 5 Randomized Controlled Trials (RCTs) and

27 observational studies, met the inclusion criteria. The majority of studies

showed that MD improved cognitive function and/or decreased risk of CI

and/or decreased risk of dementia/AD. Three studies found no correlation

between MD and AD, 3 found no association between MD and CI and 5

found no association between MD and cognitive function. There was large

heterogeneity and studies differed with regards to quality.

Conclusion: Overall, the existing evidence, stemming mostly from

epidemiological studies, suggests that MD improves cognitive function

and delays the onset of dementia. However, more RCTs are required to

establish a causational relationship.

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Mediterranean Diet, Cognitive Function, and Dementia: A Systematic Review of the Evidence.

Petersson SD, Philippou E.

Adv Nutr. 2016 Sep 15;7(5):889-904. doi: 10.3945/an.116.012138. Print 2016 Sep. Review.

PMID: 27633105

http://sci-hub.cc/10.3945/an.116.012138

Abstract

A growing body of evidence suggests that adherence to the Mediterranean diet (MD) may protect against cognitive decline and dementia. Many epidemiologic studies and several randomized controlled trials (RCTs) have found positive effects of the MD on cognitive function, but findings remain inconsistent. The aim of this systematic review was to provide an update on the current knowledge of the effects of the MD on cognitive function, cognitive impairment, Alzheimer disease (AD), and all-type dementia. Five databases were searched-PubMed, Embase, CINAHL, CENTRAL, and PsycINFO (1806 to 25 May 2015)-with the use of prespecified criteria. Human studies that were published in English without any restriction on study type, population assessed, intervention period, follow-up time, or publication date, and that examined the association between adherence to the MD and cognitive function or dementia symptoms (as measured by cognitive function tests), were included. Only primary publication types were included. Thirty-two studies from 25 unique cohorts, including 5 RCTs and 27 observational studies, met the inclusion criteria. The majority of studies showed that the MD was associated with improved cognitive function, a decreased risk of cognitive impairment or decreased risk of dementia, or AD. Three studies found no correlation between the MD and AD, 3 further studies found no association between the MD and cognitive impairment, and 5 studies found no association between the MD and cognitive function. There was large heterogeneity, and studies differed with regard to quality. Based on the findings and the limitations in study design, we conclude that adherence to the MD is associated with better cognitive performance. However, it should be noted that the majority of findings come from epidemiologic studies that provide evidence for a correlation between the MD and cognition but not for a cause-and-effect relation. More controlled trials are required to establish a causational relation.

KEYWORDS:

Alzheimer disease; Mediterranean diet; cognitive function; cognitive impairment; dementia; dietary patterns; systematic review

 

Health and Functional Status of Adults Aged 90 Years in the United States.

Odden MC, Koh WJH, Arnold AM, Psaty BM, Newman AB.

JAMA Intern Med. 2017 May 1;177(5):732-734. doi: 10.1001/jamainternmed.2017.0242. No abstract available.

PMID: 28319228

10.1001/jamainternmed.2017.0242

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Leucine-nicotinic acid synergy stimulates AMPK/Sirt1 signaling and regulates lipid metabolism and lifespan in Caenorhabditis elegans, and hyperlipidemia and atherosclerosis in mice.

Bruckbauer A, Banerjee J, Cao Q, Cui X, Jing J, Zha L, Li F, Xue B, Shi H, Zemel MB.

Am J Cardiovasc Dis. 2017 Apr 15;7(2):33-47. eCollection 2017.

PMID: 28533928

Abstract

BACKGROUND/AIMS:

Nicotinic acid (NA), a lipid-lowering drug, serves as a source of NAD+, the cofactor for Sirt1. Leucine (Leu) stimulates the AMPK/Sirt1 axis and amplifies the effects of other AMPK/Sirt1 activating compounds. Therefore, we tested the interactive effects of leucine and low dose NA on AMPK/Sirt1 signaling and downstream effects of lipid metabolism in cell culture, C. elegans and mice.

METHODS:

LDL-receptor knockout mice were fed an atherogenic Western diet supplemented with leucine (24 g/kg diet) and sub-therapeutic NA combinations (50 mg/kg diet and 250 mg/kg diet) or low therapeutic NA (1000 mg/kg diet) for 8 weeks to evaluate markers of hyperlipidemia and atherosclerosis.

RESULTS:

NA-Leu increased P-AMPK and Sirt1 in adipocytes and myotubes. In C. elegans, NA-Leu increased P-AMPK and DAF-16 (FOXO), reduced lipid accumulation and increased median survival under mild oxidative stress conditions. In the mice, NA-Leu reduced total cholesterol, cholesterol esters, plasma triglycerides, atherosclerotic lesion size, lipid area, and aortic macrophage infiltration, similar to the therapeutic NA dose.

CONCLUSION:

Leu amplifies the effects of NA on lipid metabolism, hyperlipidemia and atherosclerosis in mice, at least in part by activation of the AMPK/Sirt1 axis. This combination may be a potential therapeutic alternative for hyperlipidemia and atherosclerosis.

KEYWORDS:

AMPK; C. elegans; Sirt1; atherosclerosis; leucine; lipid metabolism; nicotinic acid

 

Impact of legumes and plant proteins consumption on cognitive performances in the elderly.

Mazza E, Fava A, Ferro Y, Moraca M, Rotundo S, Colica C, Provenzano F, Terracciano R, Greco M, Foti D, Gulletta E, Russo D, Bosco D, Pujia A, Montalcini T.

J Transl Med. 2017 May 22;15(1):109. doi: 10.1186/s12967-017-1209-5.

PMID: 28532453

Abstract

BACKGROUND:

Numerous studies have investigated the role of the dietary factors in the prevention of cognitive decline but the short-term effects of foods choice on cognitive performances in the elderly are poorly explored. Our aim was to investigate the choice of foods among elderly Italian individuals and the association with cognitive function.

METHODS:

In this longitudinal study, the participants were 214 individuals aged ≥65 years with a score >20 at the Mini Mental State Examination. The cognitive sub-test of ADAScale was used to detect cognitive decline progression over 12 months. Food choices was measured by a combination of a 24-h recall and a seven-day diet record and Principal Components Analysis.

RESULTS:

The Principal Components Analysis identified four food and four nutrient patterns. MMSE and ADAS-cog score after 1 year were found to be associated with legumes pattern (B = 0.25, p = 0.007; 95% CI 0.07/0.44; and B = -0.10, p = 0.006; CI -0.79/-0.30, respectively). A dietary pattern including plant proteins was independently associated with an improved ADAS-cog after 1 year (B = 0.584, p = 0.04; OR 1.79, CI 0.04-0.42).

CONCLUSIONS:

The Principal Components Analysis is useful to investigate the choice of foods and nutrients in the elderly. We demonstrated an association between legumes pattern with cognitive performances.

KEYWORDS:

Cognitive decline; Elderly; Legumes; Mediterranean diet; Plant protein; Principal Components Analysis

 

Prior weight loss exacerbates the biological drive to gain weight after the loss of ovarian function.

Sherk VD, Jackman MR, Giles ED, Higgins JA, Foright RM, Presby DM, Johnson GC, Houck JA, Houser JL, Oljira R, MacLean PS.

Physiol Rep. 2017 May;5(10). pii: e13272. doi: 10.14814/phy2.13272.

PMID: 28533263

Abstract

Both the history of obesity and weight loss may change how menopause affects metabolic health. The purpose was to determine whether obesity and/or weight loss status alters energy balance (EB) and subsequent weight gain after the loss of ovarian function. Female lean and obese Wistar rats were randomized to 15% weight loss (WL) or ad libitum fed controls (CON). After the weight loss period, WL rats were kept in EB at the reduced weight for 8 weeks prior to ovariectomy (OVX). After OVX, all rats were allowed to eat ad libitum until weight plateaued. Energy intake (EI), spontaneous physical activity, and total energy expenditure (TEE) were measured with indirect calorimetry before OVX, immediately after OVX, and after weight plateau. Changes in energy intake (EI), TEE, and weight gain immediately after OVX were similar between lean and obese rats. However, obese rats gained more total weight and fat mass than lean rats over the full regain period. Post-OVX, EI increased more (P ≤ 0.03) in WL rats (58.9 ± 3.5 kcal/d) than CON rats (8.5 ± 5.2 kcal/d), and EI partially normalized (change from preOVX: 20.5 ± 4.2 vs. 1.5 ± 4.9 kcal/day) by the end of the study. As a result, WL rats gained weight (week 1:44 ± 20 vs. 7 ± 25 g) more rapidly (mean = 44 ± 20 vs. 7 ± 25 g/week; P < 0.001) than CON Prior obesity did not affect changes in EB or weight regain following OVX, whereas a history of weight loss prior to OVX augmented disruptions in EB after OVX, resulting in more rapid weight regain.

KEYWORDS:

OVX ; Energy balance; weight regain

 

Meat, dietary heme iron and risk of type 2 diabetes: The Singapore Chinese Health Study.

Talaei M, Wang YL, Yuan JM, Pan A, Koh WP.

Am J Epidemiol. 2017 May 23. doi: 10.1093/aje/kwx156. [Epub ahead of print]

PMID: 28535164

Abstract

We evaluated the relations of red meat, poultry, fish and shellfish, as well as heme iron intake, with risk of type 2 diabetes (T2D).The Singapore Chinese Health Study is a population-based cohort that recruited 63,257 Chinese adults aged 45-74 years from 1993 to 1998. Usual diet was evaluated by a validated 165-item semi-quantitative food-frequency questionnaire at recruitment. Physician-diagnosed T2D was self-reported during two follow-up interviews in 1999-2004 and 2006-2010. During a mean follow-up of 10.9 years, 5207 incident cases of T2D were reported. The multivariate-adjusted HR (95% CI) for T2D comparing highest versus the lowest quartiles was 1.23 (1.14, 1.33) for red meat (P for trend < 0.001), 1.15 (1.06, 1.24) for poultry (P for trend = 0.004), and 1.07 (0.99, 1.16) for fish/shellfish (P for trend = 0.12). After additional adjustment for heme iron, only red meat intake remained significantly associated with T2D risk (1.13; 1.01, 1.25; P for trend = 0.02). Heme iron was associated with increased T2D risk even after additionally adjusted for red meat (1.14; 1.02, 1.28; P for trend = 0.03).In conclusion, red meat and poultry intake was associated with an increased risk of T2D. These associations were mediated by heme iron, for poultry completely but partially for red meat.

© The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

KEYWORDS:

epidemiology; fish; heme iron; poultry; prospective studies; red meat; type 2 diabetes

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Chocolate intake and risk of clinically apparent atrial fibrillation: the Danish Diet, Cancer, and Health Study.

Mostofsky E, Berg Johansen M, Tjønneland A, Chahal HS, Mittleman MA, Overvad K.

Heart. 2017 May 23. pii: heartjnl-2016-310357. doi: 10.1136/heartjnl-2016-310357. [Epub ahead of print]

PMID: 28536115

Abstract

OBJECTIVE:

To evaluate the association between chocolate intake and incident clinically apparent atrial fibrillation or flutter (AF).

METHODS:

The Danish Diet, Cancer, and Health Study is a large population-based prospective cohort study. The present study is based on 55 502 participants (26 400 men and 29 102 women) aged 50-64 years who had provided information on chocolate intake at baseline. Incident cases of AF were ascertained by linkage with nationwide registries.

RESULTS:

During a median of 13.5 years there were 3346 cases of AF. Compared with chocolate intake less than once per month, the rate of AF was lower for people consuming 1-3 servings/month (hazard ratio (HR) 0.90, 95% confidence interval (CI) 0.82 to 0.98), 1 serving/week (HR 0.83, 95% CI 0.74 to 0.92), 2-6 servings/week (HR 0.80, 95% CI 0.71 to 0.91) and ≥1 servings/day (HR 0.84, 95% CI 0.65 to 1.09; p-linear trend <0.0001), with similar results for men and women.

CONCLUSIONS:

Accumulating evidence indicates that moderate chocolate intake may be inversely associated with AF risk, although residual confounding cannot be ruled out.

 

Dietary intake of fibre and risk of knee osteoarthritis in two US prospective cohorts.

Dai Z, Niu J, Zhang Y, Jacques P, Felson DT.

Ann Rheum Dis. 2017 May 23. pii: annrheumdis-2016-210810. doi: 10.1136/annrheumdis-2016-210810. [Epub ahead of print]

PMID: 28536116

Abstract

OBJECTIVES:

Dietary fibre reduces body weight and inflammation both of which are linked with knee osteoarthritis (OA). We examined the association between fibre intake and risk of knee OA.

METHODS:

We used data from the Osteoarthritis Initiative (OAI) of 4796 participants and Framingham Offspring Osteoarthritis Study (Framingham) of 1268 persons. Dietary intake of fibre was estimated at baseline, and incident radiographic OA (ROA) and symptomatic OA (SxOA) were followed annually until 48 months in OAI and assessed 9 years later in Framingham. Knee pain worsening was also examined in OAI. Generalised estimating equations were applied in multivariable regression models.

RESULTS:

In OAI, we identified 861 knees with SxOA, 152 knees with ROA and 1964 knees with pain worsening among 4051 subjects with valid dietary intake (baseline mean age: 61.2 years; mean body mass index (BMI): 28.6). In Framingham, 143 knees with SxOA and 175 knees with ROA among 971 such subjects (baseline mean age: 53.9 years; mean BMI: 27.0) were identified. In both cohorts, dietary total fibre was inversely associated with risk of SxOA (p trend <0.03) with significantly lower risk at the highest versus lowest quartile (OR (95% CI): 0.70 (0.52, 0.94) for OAI and 0.39 (0.17, 0.88) for Framingham). Furthermore, dietary total and cereal fibre were significantly inversely associated with knee pain worsening in OAI (p trend <0.02). No apparent association was found with ROA.

CONCLUSIONS:

Findings from two longitudinal studies consistently showed that higher total fibre intake was related to a lower risk of SxOA, while the relation to ROA was unclear.

KEYWORDS:

Epidemiology; Knee Osteoarthritis; Treatment

 

Relation of total sugars, fructose and sucrose with incident type 2 diabetes: a systematic review and meta-analysis of prospective cohort studies.

Tsilas CS, de Souza RJ, Mejia SB, Mirrahimi A, Cozma AI, Jayalath VH, Ha V, Tawfik R, Di Buono M, Jenkins AL, Leiter LA, Wolever TMS, Beyene J, Khan T, Kendall CWC, Jenkins DJA, Sievenpiper JL.

CMAJ. 2017 May 23;189(20):E711-E720. doi: 10.1503/cmaj.160706.

PMID: 28536126

Abstract

BACKGROUND:

Sugar-sweetened beverages are associated with type 2 diabetes. To assess whether this association holds for the fructose-containing sugars they contain, we conducted a systematic review and meta-analysis of prospective cohort studies.

METHODS:

We searched MEDLINE, Embase, CINAHL and the Cochrane Library (through June 2016). We included prospective cohort studies that assessed the relation of fructose-containing sugars with incident type 2 diabetes. Two independent reviewers extracted relevant data and assessed risk of bias. We pooled risk ratios (RRs) using random effects meta-analyses. The overall quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.

RESULTS:

Fiffeen prospective cohort studies (251 261 unique participants, 16 416 cases) met the eligibility criteria, comparing the highest intake (median 137, 35.2 and 78 g/d) with the lowest intake (median 65, 9.7 and 25.8 g/d) of total sugars, fructose and sucrose, respectively. Although there was no association of total sugars (RR 0.91, 95% confidence interval [CI] 0.76-1.09) or fructose (RR 1.04, 95% CI 0.84-1.29) with type 2 diabetes, sucrose was associated with a decreased risk of type 2 diabetes (RR 0.89, 95% CI 0.80-0.98). Our confidence in the estimates was limited by evidence of serious inconsistency between studies for total sugars and fructose, and serious imprecision in the pooled estimates for all 3 sugar categories.

INTERPRETATION:

Current evidence does not allow us to conclude that fructose-containing sugars independent of food form are associated with increased risk of type 2 diabetes. Further research is likely to affect our estimates.

 

Caffeine ingestion acutely enhances muscular strength and power but not muscular endurance in resistance-trained men.

Grgic J, Mikulic P.

Eur J Sport Sci. 2017 May 24:1-8. doi: 10.1080/17461391.2017.1330362. [Epub ahead of print]

PMID: 28537195

Abstract

The goal of this randomized, double-blind, cross-over study was to assess the acute effects of caffeine ingestion on muscular strength and power, muscular endurance, rate of perceived exertion (RPE), and pain perception (PP) in resistance-trained men. Seventeen volunteers (mean ± SD: age = 26 ± 6 years, stature = 182 ± 9 cm, body mass = 84 ± 9 kg, resistance training experience = 7 ± 3 years) consumed placebo or 6 mg kg-1 of anhydrous caffeine 1 h before testing. Muscular power was assessed with seated medicine ball throw and vertical jump exercises, muscular strength with one-repetition maximum (1RM) barbell back squat and bench press exercises, and muscular endurance with repetitions of back squat and bench press exercises (load corresponding to 60% of 1RM) to momentary muscular failure. RPE and PP were assessed immediately after the completion of the back squat and bench press exercises. Compared to placebo, caffeine intake enhanced 1RM back squat performance (+2.8%; effect size [ES] = 0.19; p = .016), which was accompanied by a reduced RPE (+7%; ES = 0.53; p = .037), and seated medicine ball throw performance (+4.3%, ES = 0.32; p = .009). Improvements in 1RM bench press were not noted although there were significant (p = .029) decreases in PP related to this exercise when participants ingested caffeine. The results point to an acute benefit of caffeine intake in enhancing lower-body strength, likely due to a decrease in RPE; upper-, but not lower-body power; and no effects on muscular endurance, in resistance-trained men. Individuals competing in events in which strength and power are important performance-related factors may consider taking 6 mg kg-1 of caffeine pre-training/competition for performance enhancement.

KEYWORDS:

Fatigue; metabolism; nutrition; performance

 

Association of Protein Intake with Bone Mineral Density and Bone Mineral Content among Elderly Women: The OSTPRE Fracture Prevention Study.

Isanejad M, Sirola J, Mursu J, Kröger H, Tuppurainen M, Erkkilä AT.

J Nutr Health Aging. 2017;21(6):622-630. doi: 10.1007/s12603-016-0800-4.

PMID: 28537325

Abstract

It has been hypothesized that high protein intakes are associated with lower bone mineral content (BMC). Previous studies yield conflicting results and thus far no studies have undertaken the interaction of body mass index (BMI) and physical activity with protein intakes in relation to BMC and bone mineral density (BMD).

OBJECTIVE:

To evaluate the associations of dietary total protein (TP), animal protein (AP) and plant protein (PP) intakes with BMC and BMD and their changes. We tested also the interactions of protein intake with, obesity (BMI ≤30 vs. >30 kg/m2) and physical activity level (passive vs. active). Design/ Setting: Prospective cohort study (Osteoporosis Risk-Factor and Fracture-Prevention Study). Participants/measures: At the baseline, 554 women aged 65-72 years filled out a 3-day food record and a questionnaire covering data on lifestyle, physical activity, diseases, and medications. Intervention group received calcium 1000 mg/d and cholecalciferol 800 IU for 3 years. Control group received neither supplementation nor placebo. Bone density was measured at baseline and year 3, using dual energy x-ray absorptiometry. Multivariable regression analyses were conducted to examine the associations between protein intake and BMD and BMC.

RESULTS:

In cross-sectional analyses energy-adjusted TP (P≤0·029) and AP (P≤0·045) but not PP (g/d) were negatively associated with femoral neck (FN) BMD and BMC. Women with TP≥1·2 g/kg/body weight (BW) (Ptrend≤0·009) had lower FN, lumbar spine (LS) and total BMD and BMC. In follow-up analysis, TP (g/kg/BW) was inversely associated with LS BMD and LS BMC. The detrimental associations were stronger in women with BMI<30 kg/m2. In active women, TP (g/kg/BW) was positively associated with LS BMD and FN BMC changes.

CONCLUSIONS:

This study suggests detrimental associations between protein intake and bone health. However, these negative associations maybe counteracted by BMI>30 kg/m2 and physical activity.

KEYWORDS:

Dietary protein intake; body mass index; bone mineral density; physical activity; source of protein intake

 

A NAD+/PARP1/SIRT1 axis in Aging.

Mendelsohn AR, Larrick J.

Rejuvenation Res. 2017 May 24. doi: 10.1089/rej.2017.1980. [Epub ahead of print]

PMID: 28537485

Abstract

NAD+ levels decline with age in diverse animals from C. elegans to mice. Raising NAD+ levels by dietary supplementation with NAD+ precursors NR or NMN improves mitochondrial function and muscle, neural and melanocyte stem cell function in mice as well as increasing murine lifespan. Decreased NAD+ levels with age reduces SIRT1 function and reduces the mitochondrial unfolded protein response, which can be overcome by NR supplementation. Decreased NAD+ levels cause NAD+-binding protein DCB1 to form a complex with PARP1, inhibiting PARP catalytic activity. Old mice have increased amounts of DCB1-PARP1 complexes. lower PARP activity, increased DNA damage and reduced non-homologous end joining (NHEJ) and homologous recombination (HR) repair. DCB1-PARP1 complexes in old mice can be broken by increasing NAD+ levels through treatment with NMN, reducing DNA damage and restoring PARP activity to youthful levels. The mechanism of declining NAD+ levels and its fundamental importance to aging are yet to be elucidated. There is a correlation of PARP activity with mammalian lifespan, that suggests that a NAD+/SIRT1/PARP1 may be more significant than the modest effects on lifespan observed for NR supplementation on old mice. A NAD+/PARP1/SIRT1 axis may link NAD+ levels and DNA damage with the apparent epigenomic DNA methylation "clocks" that have been described.

 

Oral health in relation to all-cause mortality: the IPC cohort study.

Adolph M, Darnaud C, Thomas F, Pannier B, Danchin N, Batty GD, Bouchard P.

Sci Rep. 2017 Mar 15;7:44604. doi: 10.1038/srep44604.

PMID: 28294149 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5353629/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5353629/pdf/srep44604.pdf

Abstract

We evaluated the association between oral health and mortality. The study population comprised 76,188 subjects aged 16-89 years at recruitment. The mean follow-up time was 3.4 ± 2.4 years. Subjects with a personal medical history of cancer or cardiovascular disease and death by casualty were excluded from the analysis. A full-mouth clinical examination was performed in order to assess dental plaque, dental calculus and gingival inflammation. The number of teeth and functional masticatory units <5 were recorded. Causes of death were ascertained from death certificates. Mortality risk was evaluated using Cox regression model with propensity score calibrated for each oral exposure. All-cause mortality risk were raised with dental plaque, gingival inflammation, >10 missing teeth and functional masticatory units <5. All-cancer mortality was positively associated with dental plaque and gingival inflammation. Non-cardiovascular and non-cancer mortality were also positively associated with high dental plaque (HR = 3.30, [95% CI: 1.76-6.17]), high gingival inflammation (HR = 2.86, [95% CI: 1.71-4.79]), >10 missing teeth (HR = 2.31, [95% CI: 1.40-3.82]) and functional masticatory units <5 (HR = 2.40 [95% CI 1.55-3.73]). Moreover, when ≥3 oral diseases were cumulated in the model, the risk increased for all-cause mortality (HR = 3.39, [95% CI: 2.51-5.42]), all-cancer mortality (HR = 3.59, [95% CI: 1.23-10.05]) and non-cardiovascular and non-cancer mortality (HR = 4.71, [95% CI: 1.74-12.7]). The present study indicates a postive linear association between oral health and mortality.

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Association of Grip Strength With Risk of All-Cause Mortality, Cardiovascular Diseases, and Cancer in Community-Dwelling Populations: A Meta-analysis of Prospective Cohort Studies.

Wu Y, Wang W, Liu T, Zhang D.

J Am Med Dir Assoc. 2017 Jun 1;18(6):551.e17-551.e35. doi: 10.1016/j.jamda.2017.03.011.

PMID: 28549705

http://jech.bmj.com/content/jech/early/2016/06/08/jech-2015-206776.full.pdf

Abstract

OBJECTIVES:

Grip strength has been linked to risk of adverse health outcomes. This study aimed to quantitatively assess the associations between grip strength and risk of all-cause mortality, cardiovascular diseases, and cancer in community-dwelling populations.

DESIGN:

A meta-analysis of prospective cohort studies was conducted.

SETTING:

Embase, Medline, and PubMed were searched from inception to September 14, 2016. Study-specific most adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were combined with a random effects model. Dose-response relation was assessed by restricted cubic splines.

RESULTS:

Data were obtained from 42 studies including 3,002,203 participants. For lowest versus highest category of grip strength, the HRs (95% CIs) were 1.41 (1.30-1.52) for all-cause mortality, 1.63 (1.36-1.96) for cardiovascular diseases and 0.89 (0.66-1.20) for cancer. The HRs (95% CIs) with per-5-kg decrease in grip strength was 1.16 (1.12-1.20) for all-cause mortality, 1.21 (1.14-1.29) for cardiovascular diseases, 1.09 (1.05-1.14) for stroke, 1.07 (1.03-1.11) for coronary heart disease, and 1.01 (0.98-1.05) for cancer. The observed associations did not differ by sex, and remained after excluding participants with cardiovascular diseases or cancer at baseline. Adjustment for other covariates cannot fully explain the observed associations. Linear relationships were found between grip strength and risk of all-cause mortality and cardiovascular diseases within grip strength of 56 kg.

CONCLUSION:

Grip strength was an independent predictor of all-cause mortality and cardiovascular diseases in community-dwelling populations.

KEYWORDS:

Grip strength; all-cause mortality; cancer; cardiovascular diseases; meta-analysis

 

Extreme changes in dietary sodium effect daily variability and level of blood pressure in borderline hypertensive patients.

James GD, Pecker MS, Pickering TG, Jackson S, Difabio B, Carroll L, Laragh JH.

Am J Hum Biol. 1994;6(3):283-291. doi: 10.1002/ajhb.1310060303.

PMID: 28548446

Abstract

This study examined the effect of large changes in dietary sodium on the average ambulatory blood pressure and its variability in 19 patients with uncomplicated borderline hypertension. Each patient participated in a 16-week protocol that consisted of four 4-week periods of different sodium intake (medium (120-160 mEq/day) during periods 1 and 3 and low (< 40 mEq/day) or high (> 225 mEq/day) during either period 2 or 4. The 24-hour urine sodium during the low and high periods averaged 18 and 327 mEq/day, respectively. Ambulatory blood pressure monitoring was done at the end of the fourth week of the low and high diet periods. During monitoring, pressures were recorded every 15 minutes while awake; in addition, patients kept diaries noting activities, posture, and situation at each measurement. The results show that there was a decline of 16/7 mmHg in the average ambulatory awake systolic and diastolic pressures from the high sodium to low sodium diets. Corresponding casual pressures decreased an average of 15 and 8 mmHg, respectively. In examining the factors associated with ambulatory pressure variability, systolic pressure showed greater variation by activity on a low sodium diet than on the high. The findings suggest that sodium restriction has a variable, but in some cases marked, effect on lowering the ambulatory blood pressure in borderline mildly hypertensive patients and that sodium balance may be important to consider when examining ambulatory blood pressure variability.

 

How telling patients of a possible side-effect may make it more likely

Study offers insight into how an expectation of side-effects may make patients more likely to perceive them

Thomson Reuters Posted: May 27, 2017

http://www.cbc.ca/news/health/placebo-effect-opposite-1.4133814

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

Adverse events associated with unblinded, but not with blinded, statin therapy in the Anglo-Scandinavian Cardiac Outcomes Trial-Lipid-Lowering Arm (ASCOT-LLA): a randomised double-blind placebo-controlled trial and its non-randomised non-blind extension phase.

Gupta A, Thompson D, Whitehouse A, Collier T, Dahlof B, Poulter N, Collins R, Sever P; ASCOT Investigators..

Lancet. 2017 May 2. pii: S0140-6736(17)31075-9. doi: 10.1016/S0140-6736(17)31075-9. [Epub ahead of print]

PMID: 28476288

Abstract

Background

In blinded randomised controlled trials, statin therapy has been associated with few adverse events (AEs). By contrast, in observational studies, larger increases in many different AEs have been reported than in blinded trials.

Methods

In the Lipid-Lowering Arm of the Anglo-Scandinavian Cardiac Outcomes Trial, patients aged 40–79 years with hypertension, at least three other cardiovascular risk factors, and fasting total cholesterol concentrations of 6·5 mmol/L or lower, and who were not taking a statin or fibrate, had no history of myocardial infarction, and were not being treated for angina were randomly assigned to atorvastatin 10 mg daily or matching placebo in a randomised double-blind placebo-controlled phase. In a subsequent non-randomised non-blind extension phase (initiated because of early termination of the trial because efficacy of atorvastatin was shown), all patients were offered atorvastatin 10 mg daily open label. We classified AEs using the Medical Dictionary for Regulatory Activities. We blindly adjudicated all reports of four prespecified AEs of interest—muscle-related, erectile dysfunction, sleep disturbance, and cognitive impairment—and analysed all remaining AEs grouped by system organ class. Rates of AEs are given as percentages per annum.

Results

The blinded randomised phase was done between February, 1998, and December, 2002; we included 101 80 patients in this analysis (5101 [50%] in the atorvastatin group and 5079 [50%] in the placebo group), with a median follow-up of 3·3 years (IQR 2·7–3·7). The non-blinded non-randomised phase was done between December, 2002, and June, 2005; we included 9899 patients in this analysis (6409 [65%] atorvastatin users and 3490 [35%] non-users), with a median follow-up of 2·3 years (2·2–2·4). During the blinded phase, muscle-related AEs (298 [2·03% per annum] vs 283 [2·00% per annum]; hazard ratio 1·03 [95% CI 0·88–1·21]; p=0·72) and erectile dysfunction (272 [1·86% per annum] vs 302 [2·14% per annum]; 0·88 [0·75–1·04]; p=0·13) were reported at a similar rate by participants randomly assigned to atorvastatin or placebo. The rate of reports of sleep disturbance was significantly lower among participants assigned atorvastatin than assigned placebo (149 [1·00% per annum] vs 210 [1·46% per annum]; 0·69 [0·56–0·85]; p=0·0005). Too few cases of cognitive impairment were reported for a statistically reliable analysis (31 [0·20% per annum] vs 32 [0·22% per annum]; 0·94 [0·57–1·54]; p=0·81). We observed no significant differences in the rates of all other reported AEs, with the exception of an excess of renal and urinary AEs among patients assigned atorvastatin (481 [1·87%] per annum vs 392 [1·51%] per annum; 1·23 [1·08–1·41]; p=0·002). By contrast, during the non-blinded non-randomised phase, muscle-related AEs were reported at a significantly higher rate by participants taking statins than by those who were not (161 [1·26% per annum] vs 124 [1·00% per annum]; 1·41 [1·10–1·79]; p=0·006). We noted no significant differences between statin users and non-users in the rates of other AEs, with the exception of musculoskeletal and connective tissue disorders (992 [8·69% per annum] vs 831 [7·45% per annum]; 1·17 [1·06–1·29]; p=0·001) and blood and lymphatic system disorders (114 [0·88% per annum] vs 80 [0·64% per annum]; 1·40 [1·04–1·88]; p=0·03), which were reported more commonly by statin users than by non-users.

