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Al's papers' citations and possibly links and excerpts or my synopses

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Low vegetable intake increases the risk of fall-related fragility fracture in postmenopausal Taiwanese women, a prospective pilot study in the community.

Lin CH, Chen KH, Chen CM, Chang CH, Huang TJ, Hsu HC, Huang SY.

Biomed J. 2016 Jun;39(3):214-22. doi: 10.1016/j.bj.2015.11.003. Epub 2016 Aug 9.

PMID: 27621124


older age and hypertension were associated with increased risks of falling. Intake of other deep-colored (nondark-green) vegetables and light-colored vegetables as well as total vegetable intake were associated with reduced risk of fall-related fragility fracture.

"foods included fruits (including fresh fruit

juice); dark-green vegetables (including green peppers,

broccoli, and dark-green leafy vegetables such as spinach,

chrysanthemum, and bok choy); other deep-colored vegetables

(including deep yellow vegetables such as carrots,

pumpkin, sweet potatoes, tomatoes, and yellow pepper;

dark-red vegetables such as red peppers, red phoenix vegetables,

and red amaranth; and others such as eggplant);

light-colored vegetables (such as kale, cabbage, bamboo

shoots, radish, cauliflower, white gourd, cabbage [twice], Chinese

cabbage, and celery)"


 [i wonder if using ultra-high intake percent intakes of lard and fructose versus casein provides a fair comparison for the three macronutrients.]

Effects of different diets on intestinal microbiota and nonalcoholic fatty liver disease development.

Liu JP, Zou WL, Chen SJ, Wei HY, Yin YN, Zou YY, Lu FG.

World J Gastroenterol. 2016 Aug 28;22(32):7353-64. doi: 10.3748/wjg.v22.i32.7353.

PMID: 27621581


nonalcoholic fatty liver disease (NAFLD) development at the same caloric intake. .... The control diet (CON) group and free high-fat diet (FFAT) group were allowed ad libitum access to a normal chow diet and a high-fat diet, respectively. The restrictive high-fat diet (RFAT) group, restrictive high-sugar diet (RSUG) group, and high-protein diet (PRO) group were fed a high-fat diet, a high-sugar diet, and a high-protein diet, respectively, in an isocaloric way. … FFAT group had higher body weight, visceral fat index, liver index, peripheral insulin resistance, portal LPS, serum ALT, serum AST, and liver triglycerides compared with all other groups (P < 0.05). Taking the same calories, the RFAT and RSUG groups demonstrated increased body weight, visceral fat index, peripheral insulin resistance and liver triglycerides compared with the PRO group (P < 0.05). The RFAT group also showed increased portal LPS compared with the PRO group (P < 0.05).


Androgens have antiresorptive effects on trabecular disuse osteopenia independent from muscle atrophy.

Laurent MR, Jardí F, Dubois V, Schollaert D, Khalil R, Gielen E, Carmeliet G, Claessens F, Vanderschueren D.

Bone. 2016 Sep 10. pii: S8756-3282(16)30257-5. doi: 10.1016/j.bone.2016.09.011. [Epub ahead of print]

PMID: 27622887


 androgen receptor (AR) … androgens have antiresorptive effects on trabecular disuse osteopenia which do not require AR actions on bone via muscle or via osteocytes.


"What makes some rats live so long?" The mitochondrial contribution to longevity through balance of mitochondrial dynamics and mtDNA content.

Picca A, Pesce V, Sirago G, Fracasso F, Leeuwenburgh C, Lezza AM.

Exp Gerontol. 2016 Sep 9. pii: S0531-5565(16)30336-9. doi: 10.1016/j.exger.2016.09.010. [Epub ahead of print]

PMID: 27620821


among the multiple causes leading to the longevity of the AL-32 rats, the maintenance of an adult-like balance of mitochondrial dynamics seems to be very relevant for the regulation of mtDNA content and functionality.


rs2802292 polymorphism in the FOXO3A gene and exceptional longevity in two ethnically distinct cohorts.

Fuku N, Díaz-Peña R, Arai Y, Abe Y, Pareja-Galeano H, Sanchis-Gomar F, Santos-Lozano A, Zempo H, Naito H, Murakami H, Miyachi M, Venturini L, Ricevuti G, Nobuyoshi H, Emanuele E, Lucia A.

Maturitas. 2016 Oct;92:110-4. doi: 10.1016/j.maturitas.2016.07.016. Epub 2016 Jul 28.

PMID: 27621247


exceptional longevity (EL, i.e., living 100+ years) … No statistically significant association was found between the rs2802292 polymorphism and EL in either cohort (either examined in their entirety or in a sex-based analysis).


Overeat today, skip the scale tomorrow: An examination of caloric intake predicting nonadherence to daily self-weighing.

Tanenbaum ML, Ross KM, Wing RR.

Obesity (Silver Spring). 2016 Sep 13. doi: 10.1002/oby.21650. [Epub ahead of print]

PMID: 27619935



[ignorance is guiltless.]

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Role of gut microbiota and nutrients in amyloid formation and pathogenesis of Alzheimer disease

Francesca Pistollato, Sandra Sumalla Cano, Iñaki Elio, Manuel Masias Vergara, Francesca Giampieri, and Maurizio Battino

Nutr Rev 2016 74: 624-634


modulating the gut microbiome and amyloidogenesis through specific nutritional interventions might prove to be an effective strategy to prevent or reduce the risk of Alzheimer disease.

“For example, α-mangostin, a xanthone found in mangosteen fruit, has been reported to promote dysbiosis in mice in vivo, elevating serum levels of granulocyte colony-stimulating factor, IL-6, and serum amyloid A,171 while inhibiting Ab aggregation in rat cortical neurons in vitro.172”

171. Dietary α-mangostin, a xanthone from mangosteen fruit, exacerbates experimental colitis and promotes dysbiosis in mice.

Gutierrez-Orozco F, Thomas-Ahner JM, Berman-Booty LD, Galley JD, Chitchumroonchokchai C, Mace T, Suksamrarn S, Bailey MT, Clinton SK, Lesinski GB, Failla ML.

Mol Nutr Food Res. 2014 Jun;58(6):1226-38. doi: 10.1002/mnfr.201300771. Epub 2014 Feb 17.

PMID: 24668769

Free PMC Article


172.  α-mangostin, a polyphenolic xanthone derivative from mangosteen, attenuates β-amyloid oligomers-induced neurotoxicity by inhibiting amyloid aggregation.

Wang Y, Xia Z, Xu JR, Wang YX, Hou LN, Qiu Y, Chen HZ.

Neuropharmacology. 2012 Feb;62(2):871-81. doi: 10.1016/j.neuropharm.2011.09.016. Epub 2011 Sep 24.

PMID: 21958557



Salt-sensitive hypertension: mechanisms and effects of dietary and other lifestyle factors.

Pilic L, Pedlar CR, Mavrommatis Y.

Nutr Rev. 2016 Aug 25. pii: nuw028. [Epub ahead of print] Review.

PMID: 27566757


higher dietary intakes of potassium, calcium, vitamin D, antioxidant vitamins, and proteins rich in L-arginine, as well as adherence to dietary patterns similar to the DASH (Dietary Approaches to Stop Hypertension) diet, can be beneficial to salt-sensitive populations. In contrast, diets similar to the typical Western diet, which is rich in saturated fats, sucrose, and fructose, together with excessive alcohol consumption, may exacerbate salt-sensitive changes in blood pressure.


Urine Albumin/Creatinine Ratio Below 30 mg/g is a Predictor of Incident Hypertension and Cardiovascular Mortality.

Sung KC, Ryu S, Lee JY, Lee SH, Cheong E, Hyun YY, Lee KB, Kim H, Byrne CD.

J Am Heart Assoc. 2016 Sep 13;5(9). pii: e003245. doi: 10.1161/JAHA.116.003245.

PMID: 27625343

Free Article



urine albumin:creatinine ratio (UACR) … HR for the association between UACR and incident hypertension (highest UACR quartile HR 1.95 [95% CI 1.51, 2.53], P-value for trend across UACR quartiles P<0.001). ... For CVD mortality, with increasing UACR quartiles, there was a significant increase in HR across quartiles, P=0.029, (for all-cause mortality, P=0.078).


Quantifying the contributions of behavioral and biological risk factors to socioeconomic disparities in coronary heart disease incidence: the MORGEN study.