Interpretation

These analyses illustrate the so-called nocebo effect, with an excess rate of muscle-related AE reports only when patients and their doctors were aware that statin therapy was being used and not when its use was blinded. these results will help assure both physicians and patients that most AEs associated with statins are not causally related to use of the drug and should help counter the adverse effect on public health of exaggerated claims about statin-related side-effects.

Funding

Pfizer, Servier Research Group, and Leo Laboratories.

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Statin-associated muscle symptoms: beware of the nocebo effect.

Pedro-Botet J, Rubiés-Prat J.

Lancet. 2017 May 2. pii: S0140-6736(17)31163-7. doi: 10.1016/S0140-6736(17)31163-7. [Epub ahead of print] No abstract available.

PMID: 28476289

Patient-reported statin intolerance, predominantly due to statin-associated muscle symptoms (SAMS), is a common and difficult-to-manage condition affecting millions of patients worldwide.1 Different expert panels have proposed various definitions and classifications for statin intolerance.2,3 However, the development of SAMS does not necessarily signify statin intolerance since statin therapy might not always be pharmacologically involved. Moreover, some patients with SAMS might be able to tolerate a lower dose than the dose that leads to SAMS, longer dose intervals, or an alternative statin.

Edited by AlPater

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Resting heart rate 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, Sen A, ó'Hartaigh B, Janszky I, Romundstad PR, Tonstad S, Vatten LJ.

Nutr Metab Cardiovasc Dis. 2017 Apr 21. pii: S0939-4753(17)30085-6. doi: 10.1016/j.numecd.2017.04.004. [Epub ahead of print]

PMID: 28552551

http://sci-hub.cc/10.1016/j.numecd.2017.04.004

Abstract

BACKGROUND AND AIM:

Epidemiological studies have reported increased risk of cardiovascular disease, cancer and all-cause mortality with greater resting heart rate, however, the evidence is not consistent. Differences by gender, adjustment for confounding factors, as well as the potential impact of subclinical disease are not clear. A previous meta-analysis missed a large number of studies, and data for atrial fibrillation have not been summarized before. We therefore aimed to clarify these associations in a systematic review and meta-analysis of prospective studies.

METHODS AND RESULTS:

PubMed and Embase were searched up to 29 March 2017. Summary RRs and 95% confidence intervals (CIs) were calculated using random effects models. Eighty seven studies were included. The summary RR per 10 beats per minute increase in resting heart rate was 1.07 (95% CI: 1.05-1.10, I2 = 61.9%, n = 31) for coronary heart disease, 1.09 (95% CI: 1.00-1.18, I2 = 62.3%, n = 5) for sudden cardiac death, 1.18 (95% CI: 1.10-1.27, I2 = 74.5%, n = 8) for heart failure, 0.97 (95% CI: 0.92-1.02, I2 = 91.4%, n = 9) for atrial fibrillation, 1.06 (95% CI: 1.02-1.10, I2 = 59.5%, n = 16) for total stroke, 1.15 (95% CI: 1.11-1.18, I2 = 84.3%, n = 35) for cardiovascular disease, 1.14 (95% CI: 1.06-1.23, I2 = 90.2%, n = 12) for total cancer, and 1.17 (95% CI: 1.14-1.19, I2 = 94.0%, n = 48) for all-cause mortality. There was a positive dose-response relationship for all outcomes except for atrial fibrillation for which there was a J-shaped association.

CONCLUSION:

This meta-analysis found an increased risk of coronary heart disease, sudden cardiac death, heart failure, atrial fibrillation, stroke, cardiovascular disease, total cancer and all-cause mortality with greater resting heart rate.

KEYWORDS:

All-cause mortality; Atrial fibrillation; Cancer; Cardiovascular disease; Coronary heart disease; Heart failure; Stroke; Sudden cardiac death

 

Does Time of Sampling or Food Intake Alter Thyroid Function Test?

Mahadevan S, Sadacharan D, Kannan S, Suryanarayanan A.

Indian J Endocrinol Metab. 2017 May-Jun;21(3):369-372. doi: 10.4103/ijem.IJEM_15_17.

PMID: 28553588

Abstract

CONTEXT:

A common question from most patients or laboratories is whether blood sample for thyroid-stimulating hormone (TSH) and free T4 (fT4) needs to be collected in a fasting state and whether time of the day when sample is collected matters.

AIMS:

The aim of the study was to study the impact of the time of day and food intake on levels of TSH and fT4.

SETTINGS AND DESIGN:

Cross-sectional prospective data collection.

SUBJECTS AND METHODS:

We prospectively collected data from 52 volunteers who were not known to have any thyroid disorder and were not on any thyroid-related medication. Blood samples for TSH and fT4 were collected on day 1 at 8 am and 10 am with the patient remaining in the fasting state till the collection of the second sample at 10 am. On day 2, samples were collected at 8 am (fasting state) and at 10 am (2 h postprandial state). In 22 volunteers from the group, the tests were performed in three common assay techniques including chemiluminescent assays (chemiluminescent immunoassay [CLIA] and chemiluminescent microparticle immunoassay [CMIA]) and enzyme-linked fluorescence assay.

RESULTS:

The mean (standard deviation) and median (interquartile range) TSH during the extended fast on day 1 were 2.26 ± 1.23 and 2.19 (1.21-3.18), which was significantly lower than the fasting TSH performed on day 1 (P < 0.001). Similarly, the values of TSH 2 h postmeal on day 2 of the testing (mean 1.93 ± 1.12; median 1.64 [1.06-2.86]) were significantly lower than TSH performed in the fasting state on day 2 (P < 0.001). The mean fT4 value was 1.01 ± 0.15 with median of 0.99 (0.91-1.11) in the fasting state and there was no significant difference between the fT4 values performed during fasting, extended fasting, and postmeal state. Among the volunteers in whom the test was performed in the three different assay techniques, the TSH was not statistically different either in the fasting (P = 0.801), extended fasting (P = 0.955), and postprandial samples (P = 0.989). The fT4 values did not vary significantly when done by the same assay method. However, the fT4 levels varied significantly (P < 0.001) when done by another assay method.

CONCLUSIONS:

We conclude stating that the timing of the test affects TSH values and this should be factored in making decisions in diagnosis of subclinical hypothyroidism.

KEYWORDS:

Fasting; postprandial; thyroid-stimulating hormone; timing of test

 

Mastery and Depressive Symptoms: How Does Mastery Influence the Impact of Stressors From Midlife to Old Age?

Nicolaisen M, Moum T, Thorsen K.

J Aging Health. 2017 Apr 1:898264317705782. doi: 10.1177/0898264317705782. [Epub ahead of print]

PMID: 28553818

Abstract

OBJECTIVE:

The objective of this research is to study depressive symptoms (DS) among adults aged 40 to 79 years and examine how mastery influences the impact of sociodemographic, socioeconomic, and health factors on DS.

METHOD:

We used a sample of the Norwegian Life Course, Generation, and Gender (LOGG) study ( N = 6,879) and analyzed how mastery influences the independent variables on DS via regression analyses.

RESULTS:

Mastery affected DS directly and influenced the effects of sociodemographic, socioeconomic, and health factors on DS. There was a stronger relationship between stressors and DS among respondents with low than high mastery. DS were most prevalent among people aged 70 to 79 years. When mastery was also controlled for, the oldest group (70-79 years) had significantly fewer DS than those aged 40 to 49 years.

DISCUSSION:

The influence of mastery and stressors on DS seems to vary along the life span. The result that mastery was a relatively stronger buffer against DS in midlife than in old age is discussed.

KEYWORDS:

age groups; life course; mental health; psychosocial factors

 

Remote tissue conditioning - an emerging approach for inducing body-wide protection against diseases of ageing.

Kim B, Brandli A, Mitrofanis J, Stone J, Purushothuman S, Johnstone DM.

Ageing Res Rev. 2017 May 24. pii: S1568-1637(17)30005-3. doi: 10.1016/j.arr.2017.05.005. [Epub ahead of print] Review.

PMID: 28552720

Abstract

We have long accepted that exercise is 'good for us'; that - put more rigorously - moderate exercise is associated with not just aerobic fitness but also reduced morbidity and reduced mortality from cardiovascular disease and even malignancies. Caloric restriction (moderate hunger) and our exposure to dietary phytochemicals are also emerging as stresses which are 'good for us' in the same sense. This review focuses on an important extension of this concept: that stress localized within the body (e.g. in a limb) can induce resilience in tissues throughout the body. We describe evidence for the efficacy of two 'remote' protective interventions - remote ischemic conditioning and remote photobiomodulation - and discuss the mechanisms underlying their protective actions. While the biological phenomenon of remote tissue conditioning is only partially understood, it holds promise for protecting critical-to-life tissues while mitigating risks and practical barriers to direct conditioning of these tissues.

KEYWORDS:

hormesis; ischemic conditioning; photobiomodulation; remote; resilience; stress response

 

A 1-Hour Walk, 3 Times a Week, Has Benefits for Dementia

Phys Ed

By GRETCHEN REYNOLDS MAY 24, 2017

https://www.nytimes.com/2017/05/24/well/move/a-1-hour-walk-3-times-a-week-has-benefits-for-dementia.html?rref=collection%2Fsectioncollection%2Fhealth&action=click&contentCollection=health&region=rank&module=package&version=highlights&contentPlacement=8&pgtype=sectionfront

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

Aerobic exercise promotes executive functions and impacts functional neural activity among older adults with vascular cognitive impairment.

Hsu CL, Best JR, Davis JC, Nagamatsu LS, Wang S, Boyd LA, Hsiung GR, Voss MW, Eng JJ, Liu-Ambrose T.

Br J Sports Med. 2017 Apr 21. pii: bjsports-2016-096846. doi: 10.1136/bjsports-2016-096846. [Epub ahead of print]

PMID: 28432077

Abstract

BACKGROUND:

Vascular cognitive impairment (VCI) results from cerebrovascular disease, and worldwide, it is the second most common type of cognitive dysfunction. While targeted aerobic training is a promising approach to delay the progression of VCI by reducing cardiometabolic risk factors, few randomised controlled trials to date have specifically assessed the efficacy of aerobic training on cognitive and brain outcomes in this group at risk for functional decline.

AIM:

To examine the effect of moderate-intensity aerobic training on executive functions and functional neural activity among older adults with mild subcortical ischaemic VCI (SIVCI).

METHODS:

Older adults with mild SIVCI were randomly assigned to: (1) 6-month, 3×/week aerobic training (n=10) or (2) usual care (control; n=11). Participants completed functional MRI (fMRI) at baseline and trial completion. During the fMRI sessions, behavioural performance on the Eriksen flanker task and task-evoked neural activity were assessed.

RESULTS:

At trial completion, after adjusting for baseline general cognition, total white matter lesion volume and flanker performance, compared with the control group, the aerobic training group significantly improved flanker task reaction time. Moreover, compared with the controls, the aerobic training group demonstrated reduced activation in the left lateral occipital cortex and right superior temporal gyrus. Reduced activity in these brain regions was significantly associated with improved (ie, faster) flanker task performance at trial completion.

SUMMARY:

Aerobic training among older adults with mild SIVCI can improve executive functions and neural efficiency of associated brain areas. Future studies with greater sample size should be completed to replicate and extend these findings.

KEYWORDS:

Exercise

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

Aerobic exercise and vascular cognitive impairment: A randomized controlled trial.

Liu-Ambrose T, Best JR, Davis JC, Eng JJ, Lee PE, Jacova C, Boyd LA, Brasher PM, Munkacsy M, Cheung W, Hsiung GR.

Neurology. 2016 Nov 15;87(20):2082-2090. Epub 2016 Oct 19.

PMID: 27760869

Abstract

OBJECTIVE:

To assess the efficacy of a progressive aerobic exercise training program on cognitive and everyday function among adults with mild subcortical ischemic vascular cognitive impairment (SIVCI).

METHODS:

This was a proof-of-concept single-blind randomized controlled trial comparing a 6-month, thrice-weekly, progressive aerobic exercise training program (AT) with usual care plus education on cognitive and everyday function with a follow-up assessment 6 months after the formal cessation of aerobic exercise training. Primary outcomes assessed were general cognitive function (Alzheimer's Disease Assessment Scale-Cognitive subscale [ADAS-Cog]), executive functions (Executive Interview [EXIT-25]), and activities of daily living (Alzheimer's Disease Cooperative Study-Activities of Daily Living [ADCS-ADL]).

RESULTS:

Seventy adults randomized to aerobic exercise training or usual care were included in intention-to-treat analyses (mean age 74 years, 51% female, n = 35 per group). At the end of the intervention, the aerobic exercise training group had significantly improved ADAS-Cog performance compared with the usual care plus education group (-1.71 point difference, 95% confidence interval [CI] -3.15 to -0.26, p = 0.02); however, this difference was not significant at the 6-month follow-up (-0.63 point difference, 95% CI -2.34 to 1.07, p = 0.46). There were no significant between-group differences at intervention completion and at the 6-month follow-up in EXIT-25 or ADCS-ADL performance. Examination of secondary measures showed between-group differences at intervention completion favoring the AT group in 6-minute walk distance (30.35 meter difference, 95% CI 5.82 to 54.86, p = 0.02) and in diastolic blood pressure (-6.89 mm Hg difference, 95% CI -12.52 to -1.26, p = 0.02).

CONCLUSIONS:

This study provides preliminary evidence for the efficacy of 6 months of thrice-weekly progressive aerobic training in community-dwelling adults with mild SIVCI, relative to usual care plus education.

 

Anti-Inflammatory Effects of the Mediterranean Diet in the Early and Late Stages of Atheroma Plaque Development.

Casas R, Urpi-Sardà M, Sacanella E, Arranz S, Corella D, Castañer O, Lamuela-Raventós RM, Salas-Salvadó J, Lapetra J, Portillo MP, Estruch R.

Mediators Inflamm. 2017;2017:3674390. doi: 10.1155/2017/3674390. Epub 2017 Apr 18.

PMID: 28484308 Free PMC Article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5412172/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5412172/pdf/MI2017-3674390.pdf

Abstract

Objective. To evaluate the long-term effects of a Mediterranean diet (MeDiet) intervention on the plasma concentrations of inflammatory and plaque stability-related molecules in elderly people at high risk for cardiovascular disease. Design and Setting. 66 participants from primary care centers affiliated with the Hospital Clinic of Barcelona were randomized into 3 groups: MeDiet plus extra virgin olive oil (EVOO) or nuts and a low-fat diet (LFD). At baseline and at 3 and 5 years, we evaluated the changes in the plasma concentrations of 24 inflammatory biomarkers related to the different stages of the atherosclerotic process by Luminex®. Results. At 3 and 5 years, both MeDiet groups showed a significant reduction of IL-6, IL-8, MCP-1, and MIP-1β (P < 0.05; all) compared to LFD. IL-1β, IL-5, IL-7, IL-12p70, IL-18, TNF-α, IFN-γ, GCSF, GMCSF, and ENA78 (P < 0.05; all) only decreased in the MeDiet+EVOO group and E-selectin and sVCAM-1 (P < 0.05; both) in the MeDiet+nuts group. Conclusions. Long-term adherence to MeDiet decreases the plasma concentrations of inflammatory biomarkers related to different steps of atheroma plaque development in elderly persons at high cardiovascular risk.

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Moderate-to-high normal levels of thyrotropin is a risk factor for urinary incontinence and an unsuitable quality of life in women over 65 years.

Cuevas-Romero E, Sánchez-Cardiel A, Zamora-Gallegos AM, Cruz-Lumbreras R, Quintanilla DL, Castelán F, Martínez-Gómez M.

Clin Exp Pharmacol Physiol. 2017 May 28. doi: 10.1111/1440-1681.12788. [Epub ahead of print]

PMID: 28556290

Abstract

The present study was aimed to investigate the relationship between normal serum concentrations of thyrotropin (TSH) and urinary incontinence (IU), urinary infections, and quality of life in old women. Euthyroid post-menopausal women without sarcopenia, estrogen replacement, emotional illness, and-or cancer were enrolled as participants. Anthropometric indicators, serum glucose and estradiol, and thyroid profile were measured. Sociodemographic, clinical, physical activity, and quality of life (SF-36) surveys were applied. One-hour pad test and International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) were used to determine UI. Urinalysis was also done. In agreement with results from the pad test (cut-off point ≥ 1.4 g), the ICIQ-SF reveled ~50% of incontinent women. A high percentage of women had moderate-high bacteriuria and urinary infections. Logistic regression analysis showed that age is a risk factor for both UI and urinary infection. Nor diabetes, number of pregnancies or childbirths, urinary infections, and bacteriuria influenced in the presence of UI. To allocate women into four groups according to their age (<65 or ≥65 years old) and TSH concentrations (0.3-1.9 or 2-10 μUI/mL), we found that moderate-to-high normal levels of TSH is a risk factor for UI and a worst quality of life in the oldest women. Our results highlight the profit of measuring TSH concentrations in post-menopausal women.

KEYWORDS:

Ageing; ICIQ-SF; pad test; quality of life; thyroid hormones; thyrotropin

 

Evidence of the Anti-Inflammatory Effects of Probiotics and Synbiotics in Intestinal Chronic Diseases.

Plaza-Díaz J, Ruiz-Ojeda FJ, Vilchez-Padial LM, Gil A.

Nutrients. 2017 May 28;9(6). pii: E555. doi: 10.3390/nu9060555. Review.

PMID: 28555037

Abstract

Probiotics and synbiotics are used to treat chronic diseases, principally due to their role in immune system modulation and the anti-inflammatory response. The present study reviewed the effects of probiotics and synbiotics on intestinal chronic diseases in in vitro, animal, and human studies, particularly in randomized clinical trials. The selected probiotics exhibit in vitro anti-inflammatory properties. Probiotic strains and cell-free supernatants reduced the expression of pro-inflammatory cytokines via action that is principally mediated by toll-like receptors. Probiotic administration improved the clinical symptoms, histological alterations, and mucus production in most of the evaluated animal studies, but some results suggest that caution should be taken when administering these agents in the relapse stages of IBD. In addition, no effects on chronic enteropathies were reported. Probiotic supplementation appears to be potentially well tolerated, effective, and safe in patients with IBD, in both CD and UC. Indeed, probiotics such as Bifidobacterium longum 536 improved the clinical symptoms in patients with mild to moderate active UC. Although it has been proposed that probiotics can provide benefits in certain conditions, the risks and benefits should be carefully assessed before initiating any therapy in patients with IBD. For this reason, further studies are required to understand the precise mechanism by which probiotics and synbiotics affect these diseases.

KEYWORDS:

anti-inflammatory effects; inflammatory bowel diseases; intestinal diseases; probiotics

 

Is There a Dose-Response Relationship between Tea Consumption and All-Cause, CVD, and Cancer Mortality?

Yan Y, Sui X, Yao B, Lavie CJ, Blair SN.

J Am Coll Nutr. 2017 May-Jun;36(4):281-286. doi: 10.1080/07315724.2016.1261054.

PMID: 28557683

Abstract

BACKGROUND:

A small change in tea consumption at population level could have large impact on public health. However, the health benefits of tea intake among Americans are inconclusive.

OBJECTIVE:

To evaluate the association between tea consumption and all-causes, cardiovascular disease (CVD) and cancer mortality in the Aerobics Center Longitudinal study (ACLS).

METHODS:

11808 participants (20-82 years) initially free of CVD and cancers enrolled in the ACLS and were followed for mortality. Participants provided baseline self-report of tea consumption (cups/day). During a median follow-up of 16 years, 842 participants died. Of others, 250 died from CVD, and 345 died from cancer, respectively. A Cox proportional hazard model was used to produce hazard ratio (HR) and 95% confidence interval (CI).

RESULTS:

Compared with participants consuming no tea, tea drinkers had a survival advantage ( Log-2 = 10.2, df = 3, P = 0.017); however, the multivariate hazard ratios (HRs) of all-cause mortality for those drinking 1-7, 8-14, and >14 cups/week were 0.95 (95% CI, 0.81-1.12), 1.00 (95% CI, 0.82-1.22), and 0.98 (95% CI, 0.76-1.25), respectively (P for linear trend = 0.83). The multivariate HR were 1.16 (95% CI, 0.86-1.56), 1.22 (95% CI, 0.85-1.76), and 0.94 (95% CI, 0.56-1.54) for CVD mortality (P for linear trend = 0.47), and 0.97 (95% CI, 0.75-1.25), 0.85 (95% CI, 0.60-1.16), and 0.94 (95% CI, 0.64-1.38) for cancer mortality (P for trend = 0.62).

CONCLUSIONS:

There were week or null relationships between tea consumption and mortality due to all-cause, CVD disease or cancer were observed in ACLS.

KEYWORDS:

Tea consumption; all-cause mortality; cancer mortality; cardiovascular disease mortality; survival probability

 

Website Flags Wrongly Paywalled Papers

By Dalmeet Singh Chawla

http://www.the-scientist.com/?articles.view/articleNo/49544/title/Website-Flags-Wrongly-Paywalled-Papers/&utm_campaign=NEWSLETTER_TS_The-Scientist-Daily_2016&utm_source=hs_email&utm_medium=email&utm_content=52560558&_hsenc=p2ANqtz-86oKijzDpXC78E2YmS1T6zRMQM6HsF0Xh_0vHT8yyQtRsCDgbLIqqlmW__DbzKhTWmaymYs5i1w5Oc25iDs3aGRPF4PA&_hsmi=52560558

Thousands of open access papers have mistakenly asked readers to pay access fees, but publishers are correcting the errors.

 

[There otta be a law.]

Opioid epidemic fuelled by 1 paragraph in journal, doctors say

CBC News Posted: May 31, 2017

http://www.cbc.ca/news/health/opioid-letter-nejm-1.4140182

http://www.nejm.org/doi/full/10.1056/NEJMc1700150?query=featured_home

http://www.nejm.org/doi/10.1056/NEJM198001103020221

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Gender differences and similarities in effects of nonpharmacologic approaches to the treatment of mild hypertension.

Wassertheil-Smoller S, Davis BR, Oberman A, Blaufox MD, Kirchner K.

Am J Hum Biol. 1995;7(2):195-201. doi: 10.1002/ajhb.1310070207.

PMID: 28557221

Abstract

TAIM, the Trial of Antihypertensive Interventions and Management, studied the effects of dietary sodium restriction or weight reduction, alone and in combination with low-dose diuretic or beta blocker on blood pressure after 6 months. The responses to these interventions of men compared to women are presented for those persons randomized to placebo drug. Men undergoing a weight-reduction intervention were able to lose more weight (5.9 kg) than women (3.1 kg), P ⩽ 05. Men also had a greater percentage of wright loss and a greater reduction in body mass index (BMI), although not significantly so. Weight loss was correlated to a decrease in triglycerides (r = 0.37), but not in cholesterol. The weight-reduction intervention lowered triglycerides more in men (-81 mg/dl) than in women(-21 mg/dl; P = .008). There were no sex differences in abiility to reduce sodium or increase potassium for those in the sodium restriction group. Both men and women decreased their sodium to the same extent by 36 mmol/day and 25 mmol, respectively, and increased their potassium by 13 mmol and 11 mmol, respectively. Blood pressure response at 6 months was greater in men than in women on weight reduction (a drop in diastolic pressure of -11 mmHg in men and 7 mmHg in women, P =.04). Sodium restriction had a similar effect on blood pressure in both sexes, and among men resulted in a significantly smaller reduction in blood pressure than did weight reduction.

 

Prevalence, Correlates, and Prognosis of Healthy Vascular Aging in a Western Community-Dwelling Cohort: The Framingham Heart Study.

Niiranen TJ, Lyass A, Larson MG, Hamburg NM, Benjamin EJ, Mitchell GF, Vasan RS.

Hypertension. 2017 May 30. pii: HYPERTENSIONAHA.117.09026. doi: 10.1161/HYPERTENSIONAHA.117.09026. [Epub ahead of print]

PMID: 28559398

Abstract

Hypertension and increased vascular stiffness are viewed as inevitable parts of aging. To elucidate whether the age-related decrease in vascular function is avoidable, we assessed the prevalence, correlates, and prognosis of healthy vascular aging (HVA) in 3196 Framingham Study participants aged ≥50 years. We defined HVA as absence of hypertension and pulse wave velocity <7.6 m/s (mean+2 SD of a reference sample aged <30 years). Overall, 566 (17.7%) individuals had HVA, with prevalence decreasing from 30.3% in people aged 50 to 59 to 1% in those aged ≥70 years. In regression models adjusted for physical activity, caloric intake, and traditional cardiovascular disease (CVD) risk factors, we observed that lower age, female sex, lower body mass index, use of lipid-lowering drugs, and absence of diabetes mellitus were cross-sectionally associated with HVA (P<0.001 for all). A unit increase in a cardiovascular health score (Life's Simple 7) was associated with 1.55-fold (95% confidence interval, 1.38-1.74) age- and sex-adjusted odds of HVA. During a follow-up of 9.6 years, 391 CVD events occurred. In Cox regression models adjusted for traditional CVD risk factors, including blood pressure, HVA was associated with a hazard ratio of 0.45 (95% confidence interval, 0.26-0.77) for CVD relative to absence of HVA. Although HVA is achievable in individuals acculturated to a Western lifestyle, maintaining normal vascular function beyond 70 years of age is challenging. Although our data are observational, our findings support prevention strategies targeting modifiable factors and behaviors and obesity, in particular, to prevent or delay vascular aging and the associated risk of CVD.

KEYWORDS:

aging; blood pressure; epidemiology; hypertension; vascular stiffness

 

Association Between Endometriosis and Hypercholesterolemia or Hypertension.

Mu F, Rich-Edwards J, Rimm EB, Spiegelman D, Forman JP, Missmer SA.

Hypertension. 2017 May 30. pii: HYPERTENSIONAHA.117.09056. doi: 10.1161/HYPERTENSIONAHA.117.09056. [Epub ahead of print]

PMID: 28559401

Abstract

An altered hormonal or chronic systemic inflammatory milieu characterizing endometriosis may result in a higher risk of hypercholesterolemia and hypertension. Conversely, elevated low-density lipoprotein in hypercholesterolemia and chronic systemic inflammation resulting from hypertension may increase the risk of endometriosis. We assessed the association of laparoscopically confirmed endometriosis with hypercholesterolemia and hypertension in a large prospective cohort study. In 1989, 116 430 registered female nurses aged 25 to 42 completed the baseline questionnaire and were followed for 20 years. Multivariable Cox proportional hazards models were applied. In 1989, there were 4244 women with laparoscopically confirmed endometriosis and 91 554 women without. After adjusting for demographic, anthropometric, family history, reproductive, dietary, and lifestyle risk factors prospectively, comparing women with laparoscopically confirmed endometriosis to women without, the relative risks were 1.25 (95% confidence interval, 1.21-1.30) for development of hypercholesterolemia and 1.14 (95% confidence interval, 1.09-1.18) for hypertension. Conversely, the relative risks of developing laparoscopically confirmed endometriosis were 1.22 (95% confidence interval, 1.15-1.31) comparing women with hypercholesterolemia to women without and 1.29 (95% confidence interval, 1.18-1.41) comparing women with hypertension to women without. The strength of associations of laparoscopically confirmed endometriosis with hypercholesterolemia or hypertension was strongest among women aged ≤40 and weakened as age increased (P values for interaction <0.001). We observed that ≈45% of the associations between endometriosis and hypercholesterolemia and hypertension could be accounted for by treatment factors after endometriosis diagnosis, including greater frequency of hysterectomy/oophorectomy and earlier age for this surgery. In this large cohort study, laparoscopically confirmed endometriosis was prospectively associated with increased risk of hypercholesterolemia and hypertension. Conversely, hypercholesterolemia and hypertension were prospectively associated with higher risk of laparoscopically confirmed endometriosis.

KEYWORDS:

endometriosis; epidemiology; hypertension; inflammation

 

Systolic Blood Pressure Reduction and Risk of Cardiovascular Disease and Mortality: A Systematic Review and Network Meta-analysis.

Bundy JD, Li C, Stuchlik P, Bu X, Kelly TN, Mills KT, He H, Chen J, Whelton PK, He J.

JAMA Cardiol. 2017 May 31. doi: 10.1001/jamacardio.2017.1421. [Epub ahead of print]

PMID: 28564682

http://sci-hub.cc/10.1001/jamacardio.2017.1421

Abstract

IMPORTANCE:

Clinical trials have documented that lowering blood pressure reduces cardiovascular disease and premature deaths. However, the optimal target for reduction of systolic blood pressure (SBP) is uncertain.

OBJECTIVE:

To assess the association of mean achieved SBP levels with the risk of cardiovascular disease and all-cause mortality in adults with hypertension treated with antihypertensive therapy.

DATA SOURCES:

MEDLINE and EMBASE were searched from inception to December 15, 2015, supplemented by manual searches of the bibliographies of retrieved articles.

STUDY SELECTION:

Studies included were clinical trials with random allocation to an antihypertensive medication, control, or treatment target. Studies had to have reported a difference in mean achieved SBP of 5 mm Hg or more between comparison groups.

DATA EXTRACTION AND SYNTHESIS:

Data were extracted from each study independently and in duplicate by at least 2 investigators according to a standardized protocol. Network meta-analysis was used to obtain pooled randomized results comparing the association of each 5-mm Hg SBP category with clinical outcomes after adjusting for baseline risk.

MAIN OUTCOMES AND MEASURES:

Cardiovascular disease and all-cause mortality.

RESULTS:

Forty-two trials, including 144 220 patients, met the eligibility criteria. In general, there were linear associations between mean achieved SBP and risk of cardiovascular disease and mortality, with the lowest risk at 120 to 124 mm Hg. Randomized groups with a mean achieved SBP of 120 to 124 mm Hg had a hazard ratio (HR) for major cardiovascular disease of 0.71 (95% CI, 0.60-0.83) compared with randomized groups with a mean achieved SBP of 130 to 134 mm Hg, an HR of 0.58 (95% CI, 0.48-0.72) compared with those with a mean achieved SBP of 140 to 144 mm Hg, an HR of 0.46 (95% CI, 0.34-0.63) compared with those with a mean achieved SBP of 150 to 154 mm Hg, and an HR of 0.36 (95% CI, 0.26-0.51) compared with those with a mean achieved SBP of 160 mm Hg or more. Likewise, randomized groups with a mean achieved SBP of 120 to 124 mm Hg had an HR for all-cause mortality of 0.73 (95% CI, 0.58-0.93) compared with randomized groups with a mean achieved SBP of 130 to 134 mm Hg, an HR of 0.59 (95% CI, 0.45-0.77) compared with those with a mean achieved SBP of 140 to 144 mm Hg, an HR of 0.51 (95% CI, 0.36-0.71) compared with those with a mean achieved SBP of 150 to 154 mm Hg, and an HR of 0.47 (95% CI, 0.32-0.67) compared with those with a mean achieved SBP of 160 mm Hg or more.

CONCLUSIONS AND RELEVANCE:

This study suggests that reducing SBP to levels below currently recommended targets significantly reduces the risk of cardiovascular disease and all-cause mortality. These findings support more intensive control of SBP among adults with hypertension.

 

Baseline dietary intake and physical activity of Japanese American men in relation to glucose tolerance at 5-year follow-up.

Leonetti DL, Tsunehara CH, Wahl PW, Fujimoto WY.

Am J Hum Biol. 1996;8(1):55-67. doi: 10.1002/(SICI)1520-6300(1996)8:1<55::AID-AJHB5>3.0.CO;2-P.

PMID: 28557267

Abstract

Japanese American men (n = 124), with normal glucose tolerance (NGT, n = 69) or impaired glucose tolerance (IGT, n = 55) at baseline, were studied for effects of baseline dietary intake and physical activity on glucose tolerance at baseline and at 5-year follow-up. At baseline, both NGT and IGT men with positive family history of diabetes (FH) showed high intakes of animal fat and protein, but only the NGT men countered this with high levels of energy expenditure. In the total sample at 5-year follow-up, 2-hour plasma glucose was significantly related to intake of animal fat (AF), partial correlation r = 0.32, P < 0.001, adjusted for total energy intake, age, self-reported health, body mass index, FH, and baseline glucose tolerance category. Energy expenditure (EE) was not related to 5-year 2-hour plasma glucose in the total sample, but displayed a relationship with 5-year 2-hour plasma glucose in those IGT (r = -0.27, P < 0.05), but not in those NGT at baseline, and in those with positive FH (r = -0.33, P < 0.05), but not in those with negative FH. Additionally, AF showed a relationship to 5-year 2-hour plasma glucose only for those in the lowest (r = 0.37, P < 0.05) and middle (r = 0.33, P < 0.05) tertiles, but not in the highest tertile of EE. For baseline IGT men, 5-year 2-hour plasma glucose was related to "high vs. low risk" categories of AF intake and EE, but only in men with a positive FH (AF ≥ 25 vs. < 25 g/day: 180.1 ± 38.6 vs. 143.6 ± 39.7 mg/dl, P = 0.048; EE ≤ 2,000 kcal/week vs. > 2,000 kcal/week, 189.9 ± 39.2 vs. 150.8 ± 37.4 mg/dl, P = 0.028; with risk categories combined, i.e., both high, mixed, both low: 192.0 ± 41.3, 165.4 ± 28.4, 139.4 ± 40.9 mg/dl, P = 0.045, linear trend, P = 0.014). Thus, high AF intake and low EE may have long-range detrimental effects on glucose tolerance, especially for those with IGT and positive FH.

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Improving risk estimates for metabolically healthy obesity and mortality using a refined healthy reference group.

Hamer M, Johnson W, Bell JA.

Eur J Endocrinol. 2017 May 31. pii: EJE-17-0217. doi: 10.1530/EJE-17-0217. [Epub ahead of print]

PMID: 28566442

Abstract

OBJECTIVE:

We aimed to re-examine mortality risk estimates for metabolically healthy obesity by using a 'stable' healthy non-obese referent group.

DESIGN:

prospective cohort study Methods: Participants were 5,427 men and women (aged 65.9 ± 9.4 years, 45.9% men) from the English Longitudinal Study of Ageing. Obesity was defined as body mass index ≥ 30 kg/m2 (vs. non-obese as below this threshold). Based on blood pressure, HDL-cholesterol, triglycerides, glycated haemoglobin, and C-reactive protein, participants were classified as 'healthy' (0 or 1 metabolic abnormality) or 'unhealthy' (≥ 2 metabolic abnormalities).

RESULTS:

671 deaths were observed over an average follow up of 8 years. When defining the referent group based on 1 clinical assessment, the unhealthy non-obese (Hazard ratio = 1.22; 95% CI, 1.01, 1.45) and unhealthy obese (1.29; 1.05, 1.60) were at greater risk of all-cause mortality compared to the healthy non-obese, yet no excess risk was seen in the healthy obese (1.14; 0.83, 1.52). When we re-defined the referent group based on 2 clinical assessments, effect estimates were accentuated and healthy obesity was at increased risk of mortality (2.67; 1.64, 4.34).

CONCLUSION:

An unstable healthy referent group may make 'healthy obesity' appear less harmful by obscuring the benefits of remaining never obese without metabolic dysfunction.

 

Common acne medicine reduces risk of multiple sclerosis, Calgary researchers find

'It’s a big discovery because it’s a cheap, generic, oral medication,' says University of Calgary neurologist

By Robson Fletcher, CBC News Posted: May 31, 2017

http://www.cbc.ca/news/canada/calgary/minocycline-ms-multiple-sclerosis-calgary-research-1.4139877

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Minocycline in Multiple Sclerosis - Compelling Results but Too Early to Tell.

Xia Z, Friedlander RM.

N Engl J Med. 2017 Jun 1;376(22):2191-2193. doi: 10.1056/NEJMe1703230. No abstract available.

PMID: 28564559

Journal pre-amble: Care for persons with multiple sclerosis has evolved as options for disease-modifying treatments have expanded. The high cost of current treatments1 has stimulated interest in repurposing existing, lower-cost drugs as new therapies for multiple sclerosis.

This article has no abstract; the first 100 words appear below.

Care for persons with multiple sclerosis has evolved as options for disease-modifying treatments have expanded. The high cost of current treatments1 has stimulated interest in repurposing existing, lower-cost drugs as new therapies for multiple sclerosis. One appealing candidate is minocycline, a relatively safe and inexpensive synthetic tetracycline that crosses the blood–brain barrier.2 Minocycline has antiinflammatory and antiapoptotic properties beyond its antibiotic activity. As an antiinflammatory agent, minocycline inhibits reactive microgliosis, production of interleukin-1β, up-regulation of inducible nitric oxide synthase, and activation of CD4+ T cells.3–5 As an antiapoptotic agent, the drug impedes cellular stress–mediated release of caspase-dependent and caspase-independent . . .

 

Endocrine responses and acute mTOR pathway phosphorylation to resistance exercise with leucine and whey.

Lane MT, Herda TJ, Fry AC, Cooper MA, Andre MJ, Gallagher PM.

Biol Sport. 2017 Jun;34(2):197-203. doi: 10.5114/biolsport.2017.65339. Epub 2017 Jan 20.

PMID: 28566814

Abstract

Leucine ingestion reportedly activates the mTOR pathway in skeletal muscle, contributing to a hypertrophy response. The purpose of the study was to compare the post-resistance exercise effects of leucine and whey protein supplementation on endocrine responses and muscle mTOR pathway phosphorylation. On visit 1, subjects (X±SD; n=20; age=27.8±2.8yrs) provided baseline blood samples for analysis of cortisol, glucose and insulin; a muscle biopsy of the vastus lateralis muscle to assess mTOR signaling pathway phosphorylation; and were tested for maximum strength on the leg press and leg extension exercises. For visits 2 and 3, subjects were randomized in a double-blind crossover design to ingest either leucine and whey protein (10g+10g; supplement) or a non-caloric placebo. During these visits, 5 sets of 10 repetitions were performed on both exercises, immediately followed by ingestion of the supplement or placebo. Blood was sampled 30 min post-, and a muscle biopsy 45 min post-exercise. Western blots quantified total and phosphorylated proteins. Insulin increased (α<.05) with supplementation with no change in glucose compared to placebo. Relative phosphorylation of AKT and rpS6 were greater with leucine and whey supplementation compared to placebo. Supplementation of leucine and whey protein immediately after heavy resistance exercise increases anabolic signaling in human skeletal muscle.

KEYWORDS:

AKT; Hypertrophy; Leucine; Resistance training; mTOR

 

Vitamin B<sub>6</sub> Intake and the Risk of Colorectal Cancer: A Meta-Analysis of Prospective Cohort Studies.

Jia K, Wang R, Tian J.

Nutr Cancer. 2017 Jun 1:1-9. doi: 10.1080/01635581.2017.1324633. [Epub ahead of print]

PMID: 28569561

Abstract

OBJECTIVES:

We performed this meta-analysis to estimate the association between vitamin B6 intake and colorectal cancer risk.

METHODS:

Prospective cohort studies on vitamin B6 intake and colorectal cancer risk were identified by searching databases from the period of 1960 to 2016. Results from individual studies were synthetically combined using Stata 13.0 software.

RESULTS:

A total of 10 prospective cohort studies including 13 data sets were included in our meta-analysis, containing 7,817 cases and 784,550 subjects. The combined relative risks (RR) of colorectal cancer for the highest vitamin B6 intake compared with the lowest vitamin B6 intake was 0.88 [95% confidence intervals (CIs): 0.77-1.02]. Dose-response meta-analysis based on five eligible studies showed that for each additional 3 and 5 mg of vitamin B6 intake, the risk would decrease by 11% (RR: 0.89, 95%CI: 0.81-0.98) and 17% (RR: 0.83, 95%CI: 0.71-0.97), respectively. Little evidence of publication bias was found.

CONCLUSION:

This meta-analysis provides evidence of a nonsignificant decrease in colorectal cancer risk associated with the high level of vitamin B6 intake, but the risk in dose-response analysis is significant. However, the latter finding is based on a limited number of studies, which should be interpreted with caution.

 

Association between blood pressure and Alzheimer disease measured up to 27 years prior to diagnosis: the HUNT Study.

Gabin JM, Tambs K, Saltvedt I, Sund E, Holmen J.

Alzheimers Res Ther. 2017 May 31;9(1):37. doi: 10.1186/s13195-017-0262-x.

PMID: 28569205

http://alzres.biomedcentral.com.sci-hub.cc/articles/10.1186/s13195-017-0262-x

http://download.springer.com.sci-hub.cc/static/pdf/518/art%3A10.1186%2Fs13195-017-0262-x.pdf?originUrl=http%3A%2F%2Falzres.biomedcentral.com%2Farticle%2F10.1186%2Fs13195-017-0262-x&token2=exp=1496425954~acl=%2Fstatic%2Fpdf%2F518%2Fart%253A10.1186%252Fs13195-017-0262-x.pdf*~hmac=f3de75df228aeb8a04032acd0ac036ff6d9514d602cf1a1a9ca11acba2a7b464

Abstract

BACKGROUND:

A lot of attention has been paid to the relationship of blood pressure and dementia because epidemiological research has reported conflicting evidence. Observational data has shown that midlife hypertension is a risk factor for cognitive decline and dementia later in life, whereas there is evidence that low blood pressure is predictive in later life. The aim of the present study was to examine the association between dementia and blood pressure measured up to 27 years (mean 17.6 years) prior to ascertainment.

METHODS:

In Nord-Trøndelag County, Norway, incident dementia data were collected during 1995-2011, and the diagnoses were validated by a panel of experts in the field. By using the subjects' personal identification numbers, the dementia data were linked to data from the Nord-Trøndelag Health Study (the HUNT Study), a large, population-based health study performed in 1984-1986 (HUNT 1) and 1995-1997 (HUNT 2). A total of 24,638 participants of the HUNT Study were included in the present study, 579 of whom were diagnosed with Alzheimer disease, mixed Alzheimer/vascular dementia, or vascular dementia. Multiple logistic regression analyses were conducted to analyze the association between dementia and blood pressure data from HUNT 1 and HUNT 2.

RESULTS:

Over the age of 60 years, consistent inverse associations were observed between systolic blood pressure and all-cause dementia, mixed Alzheimer/vascular dementia, and Alzheimer disease, but not with vascular dementia, when adjusting for age, sex, education, and other relevant covariates. This was observed for systolic blood pressure in both HUNT 1 and HUNT 2, regardless of antihypertensive medication use. There was an adverse association between systolic blood pressure, pulse pressure, and Alzheimer disease in individuals treated with antihypertensive medication under the age of 60 years.

CONCLUSIONS:

Our data are in line with those in previous studies demonstrating an inverse association between dementia and systolic blood pressure in individuals over the age of 60 years. We cannot exclude a survival effect, however. Among middle-aged subjects (<60 years), elevated systolic blood pressure and pulse pressure were associated with eventual Alzheimer disease in individuals who reported using antihypertensive medication.

KEYWORDS:

Alzheimer disease; Blood pressure; Epidemiology; Prospective case cohort; Risk factors; Vascular dementia

 

Blocking FSH induces thermogenic adipose tissue and reduces body fat.

Liu P, Ji Y, Yuen T, Rendina-Ruedy E, DeMambro VE, Dhawan S, Abu-Amer W, Izadmehr S, Zhou B, Shin AC, Latif R, Thangeswaran P, Gupta A, Li J, Shnayder V, Robinson ST, Yu YE, Zhang X, Yang F, Lu P, Zhou Y, Zhu LL, Oberlin DJ, Davies TF, Reagan MR, Brown A, Kumar TR, Epstein S, Iqbal J, Avadhani NG, New MI, Molina H, van Klinken JB, Guo EX, Buettner C, Haider S, Bian Z, Sun L, Rosen CJ, Zaidi M.

Nature. 2017 Jun 1;546(7656):107-112. doi: 10.1038/nature22342. Epub 2017 May 24.

PMID: 28538730

Abstract

Menopause is associated with bone loss and enhanced visceral adiposity. A polyclonal antibody that targets the β-subunit of the pituitary hormone follicle-stimulating hormone (Fsh) increases bone mass in mice. Here, we report that this antibody sharply reduces adipose tissue in wild-type mice, phenocopying genetic haploinsufficiency for the Fsh receptor gene Fshr. The antibody also causes profound beiging, increases cellular mitochondrial density, activates brown adipose tissue and enhances thermogenesis. These actions result from the specific binding of the antibody to the β-subunit of Fsh to block its action. Our studies uncover opportunities for simultaneously treating obesity and osteoporosis.

Edited by AlPater

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Pregnancy increases stroke risk up to 1 year postpartum and reduces long-term risk.

Cheng CA, Lee JT, Lin HC, Lin HC, Chung CH, Lin FH, Tsao CH, Wu YF, Chien WC, Chiu HW.

QJM. 2017 Jun 1;110(6):355-360. doi: 10.1093/qjmed/hcw222.

PMID: 28069909

http://sci-hub.cc/10.1093/qjmed/hcw222

Abstract

BACKGROUND:

: The incidence of stroke in pregnant women is low but trending upward. There are few studies of the topic in women of Asian ethnicity.

AIM:

We aim to evaluate stroke risk in Asian women during and after pregnancy.

DESIGN:

: Using the Taiwan National Health Insurance database, we designed a retrospective study that included 18-45-year-old pregnant women between the years 2000 and 2010. We selected a 1:1 age-matched control group of non-pregnant women. The endpoint was any type of stroke during pregnancy or the postpartum period; otherwise, the patients were tracked until 31 December 2010.

METHODS:

: The risk factors for stroke were found using Cox proportional regression to calculate the hazard ratio (HR) with a 95% CI compared with the control group.

RESULTS:

: The incidence of stroke within 1 year postpartum was 71/100,000. The risk of postpartum stroke within 1 year was an HR of 1.208 (95% CI: 1.001-5.129). The occurrence of stroke was associated with hypertension, diabetes mellitus, coagulation disorders, migraine, obesity, cerebrovascular malformation and parity. Women with third and fourth parity carried increased risks of 13.3% and 2.5%, respectively, compared with first parity women. In long-term follow-ups, stroke risk was significantly lower, with an adjusted HR of 0.362 (95% CI: 0.269-0.489).

CONCLUSION:

The risk of stroke was elevated during the first year postpartum, but lower in subsequent years. Stroke risk increased in multiparous (≥3) women. Physicians should be on alert for pregnancy complications and ensure appropriate management to prevent postpartum stroke.

 

Pre-diagnostic copper and zinc biomarkers and colorectal cancer risk in the European Prospective Investigation into Cancer and Nutrition cohort.

Stepien M, Jenab M, Freisling H, Becker NP, Czuban M, Tjønneland A, Olsen A, Overvad K, Boutron-Ruault MC, Mancini FR, Savoye I, Katzke V, Kühn T, Boeing H, Iqbal K, Trichopoulou A, Bamia C, Orfanos P, Palli D, Sieri S, Tumino R, Naccarati A, Panico S, Bueno-de-Mesquita HBA, Peeters PH, Weiderpass E, Merino S, Jakszyn P, Sanchez MJ, Dorronsoro M, Huerta JM, Barricarte A, Boden S, van Guelpen B, Wareham N, Khaw KT, Bradbury KE, Cross AJ, Schomburg L, Hughes DJ.

Carcinogenesis. 2017 Jun 1. doi: 10.1093/carcin/bgx051. [Epub ahead of print]

PMID: 28575311

Abstract

Adequate intake of copper and zinc, two essential micronutrients, are important for antioxidant functions. Their imbalance may have implications for development of diseases like colorectal cancer (CRC), where oxidative stress is thought to be etiologically involved. As evidence from prospective epidemiologic studies is lacking, we conducted a case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort to investigate the association between circulating levels of copper and zinc, and their calculated ratio, with risk of CRC development. Copper and zinc levels were measured by reflection X-ray fluorescence spectrometer in 966 cases and 966 matched controls. Multivariable adjusted odds ratios {OR} and 95% confidence intervals (CI) were calculated using conditional logistic regression and are presented for the 5th vs.1st quintile.Higher circulating concentration of copper was associated with a raised CRC risk (OR=1.50; 95%CI: 1.06, 2.13; p-trend=0.02) while an inverse association with cancer risk was observed for higher zinc levels (OR=0.65; 95%CI: 0.43, 0.97; p-trend=0.07). Consequently, the ratio of copper/zinc was positively associated with CRC (OR=1.70; 95%CI: 1.20, 2.40; p-trend=0.0005). In subgroup analyses by follow-up time, the associations remained statistically significant only in those diagnosed within two years of blood collection.In conclusion, these data suggest that copper or copper levels in relation to zinc (copper to zinc ratio) become imbalanced in the process of CRC development. Mechanistic studies into the underlying mechanisms of regulation and action are required to further examine a possible role for higher copper and copper/zinc ratio levels in CRC development and progression.

 

Efficacy of maternal influenza vaccination against all-cause lower respiratory tract infection hospitalizations in young infants: Results from a randomized controlled trial.

Nunes MC, Cutland CL, Jones S, Downs S, Weinberg A, Ortiz JR, Neuzil KM, Simões EAF, Klugman KP, Madhi SA.

Clin Infect Dis. 2017 May 29. doi: 10.1093/cid/cix497. [Epub ahead of print]

PMID: 28575286

Abstract

BACKGROUND:

Influenza immunization of pregnant women protects their young infants against laboratory-confirmed influenza infection. Influenza infection might predispose to subsequent bacterial infections that cause severe pneumonia. In a secondary analysis of a randomized clinical trial (RCT), we evaluated the effect of maternal vaccination on infant hospitalizations for all-cause acute lower respiratory tract infection (ALRI).

METHODS:

Infants born to women who participated in a double-blind placebo-controlled RCT in 2011 and 2012 on the efficacy of trivalent inactivated influenza vaccine (IIV) during pregnancy were followed during the first 6 months of life.

RESULTS:

The study included 1026 infants born to IIV-recipients and 1023 born to placebo- recipients. There were 52 ALRI hospitalizations (median age 72 days). The incidence (per 1,000 infant-months) of ALRI hospitalizations was lower in infants born to IIV-recipients (3.4 [95%CI: 2.2, 5.4], 19 cases) compared to placebo-recipients (6.0 [95%CI: 4.3, 8.5], 33 cases) with a vaccine efficacy of 43.1% (p=0.050). Thirty of the ALRI hospitalizations occurred during the first 90 days of life, 9 in the IIV-group (3.0 [95%CI: 1.6, 5.7]) and 21 in the placebo-group (7.0 [95%CI: 4.6, 10.8]; incidence rate ratio: 0.43 [95%CI: 0.19, 0.93]) for a vaccine efficacy of 57.5% (p=0.032). The incidence of ALRI hospitalizations was similar in the IIV- and placebo-group for infants older than 3 months. Forty-four of the hospitalized infants were tested for influenza virus infection and one tested positive.

CONCLUSION:

Using a RCT as a vaccine-probe, influenza vaccination during pregnancy decreased all-cause ALRI hospitalization during the first 3 months of life, suggesting possible protection against subsequent bacterial infections that influenza infection might predispose to.

KEYWORDS:

efficacy; hospitalizations; influenza vaccine; lower respiratory tract infections; phase III trial

 

Mortality rates are lower in siad, than in hypervolaemic or hypovolaemic hyponatraemia; results of a prospective observational study.

Cuesta M, Garrahy A, Slattery D, Gupta S, Hannon AM, McGurren K, Sherlock M, Tormey W, Thompson CJ.

Clin Endocrinol (Oxf). 2017 Jun 2. doi: 10.1111/cen.13388. [Epub ahead of print]

PMID: 28574597

Abstract

OBJECTIVE:

Hyponatremia is associated with increased mortality, but the mortality associated specifically with SIAD is not known. We hypothesised that mortality in SIAD was elevated, but that it was less than in hypervolemic(HEN) or hypovolemic(HON) hyponatremia.

DESIGN:

Mortality rates are presented as risk ratios(RR),with 95% confidence intervals (CI), and compared to normonatremic controls(NN).

METHODS:

Prospective, single center, non-interventional study of all patients with hyponatremia(≤ 130 mmol/l) admitted to hospital.

RESULTS:

1323 admissions with hyponatremia were prospectively evaluated and 1136 contemporaneous NN controls. 431(32.6%) hyponatraemic patients had HON, 573(43.3%) had SIAD and 275(20.8%) patients had HEN. In patient mortality was higher in hyponatremia than NN (9.1% v 3.3%, p<0.0001). The RRs for in-hospital mortality compared to NN were: SIAD, 1.76 (95% CI 1.08-2.8, p=0.02), HON 2.77 (95% CI 1.8-4.3, p<0.0001) and HEN, 4.9 (95% CI 3.2-7.4, p<0.0001). The mortality rate was higher in HEN (RR 2.85; 95% CI 1.86-4.37, p<0.0001) and in HON, (RR 1.6; 95% CI 1.04-2.52; p=0.03), when compared to SIAD. The Charlson Comorbidity Index was lower in SIAD than in eunatraemic patients(p<0.0001). 9/121(7.4%) patients died with plasma sodium <125 mmol/l and 4(3.3%) with plasma sodium <120 mmol/l. However, 69/121(57%) patients died with a plasma sodium above 133 mmol/l.

CONCLUSIONS:

We confirmed higher all-cause mortality in hyponatremia than in NN. Mortality was higher in SIAD than in normonatraemia, and was not explained on the basis of co-morbidities. Mortality was higher in HON and HEN than in SIAD. Mortality rates reported for all-cause hyponatremia in the medical literature are not applicable to SIAD.

KEYWORDS:

SIAD ; SIADH ; Hyponatremia; Mortality

 

mTORC1 activity repression by late endosomal phosphatidylinositol 3,4-bisphosphate.

Marat AL, Wallroth A, Lo WT, Müller R, Norata GD, Falasca M, Schultz C, Haucke V.

Science. 2017 Jun 2;356(6341):968-972. doi: 10.1126/science.aaf8310.

PMID: 28572395

Abstract

Nutrient sensing by mechanistic target of rapamycin complex 1 (mTORC1) on lysosomes and late endosomes (LyLEs) regulates cell growth. Many factors stimulate mTORC1 activity, including the production of phosphatidylinositol 3,4,5-trisphosphate [PI(3,4,5)P3] by class I phosphatidylinositol 3-kinases (PI3Ks) at the plasma membrane. We investigated mechanisms that repress mTORC1 under conditions of growth factor deprivation. We identified phosphatidylinositol 3,4-bisphosphate [PI(3,4)P2], synthesized by class II PI3K β (PI3KC2β) at LyLEs, as a negative regulator of mTORC1, whereas loss of PI3KC2β hyperactivated mTORC1. Growth factor deprivation induced the association of PI3KC2β with the Raptor subunit of mTORC1. Local PI(3,4)P2 synthesis triggered repression of mTORC1 activity through association of Raptor with inhibitory 14-3-3 proteins. These results unravel an unexpected function for local PI(3,4)P2 production in shutting off mTORC1.

 

Achieved blood pressure and cardiovascular outcomes in high-risk patients: results from ONTARGET and TRANSCEND trials.

Böhm M, Schumacher H, Teo KK, Lonn EM, Mahfoud F, Mann JF, Mancia G, Redon J, Schmieder RE, Sliwa K, Weber MA, Williams B, Yusuf S.

Lancet. 2017 Apr 5. pii: S0140-6736(17)30754-7. doi: 10.1016/S0140-6736(17)30754-7. [Epub ahead of print]

PMID: 28390695

Abstract

BACKGROUND:

Studies have challenged the appropriateness of accepted blood pressure targets. We hypothesised that different levels of low blood pressure are associated with benefit for some, but harm for other outcomes.

METHODS:

In this analysis, we assessed the previously reported outcome data from high-risk patients aged 55 years or older with a history of cardiovascular disease, 70% of whom had hypertension, from the ONTARGET and TRANSCEND trials investigating ramipril, telmisartan, and their combination, with a median follow-up of 56 months. Detailed descriptions of randomisation and intervention have already been reported. We analysed the associations between mean blood pressure achieved on treatment; prerandomisation baseline blood pressure; or time-updated blood pressure (last on treatment value before an event) on the composite outcome of cardiovascular death, myocardial infarction, stroke, and hospital admission for heart failure; the components of the composite outcome; and all-cause death. Analysis was done by Cox regression analysis, ANOVA, and χ2.

FINDINGS:

Recruitment for ONTARGET took place between Dec 1, 2001, and July 31, 2008. TRANSCEND took place between Nov 1, 2001, and May 30, 2004. 30 937 patients were recruited from 733 centres in 40 countries and followed up for a median of 56 months. In ONTARGET, 25 127 patients known to be tolerant to angiotensin-converting-enzyme (ACE)-inhibitors were randomly assigned after a run-in period to oral ramipril 10 mg/day (n=8407), telmisartan 80 mg/day (n=8386), or the combination of both (n=8334). In TRANSCEND, 5810 patients who were intolerant to ACE-inhibitors were randomly assigned to oral telmisartan 80 mg/day (n=2903) or placebo (n=2907). Baseline systolic blood pressure (SBP) 140 mm Hg or higher was associated with greater incidence of all outcomes compared with 120 mm Hg to less than 140 mm Hg. By contrast, a baseline diastolic blood pressure (DBP) less than 70 mm Hg was associated with the highest risk for most outcomes compared with all DBP categories 70 mm Hg or more. In 4052 patients with SBP less than 120 mm Hg on treatment, the risk of the composite cardiovascular outcome (adjusted hazard ratio {HR} 1·14, 95% CI 1·03-1·26), cardiovascular death (1·29, 1·12-1·49), and all deaths (1·28, 1·15-1·42) were increased compared with those in whom SBP was 120-140 mm Hg during treatment (HR 1 for all outcomes, n=16099). No harm or benefit was observed for myocardial infarction, stroke, or hospital admission for heart failure. Mean achieved SBP more accurately predicted outcomes than baseline or time-updated SBP, and was associated with the lowest risk at approximately 130 mm Hg, and at 110-120 mm Hg risk increased for the combined outcome, cardiovascular death, and all-cause death except stroke. A mean DBP less than 70 mm Hg (n=5352) during treatment was associated with greater risk of the composite primary outcome (HR 1·31, 95% CI 1·20-1·42), myocardial infarction (1·55, 1·33-1·80), hospital admission for heart failure (1·59, 1·36-1·86) and all-cause death (1·16, 1·06-1·28) than a DBP 70-80 mm Hg (14 305). A pretreatment and mean on-treatment DBP of about 75 mm Hg was associated with the lowest risk.

INTERPRETATION:

Mean achieved SBP less than 120 mm Hg during treatment was associated with increased risk of cardiovascular outcomes except for myocardial infarction and stroke. Similar patterns were observed for DBP less than 70 mm Hg, plus increased risk for myocardial infarction and hospital admission for heart failure. Very low blood pressure achieved on treatment was associated with increased risks of several cardiovascular disease events. These data suggest that the lowest blood pressure possible is not necessarily the optimal target for high-risk patients, although it is not possible to rule out some effect of reverse causality.

FUNDING:

Boehringer Ingelheim.

Edited by AlPater

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A pilot study into a possible relationship between diet and stuttering.

Hum J, Rietveld T, Wiedijk P, van Lieshout P.

J Fluency Disord. 2017 Jun;52:25-36. doi: 10.1016/j.jfludis.2017.02.004. Epub 2017 Mar 2.

PMID: 28576291

http://sci-hub.cc/10.1016/j.jfludis.2017.02.004

Abstract

PURPOSE:

There are theoretical and empirical reasons to consider a potential role for copper metabolism in the brain in how it could influence stuttering. However, a link between stuttering and dietary intake has never been researched in a systematic way. This pilot study therefore aimed to explore a possible association between ingested amounts of copper and thiamine (vitamin B1) with stuttering frequency using a double blind cross-over longitudinal paradigm.