Kershaw KN, Droomers M, Robinson WR, Carnethon MR, Daviglus ML, Monique Verschuren WM.

Eur J Epidemiol. 2013 Oct;28(10):807-14. doi: 10.1007/s10654-013-9847-2. Epub 2013 Sep 14.

PMID: 24037117

Free PMC Article



Behavioral and biological risk factors accounted for 56.6 % (95 % CI 42.6-70.8 %) of the low education-incident CHD association. Smoking was the strongest mediator, accounting for 27.3 % (95 % CI 17.7-37.4 %) of the association, followed by obesity (10.2 %; 95 % CI 4.5-16.1 %), physical inactivity (6.3 %; 95 % CI 2.7-10.0 %), and hypertension (5.3 %; 95 % CI: 2.8-8.0 %).


Infection: Feed a virus, starve a bacterium.

[No authors listed]

Nature. 2016 Sep 14;537(7620):283. doi: 10.1038/537283c. No abstract available.

PMID: 27629613


Feeding mice helps them to fight viral infection, whereas starvation is a better strategy against bacterial infection — lending support to the proverb 'feed a cold, starve a fever'.

Bacterium-infected mice that were deprived of food stayed alive, whereas well-fed animals died. By contrast, almost all mice with flu died when they were starved, but most survived when they were fed. During bacterial inflammation, glucose from food inhibited a metabolic process that protects brain tissue from damage, whereas the sugar protected the brain during viral inflammation.


Opposing Effects of Fasting Metabolism on Tissue Tolerance in Bacterial and Viral Inflammation.

Wang A, Huen SC, Luan HH, Yu S, Zhang C, Gallezot JD, Booth CJ, Medzhitov R.

Cell. 2016 Sep 8;166(6):1512-1525.e12. doi: 10.1016/j.cell.2016.07.026.

PMID: 27610573


    Fasting metabolism is protective in bacterial, but not viral, inflammation

    Ketone bodies limit ROS-induced neuronal damage during bacterial inflammation

    Glucose utilization prevents UPR-mediated neuronal damage during viral inflammation opposing metabolic requirements tied to cellular stress adaptations critical for tolerance of differential inflammatory states.


Obesity: The fat advantage.

Gupta S.

Nature. 2016 Sep 14;537(7620):S100-S102. doi: 10.1038/537S100a. No abstract available.

PMID: 27626776


Obese people have a higher incidence of kidney cancer, but are also more likely to survive the disease. Is the 'obesity paradox' real or an artefact of how studies are conducted?


Alcohol: Fortifying spirits.

Emspak J.

Nature. 2016 Sep 14;537(7620):S103-S104. doi: 10.1038/537S103a. No abstract available.

PMID: 27626777


Alcohol intake boosts the risk of cancers of the liver, breast and colon, but it seems to reduce the risk of kidney cancer.


Preventing Shingles and Its Complications in Older Persons.

Neuzil KM, Griffin MR.

N Engl J Med. 2016 Sep 15;375(11):1079-1080. No abstract available.

PMID: 27626522


In the United States each year, herpes zoster, or shingles, develops in half a million people 60 years of age or older. Although the symptoms are often mild in younger persons, the risk for serious complications of herpes zoster, including postherpetic neuralgia ...


Efficacy of the Herpes Zoster Subunit Vaccine in Adults 70 Years of Age or Older.

Cunningham AL, Lal H, Kovac M, Chlibek R, Hwang SJ, Díez-Domingo J, Godeaux O, Levin MJ, McElhaney JE, Puig-Barberà J, Vanden Abeele C, Vesikari T, Watanabe D, Zahaf T, Ahonen A, Athan E, Barba-Gomez JF, Campora L, de Looze F, Downey HJ, Ghesquiere W, Gorfinkel I, Korhonen T, Leung E, McNeil SA, Oostvogels L, Rombo L, Smetana J, Weckx L, Yeo W, Heineman TC; ZOE-70 Study Group.

N Engl J Med. 2016 Sep 15;375(11):1019-1032.

PMID: 27626517


vaccine efficacy against herpes zoster was 91.3% (95% CI, 86.8 to 94.5; P<0.001), and vaccine efficacy against postherpetic neuralgia was 88.8% (95% CI, 68.7 to 97.1; P<0.001).


[it was not a prospective study, unfortunately.]

Associations of Source-Specific Fine Particulate Matter With Emergency Department Visits in California.

Ostro B, Malig B, Hasheminassab S, Berger K, Chang E, Sioutas C.

Am J Epidemiol. 2016 Sep 6. pii: kwv343. [Epub ahead of print]

PMID: 27605585


we observed associations of vehicular emissions with all cardiovascular [Emergency Department Visits  (EDVs)] (excess risk = 1.6%, 95% confidence interval: 0.9, 2.4 for an interquartile-range increment of 2.8 µg/m3) and with several subclasses of disease. In addition, vehicular emissions, biomass burning, and soil sources were associated with all respiratory EDVs and with EDVs for asthma. The soil source, which includes resuspended road dust, generated the highest risk estimate for asthma (excess risk = 4.5%, 95% confidence interval: 1.1, 8.0).


Examining the Long-Term Association of Personality With Cause-Specific Mortality in London: Four Decades of Mortality Surveillance in the Original Whitehall Smoking Cessation Trial.

Batty GD, Jokela M, Kivimaki M, Shipley M.

Am J Epidemiol. 2016 Sep 1. pii: kwv454. [Epub ahead of print]

PMID: 27589990


no support for a role of either extraversion or neuroticism as determinants of long-term mortality risk.


[The data are pretty clear but I would have a difficult time deciding which way to go.  Watchful waiting subjects had more metastatic disease and some underwent treatment anyway.  Side effects of metastatic disease are great too and the final result is almost always fatal if the subjects were followed for more years and did not die from other causes.]

Treat or monitor early prostate cancer? 10-year survival same

No hard evidence that treating early disease makes a difference

The Associated Press Posted: Sep 14, 2016 5:53 PM ET



10-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Localized Prostate Cancer.

Hamdy FC, Donovan JL, Lane JA, Mason M, Metcalfe C, Holding P, Davis M, Peters TJ, Turner EL, Martin RM, Oxley J, Robinson M, Staffurth J, Walsh E, Bollina P, Catto J, Doble A, Doherty A, Gillatt D, Kockelbergh R, Kynaston H, Paul A, Powell P, Prescott S, Rosario DJ, Rowe E, Neal DE; ProtecT Study Group.

N Engl J Med. 2016 Sep 14. [Epub ahead of print]

PMID: 27626136


There were 17 prostate-cancer-specific deaths overall: 8 in the active-monitoring group (1.5 deaths per 1000 person-years; 95% confidence interval [CI], 0.7 to 3.0), 5 in the surgery group (0.9 per 1000 person-years; 95% CI, 0.4 to 2.2), and 4 in the radiotherapy group (0.7 per 1000 person-years; 95% CI, 0.3 to 2.0); the difference among the groups was not significant (P=0.48 for the overall comparison). … no significant difference was seen among the groups in the number of deaths from any cause ... Metastases developed in more men in the active-monitoring group (33 men; 6.3 events per 1000 person-years; 95% CI, 4.5 to 8.8) than in the surgery group (13 men; 2.4 per 1000 person-years; 95% CI, 1.4 to 4.2) or the radiotherapy group (16 men; 3.0 per 1000 person-years; 95% CI, 1.9 to 4.9) (P=0.004 for the overall comparison). Higher rates of disease progression were seen in the active-monitoring group (112 men; 22.9 events per 1000 person-years; 95% CI, 19.0 to 27.5) than in the surgery group (46 men; 8.9 events per 1000 person-years; 95% CI, 6.7 to 11.9) or the radiotherapy group (46 men; 9.0 events per 1000 person-years; 95% CI, 6.7 to 12.0) (P<0.001 for the overall comparison). oring.


Effects of Diet on Sleep Quality

Marie-Pierre St-Onge, Anja Mikic, and Cara E Pietrolungo

Adv Nutr 2016; 7:938-949 doi:10.3945/an.116.012336


intake of specific foods, consumed at a fixed time relative to sleep, on sleep architecture and quality. Those foods, specifically milk, fatty fish, tart cherry juice, and kiwifruit, are reviewed

Edited by AlPater
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Reduction in circulating bile acid and restricted diffusion across the intestinal epithelium are associated with a decrease in blood cholesterol in the presence of oat β-glucan.