METHODS:

19 adults who stutter between 20 and 51 years old filled out an online survey for 9 consecutive weeks. The survey consisted of self-assessed fluency and mood state scales, as well as food journals. After 4 weeks, the participants consumed either copper or thiamine supplements for 2 weeks, followed by a 1-week washout period, and another period of two weeks taking the other supplement. Formal speech assessments were done pre/post baseline and at the end of each supplement intake. Participants were not informed about the nature of the supplements during the experiment and the investigators were blinded to the order of the supplements.

RESULTS:

The results demonstrated that copper and thiamine had no measurable effect on the amount of stuttering (self and formal assessments) but there was a moderate, significant correlation between mood state and fluency.

CONCLUSION:

The findings do not support notions of dietary influences of ingested copper or thiamine on stuttering but do provide modest support for a relationship between variations in stuttering and self-perceived anxiety.

KEYWORDS:

Anxiety; Copper; Diet; Stuttering; Thiamine

 

Low Bone Density and Bisphosphonate Use and the Risk of Kidney Stones.

Prochaska M, Taylor E, Vaidya A, Curhan G.

Clin J Am Soc Nephrol. 2017 Jun 2. pii: CJN.01420217. doi: 10.2215/CJN.01420217. [Epub ahead of print]

PMID: 28576907

Abstract

BACKGROUND AND OBJECTIVES:

Previous studies have demonstrated lower bone density in patients with kidney stones, but no longitudinal studies have evaluated kidney stone risk in individuals with low bone density. Small studies with short follow-up reported reduced 24-hour urine calcium excretion with bisphosphonate use. We examined history of low bone density and bisphosphonate use and the risk of incident kidney stone as well as the association with 24-hour calcium excretion.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS:

We conducted a prospective analysis of 96,092 women in the Nurses' Health Study II. We used Cox proportional hazards models to adjust for age, body mass index, thiazide use, fluid intake, supplemental calcium use, and dietary factors. We also conducted a cross-sectional analysis of 2294 participants using multivariable linear regression to compare 24-hour urinary calcium excretion between participants with and without a history of low bone density, and among 458 participants with low bone density, with and without bisphosphonate use.

RESULTS:

We identified 2564 incident stones during 1,179,860 person-years of follow-up. The multivariable adjusted relative risk for an incident kidney stone for participants with history of low bone density compared with participants without was 1.39 (95% confidence interval [95% CI], 1.20 to 1.62). Among participants with low bone density, the multivariable adjusted relative risk for an incident kidney stone for bisphosphonate users was 0.68 (95% CI, 0.48 to 0.98). In the cross-sectional analysis of 24-hour urine calcium excretion, the multivariable adjusted mean difference in 24-hour calcium was 10 mg/d (95% CI, 1 to 19) higher for participants with history of low bone density. However, among participants with history of low bone density, there was no association between bisphosphonate use and 24-hour calcium with multivariable adjusted mean difference in 24-hour calcium of -2 mg/d (95% CI, -25 to 20).

CONCLUSIONS:

Low bone density is an independent risk factor for incident kidney stone and is associated with higher 24-hour urine calcium excretion. Among participants with low bone density, bisphosphonate use was associated with lower risk of incident kidney stone but was not independently associated with 24-hour urine calcium excretion.

KEYWORDS:

Body Mass Index; Bone Density; Calcium, Dietary; Cross-Sectional Studies; Diphosphonates; Epidemiologic Studies; Female; Follow-Up Studies; Humans; Kidney Calculi; Linear Models; Proportional Hazards Models; Prospective Studies; Risk Assessment; Thiazides; risk factors

 

Impact of breakfast skipping compared with dinner skipping on regulation of energy balance and metabolic risk.

Nas A, Mirza N, Hägele F, Kahlhöfer J, Keller J, Rising R, Kufer TA, Bosy-Westphal A.

Am J Clin Nutr. 2017 Jun;105(6):1351-1361. doi: 10.3945/ajcn.116.151332. Epub 2017 May 10.

PMID: 28490511

Abstract

Background: Meal skipping has become an increasing trend of the modern lifestyle that may lead to obesity and type 2 diabetes.Objective: We investigated whether the timing of meal skipping impacts these risks by affecting circadian regulation of energy balance, glucose metabolism, and postprandial inflammatory responses.Design: In a randomized controlled crossover trial, 17 participants [body mass index (in kg/m2): 23.7 ± 4.6] underwent 3 isocaloric 24-h interventions (55%, 30%, and 15% carbohydrate, fat, and protein, respectively): a breakfast skipping day (BSD) and a dinner skipping day (DSD) separated by a conventional 3-meal-structure day (control). Energy and macronutrient balance was measured in a respiration chamber. Postprandial glucose, insulin, and inflammatory responses in leukocytes as well as 24-h glycemia and insulin secretion were analyzed.Results: When compared with the 3-meal control, 24-h energy expenditure was higher on both skipping days (BSD: +41 kcal/d; DSD: +91 kcal/d; both P < 0.01), whereas fat oxidation increased on the BSD only (+16 g/d; P < 0.001). Spontaneous physical activity, 24-h glycemia, and 24-h insulin secretion did not differ between intervention days. The postprandial homeostasis model assessment index (+54%) and glucose concentrations after lunch (+46%) were, however, higher on the BSD than on the DSD (both P < 0.05). Concomitantly, a longer fasting period with breakfast skipping also increased the inflammatory potential of peripheral blood cells after lunch.Conclusions: Compared with 3 meals/d, meal skipping increased energy expenditure. In contrast, higher postprandial insulin concentrations and increased fat oxidation with breakfast skipping suggest the development of metabolic inflexibility in response to prolonged fasting that may in the long term lead to low-grade inflammation and impaired glucose homeostasis.

KEYWORDS:

energy balance; insulin sensitivity; macronutrient oxidation; meal frequency; meal skipping

 

Biomarker-calibrated nutrient intake and healthy diet index associations with mortality risks among older and frail women from the Women's Health Initiative.

Zaslavsky O, Zelber-Sagi S, Hebert JR, Steck SE, Shivappa N, Tabung FK, Wirth MD, Bu Y, Shikany JM, Orchard T, Wallace RB, Snetselaar L, Tinker LF.

Am J Clin Nutr. 2017 Jun;105(6):1399-1407. doi: 10.3945/ajcn.116.151530. Epub 2017 Apr 19.

PMID: 28424183

Abstract

Background: Although studies to date have confirmed the association between nutrition and frailty, the impact of dietary intake and dietary patterns on survivorship in those with frailty is yet to be examined in a well-powered cohort with validated frailty status. Moreover, previous studies were limited by measurement error from dietary self-reports.Objective: We derived biomarker-calibrated dietary energy and protein intakes to address dietary self-report error. Using these data, we then evaluated the association of mortality in older women with frailty and dietary intake and healthy diet indexes, such as the alternate Mediterranean Diet (aMED), the Dietary Approaches to Stop Hypertension (DASH) score, and the Dietary Inflammatory Index (DII).Design: The analytic sample included 10,034 women aged 65-84 y with frailty and complete dietary data from the Women's Health Initiative Observational Study. Frailty was assessed with modified Fried's criteria. Dietary data were collected by food-frequency questionnaire.Results: Over a mean follow-up period of 12.4 y, 3259 (31%) deaths occurred. The HRs showed progressively decreased rates of mortality in women with higher calibrated dietary energy intakes (P-trend = 0.003), higher calibrated dietary protein intakes (P-trend = 0.03), higher aMED scores (P-trend = 0.006), and higher DASH scores (P-trend = 0.02). Although the adjusted point estimates of HRs (95% CIs) for frail women scoring in the second, third, and fourth quartiles on DII measures were 1.15 (1.03, 1.27), 1.28 (1.15, 1.42), and 1.24 (1.12, 1.38), respectively, compared with women in the first quartile, no overall effect was observed across quartiles (P-trend = 0.35). Subgroup analyses by chronic morbidity or smoking status or by excluding women with early death did not substantially change these findings.Conclusions: The current study highlights the importance of nutrition in older, frail women. Diet quality and quantity should be considered in managing persons with frailty.

KEYWORDS:

aging; biomarker; frailty; inflammation; mortality

 

Food groups and risk of all-cause mortality: a systematic review and meta-analysis of prospective studies.

Schwingshackl L, Schwedhelm C, Hoffmann G, Lampousi AM, Knüppel S, Iqbal K, Bechthold A, Schlesinger S, Boeing H.

Am J Clin Nutr. 2017 Jun;105(6):1462-1473. doi: 10.3945/ajcn.117.153148. Epub 2017 Apr 26.

PMID: 28446499 Free Article

http://ajcn.nutrition.org/content/105/6/1462.abstract?etoc

http://ajcn.nutrition.org/content/105/6/1462.full.pdf+html

Abstract

Background: Suboptimal diet is one of the most important factors in preventing early death and disability worldwide.Objective: The aim of this meta-analysis was to synthesize the knowledge about the relation between intake of 12 major food groups, including whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages, with risk of all-cause mortality.Design: We conducted a systematic search in PubMed, Embase, and Google Scholar for prospective studies investigating the association between these 12 food groups and risk of all-cause mortality. Summary RRs and 95% CIs were estimated with the use of a random effects model for high-intake compared with low-intake categories, as well as for linear and nonlinear relations. Moreover, the risk reduction potential of foods was calculated by multiplying the RR by optimal intake values (serving category with the strongest association) for risk-reducing foods or risk-increasing foods, respectively.Results: With increasing intake (for each daily serving) of whole grains (RR: 0.92; 95% CI: 0.89, 0.95), vegetables (RR: 0.96; 95% CI: 0.95, 0.98), fruits (RR: 0.94; 95% CI: 0.92, 0.97), nuts (RR: 0.76; 95% CI: 0.69, 0.84), and fish (RR: 0.93; 95% CI: 0.88, 0.98), the risk of all-cause mortality decreased; higher intake of red meat (RR: 1.10; 95% CI: 1.04, 1.18) and processed meat (RR: 1.23; 95% CI: 1.12, 1.36) was associated with an increased risk of all-cause mortality in a linear dose-response meta-analysis. A clear indication of nonlinearity was seen for the relations between vegetables, fruits, nuts, and dairy and all-cause mortality. Optimal consumption of risk-decreasing foods results in a 56% reduction of all-cause mortality, whereas consumption of risk-increasing foods is associated with a 2-fold increased risk of all-cause mortality.Conclusion: Selecting specific optimal intakes of the investigated food groups can lead to a considerable change in the risk of premature death.

KEYWORDS:

diet; dose response; food groups; meta-analysis; mortality

 

Effects of blood triglycerides on cardiovascular and all-cause mortality: a systematic review and meta-analysis of 61 prospective studies.

Liu J, Zeng FF, Liu ZM, Zhang CX, Ling WH, Chen YM.

Lipids Health Dis. 2013 Oct 29;12:159. doi: 10.1186/1476-511X-12-159. Review.

PMID: 24164719 Free PMC Article

Abstract

The relationship of triglycerides (TG) to the risk of death remains uncertain. The aim of this study was to determine the associations between blood triglyceride levels and cardiovascular diseases (CVDs) mortality and all-cause mortality. Four databases were searched without language restriction for relevant studies: PubMed, ScienceDirect, EMBASE, and Google Scholar. All prospective cohort studies reporting an association between TG and CVDs or all-cause mortality published before July 2013 were included. Risk ratios (RRs) with 95% confidence intervals (CIs) were extracted and pooled according to TG categories, unit TG, and logarithm of TG using a random-effects model with inverse-variance weighting. We identified 61 eligible studies, containing 17,018 CVDs deaths in 726,030 participants and 58,419 all-cause deaths in 330,566 participants. Twelve and fourteen studies, respectively, reported the effects estimates of CVDs and total mortality by TG categories. Compared to the referent (90-149 mg/dL), the pooled RRs (95% CI) of CVDs mortality for the lowest (< 90 mg/dL), borderline-high (150-199 mg/dL), and high TG (≥ 200 mg/dL) groups were 0.83 (0.75 to 0.93), 1.15 (1.03 to 1.29), and 1.25 (1.05 to 1.50); for total mortality they were 0.94 (0.85 to 1.03), 1.09 (1.02 to 1.17), and 1.20 (1.04 to 1.38), respectively. The risks of CVDs and all-cause deaths were increased by 13% and 12% (p < 0.001) per 1-mmol/L TG increment in twenty-two and twenty-two studies reported RRs per unit TG, respectively. In conclusion, elevated blood TG levels were dose-dependently associated with higher risks of CVDs and all-cause mortality.

 

Prospective study of dietary fat and the risk of age-related macular degeneration.

Cho E, Hung S, Willett WC, Spiegelman D, Rimm EB, Seddon JM, Colditz GA, Hankinson SE.

Am J Clin Nutr. 2001 Feb;73(2):209-18.

PMID: 11157315 Free Article

Abstract

BACKGROUND:

The relation between intakes of total fat and specific types of fat and age-related macular degeneration (AMD) remains unclear.

OBJECTIVE:

Our objective was to examine prospectively the association between fat intake and AMD.

DESIGN:

We conducted a prospective follow-up study of participants in the Nurses' Health Study and the Health Professionals Follow-up Study. At baseline (1984 for women and 1986 for men), the study included 42743 women and 29746 men aged > or = 50 y with no diagnosis of AMD who were followed until 1996. Fat intake was assessed with a food-frequency questionnaire.

RESULTS:

We accrued 567 patients with AMD with a visual loss of 20/30 or worse. The pooled multivariate relative risk (RR) for the highest compared with the lowest quintile of total fat intake was 1.54 (95% CI: 1.17, 2.01; P for trend = 0.008). Linolenic acid was positively associated with risk of AMD (top versus bottom quintile of RR: 1.49; 95% CI: 1.15, 1.94; P for trend = 0.0009). Docosahexaenoic acid had a modest inverse relation with AMD (top versus bottom quintile of RR: 0.70; 95% CI: 0.52, 0.93; P for trend = 0.05), and >4 servings of fish/wk was associated with a 35% lower risk of AMD compared with < or = 3 servings/mo (RR: 0.65; 95% CI: 0.46, 0.91; P for trend = 0.009).

CONCLUSIONS:

Total fat intake was positively associated with risk of AMD, which may have been due to intakes of individual fatty acids, such as linolenic acid, rather than to total fat intakes per se. A high intake of fish may reduce the risk of AMD.

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Dietary intake of α-linolenic acid and risk of age-related macular degeneration.

Wu J, Cho E, Giovannucci EL, Rosner BA, Sastry SM, Schaumberg DA, Willett WC.

Am J Clin Nutr. 2017 Jun;105(6):1483-1492. doi: 10.3945/ajcn.116.143453. Epub 2017 May 3.

PMID: 28468892

Abstract

Background: The relation between α-linolenic acid (ALA), a plant-derived omega-3 (n-3) fatty acid, and age-related macular degeneration (AMD) is unclear. European researchers reported that ≤40% of ALA can be present as trans forms.Objective: We aimed to evaluate the associations between intake of ALA and intermediate and advanced AMD.Design: Seventy-five thousand eight hundred eighty-nine women from the Nurses' Health Study and 38,961 men from Health Professionals Follow-Up Study were followed up from 1984 to 2012 and from 1986 to 2010, respectively. We assessed dietary intake by a validated food-frequency questionnaire at baseline and every 4 y thereafter. One thousand five hundred eighty-nine incident intermediate and 1356 advanced AMD cases (primarily neovascular AMD) were confirmed by medical record review.Results: The multivariable-adjusted HR for intermediate AMD comparing ALA intake at the top quintile to the bottom quintile was 1.28 (95% CI: 1.05, 1.56; P-trend = 0.01) in the analyses combining 2 cohorts. The HR in each cohort was in the positive direction but reached statistical significance only in the women. However, the positive association was apparent only in the pre-2002 era in each cohort and not afterward (P-time interaction = 0.003). ALA intake was not associated with advanced AMD in either time period. Using gas-liquid chromatography, we identified both cis ALA (mean ± SD: 0.13% ± 0.04%) and trans ALA isomers (0.05% ± 0.01%) in 395 erythrocyte samples collected in 1989-1990. In stepwise regression models, mayonnaise was the leading predictor of erythrocyte concentrations of cis ALA and one isomer of trans ALA. We also found trans ALA in mayonnaise samples.Conclusions: A high intake of ALA was associated with an increased risk of intermediate AMD before 2002 but not afterward. The period before 2002 coincides with the same time period when trans ALA was found in food and participants' blood; this finding deserves further study.

KEYWORDS:

age-related macular degeneration; food-frequency questionnaire; omega-3 fatty acids; prospective cohort study; trans fat; α-linolenic acid

 

Dietary Methionine Restriction Regulates Liver Protein Synthesis and Gene Expression Independently of Eukaryotic Initiation Factor 2 Phosphorylation in Mice.

Pettit AP, Jonsson WO, Bargoud AR, Mirek ET, Peelor FF 3rd, Wang Y, Gettys TW, Kimball SR, Miller BF, Hamilton KL, Wek RC, Anthony TG.

J Nutr. 2017 Jun;147(6):1031-1040. doi: 10.3945/jn.116.246710. Epub 2017 Apr 26.

PMID: 28446632

Abstract

Background: The phosphorylation of eukaryotic initiation factor 2 (p-eIF2) during dietary amino acid insufficiency reduces protein synthesis and alters gene expression via the integrated stress response (ISR).Objective: We explored whether a Met-restricted (MR) diet activates the ISR to reduce body fat and regulate protein balance.Methods: Male and female mice aged 3-6 mo with either whole-body deletion of general control nonderepressible 2 (Gcn2) or liver-specific deletion of protein kinase R-like endoplasmic reticulum kinase (Perk) alongside wild-type or floxed control mice were fed an obesogenic diet sufficient in Met (0.86%) or an MR (0.12% Met) diet for ≤5 wk. Ala enrichment with deuterium was measured to calculate protein synthesis rates. The guanine nucleotide exchange factor activity of eIF2B was measured alongside p-eIF2 and hepatic mRNA expression levels at 2 d and 5 wk. Metabolic phenotyping was conducted at 4 wk, and body composition was measured throughout. Results were evaluated with the use of ANOVA (P < 0.05).Results: Feeding an MR diet for 2 d did not increase hepatic p-eIF2 or reduce eIF2B activity in wild-type or Gcn2-/- mice, yet many genes transcriptionally regulated by the ISR were altered in both strains in the same direction and amplitude. Feeding an MR diet for 5 wk increased p-eIF2 and reduced eIF2B activity in wild-type but not Gcn2-/- mice, yet ISR-regulated genes altered in both strains similarly. Furthermore, the MR diet reduced mixed and cytosolic but not mitochondrial protein synthesis in both the liver and skeletal muscle regardless of Gcn2 status. Despite the similarities between strains, the MR diet did not increase energy expenditure or reduce body fat in Gcn2-/- mice. Finally, feeding the MR diet to mice with Perk deleted in the liver increased hepatic p-eIF2 and altered body composition similar to floxed controls.Conclusions: Hepatic activation of the ISR resulting from an MR diet does not require p-eIF2. Gcn2 status influences body fat loss but not protein balance when Met is restricted.

KEYWORDS:

ATF4; GCN2; PERK; eIF2B; integrated stress response

 

Dietary Patterns and Type 2 Diabetes: A Systematic Literature Review and Meta-Analysis of Prospective Studies.

Jannasch F, Kröger J, Schulze MB.

J Nutr. 2017 Jun;147(6):1174-1182. doi: 10.3945/jn.116.242552. Epub 2017 Apr 19.

PMID: 28424256

Abstract

Background: Different methodologic approaches for constructing dietary patterns and differences in their composition limit conclusions on healthful patterns for diabetes prevention.Objective: We summarized evidence from prospective studies that examined associations of dietary patterns with type 2 diabetes by considering different methodologic approaches.Methods: The literature search (MEDLINE and Web of Science) identified prospective studies (cohorts or trials) that associated dietary patterns with diabetes incidence in nondiabetic and apparently healthy participants. We summarized evidence by meta-analyses and distinguished different methodologic approaches.Results: The search resulted in 48 articles comprising 16 cohorts. Adherence to the Mediterranean diet (RR for comparing extreme quantiles: 0.87; 95% CI: 0.82, 0.93), Dietary Approaches to Stop Hypertension (DASH) (RR: 0.81; 95% CI: 0.72, 0.92), and Alternative Healthy Eating Index (AHEI) (RR: 0.79; 95% CI: 0.69, 0.90) was associated with significant risk reductions of incident diabetes. Patterns from exploratory factor and principal component analyses characterized by red and processed meat, refined grains, high-fat dairy, eggs, and fried products ("mainly unhealthy") were positively associated with diabetes (RR: 1.44; 95% CI: 1.27, 1.62), whereas patterns characterized by vegetables, legumes, fruits, poultry, and fish ("mainly healthy") were inversely associated with diabetes (RR: 0.84; 95% CI: 0.77, 0.91). Reduced rank regression (RRR) used diabetes-related biomarkers to identify patterns. These patterns were characterized by high intakes of refined grains, sugar-sweetened soft drinks, and processed meat and were all significantly associated with diabetes risk.Conclusions: Our meta-analysis suggests that diets according to the Mediterranean diet, DASH, and AHEI have a strong potential for preventing diabetes, although they differ in some particular components. Exploratory dietary patterns were grouped based on concordant food groups and were significantly associated with diabetes risk despite single-component foods having limited evidence for an association. Still, they remain population-specific observations. Consistent positive associations with diabetes risk were observed for 3 RRR patterns.

KEYWORDS:

dietary patterns; exploratory statistical methods; investigator-driven statistical methods; meta-analysis; systematic review; type 2 diabetes

 

Implications of US Nutrition Facts Label Changes on Micronutrient Density of Fortified Foods and Supplements.

McBurney MI, Hartunian-Sowa S, Matusheski NV.

J Nutr. 2017 Jun;147(6):1025-1030. doi: 10.3945/jn.117.247585. Epub 2017 May 10.

PMID: 28490678 Free Article

http://jn.nutrition.org/content/147/6/1025.abstract?etoc

http://jn.nutrition.org/content/147/6/1025.full.pdf+html

Abstract

The US FDA published new nutrition-labeling regulations in May 2016. For the first time since the implementation of the Nutrition Labeling and Education Act of 1990, the Daily Value (DV) for most vitamins will change, as will the units of measurement used in nutrition labeling for some vitamins. For some food categories, the Reference Amounts Customarily Consumed (RACCs) will increase to reflect portions commonly consumed on a single occasion. These regulatory changes are now effective, and product label changes will be mandatory beginning 26 July 2018. This commentary considers the potential impact of these regulatory changes on the vitamin and mineral contents of foods and dietary supplements. Case studies examined potential effects on food fortification and nutrient density. The updated DVs may lead to a reduction in the nutrient density of foods and dietary supplements with respect to 8 vitamins (vitamin A, thiamin, riboflavin, niacin, vitamin B-6, vitamin B-12, biotin, and pantothenic acid) and 6 minerals (zinc, selenium, copper, chromium, molybdenum, and chloride), and have mixed effects on 2 vitamins where the amount required per serving is affected by chemical structure (i.e., form) (natural vitamin E compared with synthetic vitamin E and folic acid compared with folate). Despite an increased DV for vitamin D, regulations limit food fortification. The adoption of Dietary Folate Equivalents for folate labeling may lead to reductions in the quantity of folic acid voluntarily added per RACC. Finally, because of increased RACCs in some food categories to reflect portions that people typically eat at one time, the vitamin and mineral density of these foods may be affected adversely. In totality, the United States is entering an era in which the need to monitor dietary intake patterns and nutritional status is unprecedented.

KEYWORDS:

DV; Daily Value; Nutrition Facts panel; RACC; RDI; Reference Amount Customarily Consumed; Reference Dietary Intake; fortification; nutrient density; vitamins

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SIRT1 Polymorphisms and Serum-Induced SIRT1 Protein Expression in Aging and Frailty: The CHAMP Study.

Razi S, Cogger VC, Kennerson M, Benson VL, McMahon AC, Blyth FM, Handelsman DJ, Seibel MJ, Hirani V, Naganathan V, Waite L, de Cabo R, Cumming RG, Le Couteur DG.

J Gerontol A Biol Sci Med Sci. 2017 Jul 1;72(7):870-876. doi: 10.1093/gerona/glx018.

PMID: 28329314

http://sci-hub.cc/10.1093/gerona/glx018

Abstract

The nutrient sensing protein, SIRT1 influences aging and nutritional interventions such as caloric restriction in animals, however, the role of SIRT1 in human aging remains unclear. Here, the role of SIRT1 single-nucleotide polymorphisms (SNPs) and serum-induced SIRT1 protein expression (a novel assay that detects circulating factors that influence SIRT1 expression in vitro) were studied in the Concord Health and Ageing in Men Project (CHAMP), a prospective cohort of community dwelling men aged 70 years and older. Serum-induced SIRT1 expression was not associated with age or mortality, however participants within the lowest quintile were less likely to be frail (odds ratio (OR) 0.34, 95% confidence interval (CI) 0.17-0.69, N = 1,309). Serum-induced SIRT1 expression was associated with some markers of body composition and nutrition (height, weight, body fat and lean % mass, albumin, and cholesterol) but not disease. SIRT1 SNPs rs2273773, rs3740051, and rs3758391 showed no association with age, frailty, or mortality but were associated with weight, height, body fat and lean, and albumin levels. There were some weak associations between SIRT1 SNPs and arthritis, heart attack, deafness, and cognitive impairment. There was no association between SIRT1 SNPs and the serum-induced SIRT1 assay. SIRT1 SNPs and serum-induced SIRT1 expression in older men may be more closely associated with nutrition and body composition than aging and age-related conditions.

KEYWORDS:

Body composition; Frailty; Mortality; Polymorphism; SIRT1; Sirtuin

 

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Changes in the Lethality of Frailty Over 30 Years: Evidence From Two Cohorts of 70-Year-Olds in Gothenburg Sweden.

Bäckman K, Joas E, Falk H, Mitnitski A, Rockwood K, Skoog I.

J Gerontol A Biol Sci Med Sci. 2017 Jul 1;72(7):945-950. doi: 10.1093/gerona/glw160.

PMID: 27522060

http://sci-hub.cc/10.1093/gerona/glw160

Abstract

BACKGROUND:

With aging, health deficits accumulate: people with few deficits for their age are fit, and those with more are frail. Despite recent reports of improved health in old age, how deficit accumulation is changing is not clear. Our objectives were to evaluate changes over 30 years in the degree of deficit accumulation and in the relationship between frailty and mortality in older adults.

METHODS:

We analyzed data from two population based, prospective longitudinal cohorts, assembled in 1971-1972 and 2000-2001, respectively. Residents of Gothenburg Sweden, systematically drawn from the Swedish population registry. The 1901-1902 cohort (N = 973) had a response rate of 84.8%; the 1930 cohort (N = 500) had a response rate of 65.1%. A frailty index using 36 deficits was calculated using data from physical examinations, assessments of physical activity, daily, sensory and social function, and laboratory tests. We evaluated mortality over 12.5 years in relation to the frailty index.

RESULTS:

Mean frailty levels were the same (x¯ = 0.20, p = .37) in the 1901-1902 cohort as in the 1930 cohort. Although the frailty index was linked to the risk of death in both cohorts, the hazards ratio decreased from 1.67 per 0.1 increment in the frailty index for the first cohort to 1.32 for the second cohort (interaction term p = .005).

DISCUSSION:

Although frailty was as common at age 70 as before, its lethality appears to be less. Just why this is so should be explored further.

KEYWORDS:

Cohort effects; Deficit accumulation; Frail older adults; Frailty index; Mortality

 

Heterogeneity of Human Aging and Its Assessment.

Mitnitski A, Howlett SE, Rockwood K.

J Gerontol A Biol Sci Med Sci. 2017 Jul 1;72(7):877-884. doi: 10.1093/gerona/glw089.

PMID: 27216811

https://academic.oup.com/biomedgerontology/article/72/7/877/2629918/Heterogeneity-of-Human-Aging-and-Its-Assessment

Abstract

Understanding the heterogeneity in health of older adults is a compelling question in the biology of aging. We analyzed the performance of five measures of health heterogeneity, judging them by their ability to predict mortality. Using clinical and biomarker data on 1,013 participants of the Canadian Study of Health and Aging who were followed for up to 6 years, we calculated two indices of biological age using the Klemera and Doubal method, which controversially includes using chronological age as a "biomarker," and three frailty indices (FIs) that do not include chronological age: a standard clinical FI, an FI from standard laboratory blood tests and blood pressure, and their combination (FI-combined). Predictive validity was tested using Cox proportional hazards analysis and discriminative ability by the area under the receiver-operating characteristic curves. All five measures showed moderate performance that was improved by combining measures to evaluate larger numbers of items. The greatest addition in explanatory power came from the FI-combined that showed the best mortality prediction in an age-adjusted model. More extensive comparisons across different databases are required, but these results do not support including chronological age as a biomarker.

KEYWORDS:

Biological age; Biological aging; Biomarkers; Frailty indices; Health heterogeneity

 

Oral Disease and 3-Year Incidence of Frailty in Mexican Older Adults.

Castrejón-Pérez RC, Jiménez-Corona A, Bernabé E, Villa-Romero AR, Arrivé E, Dartigues JF, Gutiérrez-Robledo LM, Borges-Yáñez SA.

J Gerontol A Biol Sci Med Sci. 2017 Jul 1;72(7):951-957. doi: 10.1093/gerona/glw201.

PMID: 28329793

Abstract

BACKGROUND:

Poor oral health has been associated with some components of frailty. The objective of this study was to identify the association between clinical measures of oral health and the incidence of frailty among community-dwelling older adults aged 70 or older in Mexico City.

METHODS:

A 3-year cohort study with a probabilistic representative sample of home-dwelling elders of one district of Mexico City was performed. Baseline and follow-up interview and oral clinical evaluations were carried out by standardized examiners in participants' homes. Dependent variable was incident frailty defined according to the frailty phenotype. Independent variables were the utilization of dental services, the presence of xerostomia, the number of natural teeth, use of removable dental prostheses, presence of severe periodontitis, and presence of root remnants. Sociodemographic, behavioral, and health measures were included as confounders. The association between oral health conditions and incident frailty was modeled using Poisson regression models with robust variance estimators. The models were adjusted for confounders and interactions.

RESULTS:

We identified a 14.8% cumulative incidence of frailty. Each additional tooth was associated with a lower probability of developing frailty by 5.0% (risk ratio = 0.90; 95% CI 1.02-1.10). The 3-year risk ratio of developing frailty was 2.13 times higher (95% CI 1.01-4.50) among participants having severe periodontitis.

CONCLUSIONS:

The number of teeth and the presence of severe periodontitis are associated with the development of frailty after controlling for confounders. Further studies are needed on this topic.

KEYWORDS:

Cohort; Frailty; Incidence; Oral health; Periodontitis; Tooth loss

 

Survival Comparison of Patients With Cystic Fibrosis in Canada and the United States: A Population-Based Cohort Study.

Stephenson AL, Sykes J, Stanojevic S, Quon BS, Marshall BC, Petren K, Ostrenga J, Fink AK, Elbert A, Goss CH.

Ann Intern Med. 2017 Apr 18;166(8):537-546. doi: 10.7326/M16-0858. Epub 2017 Mar 14.

PMID: 28288488

Abstract

BACKGROUND:

In 2011, the median age of survival of patients with cystic fibrosis reported in the United States was 36.8 years, compared with 48.5 years in Canada. Direct comparison of survival estimates between national registries is challenging because of inherent differences in methodologies used, data processing techniques, and ascertainment bias.

OBJECTIVE:

To use a standardized approach to calculate cystic fibrosis survival estimates and to explore differences between Canada and the United States.

DESIGN:

Population-based study.

SETTING:

42 Canadian cystic fibrosis clinics and 110 U.S. cystic fibrosis care centers.

PATIENTS:

Patients followed in the Canadian Cystic Fibrosis Registry (CCFR) and U.S. Cystic Fibrosis Foundation Patient Registry (CFFPR) between 1990 and 2013.

MEASUREMENTS:

Cox proportional hazards models were used to compare survival between patients followed in the CCFR (n = 5941) and those in the CFFPR (n = 45 448). Multivariable models were used to adjust for factors known to be associated with survival.

RESULTS:

Median age of survival in patients with cystic fibrosis increased in both countries between 1990 and 2013; however, in 1995 and 2005, survival in Canada increased at a faster rate than in the United States (P < 0.001). On the basis of contemporary data from 2009 to 2013, the median age of survival in Canada was 10 years greater than in the United States (50.9 vs. 40.6 years, respectively). The adjusted risk for death was 34% lower in Canada than the United States (hazard ratio, 0.66 [95% CI, 0.54 to 0.81]). A greater proportion of patients in Canada received transplants (10.3% vs. 6.5%, respectively [standardized difference, 13.7]). Differences in survival between U.S. and Canadian patients varied according to U.S. patients' insurance status.

LIMITATION:

Ascertainment bias due to missing data or nonrandom loss to follow-up might affect the results.

CONCLUSION:

Differences in cystic fibrosis survival between Canada and the United States persisted after adjustment for risk factors associated with survival, except for private-insurance status among U.S. patients. Differential access to transplantation, increased posttransplant survival, and differences in health care systems may, in part, explain the Canadian survival advantage.

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The Cystic Fibrosis Survival Gap: Why Do Canadians Fare Better Than Americans?

Flume PA, VanDevanter DR.

Ann Intern Med. 2017 Apr 18;166(8):599-600. doi: 10.7326/M17-0564. Epub 2017 Mar 14. No abstract available.

PMID: 28289748

http://sci-hub.cc/10.7326/M17-0564

 

Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older to Higher Versus Lower Blood Pressure Targets: A Clinical Practice Guideline From the American College of Physicians and the American Academy of Family Physicians.

Qaseem A, Wilt TJ, Rich R, Humphrey LL, Frost J, Forciea MA; Clinical Guidelines Committee of the American College of Physicians and the Commission on Health of the Public and Science of the American Academy of Family Physicians..

Ann Intern Med. 2017 Mar 21;166(6):430-437. doi: 10.7326/M16-1785. Epub 2017 Jan 17.

PMID: 28135725

Abstract

DESCRIPTION:

The American College of Physicians (ACP) and the American Academy of Family Physicians (AAFP) jointly developed this guideline to present the evidence and provide clinical recommendations based on the benefits and harms of higher versus lower blood pressure targets for the treatment of hypertension in adults aged 60 years or older.

METHODS:

This guideline is based on a systematic review of published randomized, controlled trials for primary outcomes and observational studies for harms only (identified through EMBASE, the Cochrane Database of Systematic Reviews, MEDLINE, and ClinicalTrials.gov), from database inception through January 2015. The MEDLINE search was updated through September 2016. Evaluated outcomes included all-cause mortality, morbidity and mortality related to stroke, major cardiac events (fatal and nonfatal myocardial infarction and sudden cardiac death), and harms. This guideline grades the evidence and recommendations using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) method.

TARGET AUDIENCE AND PATIENT POPULATION:

The target audience for this guideline includes all clinicians, and the target patient population includes all adults aged 60 years or older with hypertension.

RECOMMENDATION 1:

ACP and AAFP recommend that clinicians initiate treatment in adults aged 60 years or older with systolic blood pressure persistently at or above 150 mm Hg to achieve a target systolic blood pressure of less than 150 mm Hg to reduce the risk for mortality, stroke, and cardiac events. (Grade: strong recommendation, high-quality evidence). ACP and AAFP recommend that clinicians select the treatment goals for adults aged 60 years or older based on a periodic discussion of the benefits and harms of specific blood pressure targets with the patient.

RECOMMENDATION 2:

ACP and AAFP recommend that clinicians consider initiating or intensifying pharmacologic treatment in adults aged 60 years or older with a history of stroke or transient ischemic attack to achieve a target systolic blood pressure of less than 140 mm Hg to reduce the risk for recurrent stroke. (Grade: weak recommendation, moderate-quality evidence). ACP and AAFP recommend that clinicians select the treatment goals for adults aged 60 years or older based on a periodic discussion of the benefits and harms of specific blood pressure targets with the patient.

RECOMMENDATION 3:

ACP and AAFP recommend that clinicians consider initiating or intensifying pharmacologic treatment in some adults aged 60 years or older at high cardiovascular risk, based on individualized assessment, to achieve a target systolic blood pressure of less than 140 mm Hg to reduce the risk for stroke or cardiac events. (Grade: weak recommendation, low-quality evidence). ACP and AAFP recommend that clinicians select the treatment goals for adults aged 60 years or older based on a periodic discussion of the benefits and harms of specific blood pressure targets with the patient.

 

The Accuracy of Heart Rate Monitoring by Some Wrist-Worn Activity Trackers.

Cadmus-Bertram L, Gangnon R, Wirkus EJ, Thraen-Borowski KM, Gorzelitz-Liebhauser J.

Ann Intern Med. 2017 Apr 18;166(8):610-612. doi: 10.7326/L16-0353. Epub 2017 Apr 11. No abstract available.

PMID: 28395305

http://sci-hub.cc/10.7326/L16-0353

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Accuracy in Wrist-Worn, Sensor-Based Measurements of Heart Rate and Energy Expenditure in a Diverse Cohort.

Shcherbina A, Mattsson CM, Waggott D, Salisbury H, Christle JW, Hastie T, Wheeler MT, Ashley EA.

J Pers Med. 2017 May 24;7(2). pii: E3. doi: 10.3390/jpm7020003.

PMID: 28538708 Free Article

https://www.ncbi.nlm.nih.gov/pubmed/28538708

Overweight: The Body Mass Index Category With an Identity Crisis.

Després JP.

Ann Intern Med. 2017 May 2;166(9):671-672. doi: 10.7326/M17-0566. Epub 2017 Apr 4. No abstract available.

PMID: 28384686

http://sci-hub.cc/10.7326/M17-0566

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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 May 2;166(9):613-620. doi: 10.7326/M16-1390. Epub 2017 Apr 4.

PMID: 28384755

https://www.crsociety.org/topic/11801-als-papers-citations-and-possibly-links-and-excerpts-or-my-synopses/page-9?hl=28384755&do=findComment&comment=21322

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.

Edited by AlPater

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Microbe from Yogurt Impedes Drug-Resistant Bacteria

By Aggie Mika

June 5, 2017

http://www.the-scientist.com/?articles.view/articleNo/49590/title/Microbe-from-Yogurt-Impedes-Drug-Resistant-Bacteria/&utm_campaign=NEWSLETTER_TS_The-Scientist-Daily_2016&utm_source=hs_email&utm_medium=email&utm_content=52722768&_hsenc=p2ANqtz-8T-J_Wem-avGS7-aXE61q4ccJIeh9yT8UsBsoTHBqUFcQT2XoPGhgtlxdlm2GQOUi4KOgqtgDvqH8rS-2spmncy_qKXQ&_hsmi=52722768

Lactobacillus parafarraginis metabolites hindered the growth of multiple, distantly related bacterial pathogens.

 

An Assessment of the Accuracy of Home Blood Pressure Monitors When Used in Device Owners.

Ringrose JS, Polley G, McLean D, Thompson A, Morales F, Padwal R.

Am J Hypertens. 2017 Jul 1;30(7):683-689. doi: 10.1093/ajh/hpx041.

PMID: 28430848

Abstract

OBJECTIVE:

To examine the accuracy of home blood pressure (BP) devices, on their owners, compared to auscultatory reference standard BP measurements.

METHODS:

Eighty-five consecutive consenting subjects ≥18 years of age, who owned an oscillometric home BP device (wrist or upper-arm device), with BP levels between 80-220/50-120 mm Hg, and with arm circumferences between 25-43 cm were studied. Pregnancy and atrial fibrillation were exclusion criteria. Device measurements from each subject's home BP device were compared to simultaneous 2-observer auscultation using a mercury sphygmomanometer. Between-group mean comparisons were conducted using paired t-tests. The proportion of patients with device-to-auscultatory differences of ≥5, 10, and 15 mm Hg were tabulated and predictors of systolic and diastolic BP differences were identified using linear regression.

RESULTS:

Mean age was 66.4 ± 11.0 years, mean arm circumference was 32.7 ± 3.7 cm, 54% were female and 78% had hypertension. Mean BPs were 125.7 ± 14.0/73.9 ± 10.4 mm Hg for home BP devices vs. 129.0 ± 14.7/72.9 ± 9.3 for auscultation (difference of -3.3 ± 7.3/0.9 ± 6.1; P values <0.0001 for systolic and 0.17 for diastolic). The proportion of devices with systolic or diastolic BP differences from auscultation of ≥5, 10, and 15 mm Hg was 69%, 29%, and 7%, respectively. Increasing arm circumference was a statistically significant predictor of higher systolic (parameter estimate 0.61 per cm increase; P value 0.004) and diastolic (0.38; 0.03) BP.

CONCLUSIONS:

Although mean differences from 2-observer auscultation were acceptable, when tested on their owners, most home BP devices were not accurate to within 5 mm Hg. Ensuring acceptable accuracy of the device-owner pairing should be prioritized.

KEYWORDS:

auscultatory; blood pressure; blood pressure measurement; home blood pressure; hypertension; oscillometry; validation.

 

Healthy Lifestyle and Blood Pressure Variability in Young Adults.

Maseli A, Aeschbacher S, Schoen T, Fischer A, Jung M, Risch M, Risch L, Conen D.

Am J Hypertens. 2017 Jul 1;30(7):690-699. doi: 10.1093/ajh/hpx034.

PMID: 28402434

http://sci-hub.cc/10.1093/ajh/hpx034

Abstract

BACKGROUND:

The aim of this study was to assess the relationships between healthy lifestyle metrics and blood pressure variability (BPV) in young and healthy adults.

METHODS:

A population-based sample of 1,999 individuals aged 25-41 years was investigated. A lifestyle-score from 0 (most unhealthy) to 7 (most healthy) was calculated by giving one point for each of the following components: never smoking cigarettes, adhering to a healthy diet, performing moderate or intense physical activity, having a body mass index <25 kg/m2, a total cholesterol <200 mg/dl, a glycated hemoglobin <5.7%, or a conventional BP <120/80 mm Hg. Standardized ambulatory 24-hour BP measurements were obtained in all individuals. BPV was defined as the SD of all individual ambulatory BP recordings. We constructed multivariable linear regression models to assess the relationships between the lifestyle-score and BPV. None of the results were adjusted for multiple testing.

RESULTS:

Median age was 37 years and 46.8% were men. With increasing lifestyle-score, systolic and diastolic BPV is decreasing linearly (P for trend <0.0001), even after multivariable adjustment. Per 1-point increase in lifestyle-score, the β-coefficient (95% confidence interval) for systolic and diastolic 24-hour BPV was -0.03 (-0.03; -0.02) and -0.04 (-0.05; -0.03), respectively, both P for trend <0.0001. These relationships were attenuated but remained statistically significant after additional adjustment for mean individual BP.

CONCLUSION:

In this study of young and healthy adults, adopting a healthy lifestyle was associated with a lower BPV. These associations were independent of mean BP levels.

KEYWORDS:

blood pressure; blood pressure variability; healthy lifestyle; hypertension; lifestyle-score; population-based.

 

Healthy obesity and risk of accelerated functional decline and disability.

Bell JA, Sabia S, Singh-Manoux A, Hamer M, Kivimäki M.

Int J Obes (Lond). 2017 Mar 14. doi: 10.1038/ijo.2017.51. [Epub ahead of print]

PMID: 28220042

https://www.nature.com/ijo/journal/v41/n6/full/ijo201751a.html

Abstract

BACKGROUND/OBJECTIVES:

Some obese adults have a normal metabolic profile and are considered 'healthy', but whether they experience faster ageing than healthy normal-weight adults is unknown. We compared decline in physical function, worsening of bodily pain and likelihood of future mobility limitation and disability between these groups.

SUBJECTS/METHODS:

This was a population-based observational study using repeated measures over 2 decades (Whitehall II cohort data). Normal-weight (body mass index (BMI) 18.5-24.9 kg m-2), overweight (25.0-29.9 kg m-2) and obese (⩾30.0 kg m-2) adults were considered metabolically healthy if they had 0 or 1 of 5 risk factors (hypertension, low high-density lipoprotein cholesterol, high triacylglycerol, high blood glucose and insulin resistance) in 1991/1994. Decline in physical function and worsening of bodily pain based on change in Short Form Health Survey items using eight repeated measures over 18.8 years (1991/1994-2012/2013) were compared between metabolic-BMI groups using linear mixed models. Odds of mobility limitation based on objective walking speed (slowest tertile) and of disability based on limitations in ⩾1 of 6 basic activities of daily living, each using three repeated measures over 8.3 years (2002/2004-2012/2013), were compared using logistic mixed models.

RESULTS:

In multivariable-adjusted mixed models on up to 6635 adults (initial mean age 50 years; 70% male), healthy normal-weight adults experienced a decline in physical function of -3.68 (95% CI=-4.19, -3.16) score units per decade; healthy obese adults showed an additional -3.48 (-4.88, -2.08) units decline. Healthy normal-weight adults experienced a -0.49 (-1.11, 0.12) score unit worsening of bodily pain per decade; healthy obese adults had an additional -2.23 (-3.78, -0.69) units worsening. Healthy obesity versus healthy normal-weight conferred 3.39 (2.29, 5.02) times higher odds of mobility limitation and 3.75 (1.94, 7.24) times higher odds of disability.

CONCLUSIONS:

Our results suggest that obesity, even if metabolically healthy, accelerates age-related declines in functional ability and poses a threat to independence in older age.

 

Antihypertensive agents do not prevent blood-brain barrier dysfunction and cognitive deficits in dietary-induced obese mice.

Mamo JC, Lam V, Giles C, Coulson SH, Fimognari N, Mooranian A, Al-Salami H, Takechi R.

Int J Obes (Lond). 2017 Mar 21. doi: 10.1038/ijo.2017.57. [Epub ahead of print]

PMID: 28239165

http://sci-hub.cc/10.1038/ijo.2017.57

Abstract

BACKGROUND:

While vascular risk factors including Western-styled diet and obesity are reported to induce cognitive decline and increase dementia risk, recent reports consistently suggest that compromised integrity of cerebrovascular blood-brain barrier (BBB) may have an important role in neurodegeneration and cognitive deficits. A number of studies report that elevated blood pressure increases the permeability of BBB.

METHODS:

In this study, we investigated the effects of antihypertensive agents, candesartan or ursodeoxycholic acid (UDCA), on BBB dysfunction and cognitive decline in wild-type mice maintained on high fat and fructose (HFF) diet for 24 weeks.

RESULTS:

In HFF-fed mice, significantly increased body weight with elevated blood pressure, plasma insulin and glucose compared with mice fed with low-fat control chow was observed. Concomitantly, significant disruption of BBB and cognitive decline were evident in the HFF-fed obese mice. Hypertension was completely prevented by the coprovision of candesartan or UDCA in mice maintained on HFF diet, while only candesartan significantly reduced the body weight compared with HFF-fed mice. Nevertheless, BBB dysfunction and cognitive decline remained unaffected by candesartan or UDCA.

CONCLUSIONS:

These data conclusively indicate that modulation of blood pressure and/or body weight may not be directly associated with BBB dysfunction and cognitive deficits in Western diet-induced obese mice, and hence antihypertensive agents may not be effective in preventing BBB disruption and cognitive decline. The findings may provide important mechanistical insights to obesity-associated cognitive decline and its therapy.

 

The Scientist » Multimedia » Infographics

Infographic: A Body Without Food

Mounting evidence suggests that intermittent fasting causes significant changes to various organs and tissue types.

By Bob Grant | June 1, 2017

http://www.the-scientist.com/?articles.view/articleNo/49505/title/Infographic--A-Body-Without-Food/&utm_campaign=NEWSLETTER_TS_The-Scientist-Daily_2016&utm_source=hs_email&utm_medium=email&utm_content=52775608&_hsenc=p2ANqtz--Kr9DIF_1EO08CEcfaE4xmeVvYJ8WHRfPE28X3RLVhuB-f9MkU1OixxxmAkmC2cEUE98HYf57tWgSrsOSTWPqTXarEog&_hsmi=52775608

The fasting signal likely starts in the liver, the body’s central command for metabolism. But through changes in gene expression and alterations in complex enzymatic pathways, the effects of food deprivation spread throughout the body, from the brain and visceral fat to the muscles and more.

LIVER

Fasting and time-restricted feeding increases insulin sensitivity, decreases insulin resistance, and lowers blood glucose levels. With prolonged periods of fasting, the liver’s glycogen stores become depleted, and visceral fat is tapped as an energy source, which releases ketones that can be metabolized by neurons and muscle cells.

IMMUNE SYSTEM

Periodic fasting reprograms T-cell populations, tamping down autoimmunity and rescuing immunosenescence. A lack of incoming calories appears to prune away autoimmune T cells, and with refeeding, hematopoietic stem cells are activated to replace T cells, lymphocytes, and other white blood cells. Several fasting studies have also pointed to a decrease in inflammatory cytokines.

HEART

Because triglycerides become mobilized for energy in the absence of incoming dietary calories, blood lipid levels tend to go down in a fasting body. Researchers have also seen decreases in blood pressure in fasting animals. In some animal studies of fasting, investigators have recorded decreases in cholesterol.

BRAIN

Intermittent fasting has improved memory, learning, and neurogenesis in rodents, and has been shown to repair some neurons in mouse models of ischemic stroke.

CANCER

By making tumor cells more susceptible to chemotherapeutic agents while protecting healthy cells from the treatment’s toxicity, intermittent fasting is showing promise in slowing the progression of breast cancers and melanoma in mice.

Tags

liver, immunology, heart, fasting, cancer and brain

Read the full story.

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The Scientist » June 2017 Issue » Features » Cover Story

Running on Empty

Regularly taking breaks from eating—for hours or days—can trigger changes both expected, such as in metabolic dynamics and inflammation, and surprising, as in immune system function and cancer progression.

By Bob Grant | June 1, 2017

http://www.the-scientist.com/?articles.view/articleNo/49462/title/Running-on-Empty/

 

The cannabis paradox: when age matters

Andrés Ozaita & Ester Aso

AffiliationsCorresponding authors

Nature Medicine 23, 661–662 (2017) doi:10.1038/nm.4348

Published online 06 June 2017

http://sci-hub.cc/10.1038/nm.4348

New evidence in mouse models reveals that exposure to Δ9-tetrahydrocannabinol (THC), the main psychoactive component in Cannabis sativa, might improve cognitive performance in aging animals.

Subject terms: Ageing Cellular neuroscience

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A chronic low dose of Δ<sup>9</sup>-tetrahydrocannabinol (THC) restores cognitive function in old mice.

Bilkei-Gorzo A, Albayram O, Draffehn A, Michel K, Piyanova A, Oppenheimer H, Dvir-Ginzberg M, Rácz I, Ulas T, Imbeault S, Bab I, Schultze JL, Zimmer A.

Nat Med. 2017 May 8. doi: 10.1038/nm.4311. [Epub ahead of print]

PMID: 28481360

http://sci-hub.cc/10.1038/nm.4311

Abstract

The balance between detrimental, pro-aging, often stochastic processes and counteracting homeostatic mechanisms largely determines the progression of aging. There is substantial evidence suggesting that the endocannabinoid system (ECS) is part of the latter system because it modulates the physiological processes underlying aging. The activity of the ECS declines during aging, as CB1 receptor expression and coupling to G proteins are reduced in the brain tissues of older animals and the levels of the major endocannabinoid 2-arachidonoylglycerol (2-AG) are lower. However, a direct link between endocannabinoid tone and aging symptoms has not been demonstrated. Here we show that a low dose of Δ9-tetrahydrocannabinol (THC) reversed the age-related decline in cognitive performance of mice aged 12 and 18 months. This behavioral effect was accompanied by enhanced expression of synaptic marker proteins and increased hippocampal spine density. THC treatment restored hippocampal gene transcription patterns such that the expression profiles of THC-treated mice aged 12 months closely resembled those of THC-free animals aged 2 months. The transcriptional effects of THC were critically dependent on glutamatergic CB1 receptors and histone acetylation, as their inhibition blocked the beneficial effects of THC. Thus, restoration of CB1 signaling in old individuals could be an effective strategy to treat age-related cognitive impairments.

 

Aging Reversal and Healthy Longevity is in Reach: Dependence on Mitochondrial DNA Heteroplasmy as a Key Molecular Target.

Stefano GB, Kream RM.

Med Sci Monit. 2017 Jun 5 [revised 2017 Jun 5];23:2732-2735. doi: 10.12659/MSM.902515.

PMID: 28579605

Abstract

Recent trends in biomedical research have highlighted the potential for effecting significant extensions in longevity with enhanced quality of life in aging human populations. Within this context, any proposed method to achieve enhanced life extension must include therapeutic approaches that draw upon essential biochemical and molecular regulatory processes found in relatively simple single cell organisms that are evolutionarily conserved within complex organ systems of higher animals. Current critical thinking has established the primacy of mitochondrial function in maintaining good health throughout plant and animal phyla. The mitochondrion represents an existentially defined endosymbiotic model of complex organelle development driven by evolutionary modification of a permanently enslaved primordial bacterium. Cellular mitochondria are biochemically and morphologically tailored to provide exponentially enhanced ATP-dependent energy production accordingly to tissue- and organ-specific physiological demands. Thus, individual variations in longevity may then be effectively sorted according to age-dependent losses of single-cell metabolic integrity functionally linked to impaired mitochondrial bioenergetics within an aggregate presentation of compromised complex organ systems. Recent empirical studies have focused on the functional role of mitochondrial heteroplasmy in the regulation of normative cellular processes and the initiation and persistence of pathophysiological states. Accordingly, elucidation of the multifaceted functional roles of mitochondrial heteroplasmy in normal aging and enhanced longevity will provide both a compelling genetic basis and potential targets for therapeutic intervention to effect meaningful life extension in human populations.

KEYWORDS:

DNA, Mitochondrial; Free Radicals; Genome, Mitochondrial; Longevity; Mutation; Oocytes

 

Body height and mortality - mortality follow-up of three Swiss surveys.

Rohrmann S, Haile SR, Staub K, Bopp M, Fäh D; Swiss National Cohort Study Group.

Prev Med. 2017 Jun 1. pii: S0091-7435(17)30185-8. doi: 10.1016/j.ypmed.2017.05.023. [Epub ahead of print]

PMID: 28579494

Abstract

BACKGROUND:

Adult body height is largely determined by genetics, but also by dietary factors, which in turn depend on socioeconomic status and lifestyle. We examined the association between adult body height and mortality in Switzerland, a country with three main language regions with different cultural background.

METHODS:

We included 16,831 men and 18,654 women, who participated in Swiss population-based health surveys conducted 1977-1993 and who were followed up until end of 2008. Multivariable Cox proportional hazards models were computed to examine the association of body height with overall, cardiovascular, and cancer mortality.

RESULTS:

We observed a positive association between adult body height and all-cause mortality in women (HR=1.34, 95% CI 1.10-1.62, tallest vs. average women). In men, mortality risk decreased with increasing height, with shortest men tending to have higher (1.06, 0.94-1.19) and tallest men a lower (0.94, 0.77-1.14) risk compared with men of average height (p-trend 0.0001). Body height was associated with cancer mortality in women, such that tallest women had a higher risk of dying from cancer than women of average height (1.37, 1.02-1.84), but there was no such association in men (0.95, 0.69-1.30). In both sexes, height was not associated with cardiovascular mortality in a statistically significant manner.

CONCLUSION:

Our study does not support an inverse association of body height with all-cause mortality. On the contrary, our data suggests a higher overall risk in taller women, mainly driven by a positive association between body height and cancer mortality.

 

Cognitive decline in normal aging and its prevention: a review on non-pharmacological lifestyle strategies.

Klimova B, Valis M, Kuca K.

Clin Interv Aging. 2017 May 25;12:903-910. doi: 10.2147/CIA.S132963. eCollection 2017. Review.

PMID: 28579767

Abstract

The purpose of this study is to examine the effects of the selected non-pharmacological lifestyle activities on the delay of cognitive decline in normal aging. This was done by conducting a literature review in the four acknowledged databases Web of Science, Scopus, MEDLINE, and Springer, and consequently by evaluating the findings of the relevant studies. The findings show that physical activities, such as walking and aerobic exercises, music therapy, adherence to Mediterranean diet, or solving crosswords, seem to be very promising lifestyle intervention tools. The results indicate that non-pharmacological lifestyle intervention activities should be intense and possibly done simultaneously in order to be effective in the prevention of cognitive decline. In addition, more longitudinal randomized controlled trials are needed in order to discover the most effective types and the duration of these intervention activities in the prevention of cognitive decline, typical of aging population groups.

KEYWORDS:

benefits; cognitive impairment; healthy older individuals; intervention

 

Decreased alertness due to sleep loss increases pain sensitivity in mice.

Alexandre C, Latremoliere A, Ferreira A, Miracca G, Yamamoto M, Scammell TE, Woolf CJ.

Nat Med. 2017 May 8. doi: 10.1038/nm.4329. [Epub ahead of print]

PMID: 28481358

Abstract

Extended daytime and nighttime activities are major contributors to the growing sleep deficiency epidemic, as is the high prevalence of sleep disorders like insomnia. The consequences of chronic insufficient sleep for health remain uncertain. Sleep quality and duration predict presence of pain the next day in healthy subjects, suggesting that sleep disturbances alone may worsen pain, and experimental sleep deprivation in humans supports this claim. We demonstrate that sleep loss, but not sleep fragmentation, in healthy mice increases sensitivity to noxious stimuli (referred to as 'pain') without general sensory hyper-responsiveness. Moderate daily repeated sleep loss leads to a progressive accumulation of sleep debt and also to exaggerated pain responses, both of which are rescued after restoration of normal sleep. Caffeine and modafinil, two wake-promoting agents that have no analgesic activity in rested mice, immediately normalize pain sensitivity in sleep-deprived animals, without affecting sleep debt. The reversibility of mild sleep-loss-induced pain by wake-promoting agents reveals an unsuspected role for alertness in setting pain sensitivity. Clinically, insufficient or poor-quality sleep may worsen pain and this enhanced pain may be reduced not by analgesics, whose effectiveness is reduced, but by increasing alertness or providing better sleep.

 

Obesity/overweight reduces the risk of active tuberculosis: a nationwide population-based cohort study in Taiwan.

Yen YF, Hu HY, Lee YL, Ku PW, Lin IF, Chu D, Lai YJ.

Int J Obes (Lond). 2017 Mar 28. doi: 10.1038/ijo.2017.64. [Epub ahead of print]

PMID: 28280271

Abstract

BACKGROUND:

Obesity affects immune function by increasing the number of T helper lymphocytes, which may reduce the risk of tuberculosis (TB) infection. However, the effect of obesity on TB development has not been extensively studied. This nationwide population-based cohort study investigated the effect of obesity on TB development in Taiwanese adults.

METHODS:

We included 46 028 adult participants (age ⩾18 years) from three rounds (2001, 2005 and 2009) of the Taiwan National Health Interview Survey. Obesity and overweight were defined as a body mass index (BMI) ⩾27 and 24-26.9 (kg/m2), respectively. Data on BMI and other covariates at baseline were collected by in-person interviews. Incident cases of active TB were identified from the National Health Insurance database. Multivariable logistic regression was used to estimate the associations of obesity and overweight with active TB, with adjustment for age, sex, smoking, alcohol consumption, socioeconomic status and other covariates.

RESULTS:

In total, 241 new cases of active TB occurred during the study period. Obesity (adjusted odds ratio [AOR], 0.43; 95% confident interval [CI], 0.28-0.67) and overweight (AOR, 0.67; 95% CI, 0.49-0.91) were associated with lower risk of incident TB, after adjusting for demographic characteristics and comorbidities. There was a linear dose-response relation of BMI with active TB incidence (AOR per unit change in BMI, 0.92; 95% CI, 0.88-0.95; P <0.001).

CONCLUSION:

Obesity and overweight are associated with lower risk of active TB. Future studies should investigate the underlying mechanisms and clinical and epidemiological consequences of these findings.

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Food components and ocular pathophysiology: a critical appraisal of the role of oxidative mechanisms.

Raman R, Vaghefi E, Braakhuis AJ.

Asia Pac J Clin Nutr. 2017;26(4):572-585. doi: 10.6133/apjcn.082016.01.

PMID: 28582804

Abstract

BACKGROUND AND OBJECTIVES:

Three of the major ocular diseases, namely cataracts, age-related macular degeneration and glaucoma are associated with oxidative damage. Disease risk and progression may be reduced through consumption of dietary components. To critically examine the literature on dietary and supplemental intakes of fruit and vegetables, meat, antioxidants (vitamins C, E and A), calcium, folate, iron, and their association with ocular disease.

METHODS AND STUDY DESIGN:

Google Scholar and key references from texts and publications were searched using search terms (eye disease, antioxidants), (vision, nutrition), no date restriction, only articles in English were included.