Gunness P, Michiels J, Vanhaecke L, De Smet S, Kravchuk O, Van de Meene A, Gidley MJ.

FASEB J. 2016 Sep 14. pii: fj.201600465R. [Epub ahead of print]

PMID: 27630168


[it seems that more than all the pigs’ diets would have to be oats to reach the level of oat β-glucan used in the study.]

(1,3:1,4)-β-glucan (BG) … bile acids (BAs) … BG added to the diet for 26 d caused decreases of 24% in blood total BAs (TBAs), 34% in total cholesterol (TC), and 57% in LDL cholesterol (LDL-C) (P < 0.01); decreases of 20% TBA in the midjejunum and terminal ileum (P < 0.01); increases of 80% in cecal total neutral sterols (TNSs) including cholesterol (P < 0.01); a 50% reduction in BA active transport across ex vivo ileum after 40 min (P < 0.001); and 32% decrease in jejunal microvilli heights with apparent increased goblet cell activity. ... Fermentation of sterols reaching the colon enhanced production of therapeutic ursodeoxycholic acid, suppressed toxic lithocholic acid, and decreased the possibility of cholesterol absorption by transforming the latter into coprostanol, a nonabsorbable NS.


Dietary saturated fat and monounsaturated fat have reversible effects on brain function and the secretion of pro-inflammatory cytokines in young women.

Dumas JA, Bunn JY, Nickerson J, Crain KI, Ebenstein DB, Tarleton EK, Makarewicz J, Poynter ME, Kien CL.

Metabolism. 2016 Oct;65(10):1582-8. doi: 10.1016/j.metabol.2016.08.003. Epub 2016 Aug 9.

PMID: 27621193

palmitic acid (PA)/oleic acid (OA) … 3-week high PA diet (HPA) and low PA and a high OA diet (HOA) … Brain activation during the HPA diet compared to the HOA diet was increased … (p<0.005). … impact brain network activation during a working memory task … lowering the dietary PA content via substitution with OA also could affect cognition.


Dietary exposure to polychlorinated biphenyls and risk of breast, endometrial and ovarian cancer in a prospective cohort.

Donat-Vargas C, Åkesson A, Berglund M, Glynn A, Wolk A, Kippler M.

Br J Cancer. 2016 Sep 15. doi: 10.1038/bjc.2016.282. [Epub ahead of print]

PMID: 27632375


no overall association between dietary PCB exposure and any of these cancer forms. The multivariable-adjusted relative risks comparing women in the highest and lowest tertile of PCB exposure were 0.96 (95% confidence interval (CI): 0.75, 1.24), 1.21 (95% CI: 0.73, 2.01) and 0.90 (95% CI: 0.45, 1.79) for breast, endometrial and ovarian cancer. In analyses stratified by factors influencing oestrogen exposure, possibly masking associations with PCBs, indications of higher risks were observed for endometrial cancer.

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Weight Gain Trajectories Associated With Elevated C‐Reactive Protein Levels in Chinese Adults

Amanda L. Thompson, Elizabeth Koehler, Amy H. Herring, Lauren Paynter, Shufa Du, Bing Zhang, Barry Popkin, and Penny Gordon‐Larsen

J Am Heart Assoc. 2016;5:e003262. Originally published September 16, 2016. doi: 10.1161/JAHA.116.003262


Steeper weight‐gain trajectories were associated with greater risk of elevated hs‐CRP compared to more moderate weight‐gain trajectories in men and women. Initially high weight gain followed by weight loss was associated with lower risk of elevated hs‐CRP in women aged 18 to 40.


[i guess that I was drawn to the issue studied in the papers by some results here.  A 68-year old guy living in our condo building had three cardiac arrests one day this summer and got the defibrillator and a stent put in.  He had his defibrullator restart his heart 82 times one day this month and burned out his defibrillator, so they had to replace it.  He was in apparent good health re lifestyle.]

Sex Differences in Survival From Out-of-Hospital Cardiac Arrest in the Era of Regionalized Systems and Advanced Post-Resuscitation Care.

Bosson N, Kaji AH, Fang A, Thomas JL, French WJ, Shavelle D, Niemann JT.

J Am Heart Assoc. 2016 Sep 15;5(9). pii: e004131. doi: 10.1161/JAHA.116.004131.

PMID: 27633392


Women were older, median 71 (interquartile range [iQR], 59–82) versus 66 years (IQR, 55–78). Despite similar frequency of witnessed arrest, women were less likely to present with a shockable rhythm (22% vs 35%; risk difference [RD], 13%; 95% CI, 11–15), have ST‐segment elevation myocardial infarction (23% vs 32%; RD, 13%; 95% CI, 7–11), or receive coronary angiography (11% vs 25%; RD, 14%; 95% CI, 12–16), percutaneous coronary intervention (5% vs 14%; RD, 9%; 95% CI, 7–11), or targeted temperature management (33% vs 40%; RD, 7%; 95% CI, 4–10). Women had decreased survival to discharge (33% vs 40%; RD, 7%; 95% CI, 4–10) and a lower proportion of good neurological outcome (16% vs 24%; RD, 8%; 95% CI, 6–10). In multivariable modeling, female sex was not associated with decreased survival with good neurological outcome (OR, 0.9; 95% CI, 0.8–1.1). … With adjustment for these factors, sex was not associated with survival or neurological outcome after OHCA.


[i thought that CPR by first responders would have led to greater one-year survival than that by bystanders.  I guess the time taken before CPR was that much different to account for this, yet EMC folks provided better response.]

Long-Term Outcomes Among Elderly Survivors of Out-of-Hospital Cardiac Arrest.

Chan PS, McNally B, Nallamothu BK, Tang F, Hammill BG, Spertus JA, Curtis LH.

J Am Heart Assoc. 2016 Mar 15;5(3):e002924. doi: 10.1161/JAHA.115.002924.

PMID: 27068632

Free PMC Article


Overall 1‐year mortality after hospital discharge was 31.8%. Among survivors, there were no long‐term mortality differences by sex, race, or initial cardiac arrest rhythm, but worse functional status and severe neurological disability at discharge were associated with higher mortality. Moreover, compared with first responders, cardiopulmonary resuscitation delivered by bystanders was associated with 23% lower mortality (hazard ratio 0.77 [confidence interval 0.58–1.02]). Besides mortality, 638 (56.6%) patients were readmitted within the first year, and the cumulative readmission incidence was 197 per 100 patient‐years. Mean 1‐year inpatient costs were $23 765±41 002. Younger age, black race, severe neurological disability at discharge, and hospital disposition to a skilled nursing or rehabilitation facility were each associated with higher 1‐year inpatient costs (P for all <0.05).


Sex and Age Aspects in Patients Suffering From Out-Of-Hospital Cardiac Arrest: A Retrospective Analysis of 760 Consecutive Patients.

Piegeler T, Thoeni N, Kaserer A, Brueesch M, Sulser S, Mueller SM, Seifert B, Spahn DR, Ruetzler K.

Medicine (Baltimore). 2016 May;95(18):e3561. doi: 10.1097/MD.0000000000003561.

PMID: 27149475

Free PMC Article


Female patients were significantly older, compared with male patients (68 ± 18 [mean ± SD] vs 64 ± 18 years, P = .012). Men were resuscitated slightly more often than women (86.4% vs 82.1%). Overall out-of-hospital mortality rate was found to be 81.2% (492/632 patients) with no differences between sexes (82.1% for males vs 79% for females, odds ratio 1.039, 95% confidence interval 0.961-1.123). … The data of our study demonstrate that there was no sex-based bias in treating patients requiring CPR in the prehospital setting in our physician-led emergency ambulance service.


Grip Strength Decline and Its Determinants in the Very Old: Longitudinal Findings from the Newcastle 85+ Study.

Granic A, Davies K, Jagger C, Kirkwood TB, Syddall HE, Sayer AA.

PLoS One. 2016 Sep 16;11(9):e0163183. doi: 10.1371/journal.pone.0163183. eCollection 2016.