RESULTS:

We found probable evidence that dietary intake of fruits and vegetables, and vitamin C lowered incidence of cataracts and age-related macular degeneration. In high supplemental doses, vitamin C increases macular degeneration risk. Vitamin A from food was protective for cataracts and glaucoma, but not in supplemental form. Vitamin A was associated with lower incidence of macular degeneration. We also found probable evidence that higher intakes of meat increased the risk of cataracts and macular degeneration. Dietary calcium and iron appeared protective against glaucoma, but not in supplemental form.

CONCLUSIONS:

While a nutrient rich diet high in fruit and vegetables, and associated antioxidants appeared to be protective, we would caution intake of supplementary antioxidants for those with ocular disease.

 

Satisfying America's Fruit Gap: Summary of an Expert Roundtable on the Role of 100% Fruit Juice.

Byrd-Bredbenner C, Ferruzzi MG, Fulgoni VL 3rd, Murray R, Pivonka E, Wallace TC.

J Food Sci. 2017 Jun 6. doi: 10.1111/1750-3841.13754. [Epub ahead of print] Review.

PMID: 28585690

http://sci-hub.cc/10.1111/1750-3841.13754

Abstract

The 2015 to 2020 Dietary Guidelines for Americans (DGAs) recognize the role of 100% fruit juice in health and in helping people meet daily fruit recommendations and state that 100% fruit juice is a nutrient-dense beverage that should be a primary choice, along with water and low-fat/fat-free milk. The DGAs note that children are consuming 100% fruit juice within recommendations (that is, 120 to 180 mL/d for children aged 1 to 6 y and 236 to 355 mL/d for children aged 7 to 18 y). Evidence shows that compared to nonconsumers, those who consume 100% fruit juice come closer to meeting daily fruit needs and have better diet quality. In children, 100% fruit juice is associated with increased intakes of nutrients such as vitamin C, folate, and potassium. When consumed within the DGA recommendations, 100% fruit juice is not associated with overweight/obesity or childhood dental caries and does not compromise fiber intake. Preliminary data suggest that polyphenols in some 100% fruit juices may inhibit absorption of naturally occurring sugars. Given its role in promoting health and in helping people meet fruit needs, experts participating in a roundtable discussion agreed that there is no science-based reason to restrict access to 100% fruit juice in public health nutrition policy and programs such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Reducing or eliminating 100% fruit juice could lead to unintended consequences such as reduced daily fruit intake and increased consumption of less nutritious beverages (for example, sugar-sweetened beverages).

KEYWORDS:

100% fruit juice; diet quality; dietary guidelines; nutrient intake; nutrition policy

"Author Disclosures: CBB has no conflicts of interest to disclose; MGF

is a member of the Advisory Boards for Alliance for Potato Research and

Education, Sensient Technologies, and Welch’s. MGF is consultant for General

Mills and Unilever and has research funded, in part, by General Mills, Welch’s,

Pepsico Global, and Alliance for Potato Research and Education; VLF III is the

Senior Vice President of Nutrition Impact LLC, where performs consulting

and database analyses for various food and beverage companies and related

entities; RM is a member of the Speaker’s Bureau for National Dairy Council

and Abbott Nutrition, a consultant for Dannon Co., Sabra Dipping Co.,

Egg Nutrition Board, Hass Avocado Board, and National Cattlemen’s Beef

Association; EP is the CEO of the Produce for Better Health, which receives

contributions from more than 350 members of the fruit/vegetable industry,

including $10000 annually from Welch’s; TCW is the Principal Consultant

at Think Healthy Group, LLC, performs consulting and clinical research for

various food, beverage and dietary supplement companies.

All authors received an honorarium for their participation in the roundtable,

which was hosted by Welch’s and facilitated by FoodMinds LLC, a food and

nutrition communications and consulting company that works with Welch’s."

 

Discrimination ability of comorbidity, frailty, and subjective health to predict mortality in community-dwelling older people: Population based prospective cohort study.

Kusumastuti S, Gerds TA, Lund R, Mortensen EL, Westendorp RGJ.

Eur J Intern Med. 2017 Jun 2. pii: S0953-6205(17)30214-5. doi: 10.1016/j.ejim.2017.05.016. [Epub ahead of print]

PMID: 28583408

http://sci-hub.cc/10.1016/j.ejim.2017.05.016

Abstract

OBJECTIVE:

To investigate the added value of comorbidity, frailty, and subjective health to mortality predictions in community-dwelling older people and whether it changes with increasing age.

PARTICIPANTS:

36,751 community-dwelling subjects aged 50-100 from the longitudinal Survey of Health, Ageing, and Retirement in Europe.

METHODS:

Mortality risk associated with Comorbidity Index, Frailty Index, Frailty Phenotype, and subjective health was analysed using Cox regression. The extent to which health indicators modified individual mortality risk predictions was examined and the added ability to discriminate mortality risks was assessed.

MAIN OUTCOME MEASURES:

Three-year mortality risks, hazard ratios, change in individual mortality risks, three-year area under the receiver operating characteristic curve (AUC).

RESULTS:

Three-year mortality risks increased 41-folds within an age span of 50years. Hazard ratios per change in health indicator became less significant with increasing age (p-value<0·001). AUC for three-year mortality prediction based on age and sex was 76·9% (95% CI 75·5% to 78·3%). Information on health indicators modified individual three-year mortality risk predictions up to 30%, both upwards and downwards, each adding <2% discriminative power. The added discrimination ability of all health indicators gradually declined from an extra 4% at age 50-59 to <1% in the oldest old. Trends were similar for one-year mortality and not different between sexes, levels of education, and household income.

CONCLUSION:

Calendar age encompasses most of the discrimination ability to predict mortality. The added value of comorbidity, frailty, and subjective health to mortality predictions decreases with increasing age.

KEYWORDS:

Mortality; Old age; Prognosis; Risk assessment; Survival analysis

 

Male Centenarians: How and Why Are They Different from Their Female Counterparts?

Perls TT.

J Am Geriatr Soc. 2017 Jun 6. doi: 10.1111/jgs.14978. [Epub ahead of print] No abstract available.

PMID: 28586117

http://onlinelibrary.wiley.com.sci-hub.cc/doi/10.1111/jgs.14978/abstract

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

Characteristics and Incidence of Chronic Illness in Community-Dwelling Predominantly Male U.S. Veteran Centenarians.

Kheirbek RE, Fokar A, Shara N, Bell-Wilson LK, Moore HJ, Olsen E, Blackman MR, Llorente MD.

J Am Geriatr Soc. 2017 Apr 19. doi: 10.1111/jgs.14900. [Epub ahead of print]

PMID: 28422270

http://sci-hub.cc/10.1111/jgs.14900

Abstract

Abstract

OBJECTIVES:

To assess the incidence of chronic illness and its effect on veteran centenarians.

DESIGN:

Retrospective longitudinal cohort study.

SETTING:

United States Veterans Affairs Corporate Data Warehouse (CDW).

PARTICIPANTS:

Community-dwelling veterans born between 1910 and 1915 who survived to at least age 80 (N = 86,892; 31,121 octogenarians, 52,420 nonagenarians, 3,351 centenarians).

MEASUREMENTS:

The Kaplan-Meier method was used to estimate cumulative incidence of chronic conditions according to age group. Incidence rates were compared using the log-rank test. Cox proportional hazards models were used to estimate unadjusted hazard ratios.

RESULTS:

Ninety-seven percent of Centenarians were male, 88.0% were white, 31.8% were widowed, 87.5% served in World War II, and 63.9% did not have a service-related disability. The incidence rates of chronic illnesses were higher in octogenarians than centenarians (atrial fibrillation, 15.0% vs 0.6%, P < .001; heart failure, 19.3% vs 0.4%, P < .001; chronic obstructive pulmonary disease, 17.9% vs 0.6%, P < .001; hypertension, 29.6% vs 3.0%, P < .001; end-stage renal disease, 7.2% vs 0.1%, P < .001; malignancy, 14.1% vs 0.6%, P < .001; diabetes mellitus, 11.1% vs 0.4%, P < .001; stroke, 4.6% vs 0.4%, P < .001) and in nonagenarians than centenarians (atrial fibrillation, 13.2% vs 3.5%, P < .001; heart failure, 15.8% vs 3.3%, P < .001; chronic obstructive pulmonary disease, 11.8% vs 3.5%, P < .001; hypertension, 27.2% vs 12.8%, P < .001; end-stage renal disease, 11.9% vs 4.5%, P < .001; malignancy, 8.6% vs 2.3%, P < .001; diabetes mellitus, 7.5% vs 2.2%, P < .001; and stroke, 3.5% vs 1.3%, P < .001).

CONCLUSION:

In a large cohort of predominantly male community-dwelling elderly veterans, centenarians had a lower incidence of chronic illness than those in their 80s and 90s, demonstrating similar compression of morbidity and extension of health span observed in other studies.

KEYWORDS:

centenarians; chronic illness; incidence; nonagenarians; octogenarians; veterans

 

Deletion of ghrelin prevents aging-associated obesity and muscle dysfunction without affecting longevity.

Guillory B, Chen JA, Patel S, Luo J, Splenser A, Mody A, Ding M, Baghaie S, Anderson B, Iankova B, Halder T, Hernandez Y, Garcia JM.

Aging Cell. 2017 Jun 6. doi: 10.1111/acel.12618. [Epub ahead of print]

PMID: 28585250

Abstract

During aging, decreases in energy expenditure and locomotor activity lead to body weight and fat gain. Aging is also associated with decreases in muscle strength and endurance leading to functional decline. Here, we show that lifelong deletion of ghrelin prevents development of obesity associated with aging by modulating food intake and energy expenditure. Ghrelin deletion also attenuated the decrease in phosphorylated adenosine monophosphate-activated protein kinase (pAMPK) and downstream mediators in muscle, and increased the number of type IIa (fatigue resistant, oxidative) muscle fibers, preventing the decline in muscle strength and endurance seen with aging. Longevity was not affected by ghrelin deletion. Treatment of old mice with pharmacologic doses of ghrelin increased food intake, body weight, and muscle strength in both ghrelin wild-type and knockout mice. These findings highlight the relevance of ghrelin during aging and identify a novel AMPK-dependent mechanism for ghrelin action in muscle.

KEYWORDS:

Sarcopenia; frailty; growth hormone; growth hormone secretagogue receptor; inflammation; wasting

 

Dietary behaviours, weight loss attempts and change in waist circumference: 15-year longitudinal study in Australian adults.

Arabshahi S, Lahmann PH, Hughes MC, Williams GW, van der Pols JC.

Asia Pac J Clin Nutr. 2017;26(4):657-664. doi: 10.6133/apjcn.062016.04.

PMID: 28582816 Free Article

Abstract

BACKGROUND AND OBJECTIVES:

Dietary behaviours are suitable as clearly identifiable targets of dietary counselling to prevent weight gain. We therefore investigated associations between dietary behaviours, weight loss attempts and waist circumference change.

METHODS AND STUDY DESIGN:

Participants were a community-based sample population residing in Nambour, Australia, including 1,317 adults, aged 25-75 years at baseline. Waist circumference was measured in 1992 and 2007, and dietary behaviours data were derived concurrently from repeated self-completed short dietary questions. Multivariable models, stratified by sex, were adjusted for potential confounders.

RESULTS:

In men, consumption of visible fat on meat and in women, weight loss attempts in the last 10 years were the most important predictors of waist circumference gain independent of socio-demographic and lifestyle characteristics and energy intake. Men who consumed most visible fat on meat had a 2.6 times larger yearly increase in waist circumference than men who tended to cut the fat off meat: 0.47 (95% CI 0.23, 0.72) vs 0.18 (95% CI 0.01, 0.34) cm/year, p=0.01. Women who reported that they were always trying to lose weight had a 2.7 times larger yearly increase in waist circumference than women who never tried to lose weight: 0.78 (0.54, 1.02) vs 0.29 (0.06, 0.52) cm/year, p=0.0001. Other dietary behaviours were not associated with change in waist circumference.

CONCLUSIONS:

Consumption of visible fat on meat by men and more frequent attempts to lose weight by women were main dietary behaviours associated with gain in abdominal adiposity in Australian adults.

 

High consumption of salt-fermented vegetables and hypertension risk in adults: a 12-year follow-up study.

Song HJ, Park SJ, Jang DJ, Kwon DY, Lee HJ.

Asia Pac J Clin Nutr. 2017;26(4):698-707. doi: 10.6133/apjcn.042016.13.

PMID: 28582822 Free Article

Abstract

BACKGROUND AND OBJECTIVES:

The aim of this study was to investigate the causal relationship between high consumption of salt-fermented vegetables and hypertension risk in adults.

METHODS AND STUDY DESIGN:

Data came from the Korean Genome and Epidemiology Study, an ongoing community-based cohort study that began in 2001. In the final analysis, a total of 5,932 participants (men=2,822, women=3,110) was included. Daily energy, nutrient, and major salt-fermented vegetables for Korean (kimchi) intakes were assessed using a semi-quantitative food frequency questionnaire. Relative risks and 95% CIs associated with kimchi intake by gender and body mass index (BMI) were estimated using the multivariate Cox proportional hazards regression model.

RESULTS:

Out of the 5,932 participants, 1,798 (905 men, 893 women) developed hypertension during the 12-year follow-up period. A significant difference in baseline BMI was shown between the non-hypertension and hypertension groups. There was no significant difference with regard to the risk of developing hypertension across quintiles for total kimchi intake and quartile or quartiles for specific kimchi intake in multivariate models by gender and baseline BMI. The trend for increased risk of hypertension according to increasing quartile of watery kimchi intake was significant for obese men in the multivariate model (p<0.05).

CONCLUSION:

High consumption of salt-fermented vegetables was not shown to be associated with increased risk of hypertension. The trend for increased risk of hypertension according to increasing quartile of watery kimchi intake was significant only in obese men.

 

Long-term a posteriori dietary patterns and risk of hip fractures in a cohort of women.

Warensjö Lemming E, Byberg L, Melhus H, Wolk A, Michaëlsson K.

Eur J Epidemiol. 2017 Jun 5. doi: 10.1007/s10654-017-0267-6. [Epub ahead of print]

PMID: 28585122

Abstract

Dietary pattern analysis is a useful tool to study the importance of food components in the context of a diet and how they relate to health and disease. The association between dietary patterns and fractures is at present uncertain. We aimed to study associations between dietary patterns and risk of hip fracture in the Swedish Mammography Cohort, including 56,736 women (median baseline age 52 years). Diet data was collected in food frequency questionnaires at two investigations and dietary patterns were defined by principal component analysis using 31 food groups. Information on hip fractures was collected from the Swedish National Patient Register. Multivariable adjusted hazard ratios (HR) with 95% confidence intervals (CI) were estimated in Cox proportional hazards regression analysis. The two patterns identified-the healthy and Western/convenience dietary patterns-were time-updated and analysed. During a median follow-up time of 25.5 years, 4997 women experienced a hip fracture. Hip fracture rate was 31% lower in the highest compared to the lowest quartile of the healthy dietary pattern [hr (95% CI) 0.69 (0.64; 0.75)]. In contrast, women in the highest compared to the lowest quartile of the Western/convenience dietary pattern had a 50% higher [hr (95% CI) 1.50 (1.38; 1.62)] hip fracture rate. Further, in each stratum of a Western/convenience dietary pattern a higher adherence to a healthy dietary pattern was associated with less hip fractures. The present results suggest that a varied healthy diet may be beneficial for the prevention of fragility fractures in women.

KEYWORDS:

Dietary pattern; Food frequency questionnaire; Healthy dietary pattern; Hip fractures; Principal component analysis; Western dietary pattern

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Effect of probiotic Lactobacillus on lipid profile: A systematic review and meta-analysis of randomized, controlled trials.

Wu Y, Zhang Q, Ren Y, Ruan Z.

PLoS One. 2017 Jun 8;12(6):e0178868. doi: 10.1371/journal.pone.0178868. eCollection 2017.

PMID: 28594860

Abstract

OBJECTIVE:

To assess the efficacy of probiotic Lactobacillus on serum lipids using a meta-analysis of randomized, controlled trials.

METHODS:

Fifteen studies containing 15 trials, with 976 subjects were included. The pooled WMD was calculated by random effects model.

RESULTS:

Probiotic Lactobacillus consumption significantly reduced TC by 0.26mmol/l (95% CI, -0.40 to -0.12) and LDL-C by 0.23mmol/l (95% CI, -0.36 to -0.10). Subgroup analysis of trials found significantly reduction of TC using L. plantarum and reduction of LDL-C using L. plantarum or L. reuteri. No significant effects were found on TG and HDL-C levels after supplementation with probiotic Lactobacillus. While, subgroup analysis found significantly beneficial effects on TG and HDL-C by consuming synbiotic food, containing L. sporogenes and inulin.

CONCLUSION:

Consuming probiotic Lactobacillus, especially L. reuteri and L. plantarm, could reduce TC and LDL-C significantly. The study also suggested significantly beneficial effects on TG and HDL-C by consuming synbiotic food, containing L. sporogenes and inulin.

 

Effects of vitamin D or its analogues on the mortality of patients with chronic kidney disease: an updated systematic review and meta-analysis.

Lu RJ, Zhu SM, Tang FL, Zhu XS, Fan ZD, Wang GL, Jiang YF, Zhang Y.

Eur J Clin Nutr. 2017 Jun;71(6):683-693. doi: 10.1038/ejcn.2017.59. Epub 2017 May 10. Review.

PMID: 28488689

Abstract

The objective of this study was to assess whether vitamin D (VD) treatment alters the overall all-cause and cardiovascular mortalities in a chronic kidney disease (CKD) population. We systematically searched PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials without language restriction, until the publication date of 22 February 2016. All related literatures that compared VD treatment with non-VD treatment and reported the mortality of patients with CKD (including those undergoing dialysis) were identified. Pooled risk ratios (RR) and 95% confidence intervals (CI) were calculated by using the random- and fixed-effects models. Randomised controlled trials (RCTs) that used the intention-to-treat principle and observational studies (OSs) were analysed separately. For this study, 38 studies involving 223 429 patients (17 RCTs, n=1819 and 21 OSs, n=221610) were included. In the OSs, VD treatment was significantly associated with reductions in both all-cause and cardiovascular mortalities; however, such significant association was not found in the RCTs. The existing RCTs do not provide sufficient or precise evidence that VD supplementation affects the mortality of patients with CKD, although subsets of patients that could potentially benefit from VD treatment can be identified by using the existing data from the RCTs. Nevertheless, large-size RCTs are needed in the future to assess any potential differences in survival prospectively.

 

Income and Cancer Overdiagnosis — When Too Much Care Is Harmful

H. Gilbert Welch, M.D., M.P.H., and Elliott S. Fisher, M.D., M.P.H.

N Engl J Med 2017; 376:2208-2209June 8, 2017DOI: 10.1056/NEJMp1615069

http://sci-hub.cc/10.1056/NEJMp1615069

There are reasons to wonder whether people with higher incomes receive too much medical care. Cancer screening is one area where overutilization can cause harm, resulting in overdiagnosis and potentially unnecessary treatment.

 

Synchronic inverse seasonal rhythmus of energy density of food intake and sleep quality: a contribution to chrono-nutrition from a Polish adult population.

Stelmach-Mardas M, Iqbal K, Mardas M, Schwingshackl L, Walkowiak J, Tower RJ, Boeing H.

Eur J Clin Nutr. 2017 Jun;71(6):718-722. doi: 10.1038/ejcn.2016.229. Epub 2016 Nov 30.

PMID: 27901029

Abstract

BACKGROUND/OBJECTIVES:

There is evidence which suggests that sleep behavior and dietary intake are interlinked. Thus, we investigated whether a seasonal rhythm in food-energy density exists, and how this relates to quality of sleep.

SUBJECTS/METHODS:

Two hundred and thirty adult volunteers were investigated across the four seasons. Anthropometrical measurements were obtained and The Pittsburgh Sleep Quality Index was used for an assessment of sleep quality and disturbances. The dietary intake was evaluated using a 24 h dietary recall. Generalized estimating equations were used to estimate seasonal changes in energy density and sleep quality, as well as the association of energy density with sleep quality. All analyses were adjusted for age, sex, education, occupation and shift-work.

RESULTS:

Mean food energy density was significantly higher in winter as compared with other seasons (P<0.05), although no seasonal variations were observed in macronutrient intake (fat and protein). Overall, the sleep quality was low (score value >5) in all seasons, with the lowest quality occurring in winter and the highest in spring (P<0.05). The components of sleep quality score showed that winter had statistically (P<0.05) poorer subjective sleep quality, sleep latency and sleep disturbances, but lower daytime dysfunction compared with spring and summer. After adjusting for seasonal effects (correlated outcome data) and shift-work, energy density was found to be inversely associated (P<0.0001) with sleep quality.

CONCLUSIONS:

An inverse association between seasonal fluctuation of food energy density and sleep quality was found with winter time, associated with the intake of higher energy dense food products and the lowest sleep quality.

 

Vegetarian diet as a risk factor for symptomatic gallstone disease.

McConnell TJ, Appleby PN, Key TJ.

Eur J Clin Nutr. 2017 Jun;71(6):731-735. doi: 10.1038/ejcn.2016.252. Epub 2017 Mar 8.

PMID: 28272400

Abstract

BACKGROUND/OBJECTIVES:

Previous small studies have shown either no difference or a lower risk of symptomatic gallstone disease in vegetarians than in non-vegetarians. This study examined the incidence of symptomatic gallstone disease in a cohort of British vegetarians and non-vegetarians, and investigated the associations between nutrient intake and risk of symptomatic gallstone disease.

SUBJECTS/METHODS:

The data were analysed from 49 652 adults enroled in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Oxford study, one-third of whom were vegetarian. The linked databases of hospital records were used to identify incident cases. Risk by diet group was estimated using Cox proportional hazards models. Further analysis quantified risk by intakes of selected macronutrients.

RESULTS:

There were 1182 cases of symptomatic gallstone disease during 687 822 person-years of follow-up (mean=13.85 years). There was a large significant association between increasing body mass index (BMI) and risk of developing symptomatic gallstone disease (overall trend P<0.001). After adjustment for BMI and other risk factors, vegetarians had a moderately increased risk compared with non-vegetarians (HR: 1.22; 95% CI: 1.06-1.41; P=0.006). Although starch consumption was positively associated with gallstones risk (P=0.002 for trend), it did not explain the increased risk in vegetarians.

CONCLUSIONS:

There is a highly significant association of increased BMI with risk of symptomatic gallstone disease. After adjusting for BMI, there is a small but statistically significant positive association between vegetarian diet and symptomatic gallstone disease.

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Ketones and Human Performance.

Scott JM, Deuster PA.

J Spec Oper Med. 2017 Summer;17(2):112-116.

PMID: 28599043

Abstract

Everyone is seeking nutritional strategies that might benefit performance. One approach receiving much attention is ketones, or ketosis. Ketones are very simple compounds made of hydrogen, carbon, and oxygen, and ketosis is a metabolic state whereby the body uses predominantly ketones. Ketosis can be achieved by fasting for longer than 72 hours or by following a very lowcarbohydrate, high-fat diet (ketogenic diet) for several days to weeks. Alternatively, ketone supplements purportedly induce ketosis rapidly and do not require strict adherence to any specific type of diet; however, much of the touted benefits are anecdotal. A potential role for ketosis as a performance enhancer was first introduced in 1983 with the idea that chronic ketosis without caloric restriction could preserve submaximal exercise capability by sparing glycogen or conserving the limited carbohydrate stores. Few human studies on the effects of a ketogenic diet on performance have yielded positive results, and most studies have yielded equivocal or null results, and a few negative results. Many questions about ketones relevant to Special Operations Forces (SOF) remain unanswered. At present, a ketogenic diet and/or a ketone supplement do not appear confer performance benefits for SOF. Instead, Operators should engage with their unit dietitian to develop individualized nutritional strategies based on unique mission requirements. The authors review the concept of a ketogenic diet, describe some potential benefits and risks of ketosis, review the performance literature and how to measure ketone status, and then summarize the landscape in 2017.

 

Rapamycin reduces <i>Drosophila</i> longevity under low nutrition.

Villa-Cuesta E, Fan F, Rand DM.

IOSR J Pharm. 2014 Aug;4(8):43-51. doi: 10.9790/3013-0408043051.

PMID: 28593179

Abstract

Rapamycin treatment is considered a pharmacological intervention with the potential to mimic the longevity benefits of dietary manipulations. However, how rapamycin interacts with nutrition is not fully understood. Here we studied the effect of rapamycin on the longevity of Drosophila under a range of dietary conditions. In diets low in nutrients, rapamycin reduced longevity in a dosage-dependent manner. This dosage effect requires some nutrients as rapamycin has no impact on survival under starvation conditions. Under a balanced diet of yeast and sugar, rapamycin had no repeatable beneficial effect on organismal longevity. These results show that the effect of rapamycin on longevity is sensitive to the nutritional environment and it can reduce lifespan when nutrients are limited.

KEYWORDS:

Longevity; Nutrition; Rapamycin

 

Intake of dairy foods and risk of Parkinson disease.

Hughes KC, Gao X, Kim IY, Wang M, Weisskopf MG, Schwarzschild MA, Ascherio A.

Neurology. 2017 Jun 8. pii: 10.1212/WNL.0000000000004057. doi: 10.1212/WNL.0000000000004057. [Epub ahead of print]

PMID: 28596209

Abstract

OBJECTIVE:

To prospectively examine the association between commonly consumed dairy products and the risk of Parkinson disease (PD) in women and men.

METHODS:

Analyses were based on data from 2 large prospective cohort studies, the Nurses' Health Study (n = 80,736) and the Health Professionals Follow-up Study (n = 48,610), with a total of 26 and 24 years of follow-up, respectively. Both US-based studies were conducted via mailed biennial questionnaires. Dietary intake was assessed with food frequency questionnaires administered repeatedly over the follow-up period. Incident cases of PD (n = 1,036) were identified via questionnaires and subsequently confirmed by reviewing medical records. We also conducted a meta-analysis to combine our study with 3 previously published prospective studies on total milk intake and PD risk and 1 study on total dairy intake and PD risk.

RESULTS:

While total dairy intake was not significantly associated with PD risk in our cohorts, intake of low-fat dairy foods was associated with PD risk. The pooled, multivariable-adjusted hazard ratio (HR) comparing people who consumed at least 3 servings of low-fat dairy per day to those who consumed none was 1.34 (95% confidence interval [CI] 1.01-1.79, p trend = 0.04). This association appeared to be driven by an increased risk of PD associated with skim and low-fat milk (HR 1.39, 95% CI 1.12-1.73, p trend <0.01). Results were similar in women and men (p for heterogeneity >0.05). In the meta-analysis, the pooled relative risk comparing extreme categories of total milk intake was 1.56 (95% CI 1.30-1.88), and the association between total dairy and PD became significant (HR 1.27, 95% CI 1.04-1.55).

CONCLUSIONS:

Frequent consumption of dairy products appears to be associated with a modest increased risk of PD in women and men.

 

Association of Vegetable Nitrate Intake With Carotid Atherosclerosis and Ischemic Cerebrovascular Disease in Older Women.

Bondonno CP, Blekkenhorst LC, Prince RL, Ivey KL, Lewis JR, Devine A, Woodman RJ, Lundberg JO, Croft KD, Thompson PL, Hodgson JM.

Stroke. 2017 Jun 8. pii: STROKEAHA.117.016844. doi: 10.1161/STROKEAHA.117.016844. [Epub ahead of print]

PMID: 28596448

Abstract

BACKGROUND AND PURPOSE:

A short-term increase in dietary nitrate (NO3-) improves markers of vascular health via formation of nitric oxide and other bioactive nitrogen oxides. Whether this translates into long-term vascular disease risk reduction has yet to be examined. We investigated the association of vegetable-derived nitrate intake with common carotid artery intima-media thickness (CCA-IMT), plaque severity, and ischemic cerebrovascular disease events in elderly women (n=1226).

METHODS:

Vegetable nitrate intake, lifestyle factors, and cardiovascular disease risk factors were determined at baseline (1998). CCA-IMT and plaque severity were measured using B-mode carotid ultrasound (2001). Complete ischemic cerebrovascular disease hospitalizations or deaths (events) over 14.5 years (15 032 person-years of follow-up) were obtained from the West Australian Data Linkage System.

RESULTS:

Higher vegetable nitrate intake was associated with a lower maximum CCA-IMT (B=-0.015, P=0.002) and lower mean CCA-IMT (B=-0.012, P=0.006). This relationship remained significant after adjustment for lifestyle and cardiovascular risk factors (P≤0.01). Vegetable nitrate intake was not a predictor of plaque severity. In total 186 (15%) women experienced an ischemic cerebrovascular disease event. For every 1 SD (29 mg/d) higher intake of vegetable nitrate, there was an associated 17% lower risk of 14.5-year ischemic cerebrovascular disease events in both unadjusted and fully adjusted models (P=0.02).

CONCLUSIONS:

Independent of other risk factors, higher vegetable nitrate was associated with a lower CCA-IMT and a lower risk of an ischemic cerebrovascular disease event.

KEYWORDS:

atherosclerosis; cardiovascular disease; cerebrovascular disease; nitrates; vegetables

 

Insulin-like growth factor-1, IGF binding protein-3, and the risk of esophageal cancer in a nested case-control study.

Adachi Y, Nojima M, Mori M, Yamashita K, Yamano HO, Nakase H, Endo T, Wakai K, Sakata K, Tamakoshi A.

World J Gastroenterol. 2017 May 21;23(19):3488-3495. doi: 10.3748/wjg.v23.i19.3488.

PMID: 28596684

Abstract

AIM:

To assess the relationship between serum levels of insulin-like growth factor-1 (IGF1)/IGF-binding protein-3 (IGFBP3) and the risk of esophageal carcinoma.

METHODS:

We assessed the relationship between the serum levels of these molecules and the risk of esophageal cancer in a prospective, nested case-control study of participants from the Japan Collaborative Cohort Study. A baseline survey was conducted from 1988 to 1990. Of the 110585 enrolled participants, 35% donated blood samples. Those who had been diagnosed with esophageal cancer were considered cases for nested case-control studies. A conditional logistic model was used to estimate odds ratios for the incidence of esophageal cancer associated with serum IGF1 and IGFBP3 levels.