PMID: 27637107


grip strength (GS) … Men's mean grip strength was 24.42 (SD = 6.77) kg, and women's 13.23 (4.42) kg (p<0.001) at baseline, with mean absolute change of -5.27 (4.90) kg and -3.14 (3.41), respectively (p<0.001) by 5-year follow-up. In the time-only mixed model, men experienced linear annual decline in GS of -1.13 (0.8) kg (β (SE), p<0.001), whilst women's decline although slower, accelerated by -0.06 (0.02) kg (p = 0.01) over time. In the saturated model, higher baseline physical activity, height, fat-free mass, better self-rated health, and not having arthritis in hand(s) were associated with stronger GS initially in both sexes. Annual GS decline in men and participants with weak GS who were highly physically active was slower by 0.95 and 0.52 kg, respectively compared with inactive counterparts. … important to reduce the morbidity and mortality in the very old.


Anti-obesogenic and antidiabetic effects of plants and mushrooms.

Martel J, Ojcius DM, Chang CJ, Lin CS, Lu CC, Ko YF, Tseng SF, Lai HC, Young JD.

Nat Rev Endocrinol. 2016 Sep 16. doi: 10.1038/nrendo.2016.142. [Epub ahead of print] Review.

PMID: 27636731


Several plants and mushrooms that are consumed in traditional Chinese medicine or as nutraceuticals contain antioxidants, fibre and other phytochemicals, and have anti-obesogenic and antidiabetic effects through the modulation of diverse cellular and physiological pathways. These effects include appetite reduction, modulation of lipid absorption and metabolism, enhancement of insulin sensitivity, thermogenesis and changes in the gut microbiota.


Exercise raises high-density lipoprotein cholesterol in men after consumption of ground beef with a high but not low monounsaturated fatty acid-saturated fatty acid ratio.

Crouse SF, Green JS, Meade TH, Smith DR, Smith SB.

Nutr Res. 2016 Sep;36(9):974-81. doi: 10.1016/j.nutres.2016.06.013. Epub 2016 Jun 29.

PMID: 27632917


[Well they tried to find a way to make beef seem to be healthy.]

high MUFA:SFA ratio (HR = 1.1) … lower MUFA:SFA ratio (LR = 0.71). … 4-week self-selected (SS) washout diet. ... Subjects reported no other changes in diets or physical activity patterns, and body weight and body mass index did not change over the study duration. Diet (3) × Exercise Time (2) repeated measures analysis of variance (α = .05) and follow-up analyses revealed that blood concentrations (mmol/L ± SD) of total cholesterol (5.07 ± 1.16 to 5.73 ± 1.36), high-density lipoprotein cholesterol (HDL-C) (1.19 ± 0.20 to 1.36 ± 0.29), HDL2-C (0.24 ± 0.08 to 0.28 ± 0.11), HDL3-C (0.94 ± 0.14 to 1.08 ± 0.20), and non-HDL-C (3.88 ± 1.24 to 4.37 ± 1.38) were significantly elevated with exercise after the HR beef diet, but not after LR and SS diets.

“MUFA:SFA of 0.70 or 1.10, representing pasture-fed

and intensively grain-fed ground beef, respectively


Partial support from: 1) The Beef Checkoff”


Changes in Overall Diet Quality and Subsequent Type 2 Diabetes Risk: Three U.S. Prospective Cohorts.

Ley SH, Pan A, Li Y, Manson JE, Willett WC, Sun Q, Hu FB.

Diabetes Care. 2016 Sep 15. pii: dc160574. [Epub ahead of print]

PMID: 27634391


Alternate Healthy Eating Index (AHEI) score ... A >10% decrease in AHEI score over 4 years was associated with a higher subsequent diabetes risk (pooled hazard ratio 1.34 [95% CI 1.23-1.46]) with multiple adjustment, whereas a >10% increase in AHEI score was associated with a lower risk (0.84 [0.78-0.90]). Greater improvement in diet quality was associated with lower diabetes risk across baseline diet quality status (P for trend ≤ 0.001 for low, medium, or high initial diet quality) and baseline BMI (P for trend ≤ 0.01 for BMI <25, 25-29, or 30 kg/m2). Changes in body weight explained 32% (95% CI 24-41) of the association between AHEI changes (per 10% increase) and diabetes risk.


Change in women's eating habits during the menstrual cycle.

Kammoun I, Ben Saâda W, Sifaou A, Haouat E, Kandara H, Ben Salem L, Ben Slama C.

Ann Endocrinol (Paris). 2016 Sep 12. pii: S0003-4266(16)30091-9. doi: 10.1016/j.ando.2016.07.001. [Epub ahead of print]

PMID: 27634490


slight but significant increase in body weight during the luteal phase (P=0.022) and the follicular phase (P=0.017) compared with the peri-ovulatory phase, without any significant change in waist circumference. The caloric intake increased during the peri-ovulatory (P<0.001) and the luteal phases (P<0.001), compared with the follicular phase, with a significant increase in carbohydrate (P<0.001), lipid (P=0.008) and protein (P=0.008) intake.


[Hyperuricemia seemed to affect bone health and total health oppositely to CR.]

Hyperuricemia Protects Against Low Bone Mineral Density, Osteoporosis and Fractures: A Systematic Review And Meta-Analysis.

Veronese N, Carraro S, Bano G, Trevisan C, Solmi M, Luchini C, Manzato E, Caccialanza R, Sergi G, Nicetto D, Cereda E.

Eur J Clin Invest. 2016 Sep 16. doi: 10.1111/eci.12677. [Epub ahead of print]

PMID: 27636234


Serum uric acid (SUA) accounts for about 50% of extracellular antioxidant activity, suggesting that hyperuricemia may have a protective role in diseases characterized by high levels of oxidative stress, such as osteoporosis. … bone mineral density (BMD) ... Subjects with higher SUA levels had significantly higher BMD values for the spine (6 studies; SMD=0.29; 95%CI: 0.22-0.35; I2 =47%), total hip (7 studies; SMD=0.29; 95%CI: 0.24-0.34; I2 =33%) and femoral neck (6 studies; SMD=0.25; 95%CI: 0.16-0.34; I2 =71%). … An increase of one standard deviation in SUA levels reduced the number of new fractures at follow-up (3 studies; HR=0.83; 95%CI: 0.74-0.92; I2 =0%). No significant differences between men and women


Hyperuricemia is associated with increased hospitalization risk and healthcare costs: Evidence from an administrative database in Italy.

Degli Esposti L, Desideri G, Saragoni S, Buda S, Pontremoli R, Borghi C.

Nutr Metab Cardiovasc Dis. 2016 Oct;26(10):951-61. doi: 10.1016/j.numecd.2016.06.008. Epub 2016 Jun 29.

PMID: 27555289


serum uric acid (SUA) … levels: <6 mg/dL (66.5%), >6 mg/dL and ≤7 mg/dL (19.3%), >7 mg/dL and ≤8 mg/dL (8.7%), and >8 mg/dL (5.5%). Compared to those with SUA level of <6 mg/dL, the risk of hospitalization related to gout and/or nephrolithiasis was higher in the three groups of patients with higher SUA levels (1.51, P = 0.100; 2.21, P = 0.005; and 1.17, P = 0.703, respectively). A similar trend was also observed for hospitalization due to chronic kidney disease (CKD) (1.31, P < 0.001; 1.40, P < 0.001; and 2.18, P < 0.001, respectively) and cardiovascular disease (CVD) (1.08, P < 0.001; 1.23, P < 0.001; and 1.67, P < 0.001, respectively) and for all-cause mortality (0.97, P = 0.309; 1.21, P < 0.001; and 2.15, P < 0.001). The mean annual healthcare costs were higher in patients with higher SUA level



CETP polymorphisms confer genetic contribution to centenarians of Hainan, south of China.

Zhang YX, Su Y, Tang L, Yang ZX, Zhou DF, Qiu YM, Cai WW.

Asian Pac J Trop Med. 2016 Sep;9(9):872-6. doi: 10.1016/j.apjtm.2016.07.009. Epub 2016 Jul 26.

PMID: 27633301


Our data indicated that allele B1 and V have the significant differences between centenarians and healthy control groups with P < 0.001. Further analysis implied that genotypes B1B1 (P < 0.001, OR = 0.148, 95% CI = 0.095-0.230) and VV (P < 0.001 and OR = 0.353, 95% CI = 0.237-0.525) were significantly different between centenarians and matched controls. The combination of B and V, such as B1B1-II (P < 0.001, OR = 0.128, 95% CI = 0.049-0.329), B1B1-IV (P < 0.001, OR = 0.115, 95% CI = 0.056-0.237), B1B2-VV (P < 0.05, OR = 0.534, 95% CI = 0.310-0.920), and B2B2-VV (P < 0.001, OR = 0.198, 95% CI = 0.086-0.453) have significant differences between centenarians and matched healthy individuals from Hainan.

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Nutrition and Healthy Aging.

Kritchevsky SB.

J Gerontol A Biol Sci Med Sci. 2016 Oct;71(10):1303-5. doi: 10.1093/gerona/glw165. No abstract available.

PMID: 27621294 


[The paper describes the journal’s http://biomedgerontology.oxfordjournals.org/content/current papers.]


Association Between Carbohydrate Nutrition and Successful Aging Over 10 Years.

Gopinath B, Flood VM, Kifley A, Louie JC, Mitchell P.

J Gerontol A Biol Sci Med Sci. 2016 Oct;71(10):1335-40. doi: 10.1093/gerona/glw091. Epub 2016 Jun 1.

PMID: 27252308


[The greater breads/cereal eating folks also died less, while the greater fruit eating ones did not.]

(15.5%) participants had aged successfully 10 years later. Dietary GI, GL, and carbohydrate intake were not significantly associated with successful aging [but, the former two were negatively associated with death.]. However, participants in the highest versus lowest (reference group) quartile of total fiber intake had greater odds of aging successfully than suboptimal aging, multivariable-adjusted odds ratio (OR), 1.79 (95% confidence interval [CI] 1.13-2.84). Those who remained consistently below the median in consumption of fiber from breads/cereal and fruit compared with the rest of cohort were less likely to age successfully, OR 0.53 (95% CI 0.34-0.84) and OR 0.64 (95% CI 0.44-0.95), respectively.


Effects of 6-Month Folic Acid Supplementation on Cognitive Function and Blood Biomarkers in Mild Cognitive Impairment: A Randomized Controlled Trial in China.

Ma F, Wu T, Zhao J, Han F, Marseglia A, Liu H, Huang G.

J Gerontol A Biol Sci Med Sci. 2016 Oct;71(10):1376-83. doi: 10.1093/gerona/glv183. Epub 2015 Oct 27.

PMID:  26508298


oral folic acid (400 µg/day) [the RDA] and (b) those treated via conventional treatment. … significant improvements in serum folate (ηp (2) = 0.712, p = .009), homocysteine (ηp (2) = 0.119, p = .017), serum vitamin B12 (ηp (2) = 0.144, p = .022), and S-adenosylmethionine (ηp (2) = 0.117, p = .033) in the intervention group over the control group. Folic acid supplementation improved Full Scale IQ (p = .031; effect size d = 0.168), Digit Span (p = .009; d = 0.176), and Block Design (p = .036; effect size d = 0.146) scores at 6 months in comparison to the control.


Vitamin D Levels and the Risk of Cognitive Decline in Chinese Elderly People: the Chinese Longitudinal Healthy Longevity Survey.

Matchar DB, Chei CL, Yin ZX, Koh V, Chakraborty B, Shi XM, Zeng Y.

J Gerontol A Biol Sci Med Sci. 2016 Oct;71(10):1363-8. doi: 10.1093/gerona/glw128. Epub 2016 Jul 12.

PMID: 27412894


Compared with the highest quartile of vitamin D levels, the multivariable odds ratios (ORs; 95% confidence interval) for cognitive decline were 2.1 (1.3-3.4) for the second highest quartile, 2.2 (1.4-3.6) for the third highest quartile, and 2.0 (1.2-3.3) for the lowest quartile. The multivariable ORs of incident cognitive impairment for the second highest, third highest, and lowest versus highest quartiles of vitamin D levels were 1.9 (0.9-4.1), 2.6 (1.2-5.6), and 3.2 (1.5-6.6), respectively.


Macronutrients Intake and Incident Frailty in Older Adults: A Prospective Cohort Study.

Sandoval-Insausti H, Pérez-Tasigchana RF, López-García E, García-Esquinas E, Rodríguez-Artalejo F, Guallar-Castillón P.

J Gerontol A Biol Sci Med Sci. 2016 Oct;71(10):1329-34. doi: 10.1093/gerona/glw033. Epub 2016 Mar 4.

PMID: 26946103


[Linoleic acid consumption quartile 3 was an over two-fold greater risk than consuming quartile 1.]

odds ratios (95% confidence interval) of frailty across increasing quartiles of total protein were 1.00, 0.55 (0.32-0.93), 0.45 (0.26-0.78), and 0.41 (0.23-0.72); p trend: .001. The corresponding figures for animal protein intake were 1.00, 0.68 (0.40-1.17), 0.56 (0.32-0.97), and 0.48 (0.26-0.87), p trend: .011. And for intake of monounsaturated fatty acids (MUFAs), the results were 1.00, 0.66 (0.37-1.20), 0.54 (0.28-1.02), and 0.50 (0.26-0.96); p trend: .038. No association was found between intake of vegetable protein, saturated fats, long-chain ω-3 fatty acids, α-linolenic acid, linoleic acid, simple sugars, or polysaccharides


COX Inhibitor Influence on Skeletal Muscle Fiber Size and Metabolic Adaptations to Resistance Exercise in Older Adults.

Trappe TA, Ratchford SM, Brower BE, Liu SZ, Lavin KM, Carroll CC, Jemiolo B, Trappe SW.

J Gerontol A Biol Sci Med Sci. 2016 Oct;71(10):1289-94. doi: 10.1093/gerona/glv231. Epub 2016 Jan 26.

PMID: 26817469



COX inhibitor (acetaminophen, 4 gram/day; n = 7; 64±1 years) in double-blind fashion. ... Type I fiber size did not change with training in the placebo group (304±590 μm2) but increased 28% in the COX inhibitor group (1,388±760 μm2, p < .1). Type II fiber size increased 26% in the placebo group (1,432±499 μm2, p < .05) and 37% in the COX inhibitor group (1,825±400 μm2, p < .05). … capillary to fiber ratio increased 24% (p < .1) and citrate synthase activity increased 18% (p < .05) in the COX inhibitor group.

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Cytomegalovirus infection is associated with an increase in systolic blood pressure in older individuals.

Firth C, Harrison R, Ritchie S, Wardlaw J, Ferro CJ, Starr JM, Deary IJ, Moss P.

QJM. 2016 Apr 12. pii: hcw026. [Epub ahead of print]

PMID: 27071749

Free Article


Sixty-five percent of participants were CMV seropositive, which indicates chronic infection. The mean sitting systolic blood pressure (SBP) was 149.2 mmHg in CMV seropositive individuals compared with 146.2 mmHg in CMV seronegative subjects (SD 18.7 vs. 19.7; P < 0.017).


Vitamin K intake and all-cause and cause specific mortality.

Zwakenberg SR, den Braver NR, Engelen AI, Feskens EJ, Vermeer C, Boer JM, Verschuren WM, van der Schouw YT, Beulens JW.

Clin Nutr. 2016 Aug 30. pii: S0261-5614(16)30216-3. doi: 10.1016/j.clnu.2016.08.017. [Epub ahead of print]

PMID: 27640076


phylloquinone and menaquinones were not associated with all-cause mortality with hazard ratios for the upper vs. the lowest quartile of intake of 1.04 (0.92;1.17) and 0.94 (0.82;1.07) respectively. Neither phylloquinone intake nor menaquinone intake was associated with risk of CVD mortality. Higher intake of long chain menaquinones was borderline significantly associated (ptrend = 0.06) with lower CHD mortality with a HR10μg of 0.86 (0.74;1.00). None of the forms of vitamin K intake were associated with cancer mortality or mortality from other causes.



Malignancy and mortality in a population-based cohort of patients with coeliac disease or "gluten sensitivity".

Anderson LA, McMillan SA, Watson RG, Monaghan P, Gavin AT, Fox C, Murray LJ.

World J Gastroenterol. 2007 Jan 7;13(1):146-51.

PMID: 17206762

Free PMC Article


all-cause mortality was significantly increased following diagnosis. ... Lung and breast cancer incidence were significantly lower and all-cause mortality, mortality from malignant neoplasms, non-Hodgkin’s lymphoma and digestive system disorders were significantly higher in gluten sensitive patients compared to the Northern Ireland population.