RESULTS:

Thirty-one cases and 86 controls were eligible for the present assessment. The molar ratio of IGF1/IGFBP3, which represents the free and active form of IGF1, was not correlated with the risk of esophageal carcinoma. A higher molar difference between IGFBP3 and IGF1, which estimates the free form of IGFBP3, was associated with a decreased risk of esophageal carcinoma (P = 0.0146), and people in the highest tertile had the lowest risk (OR = 0.107, 95%CI: 0.017-0.669). After adjustment for body mass index, tobacco use, and alcohol intake, the molar difference of IGFBP3-IGF1 was inversely correlated with the risk of esophageal carcinoma (P = 0.0150).

CONCLUSION:

The free form of IGFBP3, which is estimated by this molar difference, may be inversely associated with esophageal cancer incidence.

KEYWORDS:

Esophageal cancer; Insulin-like growth factor; Insulin-like growth factor binding protein; Nested case-control study; Odds ratio

 

https://en.wikipedia.org/wiki/Ursolic_acid#Natural_occurrence

https://en.wikipedia.org/wiki/Ursolic_acid#Potential_biochemical_effects

Effect of Ursolic Acid on Metabolic Syndrome, Insulin Sensitivity, and Inflammation.

Ramírez-Rodríguez AM, González-Ortiz M, Martínez-Abundis E, Acuña Ortega N.

J Med Food. 2017 Jun 9. doi: 10.1089/jmf.2017.0003. [Epub ahead of print]

PMID: 28598231

Abstract

To evaluate the effect of ursolic acid on metabolic syndrome, insulin sensitivity, and inflammation. A randomized, double-blind, placebo-controlled clinical trial was carried out in 24 patients (30-60 years) with a diagnosis of metabolic syndrome without treatment. They were randomly assigned to two groups of 12 patients, each to receive orally 150 mg of ursolic acid or homologated placebo once a day for 12 weeks. Before and after the intervention, the components of metabolic syndrome, insulin sensitivity (Matsuda index), and inflammation profile (interleukin-6 and C-reactive protein) were evaluated. After ursolic acid administration, the remission of metabolic syndrome occurred in 50% of patients (P = .005) with significant differences in body weight (75.7 ± 11.5 vs. 71 ± 11 kg, P = .002), body mass index (BMI) (29.9 + 3.6 vs. 24.9 ± 1.2 kg/m2, P = .049), waist circumference (93 ± 8.9 vs. 83 + 8.6 cm, P = .008), fasting glucose (6.0 ± 0.5 vs. 4.7 ± 0.4 mmol/L, P = .002), and insulin sensitivity (3.1 ± 1.1 vs. 4.2 ± 1.2, P = .003). Ursolic acid administration leads to transient remission of metabolic syndrome, reducing body weight, BMI, waist circumference and fasting glucose, as well as increasing insulin sensitivity.

KEYWORDS:

inflammation; insulin sensitivity; metabolic syndrome; ursolic acid

 

Efficacy of arginine-enriched enteral formulas for the healing of pressure ulcers: a systematic review.

Liu P, Shen WQ, Chen HL.

J Wound Care. 2017 Jun 2;26(6):319-323. doi: 10.12968/jowc.2017.26.6.319.

PMID: 28598762

Abstract

OBJECTIVE:

Arginine improves healing and modulates inflammation and the immune response. This systematic review aimed to assess the effect of arginine-enriched enteral formulas in pressure ulcer (PU) healing.

METHOD:

Systematic computerised searches of PubMed, Web of Knowledge, Scopus, ENTRAL and CINAHL databases were performed from their inception to 20 January 2016. Randomised controlled trials (RCTs) were included in this systematic review. We used the Jadad scale as a quality assessment tool.

RESULTS:

There were seven RCTs with 369 patients included in this systematic review; four RCTs assessed healing by PU area reduction. All of them reported arginine-enriched enteral nutrition led to a significant improved PU healing compared with standard hospital diet in 2-12 weeks follow-up. Among these four RCTs, one enrolled malnourished patients, one enrolled non-malnourished patients, and the other two studies did not restrict the nutritional status of the patients. Using the Pressure Ulcer Scale for Healing (PUSH) four RCTs assessed healing of PU, all reporting arginine-enriched enteral nutrition resulted in a significant PUSH score improvement compared with control at follow-up. Using the Pressure Sore Status Tool (PSST) one RCT assessed healing of PUs, finding patients receiving arginine had the lowest PSST scores compared with controls. An RCT compared healing with two doses of arginine (4.5g versus 9g), but no difference was found between the doses.

CONCLUSION:

Evidence showed that arginine-enriched enteral nutrition led to a significant improvement in PU healing. It was effective not only in malnourished patients, but also in non-malnourished patients.

KEYWORDS:

arginine; enteral nutrition; healing; pressure ulcer; systematic review

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Changes in perceived uselessness and risks for mortality: evidence from a National sample of older adults in China.

Zhao Y, Dupre ME, Qiu L, Gu D.

BMC Public Health. 2017 Jun 9;17(1):561. doi: 10.1186/s12889-017-4479-1.

PMID: 28599631

Abstract

BACKGROUND:

Self-perception of uselessness is associated with increased mortality risk in older adults. However, it is unknown whether and to what extent changes in perceived uselessness are associated with mortality risk.

METHODS:

Using four waves of national longitudinal data of older adults from China (2005, 2008, 2011, and 2014), this study examines the association between changes in perceived uselessness and risk of subsequent mortality. Perceived uselessness is classified into three major categories: high levels (always/often), moderate levels (sometimes), and low levels (seldom/never). Five categories are used to measure change over three-year intervals: (1) persistently high levels, (2) increases to moderate/high levels, (3) persistent moderate levels, (4) decreases to moderate/low levels, and (5) persistently low levels. Cox proportional hazard models were used to estimate mortality risk associated with changes in levels of perceived uselessness.

RESULTS:

Compared to those with persistently low levels of perceived uselessness, those with persistently high levels of feeling useless had 80% increased hazard ratio (HR) in mortality [hr 1.80, 95% CIs: 1.57-2.08, p < 0.001]; and those with increasing levels, persistently moderate levels, and decreasing levels of perceived uselessness had 42% [hr 1.42, 95% CIs: 1.27-159, p < 0.001], 50% [hr 1.50, 95% CIs: 1.32-1.71, p < 0.001], and 23% [hr 1.23, 95% CIs: 1.09-1.37, p < 0.001] increased hazard ratio in mortality, respectively, when background characteristics were taken into account. The associations were partially attenuated when socioeconomic, family/social support, behavioral, and health-related covariates were individually taken into account. Older adults with persistently high and moderate levels of perceived uselessness still exhibited significantly higher risks of mortality (16% [hr 1.16, 95% CIs: 1.00-1.135, p < 0.05] and 22% [hr 1.16, 95% CIs: 1.06-1.139, p < 0.015], respectively) after adjusting for all covariates, although no significant mortality risks were found for either increasing to moderate/high levels or decreasing to moderate/low levels of perceived uselessness.

CONCLUSIONS:

Persistently high and moderate levels of perceived uselessness are associated with significant increases in mortality risk. These findings have important implications for promoting successful aging in China.

KEYWORDS:

China; Older adults; Oldest-old; Perceived uselessness; Self-perceptions of aging; Young-old

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Diet quality is associated with reduced incidence of cancer and self-reported chronic disease: Observations from Alberta's Tomorrow Project.

Solbak NM, Xu JY, Vena JE, Csizmadi I, Whelan HK, Robson PJ.

Prev Med. 2017 Jun 7. pii: S0091-7435(17)30213-X. doi: 10.1016/j.ypmed.2017.06.009. [Epub ahead of print]

PMID: 28601618

Abstract

The objective of this study was to assess diet quality using the Healthy Eating Index-2005 Canada (HEI-2005-Canada) and its association with risk of cancer and chronic disease in a sample of Alberta's Tomorrow Project (ATP) participants. Food frequency questionnaires completed by 25,169 participants (38% men; mean age 50.3 (9.2)) enrolled between 2000 and 2008 were used to calculate HEI-2005-Canada scores. Data from a subset of participants (n=10,735) who reported no chronic disease at enrollment were used to investigate the association between HEI-2005-Canada score and development of self-reported chronic disease at follow-up (2008). Participants were divided into HEI-2005-Canada score quartiles. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for cancer and chronic disease incidence. In this cohort, mean HEI-2005-Canada scores for men and women were 50.9 and 55.5 (maximum range 0-100), respectively. In men, higher HEI-2005-Canada score (Q4 vs. Q1) was associated with lower cancer risk (HR (95% CI) 0.63 (0.49-0.83)) over the course of follow-up (mean (SD)=10.4 (2.3) years); the same was not observed in women. In contrast, higher overall HEI-2005-Canada score (Q4 vs. Q1) was associated with lower risk of self-reported chronic disease (0.85 (0.75-0.97)) in both men and women over follow-up (4.2 (2.3) years). In conclusion, in this cohort better diet quality was associated with a lower risk of cancer in men and lower risk of chronic disease in both sexes. Future studies with longer follow-up and repeated measures of diet may be helpful to elucidate sex-specific associations between dietary quality and disease outcomes.

KEYWORDS:

Chronic disease; Cohort studies; Diet; Incidence; Neoplasms; Nutrition policy (guidelines)

 

Are dietary vitamin D, omega-3 fatty acids and folate associated with treatment results in patients with early rheumatoid arthritis? Data from a Swedish population-based prospective study.

Lourdudoss C, Wolk A, Nise L, Alfredsson L, Vollenhoven RV.

BMJ Open. 2017 Jun 10;7(6):e016154. doi: 10.1136/bmjopen-2017-016154.

PMID: 28601838

Abstract

BACKGROUND:

Dietary intake of vitamin D and omega-3 fatty acids (FA) may be associated with superior response to antirheumatic treatments. In addition, dietary folate intake may be associated with worse response to methotrexate (MTX). The aim of this study was to investigate the association between dietary vitamin D, omega-3 FA, folate and treatment results of disease-modifying antirheumatic drugs (DMARDs) in patients with rheumatoid arthritis (RA).

METHODS:

This prospective study was based on data from the Epidemiological Investigation of Rheumatoid Arthritis (EIRA) study, and included 727 patients with early RA from 10 hospitals in Sweden. Data on dietary vitamin D, omega-3 FA and folate intake based on food frequency questionnaires were linked with data on European League Against Rheumatism (EULAR) response after 3 months of DMARD treatment. Associations between vitamin D, omega-3 FA, folate and EULAR response were analysed with logistic regression adjusted for potential confounders.

RESULTS:

The majority of patients (89.9%) were initially treated with MTX monotherapy and more than half (56.9%) with glucocorticoids. Vitamin D and omega-3 FA were associated with good EULAR response (OR 1.80 (95% CI 1.14 to 2.83) and OR 1.60 (95% CI 1.02 to 2.53), respectively). Folate was not significantly associated with EULAR response (OR 1.20 (95% CI 0.75 to 1.91)). Similar results were seen in a subgroup of patients who were initially treated with MTX monotherapy at baseline.

CONCLUSIONS:

Higher intake of dietary vitamin D and omega-3 FA during the year preceding DMARD initiation may be associated with better treatment results in patients with early RA. Dietary folate intake was not associated with worse or better response to treatment, especially to MTX. Our results suggest that some nutrients may be associated with enhanced treatment results of DMARDs.

KEYWORDS:

Epidemiology; Nutrition & Dietetics; Rheumatology

 

A systematic review of peer-supported interventions for health promotion and disease prevention.

Ramchand R, Ahluwalia SC, Xenakis L, Apaydin E, Raaen L, Grimm G.

Prev Med. 2017 Jun 7. pii: S0091-7435(17)30212-8. doi: 10.1016/j.ypmed.2017.06.008. [Epub ahead of print] Review.

PMID: 28601621

Abstract

Prior research has examined peer programs with respect to specific peer roles (e.g.; peer support) or specific health/wellness domains (e.g.; exercise/diet), or have aggregated effects across roles and domains. We sought to conduct a systematic review that categorizes and assesses the effects of peer interventions to promote health and wellness by peer role, intervention type, and outcomes. We use evidence mapping to visually catalog and synthesize the existing research. We searched PubMed and WorldCat databases (2005 to 2015) and New York Academy of Medicine Grey Literature Report (1999 to 2016) for English-language randomized control trials. We extracted study design, study participants, type of intervention(s), peer role(s), outcomes assessed and measures used, and effects from 116 randomized controlled trials. Maps were created to provide a visual display of the evidence by intervention type, peer role, outcome type, and significant vs null or negative effects. There are more null than positive effects across peer interventions, with notable exceptions: group-based interventions that use peers as educators or group facilitators commonly improve knowledge, attitudes, beliefs, and perceptions; peer educators also commonly improved social health/connectedness and engagement. Dyadic peer support influenced behavior change and peer counseling shows promising effects on physical health outcomes. Programs seeking to use peers in public health campaigns can use evidence maps to identify interventions that have previously demonstrated beneficial effects. Those seeking to produce health outcomes may benefit from identifying the mechanisms by which they expect their program to produce these effects and associated proximal outcomes for future evaluations.

PROSPERO REGISTRATION NUMBER:

Although we attempted to register our protocol with PROSPERO, we did not meet eligibility criteria because we were past the data collection phase. The full PROSPERO-aligned protocol is available from the authors.

KEYWORDS:

Peer group; Peer influence; Review

 

GREY HAIR LINKED WITH INCREASED HEART DISEASE RISK IN MEN

08 APR 2017

Topic(s): Prevention

Malaga, Spain

– 8 April 2017:

Grey hair has been linked with an increased risk of heart disease in men, in research presented today at EuroPrevent 2017.1

https://www.escardio.org/Sub-specialty-communities/European-Association-of-Preventive-Cardiology-(EAPC)/News/grey-hair-linked-with-increased-heart-disease-risk-in-men

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Abstract: 760

The degree of hair graying in male gender as an independent risk factor for coronary artery disease, a prospective study

Authors:

AMR Elfaramawy1, IRINI Samuel1, REHAM Darweesh1, AHMED Shehata1, HEBA Farouk1, HOSSAM Kandil1, 1Cairo University, Kasr Al-Ainy Hospital-Faculty of Medicine, Department of Cardiology - Cairo - Egypt,

Topic(s):

Risk factors: others

Citation:

European Journal of Preventive Cardiology ( April 2017 ) 24 ( Supplement 1 ), 168

Background: Cardiovascular disease is a leading cause of death worldwide. Aging is an unavoidable coronary risk factor and is associated with dermatological signs that could be a marker for increase coronary risk. We tested the hypothesis that hair graying as a visible marker of aging is associated with risk of coronary artery disease independent of chronological age

Method: This prospective observation study included 545 adult males who underwent a multi-slice computed tomography coronary angiography (MSCT CA) for suspicion of coronary artery disease (CAD), patients were divided into different subgroups according to the percentage of gray/white hairs (Hair Whitening Score, HWS: 1-5) and to absence or presence of CAD

Results: CAD was prevalent in 80% of our studied population, (46.8 %) had three vessels disease with mean age of 53.2 ± 10.7 yrs. Hypertension, diabetes and dyslipidemia were more prevalent in CAD group (P=0.001, P=0.001, and P=0.003 respectively). Patients with CAD had statistically significant higher HWS (3 or more, predominately white hair), (32.1 % Vs 60.1 %, p < 0.001) and significant coronary artery calcification (<0.001). Multivariate regression analysis showed that age (OR: 2.40, 95% CI: [1.31-4.39], p= 0.004), Hair Whitening Score (OR: 1.31, 95% CI: [1.09-1.57], p= 0.004), hypertension (OR: 1.63, 95% CI: [1.03-2.58], p=0.036), and dyslipidemia (OR: 1.61, 95% CI: [1.02-2.54], p=0.038) were independent predictors of presence of atherosclerotic CAD and only age (p < 0.001) was found as independent predictor of hair graying.

Conclusion: In our population, high hair whitening score was associated with increased risk of CAD independent of chronological age and other established cardiovascular risk factors.

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Alcohol attenuates myocardial ischemic injury.

Scrimgeour LA, Potz BA, Elmadhun NY, Chu LM, Sellke FW.

Surgery. 2017 Jun 8. pii: S0039-6060(17)30313-6. doi: 10.1016/j.surg.2017.04.014. [Epub ahead of print]

PMID: 28602493

Abstract

BACKGROUND:

Moderate alcohol consumption is cardioprotective but the mechanism of action remains unclear. Nuclear factor κ-B regulates the expression of genes involved in inflammation, stress, and apoptosis. We used a swine model of diet-induced metabolic syndrome to investigate the effects of red wine and vodka on nuclear factor κ-B signaling and cytokine activity in chronically ischemic myocardium.

METHODS:

Yorkshire swine were given a high-fat diet for 4 weeks; an ameroid constrictor was then placed on the left circumflex artery. The high-fat diet was continued and the swine were divided into 3 groups for 7 weeks: hypercholesterolemic diet alone (control, n = 8), hypercholesterolemic diet with vodka (vodka, n = 8), and hypercholesterolemic diet with wine (wine, n = 8). Ischemic myocardium was analyzed by Western blot and cytokine array.

RESULTS:

Administration of alcohol was associated with decreased expression of inhibitor of κ-B kinase complex α, inhibitor of κ-B kinase complex β, and phosphorylated inhibitor of κ-B β in the ischemic myocardium compared with the control group. Alcohol administration demonstrated an increase in nuclear factor κ-B in the ischemic myocardium. Both wine and vodka demonstrated a significant decrease in leptin, interleukin-1α, IL-13, IL-15, and interferon-γ. Vodka demonstrated a significant decrease in phosphorylated BCL-2 and caspase-9.

CONCLUSION:

In ischemic myocardium, alcohol modulates the nuclear factor κ-B pathway, which may contribute to the adaptive response of tissues to the stress of ischemia. Furthermore, both wine and vodka decreased multiple proinflammatory cytokines. This study provides a mechanism by which alcohol may be cardioprotective in ischemic myocardium.

 

Dental Status and Compression of Life Expectancy with Disability.

Matsuyama Y, Aida J, Watt RG, Tsuboya T, Koyama S, Sato Y, Kondo K, Osaka K.

J Dent Res. 2017 Jun 1:22034517713166. doi: 10.1177/0022034517713166. [Epub ahead of print]

PMID: 28605598

http://sci-hub.cc/10.1177/0022034517713166

Abstract

This study examined whether the number of teeth contributes to the compression of morbidity, measured as a shortening of life expectancy with disability, an extension of healthy life expectancy, and overall life expectancy. A prospective cohort study was conducted. A self-reported baseline survey was given to 126,438 community-dwelling older people aged ≥65 y in Japan in 2010, and 85,161 (67.4%) responded. The onset of functional disability and all-cause mortality were followed up for 1,374 d (follow-up rate = 96.1%). A sex-stratified illness-death model was applied to estimate the adjusted hazard ratios (HRs) for 3 health transitions (healthy to dead, healthy to disabled, and disabled to dead). Absolute differences in life expectancy, healthy life expectancy, and life expectancy with disability according to the number of teeth were also estimated. Age, denture use, socioeconomic status, health status, and health behavior were adjusted. Compared with the edentulous participants, participants with ≥20 teeth had lower risks of transitioning from healthy to dead (adjusted HR, 0.58 [95% confidence interval (CI), 0.50-0.68] for men and 0.70 [95% CI, 0.57-0.85] for women) and from healthy to disabled (adjusted HR, 0.52 [95% CI, 0.44-0.61] for men and 0.58 [95% CI, 0.49-0.68] for women). They also transitioned from disabled to dead earlier (adjusted HR, 1.26 [95% CI, 0.99-1.60] for men and 2.42 [95% CI, 1.72-3.38] for women). Among the participants aged ≥85 y, those with ≥20 teeth had a longer life expectancy (men: +57 d; women: +15 d) and healthy life expectancy (men: +92 d; women: +70 d) and a shorter life expectancy with disability (men: -35 d; women: -55 d) compared with the edentulous participants. Similar associations were observed among the younger participants and those with 1 to 9 or 10 to 19 teeth. The presence of remaining teeth was associated with a significant compression of morbidity: older Japanese adults' life expectancy with disability was compressed by 35 to 55 d within the follow-up of 1,374 d.

 

Intake of B vitamins and impairment in physical function in older adults.

Struijk EA, Lana A, Guallar-Castillón P, Rodríguez-Artalejo F, Lopez-Garcia E.

Clin Nutr. 2017 May 23. pii: S0261-5614(17)30177-2. doi: 10.1016/j.clnu.2017.05.016. [Epub ahead of print]

PMID: 28602467

http://sci-hub.cc/10.1016/j.clnu.2017.05.016

Abstract

BACKGROUND:

The effect of vitamin B intake on physical function is not well known.

OBJECTIVE:

To examine the prospective association of the intake of vitamins B6, B12 and folate with physical function impairment in older adults.

METHODS:

We performed a prospective cohort study with 1630 participants from the Seniors-ENRICA study, a cohort of community-dwelling adults aged ≥60 years who were free of physical function impairment at baseline. In 2008-2010, nutrient intake was obtained through a validated computer-assisted face-to-face diet history. Study participants were followed-up through 2012 to assess incident impairment in agility and mobility, as well as impairment in overall physical functioning, defined as a decrease in the physical component summary of the 12-Item Short-Form Health Survey.

RESULTS:

Over a median follow-up of 3.5 years, we identified 343 individuals with agility limitation, 212 with mobility limitation, and 457 with decreased overall physical functioning. A significant association was observed between intake of vitamin B6 and lower risk of impaired mobility (odds ratio [OR] for highest vs. lowest tertile: 0.66; 95% confidence interval [CI]:0.44-0.99; p-trend = 0.05). The results lost significance when additionally adjusted for vitamin B12 and folate, however the OR did not materially change. A higher consumption of important sources of vitamin B6, such as fish or fruit, was also related to a lower risk of impaired mobility (OR 100-g increase in fish: 0.50; 95% CI: 0.32-0.79; OR 100-g increase in fruit: 0.92; 95% CI: 0.84-1.01). No association was found between vitamin B12 and folate intake and physical function.

CONCLUSIONS:

A higher intake of vitamin B6 and of several of its main sources, such as fish and fruit, was associated with lower risk of impaired mobility in Spanish older adults.

KEYWORDS:

Agility; B-vitamins; Elderly; Mobility; Physical functioning

 

Adding Soy Protein to Milk Enhances the Effect of Resistance Training on Muscle Strength in Postmenopausal Women.

Orsatti FL, Maestá N, de Oliveira EP, Nahas Neto J, Burini RC, Nunes PRP, Souza AP, Martins FM, Nahas EP.

J Diet Suppl. 2017 Jun 12:1-14. doi: 10.1080/19390211.2017.1330794. [Epub ahead of print]

PMID: 28604135

Abstract

Resistance training (RT) and high-quality protein ingestion improves muscle mass (MM) and strength (MS). However, no study has evaluated the effect of ingesting milk plus soy protein (SOY) on MM and MS in postmenopausal women (PW). Thus, the aim of this study was to evaluate the effects of adding SOY to milk on MM and MS after 16 weeks of RT. Thirty-two PW were randomized and allocated into two groups: placebo and RT (PL+RT, n = 16) and SOY and RT (SOY+RT, n = 16). The SOY+RT received 25 g of SOY while the PL+RT received 25 g of maltodextrin (placebo). All supplements were given in the form of a chocolate-flavored powder added to 200 mL of milk. The RT protocol consisted of eight total body exercises at 70% of one repetition maximum (1RM), three sets of 8-12 repetitions, 2-3 times/week. No differences were found in the baseline measures between groups (age, menopause status, anthropometric and nutrition patterns), except for protein intake, which was higher in the SOY+RT. Both groups increased the MM (bioimpedance) showing no difference between groups (PL+RT = 1.5 kg; SOY+RT = 1.1 kg). For MS, the SOY+RT showed a larger (p < .05) increase in 1RM of bench press (PL+RT = 6.7 kg; SOY+RT = 12.5 kg), knee extension (PL+RT = 3.7 kg; SOY+RT = 6.7 kg), total load (PL+RT = 15.1 kg; SOY+RT = 24.2 kg), and the total load exercises/MM (PL+RT = 0.3 kg; SOY+RT = 0.9 kg). These results suggest that adding SOY to milk combined with 16 weeks of RT resulted in more significant increases in MS in PW.

KEYWORDS:

menopause; sarcopenia; supplementation; weight-lifting exercise program

 

Trans-Resveratrol Supplementation and Endothelial Function during the Fasting and Postprandial Phase: A Randomized Placebo-Controlled Trial in Overweight and Slightly Obese Participants.

Made SMV, Plat J, Mensink RP.

Nutrients. 2017 Jun 12;9(6). pii: E596. doi: 10.3390/nu9060596.

PMID: 28604618

Abstract

Studies on the effects of the long-term intake of trans-resveratrol on vascular function are conflicting. In addition, postprandial effects of long-term trans-resveratrol intake on endothelial function are not known. We therefore supplemented 45 overweight and slightly obese volunteers (25 men and 20 women) with a mean (±SD) age of 61 ± 7 years and body mass index of 28.3 ± 3.2 kg/m² in random order trans-resveratrol (2 × 75 mg/day) or placebo capsules for 4 weeks, separated by a washout period of at least 4 weeks. At the end of each intervention period, brachial artery flow-mediated vasodilation (FMD) was measured before and after meal consumption. Plasma biomarkers for endothelial function, inflammation, and glucose and lipid metabolism were also determined. Compared with the placebo, trans-resveratrol did not affect fasting FMD (2.9 ± 1.4% vs. 3.0 ± 1.9%; p = 0.69). After the postprandial test, changes in FMD (-0.7 ± 2.3% vs. 0.2 ± 2.6%; p = 0.13) were also not significantly different. Postprandial changes in biomarkers were also comparable. In conclusion, for overweight and slightly obese volunteers, a daily intake of 150 mg of trans-resveratrol for 4 weeks does not change plasma biomarkers of endothelial function or inflammation in the fasting state or postprandial phase.

KEYWORDS:

flow-mediated vasodilation; humans; postprandial; trans-resveratrol; vascular function

 

Preventive Interventions for the Second Half of Life: A Systematic Review.

Hajat C, Selwyn A, Harris M, Yach D.

Am J Health Promot. 2017 Jan 1:890117117712355. doi: 10.1177/0890117117712355. [Epub ahead of print]

PMID: 28604054

http://sci-hub.cc/10.1177/0890117117712355

Abstract

OBJECTIVE:

Recent improvements in life expectancy globally require intensified focus on noncommunicable diseases and age-related conditions. The purpose of this article is to inform the development of age-specific prevention guidelines for adults aged 50 and above, which are currently lacking.

DATA SOURCE:

PubMed, Cochrane database, and Google Scholar and explicit outreach to experts in the field.

STUDY INCLUSION AND EXCLUSION CRITERIA:

Meta-analyses, intervention-based, and prospective cohort studies that reported all-cause mortality, disease-specific mortality, or morbidity in adults were included.

DATA EXTRACTION:

A systematic review was undertaken in 2015 using search terms of a combination of <risk factor> and "intervention," "mortality," "reduction," "improvement," "death," and "morbidity."

DATA SYNTHESIS:

Interventions were categorized according to the Center for Evidence-Based Medicine Level of Evidence framework.

RESULTS:

A summary table reports for each intervention the impact, strength of evidence, initiation, duration, and details of the intervention. Age-decade-specific preventive recommendations have been proposed relating to physical activity, diet, tobacco and alcohol use, medication adherence, screening and vaccination, and mental and cognitive health.

CONCLUSION:

Clear recommendations have been made according to the existing evidence base, but further research investment is needed to fill the many gaps. Further, personalized approaches to healthy aging complemented by population-wide approaches and broader cross-sector partnerships will help to ensure greater longevity is an opportunity, rather than a burden, for society.

KEYWORDS:

age-specific; aging; lifestyle; longevity; morbidity; mortality; prevention

 

Association of Donor Age and Sex With Survival of Patients Receiving Transfusions.

Edgren G, Ullum H, Rostgaard K, Erikstrup C, Sartipy U, Holzmann MJ, Nyrén O, Hjalgrim H.

JAMA Intern Med. 2017 Jun 1;177(6):854-860. doi: 10.1001/jamainternmed.2017.0890.

PMID: 28437543

Abstract

IMPORTANCE:

Following animal model data indicating the possible rejuvenating effects of blood from young donors, there have been at least 2 observational studies conducted with humans that have investigated whether donor age affects patient outcomes. Results, however, have been conflicting.

OBJECTIVE:

To study the association of donor age and sex with survival of patients receiving transfusions.

DESIGN, SETTING, AND PARTICIPANTS:

A retrospective cohort study based on the Scandinavian Donations and Transfusions database, with nationwide data, was conducted for all patients from Sweden and Denmark who received at least 1 red blood cell transfusion of autologous blood or blood from unknown donors between January 1, 2003, and December 31, 2012. Patients were followed up from the first transfusion until death, emigration, or end of follow-up. Data analysis was performed from September 15 to November 15, 2016.

EXPOSURES:

The number of transfusions from blood donors of different age and sex. Exposure was treated time dependently throughout follow-up.

MAIN OUTCOMES AND MEASURES:

Hazard ratios (HRs) for death and adjusted cumulative mortality differences, both estimated using Cox proportional hazards regression.

RESULTS:

Results of a crude analysis including 968 264 transfusion recipients (550 257 women and 418 007 men; median age at first transfusion, 73.0 years [interquartile range, 59.8-82.4 years]) showed a U-shaped association between age of the blood donor and recipient mortality, with a nadir in recipients for the most common donor age group (40-49 years) and significant and increasing HRs among recipients of blood from donors of successively more extreme age groups (<20 years: HR, 1.12; 95% CI, 1.10-1.14; ≥70 years: HR, 1.25; 95% CI, 1.08-1.44). Higher mortality was also noted among recipients of blood from female donors (HR, 1.07; 95% CI, 1.07-1.07). Adjustments for number of transfusions with a linear term attenuated the associations, but the increased mortality for recipients of blood from young, old, and female donors was not eliminated. Closer examination of the association between number of transfusions and mortality revealed a nonlinear pattern. After adjustments to accommodate nonlinearity, donor age and sex were no longer associated with patient mortality.

CONCLUSIONS AND RELEVANCE:

Donor age and sex were not associated with patient survival and need not be considered in blood allocation. Any comparison between common and less common categories of transfusions will inevitably be confounded by the number of transfusions, which drives the probability of receiving the less common blood components. Previous positive findings regarding donor age and sex are most likely explained by residual confounding.

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Statistical Caution in Big Data Approaches to Transfusion Medicine Research.

Roubinian N, Brambilla D, Murphy EL.

JAMA Intern Med. 2017 Jun 1;177(6):860-861. doi: 10.1001/jamainternmed.2017.0914. No abstract available.