Plasma total and unacylated ghrelin predict 5-year changes in insulin resistance.

Barazzoni R, Gortan Cappellari G, Semolic A, Ius M, Mamolo L, Dore F, Giacca M, Zanetti M, Vinci P, Guarnieri G.

Clin Nutr. 2016 Oct;35(5):1168-73. doi: 10.1016/j.clnu.2015.10.002. Epub 2015 Oct 22.

PMID: 26508327


Ghrelin is a gastric hormone circulating in acylated (AG) and unacylated (UG) forms, and higher plasma total ghrelin (TG) … Baseline TG and UG were associated negatively with HOMA after adjusting for gender and body mass index (BMI). Baseline gender- and BMI-adjusted TG and UG were also negatively associated with HOMA at 5-year follow-up (n = 350), and changes in TG and UG were negatively associated with changes in HOMA (P < 0.05) after adjustment for anthropometric and metabolic confounders. No statistically significant correlations were observed between AG and baseline or 5-year HOMA.


Energy homeostasis and appetite regulating hormones as predictors of weight loss in men and women.

Williams RL, Wood LG, Collins CE, Morgan PJ, Callister R.

Appetite. 2016 Jun 1;101:1-7. doi: 10.1016/j.appet.2016.02.153. Epub 2016 Feb 26.

PMID: 26921488


In males and females, a higher baseline concentration of unacylated ghrelin predicted greater weight loss at six months. Additionally in females, higher baseline total ghrelin predicted greater weight loss and a higher ratio of leptin:ghrelin predicted weight gain at six months. A higher pre-weight-loss plasma concentration of unacylated ghrelin is a modest predictor of weight loss success in males and females, while a higher leptin:ghrelin ratio is a predictor of weight loss failure in females.


Intellectual ability in young adulthood as an antecedent of physical functioning in older age.

Poranen-Clark T, von Bonsdorff MB, Törmäkangas T, Lahti J, Wasenius N, Räikkönen K, Osmond C, Salonen MK, Rantanen T, Kajantie E, Eriksson JG.

Age Ageing. 2016 May 17. pii: afw087. [Epub ahead of print]

PMID: 27189726


better intellectual ability total and arithmetic and verbal reasoning subtest scores in young adulthood predicted better physical functioning at age 61 years (P values <0.021). Intellectual ability total and arithmetic and verbal reasoning subtest scores in young adulthood had indirect effects on physical functioning at age 71 years (P values <0.022) through better physical functioning at age 61 years.


Risk of cancer in Asian Americans: a Kaiser Permanente cohort study.

Tran HN, Li Y, Udaltsova N, Armstrong MA, Friedman GD, Klatsky AL.

Cancer Causes Control. 2016 Oct;27(10):1197-207. doi: 10.1007/s10552-016-0798-2. Epub 2016 Aug 25.

PMID: 27562672


Compared to Whites, the HR (CIs) for any cancer in Asians was 0.8 (0.7–0.9, p < 0.001). Lower Asian risk was stronger for men (HR = 0.7, p < 0.001) than for women (HR = 0.9, p = 0.003). Lower Asian vs. White risks with p < 0.05 were found for cancers of the upper airway digestive area, hematologic malignancies, melanoma, and cancers of the prostate, bladder, and brain. Melanoma contributed substantially to lower Asian risk, especially in women. HRs for specific Asian groups versus Whites follow: Chinese = 0.9 (p < 0.001), Japanese = 0.9 (p = 0.01), Filipinos = 0.8 (p < 0.001), South Asians = 0.5 (p < 0.001), and Other Asians = 0.7 (p = 0.006). Both South Asian men and women had lower risk than Whites, and South Asians had lower risk than any other racial/ethnic group.


Breastfeeding and thyroid cancer risk in women: A dose-response meta-analysis of epidemiological studies.

Yi X, Zhu J, Zhu X, Liu GJ, Wu L.

Clin Nutr. 2016 Oct;35(5):1039-46. doi: 10.1016/j.clnu.2015.12.005. Epub 2015 Dec 17.

PMID: 26732028


prominent linear dose-response relationship was detected, with the combined RR for every increment of 1 month of breastfeeding to be 0.965 (95% CI 0.96-0.97). … breastfeeding is potentially inversely associated with thyroid cancer risk. Also longer duration of breastfeeding may further decreases thyroid cancer risk.

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 [The table and figure are in the pdf.]

J Hypertens. 2016 Sep;34 Suppl 1 - ISH 2016 Abstract Book:e213-e214.


Lu Y1, Zhang H, Zhou F, Li SS, Wei FF, Yao WM, Gong L, Zhou YL, Kong XQ.

PMID: 27642970 DOI: 10.1097/01.hjh.0000500465.54741.68


cardiovascular disease incidence (CVD) of brachial-ankle pulse wave velocity (baPWV)

for each 1-SD increment in baPWV (3.23 m/s), the hazard ratios for an all-cause mortality, cardiovascular mortality, stroke or composite cardiovascular outcomes were 1.41(1.13-1.75), 1.68 (95% CI:1.20-2.35), 1.51 (95% CI:1.27-1.80), 1.57 (95% CI: 1.28-1.93), respectively. At any given level of mean arterial pressure (MAP), a higher baPWV was associated with a higher death rate. The area under curve (AUC) of baPWV was larger than pulse pressure in predicting composite cardiovascular events (Z = 2.45,P = 0.014).


 [The below paper is pdf-availed.]

J Hypertens. 2016 Oct;34(10):2053-8. doi: 10.1097/HJH.0000000000001044.

Prevalence of orthostatic hypertension in the very elderly and its relationship to all-cause mortality.

Bursztyn M1, Jacobs JM, Hammerman-Rozenberg A, Stessman J.

PMID: 27457666 DOI: 10.1097/HJH.0000000000001044

OHYPER, orthostatic hypotension (OHYPO), or orthostatic normotension (ONORMO) … Prevalence of OHYPO, ONORMO, and OHYPER was 5% (n = 48), 91% (n = 915), and 4% (n = 41) at age 85, and 9% (n = 39), 88% (n = 385), and 3% (n = 13) at age 90. There was a tendency for fewer men among OHYPER, and significantly more participants with financial hardship, higher weight, loneliness, and anemia (P < 0.05 for all) among the 85-year-olds, fewer with poor self-rated health, and more with anemia among the 90-year-olds. Sitting blood pressure was 157 ± 22/75 ± 11, 147 ± 21/74 ± 11, and 140 ± 16/74 ± 10 mmHg among OHYPO, ONORMO, and OHYPER at age 85 (P < 0.0001), and 166 ± 28/75 ± 10, 145 ± 23/69 ± 11, and 138 ± 23/74 ± 9 mmHg at age 90 (P < 0.0001). Ten-year survival were 27, 30, and 27%, respectively, at age 85 (log-rank P = 0.34). Five-year survival were 57, 67, and 55%, respectively, at age 90 (log-rank P = 0.14). In an adjusted Cox proportional hazards ratio model, OHYPER at age 85 was not associated with mortality (hazards ratio = 0.95, 95% confidence interval 0.65-1.39).


J Am Med Dir Assoc. 2012 Oct;13(8):759.e1-6. doi: 10.1016/j.jamda.2012.05.005. Epub 2012 Jun 13.

Hypertension and 5-year mortality among 85-year-olds: the Jerusalem Longitudinal Study.

Jacobs JM, Stessman J, Ein-Mor E, Bursztyn M.

PMID:  22698954 DOI: 10.1016/j.jamda.2012.05.005


One hundred and nine (9.4%) were normotensive, 152 (13.1%) untreated, and 898 (77.5%) treated hypertensives. Treatment rate was 78%, and controlled hypertension rate 38%. During 5 years 328 (28.3%) patients died. Kaplan-Meier survival curves and log rank analysis showed no difference in mortality between normotensive, untreated and treated hypertensive subjects according to sex. Treated subjects with controlled Systolic Blood Pressure (SBP) had lowest survival rate of 67%, P = .029. Continuous SBP yielded a hazard ratio (HR) for mortality of 1.00, (95% CI 0.95-1.01), after adjusting in


Arch Intern Med. 1999 Feb 8;159(3):273-80.

Prognosis of diastolic and systolic orthostatic hypotension in older persons.

Luukinen H1, Koski K, Laippala P, Kivelä SL.

PMID: 9989539


Orthostatic hypotension (OH) … hazard ratio of vascular death associated with a diastolic BP reduction of 1 mm Hg 1 minute after standing up was 1.02 (P=.03), adjusted for systolic BP postural changes at 1 and 3 minutes and a diastolic BP change at 3 minutes. Adjusted for other significant factors associated with vascular death, the hazard ratio for vascular death associated with diastolic OH 1 minute after standing up was 2.04 (95% confidence interval, 1.01-4.15). The corresponding hazard ratio for systolic OH 3 minutes after standing up was 1.69 (95% confidence interval, 1.02-2.80). Using a cutoff point of 7 mm Hg or greater for a diastolic BP change 1 minute after standing up, the hazard ratio for vascular death was highest: 2.20 (95% confidence interval, 1.23-3.93). By logistic regression analysis, the baseline associates of diastolic OH 1 minute after standing up were dizziness when turning the neck (odds ratio [OR], 2.44), the use of a calcium antagonist (OR, 2.31), the use of a diuretic medication (OR, 2.29), a high systolic BP (OR, 2.23), and a low body mass index (OR, 2.26). The baseline associates of systolic OH 3 minutes after standing up were male sex (OR, 1.52), diabetes mellitus (OR, 1.92), a high systolic BP (OR, 2.91), and a low body mass index (OR, 1.68).



Zhang H, Wang Q, Guo Y, Li D, Zhang B, Dong Y, Huang X, Liu Y, Zhao J, Li W, Brunner HR, Liu L.

J Hypertens. 2016 Sep;34 Suppl 1 - ISH 2016 Abstract Book:e52-e53.

PMID: 27643262


enriched potassium salt (KCL/NaCL = 1:1 by weight) … (p-y) … mean age, blood pressure and UNa/K are listed below. The proportion of impaired kidney function (ratio of microalbumin to creatinine> = 30 mg/g) was 26.8% and 16.2% for control and intervention group respectively (Chi square = 21.683, P < 0.001). The all causes mortality was 82.73/1000 p-y and 48.90/1000 p-y for control and intervention group respectively (Chi square = 28.626, p = 0.000).


Mayo Clin Proc. 2013 Sep;88(9):987-95. doi: 10.1016/j.mayocp.2013.06.005.

Role of dietary salt and potassium intake in cardiovascular health and disease: a review of the evidence.

Aaron KJ1, Sanders PW.

PMID: 24001491

Free PMC Article



Comment in

Mayo Clin Proc. 2014 Mar;89(3):427-8. doi: 10.1016/j.mayocp.2014.01.005.

Population-wide sodium reduction: reasons to resist.

Aaron KJ, Sanders PW.

PMID: 24582203



Associations between Coffee, Tea, and Caffeine Intake with Coronary Artery Calcification and Cardiovascular Events.

Miller PE, Zhao D, Frazier-Wood AC, Michos ED, Averill M, Sandfort V, Burke GL, Polak JF, Lima JA, Post WS, Blumenthal RS, Guallar E, Martin SS.

Am J Med. 2016 Sep 15. pii: S0002-9343(16)30925-1. doi: 10.1016/j.amjmed.2016.08.038. [Epub ahead of print]

PMID: 27640739


participants who regularly drank tea (≥1 cup/day) had a slower progression of coronary artery calcium compared with never drinkers after multivariable adjustment. This correlated with a statistically significant lower incidence of cardiovascular events for ≥1 cup/day tea drinkers (adjusted HR 0.71; 95% CI 0.53-0.95). Compared to never coffee drinkers, regular coffee intake (≥1 cup/day) was not statistically associated with coronary artery calcium progression or cardiovascular events (adjusted HR 0.97 [0.78, 1.20]). Caffeine intake was marginally inversely associated with coronary artery calcium progression.


Timing and Type of Alcohol Consumption and the Metabolic Syndrome - ELSA-Brasil.

Vieira BA, Luft VC, Schmidt MI, Chambless LE, Chor D, Barreto SM, Duncan BB.

PLoS One. 2016 Sep 19;11(9):e0163044. doi: 10.1371/journal.pone.0163044. eCollection 2016.

PMID: 27643787


light consumption of alcoholic beverages with meals was inversely associated with the metabolic syndrome (≤4 drinks/week: OR = 0.85, 95%CI 0.74-0.97; 4 to 7 drinks/week: OR = 0.75, 95%CI 0.61-0.92), compared to abstention/occasional drinking. On the other hand, greater consumption of alcohol consumed outside of meals was significantly associated with the metabolic syndrome (7 to 14 drinks/week: OR = 1.32, 95%CI 1.11-1.57; ≥14 drinks/week: OR = 1.60, 95%CI 1.29-1.98). Drinking predominantly wine, which occurred mostly with meals, was significantly related to a lower syndrome prevalence; drinking predominantly beer, most notably when outside of meals and in larger quantity, was frequently associated with a greater prevalence.


Wearable fitness devices offer no 'advantage' over standard weight-loss approaches


"Some of the study's authors received honoraria for serving on the scientific advisory board for Weight Watchers International or have received a grant from a wearable maker."


Effect of Wearable Technology Combined With a Lifestyle Intervention on Long-term Weight Loss: The IDEA Randomized Clinical Trial FREE

John M. Jakicic, PhD; Kelliann K. Davis, PhD; Renee J. Rogers, PhD; Wendy C. King, PhD; Marsha D. Marcus, PhD; Diane Helsel, PhD, RD; Amy D. Rickman, PhD, RD, LDN; Abdus S. Wahed, PhD; Steven H. Belle, PhD

JAMA. 2016;316(11):1161-1171. doi:10.1001/jama.2016.12858.

Includes: Supplemental Content, Author Video Interviews, JAMA Report Video, Author Interview


Participants were placed on a low-calorie diet, prescribed increases in physical activity, and had group counseling sessions. At 6 months, the interventions added telephone counseling sessions, text message prompts, and access to study materials on a website. At 6 months, participants randomized to the standard intervention group initiated self-monitoring of diet and physical activity using a website, and those randomized to the enhanced intervention group were provided with a wearable device and accompanying web interface to monitor diet and physical activity. … For the enhanced intervention group, mean baseline weight was 96.3 kg (95% CI, 94.2-98.5) and 24-month weight 89.3 kg (95% CI, 87.1-91.5). For the standard intervention group, mean baseline weight was 95.2 kg (95% CI, 93.0-97.3) and 24-month weight was 92.8 kg (95% CI, 90.6-95.0). Weight change at 24 months differed significantly by intervention group (estimated mean weight loss, 3.5 kg [95% CI, 2.6-4.5} in the enhanced intervention group and 5.9 kg [95% CI, 5.0-6.8] in the standard intervention group; difference, 2.4 kg [95% CI, 1.0-3.7]; P = .002). Both groups had significant improvements in body composition, fitness, physical activity, and diet


[The pdf has the three figures.]


Yan R, Li W, Hua K, Gu H, Wang Y.

J Hypertens. 2016 Sep;34 Suppl 1 - ISH 2016 Abstract Book:e53.

PMID: 27643263

DOI: 10.1097/01.hjh.0000499990.78659.54


The mean estimated sodium excretion was 5.84 g per day. … compared with an estimated sodium excretion of 5.00 to 6.99 g per day (reference range), a higher estimated sodium excretion ( 8.00 g per day) was associated with an increased but not significant risk of the composite outcome (odds ratio, 1.15; 95% confidence interval [CI], 0.82 to 1.61), as well as that with an estimated sodium excretion below 4.00 g per day (odds ratio, 1.21; 95% CI, 0.93 to 1.58). … recommended daily intake of sodium is 1 g larger than that suggested by former study, because Asian people, especially Chinese, generally eat more salt than other countries, and the tolerance of sodium may be higher.


[The pdf has the table.]

J Hypertens. 2016 Sep;34 Suppl 1 - ISH 2016 Abstract Book:e212-e213.


Lim HM1, Chia YC, Ching SM.

PMID: 27642967

DOI: 10.1097/01.hjh.0000500462.09000.21


ORs remained significant even with only 5-year of SBP measurements (adjusted OR 1.062 95% CI 1.009-1.117, p = 0.021).