PMID: 28437522

http://sci-hub.cc/10.1001/jamainternmed.2017.0914

 

Nearly one-third of the world is overweight, risking illness and death

Excess weight affected 2.2 billion people in 2015 — with about 10% of the population considered obese

Thomson Reuters Posted: Jun 12, 2017

http://www.cbc.ca/news/health/global-obesity-increasing-in-children-1.4156512

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Health Effects of Overweight and Obesity in 195 Countries over 25 Years

The GBD 2015 Obesity Collaborators

June 12, 2017DOI: 10.1056/NEJMoa1614362

Abstract

BACKGROUND

Although the rising pandemic of obesity has received major attention in many countries, the effects of this attention on trends and the disease burden of obesity remain uncertain.

METHODS

We analyzed data from 68.5 million persons to assess the trends in the prevalence of overweight and obesity among children and adults between 1980 and 2015. Using the Global Burden of Disease study data and methods, we also quantified the burden of disease related to high body-mass index (BMI), according to age, sex, cause, and BMI in 195 countries between 1990 and 2015.

RESULTS

In 2015, a total of 107.7 million children and 603.7 million adults were obese. Since 1980, the prevalence of obesity has doubled in more than 70 countries and has continuously increased in most other countries. Although the prevalence of obesity among children has been lower than that among adults, the rate of increase in childhood obesity in many countries has been greater than the rate of increase in adult obesity. High BMI accounted for 4.0 million deaths globally, nearly 40% of which occurred in persons who were not obese. More than two thirds of deaths related to high BMI were due to cardiovascular disease. The disease burden related to high BMI has increased since 1990; however, the rate of this increase has been attenuated owing to decreases in underlying rates of death from cardiovascular disease.

CONCLUSIONS

The rapid increase in the prevalence and disease burden of elevated BMI highlights the need for continued focus on surveillance of BMI and identification, implementation, and evaluation of evidence-based interventions to address this problem. (Funded by the Bill and Melinda Gates Foundation.)

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High reproductive effort is associated with decreasing mortality late in life in captive ruffed lemurs.

Tidière M, Lemaître JF, Douay G, Whipple M, Gaillard JM.

Am J Primatol. 2017 Jun 13. doi: 10.1002/ajp.22677. [Epub ahead of print]

PMID: 28608982

http://onlinelibrary.wiley.com.sci-hub.cc/doi/10.1002/ajp.22677/abstract;jsessionid=950BB151E37F5140281A54933143FB68.f02t02

Abstract

Evolutionary theories of senescence predict that a high allocation to reproduction during early life should have long-term deleterious consequences on future reproduction or survival because individuals have to face an energy allocation trade-off between reproductive effort and the maintenance of body condition. Using a high-quality dataset from 1,721 red ruffed lemurs (RRL, Varecia rubra) and 3,637 black and white ruffed lemurs (BWRM, V. variegata) living in captivity, we tested the existence of a trade-off between reproductive effort and late-life survival after accounting for possible confounding effects of natal environmental conditions. We report clear evidence of actuarial senescence (i.e., the decline of annual survival with increasing age) in both sexes and for both species of ruffed lemurs. RRL had a lower baseline mortality and senesced faster than BWRL, resulting in similar distributions of longevities for both species. No between-sex difference was observed in any species. Lastly, a higher reproductive effort was positively associated with an increase of survival late in life, and thereby an increased longevity. These findings indicate that individual quality rather than trade-off drives the association between reproductive success and survival pattern among individual lemurs of both species in the protected environment provided by zoos. Lemurs are among the world's highest conservation priorities and better understanding factors influencing their longevity and actuarial senescence patterns should improve their conservation.

KEYWORDS:

ageing; lemuridae; life-history; primates; zoo

 

Leisure-time physical activity and risk of disability incidence: A 12-year prospective cohort study among young elderly of the same age at baseline.

Matsunaga T, Naito M, Wakai K, Ukawa S, Zhao W, Okabayashi S, Ando M, Kawamura T, Tamakoshi A.

J Epidemiol. 2017 Jun 9. pii: S0917-5040(17)30120-X. doi: 10.1016/j.je.2016.11.004. [Epub ahead of print]

PMID: 28606710

http://sci-hub.cc/10.1016/j.je.2016.11.004

Abstract

BACKGROUND:

To clarify the role of physical activity in preventing disability in Japan, we investigated the association between amount of leisure-time physical activity and incidence of disability among the young elderly.

METHODS:

In the New Integrated Suburban Seniority Investigation (NISSIN) project conducted from 1996 to 2013, we followed 2888 community-dwelling adults aged 64-65 years with no history of cerebrovascular disease for a median follow-up of 11.6 years. Disabilities were defined as follows based on the classifications of the Japanese long-term care insurance system: 1) support or care levels (support levels 1-2 or care levels 1-5); 2) care levels 2-5; 3) support or care levels with dementia; and 4) care levels 2-5 or death. In addition, we also assessed 5) all-cause mortality.

RESULTS:

After controlling for sociodemographic, lifestyle, and medical factors, male participants reporting an activity level of 18.1 metabolic equivalent (MET)-hours/week (the median among those with activities) or more had 52% less risk of being classified as support or care levels with dementia compared with the no activity group (hazard ratio 0.48; 95% confidence interval, 0.25-0.94). No significant association was found among women between amount of leisure-time physical activity and incidence of disability.

CONCLUSION:

We identified an inverse dose-response relationship between the amount of leisure-time physical activity and the risk of disability with dementia in men. Therefore, a higher level of physical activity should be recommended to young elderly men to prevent disability with dementia.

KEYWORDS:

Disability; Elderly; Leisure-time physical activity

 

The Association between Age-Related Macular Degeneration and the Risk of Mortality.

Wang P, Wang J, Ma J, Jin G, Guan X.

Biomed Res Int. 2017;2017:3489603. doi: 10.1155/2017/3489603. Epub 2017 May 18.

PMID: 28607930

Abstract

Studies have investigated the association between age-related macular degeneration (AMD) and subsequent risks of mortality, but results have been equivocal. We conducted a comprehensive analysis of prospective cohort studies to assess the association of AMD and the risk of mortality in the general population. We searched PubMed and EMBASE for trials published from 1980 to 2016. We included 11 cohort studies that reported relative risks with 95% confidence intervals for the association of AMD and mortality, involving 57,069 participants. In a random-effects model, the adjusted RR (95% confidence interval) associated with AMD was 1.09 (1.02-1.17) for all-cause mortality. Findings from this research provide support that persons with AMD had a higher subsequent risk of mortality than persons without AMD.

 

Modeling anthropometric indices in relation to 10-year (2002-2012) incidence of cardiovascular disease, among apparently healthy individuals: The ATTICA study.

Filippatos TD, Kyrou I, Georgousopoulou EN, Chrysohoou C, Kouli GM, Tsigos C, Tousoulis D, Stefanadis C, Pitsavos C, Panagiotakos DB.

Diabetes Metab Syndr. 2017 Jun 3. pii: S1871-4021(17)30169-8. doi: 10.1016/j.dsx.2017.05.018. [Epub ahead of print]

PMID: 28606442

http://sci-hub.cc/10.1016/j.dsx.2017.05.018

Abstract

AIMS:

Body fat accumulation is implicated in the development of cardiovascular disease (CVD). Our objective was to explore potential associations between anthropometric indices and the 10-year CVD incidence in Greek adults without previous CVD.

METHODS:

During 2001-2, we enrolled 3042 adults without CVD from the general population of Attica, Greece. In 2011-2, the 10-year study follow-up was performed, recording the CVD incidence in 1958 participants with baseline body mass index (BMI) ≥18.5kg/m2.

RESULTS:

The study 10-year CVD incidence was 15.8%, exhibiting a gradual increase according to the baseline body mass index (BMI) category. Baseline BMI ≥30kg/m2 was related with significantly higher 10-year CVD risk compared to BMI <25kg/m2, even after adjustment for age and other known CVD risk factors. Baseline BMI, waist circumference, waist-to-hip ratio, waist-to-height ratio and waist-to-hip-to-height ratio were independently associated with the 10-year CVD risk in multi-adjusted models. Gender-specific analyses showed that these associations were more evident in men compared to women, with baseline BMI exhibiting an independent association with the 10-year CVD incidence in men.

CONCLUSIONS:

Our results indicate that even simple anthropometric indices exhibit independent associations with CVD risk in a representative sample of the Greek general population without previous CVD.

KEYWORDS:

Anthropometric indices; Body mass index; Cardiovascular disease; Obesity; Waist circumference

 

Effect of ω-3 polyunsaturated fatty acids on arthritic pain: A systematic review.

Abdulrazaq M, Innes JK, Calder PC.

Nutrition. 2017 Jul - Aug;39-40:57-66. doi: 10.1016/j.nut.2016.12.003. Epub 2016 Dec 21. Review.

PMID: 28606571

Abstract

OBJECTIVES:

Pain is a significant problem in rheumatoid arthritis (RA) and is associated with prostaglandins derived from the ω-6 polyunsaturated fatty acid (PUFA) arachidonic acid. The ω-3 PUFAs eicosapentaenoic acid and docosahexaenoic acid have been shown to reduce inflammation, with some studies showing clinical improvements in RA. The aim of this systematic review was to investigate the effect of ω-3 PUFAs on arthritic pain.

METHOD:

A systematic literature review of ω-3 PUFAs and pain associated with RA was performed up to December 2015. Randomized controlled trials (RCTs) investigating the effect of ω-3 PUFAs (>2 g/d) on patient or physician assessment of pain, or assessment by both patient and physician, were included. The Cochrane Collaboration's tool for assessing risk for 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 ω-3 PUFAs used was 2.1 to 9.1 g/d, with study durations of 12 to 52 wk. Ten studies supported the hypothesis that there is a reduction in patient or physician assessment of pain associated with RA after intake of ω-3 PUFAs. Eight studies found no statistically significant effect of ω-3 PUFAs on arthritic pain.

CONCLUSIONS:

ω-3 PUFAs may have a therapeutic role in decreasing pain associated with RA, with doses of 3 to 6 g/d appearing to have a greater effect. Due to the limitations identified in the RCTs included in this review, more research is needed to investigate ω-3 PUFAs in larger populations and over extended periods of time.

KEYWORDS:

DHA; EPA; Fish oil; Pain; Rheumatoid arthritis

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Cooking Methods for Red Meats and Risk of Type 2 Diabetes: A Prospective Study of U.S. Women.

Liu G, Zong G, Hu FB, Willett WC, Eisenberg DM, Sun Q.

Diabetes Care. 2017 Jun 13. pii: dc170204. doi: 10.2337/dc17-0204. [Epub ahead of print]

PMID: 28611054

Abstract

OBJECTIVE:

This study examined different cooking methods for red meats in relation to type 2 diabetes (T2D) risk among U.S. women who consumed red meats regularly (≥2 servings/week).

RESEARCH DESIGN AND METHODS:

We monitored 59,033 women (1986-2012) aged 30-55 years and free of diabetes, cardiovascular disease, and cancer at baseline when information on frequency of different cooking methods for red meats, including broiling, barbequing, roasting, pan-frying, and stewing/boiling, was collected.

RESULTS:

During 1.24 million person-years of follow-up, we documented 6,206 incident cases of T2D. After multivariate adjustment including red meat cooking methods, total red meat and processed red meat intake were both associated with a monotonically increased T2D risk (both P trend <0.05). After multivariate adjustment including total red meat intake, a higher frequency of broiling, barbequing, and roasting red meats was each independently associated with a higher T2D risk. When comparing ≥2 times/week with <1 time/month, the hazard ratios (HRs) and 95% CI of T2D were 1.29 (1.19, 1.40; P trend <0.001) for broiling, 1.23 (1.11, 1.38; P trend <0.001) for barbequing, and 1.11 (1.01, 1.23; P trend = 0.14) for roasting. In contrast, the frequency of stewing/boiling red meats was not associated with T2D risk, and an inverse association was observed for pan-frying frequency and T2D risk. The results remained similar after cooking methods were further mutually adjusted.

CONCLUSIONS:

Independent of total red meat consumption, high-temperature and/or open-flame cooking methods for red meats, especially broiling and barbequing, may further increase diabetes risk among regular meat eaters.

 

Daytime napping and risk of type 2 diabetes: a meta-analysis of prospective studies.

Chen GC, Liu MM, Chen LH, Xu JY, Hidayat K, Li FR, Qin LQ.

Sleep Breath. 2017 Jun 13. doi: 10.1007/s11325-017-1528-z. [Epub ahead of print]

PMID: 28612266

Abstract

PURPOSE:

Prospective studies reported inconsistent findings on the relationship between daytime napping and risk of type 2 diabetes (T2D). Categorized and dose-response meta-analyses were performed to quantify this relation.

METHODS:

Potentially eligible studies were identified by searching PubMed and Embase databases. Dose-response effects were assessed by the generalized least squares trend estimation and study-specific summary relative risks (RRs) with 95% confidence intervals (CIs) were computed with a random-effects model.

RESULTS:

Seven prospective studies including one US, four European, and two Chinese cohorts involving 249,077 participants and 13,237 cases of T2D were included. The overall analyses showed a 17% increased risk of T2D when comparing habitual nappers with non-nappers (RR = 1.17, 95% CI 1.08-1.27). By region, the summary RR was 1.21 (95% CI 1.17-1.26), 1.15 (95% CI 1.03-1.30) and 1.23 (95% CI 0.87-1.73) for the US, European, and Chinese studies, respectively. Limiting to five studies that excluded subjects with known major chronic disorders yielded a summary RR of 1.16 (95% CI 1.03-1.30). A dose-response analysis suggested an 11% (95% CI 7-16%) increased T2D risk for each increment in daytime napping of 30 min/day and, despite no evidence for nonlinearity (P nonlinearity = 0.65), the increased risk of T2D for short nap (<50 min/day) was dominated by the US study.

CONCLUSIONS:

This meta-analysis suggests that daytime napping is associated with an increased risk of T2D. Given the limited number of cohorts and inconsistency in terms of methodological and population characteristics across these cohorts, residual confounders and/or reverse causality cannot be fully addressed, and our findings should be interpreted with great caution. Future well-designed prospective studies are still warranted.

KEYWORDS:

Meta-analysis; Napping; Sleep; Type 2 diabetes

 

Dietary Phosphorus Intake and the Kidney.

Chang AR, Anderson C.

Annu Rev Nutr. 2017 Jun 14. doi: 10.1146/annurev-nutr-071816-064607. [Epub ahead of print]

PMID: 28613982

http://www.annualreviews.org.sci-hub.cc/doi/10.1146/annurev-nutr-071816-064607

Abstract

Although phosphorus is an essential nutrient required for multiple physiological functions, recent research raises concerns that high phosphorus intake could have detrimental effects on health. Phosphorus is abundant in the food supply of developed countries, occurring naturally in protein-rich foods and as an additive in processed foods. High phosphorus intake can cause vascular and renal calcification, renal tubular injury, and premature death in multiple animal models. Small studies in human suggest that high phosphorus intake may result in positive phosphorus balance and correlate with renal calcification and albuminuria. Although serum phosphorus is strongly associated with cardiovascular disease, progression of kidney disease, and death, limited data exist linking high phosphorus intake directly to adverse clinical outcomes. Further prospective studies are needed to determine whether phosphorus intake is a modifiable risk factor for kidney disease.

 

Dietary n-3 polyunsaturated fatty acids, fish consumption, and endometrial cancer risk: a meta-analysis of epidemiological studies.

Hou R, Yao SS, Liu J, Wang LL, Wu L, Jiang L.

Oncotarget. 2017 May 30. doi: 10.18632/oncotarget.18295. [Epub ahead of print]

PMID: 28614060

Abstract

The relationship between intake of fish and n-3 fatty acids and endometrial cancer risk has not been consistent across epidemiological studies. We quantitatively assessed the aforementioned association through a systematic review and meta-analysis. PubMed and Embase were searched through March 2017 for eligible epidemiological studies. Fixed or random-effects models were used to pool relative risks (RRs) and 95% confidence intervals (CIs). The dose-response relationship was also evaluated. Based on the literature search, five prospective studies and 11 case-control studies were identified. All 16 studies were categorized as high-quality studies. After pooling available risk estimates, no significant association was detected between overall fish intake and endometrial cancer risk. In subgroup analyses, every one additional serving/week of fish intake was significantly associated with inversed endometrial cancer risk in studies adjusted for smoking (RR (95% CI): 0.95 (0.91-1.00)), or studies performed in Europe (RR (95% CI): 0.90 (0.84-0.97)), but not in other tested subgroups. In studies conducted in Asia, there was significant positive association (RR (95% CI): 1.15 (1.10-1.21)). Regarding n-3 PUFA intake, marginally inverse associations of high EPA or DHA intake were detected (EPA: RR (95% CI) = 0.79 (0.61-1.04); DHA: RR (95% CI) = 0.85 (0.64-1.11)). Dose-response analyses suggested a significant nonlinear relationship between DHA intake and endometrial cancer risk (p: 0.04). Overall, this meta-analysis suggests that intake of n-3 PUFA may be inversely associated with endometrial cancer risk at some level of evidence, although the exact relationship, especially for fish intake, needs further characterization. Further well-designed studies are warranted.

KEYWORDS:

endometrial cancer; epidemiology; fish; n-3 fatty acids

 

Synbiotic supplementation and the effects on clinical and metabolic responses in patients with rheumatoid arthritis: a randomised, double-blind, placebo-controlled trial.

Zamani B, Farshbaf S, Golkar HR, Bahmani F, Asemi Z.

Br J Nutr. 2017 Apr;117(8):1095-1102. doi: 10.1017/S000711451700085X. Epub 2017 May 11.

PMID: 28490394

Abstract

Synbiotic intake may be associated with reduced inflammation in patients with rheumatoid arthritis (RA) due to optimised inflammatory markers, oxidative stress and insulin resistance. This research was conducted to assess the effects of synbiotic supplementation on the clinical and metabolic parameters of patients with RA. A total of fifty-four patients with RA were allocated into two groups to receive either a synbiotic capsule (n 27) or a placebo (n 27) for 8 weeks in this randomised, double-blind, placebo-controlled trial. Fasting blood samples were taken at baseline and week 8 of the study to quantify related markers. After the 8-week intervention, compared with the placebo, synbiotic supplementation resulted in a significant reduction in serum high-sensitivity C-reactive protein (hs-CRP) levels (-1427·8 (sd 3267·2) v. +2833·4 (sd 5639·7) ng/ml, P=0·001). In addition, compared with the placebo, synbiotic supplementation improved disease activity score-28 joints (DAS-28) (-1·6 (sd 0·8) v. -0·3 (sd 0·5), P<0·001) and visual analogue scales (VAS) pain (-30·4 (sd 18·7) v. -11·5 (sd 15·9), P<0·001). In addition, a significant elevation in plasma nitric oxide (NO) (+0·8 (sd 4·4) v. -2·6 (sd 4·5) µmol/l, P=0·008), and significant reductions in insulin values (-13·8 (sd 26·4) v. +4·2 (sd 28·2) pmol/l, P=0·01), homoeostasis model of assessment-estimated insulin resistance (HOMA-IR) (-0·5 (sd 1·0) v.+0·1 (sd 1·1), P=0·03) and homoeostatic model assessment-β-cell function (HOMA-B) (-9·4 (sd 17·9) v. +3·3 (sd 18·9), P=0·01) following supplementation with the synbiotic compared with the placebo. Compared with the placebo, synbiotic supplementation also resulted in a significant increase in plasma GSH (+36·6 (sd 63·5) v. -58·5 (sd 154·4) µmol/l, P=0·005). Overall, our study demonstrated that synbiotic supplementation for 8 weeks among patients with RA had beneficial effects on hs-CRP, DAS-28, VAS, NO, insulin levels, HOMA-IR, HOMA-B and GSH levels.

KEYWORDS:

DAS-28 disease activity score-28 joints; HOMA-B homoeostatic model assessment-β-cell function; HOMA-IR homoeostasis model of assessment-estimated insulin resistance; KUMS Kashan University of Medical Sciences; MDA malondialdehyde; RA rheumatoid arthritis; TAC antioxidant capacity; VAS visual analogue scales; hs-CRP high-sensitivity C-reactive protein; Metabolic profiles; Rheumatoid arthritis; Supplementation; Synbiotics

 

Alcohol consumption pattern and risk of Barrett's oesophagus and erosive oesophagitis: an Italian case-control study.

Filiberti RA, Fontana V, De Ceglie A, Blanchi S, Grossi E, Della Casa D, Lacchin T, De Matthaeis M, Ignomirelli O, Cappiello R, Rosa A, Foti M, Laterza F, D'Onofrio V, Iaquinto G, Conio M.

Br J Nutr. 2017 Apr;117(8):1151-1161. doi: 10.1017/S0007114517000940. Epub 2017 May 8.

PMID: 28478792

http://sci-hub.cc/10.1017/S0007114517000940

Abstract

Knowledge about the association between alcohol and Barrett's oesophagus and reflux oesophagitis is conflicting. In this case-control study we evaluated the role of specific alcoholic beverages (red and white wine, beer and liquors) in 339 Barrett's oesophagus and 462 oesophagitis patients compared with 619 endoscopic controls with other disorders, recruited in twelve Italian endoscopic units. Data on alcohol and other individual characteristics were obtained from structured questionnaires. No clear, monotonic significant dose-response relationship was pointed out for red wine. However, a generalised U-shaped trend of Barrett's oesophagus/oesophagitis risk due to red wine consumption particularly among current drinkers was found. Similar results were also found for white wine. Liquor/spirit consumption seemed to bring about a 1·14-2·30 risk excess, although statistically non-significant, for current Barrett's oesophagus/oesophagitis drinkers. Statistically significant decreasing dose-response relationships were found in Barrett's oesophagus for frequency and duration of beer consumption. Similar, but less clear downward tendencies were also found for oesophagitis patients. In conclusion, although often not statistically significant, our data suggested a reduced risk of Barrett's oesophagus and oesophagitis with a low/moderate intake of wine and beer consumption. A non-significant increased risk of Barrett's oesophagus/oesophagitis was observed with a higher intake of any type of heavy alcohol consumption, but no conclusion can be drawn owing to the high number of non-spirit drinkers and to the small number of drinkers at higher alcohol intake levels.

KEYWORDS:

BE Barrett’s oesophagus; C control; E oesophagitis; EAC oesophageal adenocarcinoma; GERD gastro-oesophageal reflux disease; MLR multinomial logistic regression; TLT test for linear trend; Alcohol; Barrett’s oesophagus; Epidemiology; Gastro-oesophageal reflux disease; Oesophagitis; Risk factors

 

Citrus consumption and incident dementia in elderly Japanese: the Ohsaki Cohort 2006 Study.

Zhang S, Tomata Y, Sugiyama K, Sugawara Y, Tsuji I.

Br J Nutr. 2017 Apr;117(8):1174-1180. doi: 10.1017/S000711451700109X. Epub 2017 May 19.

PMID: 28521847

http://sci-hub.cc/10.1017/S000711451700109X

Abstract

Although some experimental biological studies have indicated that citrus may have preventive effects against cognitive impairment, no cohort study has yet examined the relationship between citrus consumption and incident dementia. In a baseline survey, we collected data on daily citrus intake (categorised as ≤2, 3-4 times/week or almost every day) and consumption of other foods using a FFQ, and used a self-reported questionnaire to collect data on other covariates. Data on incident dementia were retrieved from the Japanese Long-term Care Insurance database. A multivariate-adjusted Cox model was used to estimate the hazard ratios (HR) and 95 % CI for incident dementia according to citrus consumption. Among 13 373 participants, the 5·7-year incidence of dementia was 8·6 %. In comparison with participants who consumed citrus ≤2 times/week, the multivariate-adjusted HR for incident dementia among those did so 3-4 times/week and almost every day was 0·92 (95 % CI 0·80, 1·07) and 0·86 (95 % CI 0·73, 1·01), respectively (P trend=0·065). The inverse association persisted after excluding participants whose dementia events had occurred in the first 2 years of follow-up. The multivariate HR was 1·00 (reference) for ≤2 times/week, 0·82 (95 % CI 0·69, 0·98) for 3-4 times/week and 0·77 (95 % CI 0·64, 0·93) for almost every day (P trend=0·006). The present findings suggest that frequent citrus consumption was associated with a lower risk of incident dementia, even after adjustment for possible confounding factors.

KEYWORDS:

HR hazard ratio; LTCI Long-term Care Insurance; Citrus; Cohort studies; Dementia; Elderly; Japan

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International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine.

Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, Candow DG, Kleiner SM, Almada AL, Lopez HL.

J Int Soc Sports Nutr. 2017 Jun 13;14:18. doi: 10.1186/s12970-017-0173-z. eCollection 2017. Review.

PMID: 28615996

Abstract

Creatine is one of the most popular nutritional ergogenic aids for athletes. Studies have consistently shown that creatine supplementation increases intramuscular creatine concentrations which may help explain the observed improvements in high intensity exercise performance leading to greater training adaptations. In addition to athletic and exercise improvement, research has shown that creatine supplementation may enhance post-exercise recovery, injury prevention, thermoregulation, rehabilitation, and concussion and/or spinal cord neuroprotection. Additionally, a number of clinical applications of creatine supplementation have been studied involving neurodegenerative diseases (e.g., muscular dystrophy, Parkinson's, Huntington's disease), diabetes, osteoarthritis, fibromyalgia, aging, brain and heart ischemia, adolescent depression, and pregnancy. These studies provide a large body of evidence that creatine can not only improve exercise performance, but can play a role in preventing and/or reducing the severity of injury, enhancing rehabilitation from injuries, and helping athletes tolerate heavy training loads. Additionally, researchers have identified a number of potentially beneficial clinical uses of creatine supplementation. These studies show that short and long-term supplementation (up to 30 g/day for 5 years) is safe and well-tolerated in healthy individuals and in a number of patient populations ranging from infants to the elderly. Moreover, significant health benefits may be provided by ensuring habitual low dietary creatine ingestion (e.g., 3 g/day) throughout the lifespan. The purpose of this review is to provide an update to the current literature regarding the role and safety of creatine supplementation in exercise, sport, and medicine and to update the position stand of International Society of Sports Nutrition (ISSN).

KEYWORDS:

Adolescents; Athletes; Children; Clinical applications; Ergogenic aids; Muscle power; Muscular strength; Performance enhancement; Safety; Sport nutrition

 

Atrial fibrillation and the risk for myocardial infarction, all-cause mortality and heart failure: A systematic review and meta-analysis.

Ruddox V, Sandven I, Munkhaugen J, Skattebu J, Edvardsen T, Otterstad JE.

Eur J Prev Cardiol. 2017 Jan 1:2047487317715769. doi: 10.1177/2047487317715769. [Epub ahead of print]

PMID: 28617620

Abstract

Background In contemporary atrial fibrillation trials most deaths are cardiac related, whereas stroke and bleeding represent only a small subset of deaths. We aimed to evaluate the long-term risk of cardiac events and all-cause mortality in individuals with atrial fibrillation compared to no atrial fibrillation. Design A systematic review and meta-analysis of studies published between 1 January 2006 and 21 October 2016. Methods Four databases were searched. Studies had follow-up of at least 500 stable patients for either cardiac endpoints or all-cause mortality for 12 months or longer. Publication bias was evaluated and random effects models were used to synthesise the results. Heterogeneity between studies was examined by subgroup and meta-regression analyses. Results A total of 15 cohort studies was included. Analyses indicated that atrial fibrillation was associated with an increased risk of myocardial infarction (relative risk (RR) 1.54, 95% confidence interval (CI) 1.26-1.85), all-cause mortality (RR 1.95, 95% CI 1.50-2.54) and heart failure (RR 4.62, 95% CI 3.13-6.83). Coronary heart disease at baseline was associated with a reduced risk of myocardial infarction and explained 57% of the heterogeneity. A prospective cohort design accounted for 25% of all-cause mortality heterogeneity. Due to there being fewer than 10 studies, sources of heterogeneity were inconclusive for heart failure. Conclusions Atrial fibrillation seems to be associated with an increased risk of subsequent myocardial infarction in patients without coronary heart disease and an increased risk of, all-cause mortality and heart failure in patients with and without coronary heart disease.

KEYWORDS:

Atrial fibrillation; heart failure; mortality; myocardial infarction

 

Risk factors and protective factors associated with incident or increase of frailty among community-dwelling older adults: A systematic review of longitudinal studies.

Feng Z, Lugtenberg M, Franse C, Fang X, Hu S, Jin C, Raat H.

PLoS One. 2017 Jun 15;12(6):e0178383. doi: 10.1371/journal.pone.0178383. eCollection 2017.

PMID: 28617837

Abstract

INTRODUCTION:

Frailty is one of the greatest challenges facing our aging population, as it can lead to adverse outcomes such as institutionalization, hospitalization, and mortality. However, the factors that are associated with frailty are poorly understood. We performed a systematic review of longitudinal studies in order to identify the sociodemographic, physical, biological, lifestyle-related, and psychological risk or protective factors that are associated with frailty among community-dwelling older adults.

METHODS:

A systematic literature search was conducted in the following databases in order to identify studies that assessed the factors associated with of frailty among community-dwelling older adults: Embase, Medline Ovid, Web of Science, Cochrane, PsychINFO Ovid, CINAHL EBSCOhost, and Google Scholar. Studies were selected if they included a longitudinal design, focused on community-dwelling older adults aged 60 years and older, and used a tool to assess frailty. The methodological quality of each study was assessed using the Quality of Reporting of Observational Longitudinal Research checklist.

RESULTS:

Twenty-three studies were included. Significant associations were reported between the following types of factors and frailty: sociodemographic factors (7/7 studies), physical factors (5/6 studies), biological factors (5/7 studies), lifestyle factors (11/13 studies), and psychological factors (7/8 studies). Significant sociodemographic factors included older age, ethnic background, neighborhood, and access to private insurance or Medicare; significant physical factors included obesity and activities of daily living (ADL) functional status; significant biological factors included serum uric acid; significant lifestyle factors included a higher Diet Quality Index International (DQI) score, higher fruit/vegetable consumption and higher tertile of all measures of habitual dietary resveratrol exposure; significant psychological factors included depressive symptoms.

CONCLUSIONS:

A broad range of sociodemographic, physical, biological, lifestyle, and psychological factors show a longitudinal association with frailty. These factors should be considered when developing interventions aimed at preventing and/or reducing the burden associated with frailty among community-dwelling older adults.

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