Ryuno H, Kamide K, Gondo Y, Kabayama M, Sugimoto K, Nakagawa T, Ikebe K, Inagaki H, Masui Y, Arai Y, Ishizaki T, Rakugi H.

J Hypertens. 2016 Sep;34 Suppl 1 - ISH 2016 Abstract Book:e396.

PMID: 27643194


After 3 years' follow-up, proportion of HT, diabetes mellitus (DM) and dyslipidemia (72.2%, 19.1% and 72.1%, respectively) were significantly higher than those at baseline (65.8%, 18.8% and 64.1%, respectively), whereas, systolic and diastolic blood pressure at follow-up period were significantly lower than those at baseline. MoCA-J score at follow-up was not significantly different from baseline, however, peoples with HT, especially combined with DM at baseline were significantly lower MoCA-J scores at follow-up (-0.6 and -1.4, respectively). Additionally, combination of HT and DM was the significant risk factor for the decline of MoCA-J scores after adjustment for sex, BMI, dyslipidemia, smoking, excessive alcohol intake, and education level (β = -0.12; p < 0.05).

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Adherence to a lifestyle programme in overweight/obese pregnant women and effect on gestational diabetes mellitus: a randomized controlled trial.

Bruno R, Petrella E, Bertarini V, Pedrielli G, Neri I, Facchinetti F.

Matern Child Nutr. 2016 Sep 19. doi: 10.1111/mcn.12333. [Epub ahead of print]

PMID: 27647837




gestational diabetes (GDM) …

 Intervention group (I = 96) received a hypocaloric, low-glycaemic, low-saturated fat diet and physical activity recommendations. Those assigned to the Standard Care group (SC = 95) received lifestyle advices regarding healthy nutrition and exercise. … diet adherence was higher in the I (57.9%) than in the SC (38.7%) group. GDM occurred less frequently in the I (18.8%) than in the SC (37.1%, P = 0.019) group. The adherent women from either groups showed a lower GDM rate (12.5% vs. 41.8%, P < 0.001). After correcting for confounders, the GDM rate was explained by allocation into the I group (P = 0.034) and a lower BMI category (P = 0.039). The rates of hypertension, preterm birth, induction of labour, large for gestational age babies and birthweight > 4000 g were significantly lower in I group.




Weight Gain over the Holidays in Three Countries

N Engl J Med 2016; 375:1200-1202September 22, 2016DOI: 10.1056/NEJMc1602012

Elina E. Helander, Ph.D.

Brian Wansink, Ph.D.

Angela Chieh



[Holiday weight gains or losses at other times is compared for American, Germans and Japanese.]


Maintenance of age in human neurons generated by microRNA-based neuronal conversion of fibroblasts.

Huh CJ, Zhang B, Victor M, Dahiya S, Batista LF, Horvath S, Yoo AS.

Elife. 2016 Sep 20;5. pii: e18648. doi: 10.7554/eLife.18648. [Epub ahead of print]

PMID: 27644593


ages of fibroblasts were highly correlated with corresponding age estimates of reprogrammed neurons.


Risk factors for short- and long-term mortality in very old patients with Clostridium difficile infection: A retrospective study.

Leibovici-Weissman Y, Atamna A, Schlesinger A, Eliakim-Raz N, Bishara J, Yahav D.

Geriatr Gerontol Int. 2016 Sep 20. doi: 10.1111/ggi.12866. [Epub ahead of print]

PMID: 27647625


Most cases of Clostridium difficile infections (CDI) occur in patients aged 65 years and older. … Risk factors for 30-day mortality in multivariate analysis were diabetes mellitus, low albumin ... Risk factors for long-term mortality analyzed in Cox regression were albumin ≤2.5 g/dL (HR 0.58, 95% CI 0.395-0.850), presentation with sepsis (HR 0.597, 95% CI 0.408-0.873), a non-independent activities of daily living baseline status (HR 0.460, 95% CI 0.236--0.897) and Charlson score (HR 0.867, 95% CI 0.801-0.938). None of the traditional severity indices for CDI (such as leukocytosis or creatinine increase) proved to be predictors of mortality over the age of 80 years.


Statins Are Associated With Reduced Mortality in Multiple Myeloma.

Sanfilippo KM, Keller J, Gage BF, Luo S, Wang TF, Moskowitz G, Gumbel J, Blue B, O'Brian K, Carson KR.

J Clin Oncol. 2016 Sep 19. pii: JCO683482. [Epub ahead of print]

PMID: 27646948 DOI: 10.1200/JCO.2016.68.3482


multiple myeloma (MM) … Statin use was associated with a 21% decrease in all-cause mortality (adjusted hazard ratio, 0.79; 95% CI, 0.73 to 0.86; P < .001) as well as a 24% decrease in MM-specific mortality (adjusted hazard ratio, 0.76; 95% CI, 0.67 to 0.86; P < .001). [and] statin use was associated with a 31% decreased risk of developing a skeletal-related event.


Association of habitual high-fat intake and desire for protein and sweet food.

Tatano H, Yamanaka-Okumura H, Zhou B, Adachi C, Kawakami Y, Katayama T, Masuda M, Takeda E, Taketani Y.

J Med Invest. 2016;63(3.4):241-247.

PMID: 27644566


calorie density (CD) … control, high-meat and low-rice, low-vegetable, medium-fat and low-vegetable, high-fat, and high-fat and low-vegetable meals over six sessions. … diet history questionnaire (BDHQ) and were divided into two groups based on a daily fat energy ratio ≥ 25% (high fat [HF], n=116) and < 25% … desire for sweetness was higher in the HF group than in the normal group, regardless of the meals consumed. Particularly, among the 500-kcal low-CD meals, a high-protein meal provided greater fullness and satisfaction and lower prospective consumption in the HF group than in the normal group.


Low-fat, plant-based diet in multiple sclerosis: A randomized controlled trial.

Yadav V, Marracci G, Kim E, Spain R, Cameron M, Overs S, Riddehough A, Li DK, McDougall J, Lovera J, Murchison C, Bourdette D.

Mult Scler Relat Disord. 2016 Sep;9:80-90. doi: 10.1016/j.msard.2016.07.001. Epub 2016 Jul 6.

PMID: 27645350


[The diet adherence was very good and is described as: Anonymous, 2014. 10-Day Live-in Program – Dr. McDougall's Health & Medical Center, https://www.drmcdougall.com/health/programs/10-day-program/.]

multiple sclerosis (MS) ... disease modifying therapies (DMT), poor quality of life (QOL) in MS patients can be a significant problem with fatigue being one of the common disabling symptoms. a very-low-fat, plant-based diet (Diet) … QOL [short Form-36 (SF-36)], and fatigue [Fatigue Severity Scale (FSS) and Modified Fatigue Impact Scale (MFIS)], in relapsing-remitting MS (RRMS) … Diet (N=32) or wait-listed … expanded disability status scale (EDSS) score … [total fat intake/total calories averaged ~15% (Diet) versus ~40% (Control)]. ... The diet group showed improvements at six months in low-density lipoprotein cholesterol (Δ=-11.99mg/dL; p=0.031), total cholesterol (Δ=-13.18mg/dL; p=0.027) and insulin (Δ=-2.82mg/dL; p=0.0067), mean monthly reductions in BMI (Rate=-1.125kg/m2 per month; p<0.001) and fatigue [FSS (Rate=-0.0639 points/month; p=0.0010); MFIS (Rate=-0.233 points/month; p=0.0011)] during the 12-month period.


Fish Consumption, Omega-3 Fatty Acids, and Risk of Cardiovascular Disease.

Rhee JJ, Kim E, Buring JE, Kurth T.

Am J Prev Med. 2016 Sep 16. pii: S0749-3797(16)30291-4. doi: 10.1016/j.amepre.2016.07.020. [Epub ahead of print]

PMID: 27646568


Tuna and dark fish intake was not associated with the risk of incident major cardiovascular disease (p-trend >0.05). Neither α-linolenic acid nor marine omega-3 fatty acid intake was associated with major cardiovascular disease or with individual cardiovascular outcomes (all p-trend >0.05).

Edited by AlPater
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Parity and All-cause Mortality in Women and Men: A Dose-Response Meta-Analysis of Cohort Studies.

Zeng Y, Ni ZM, Liu SY, Gu X, Huang Q, Liu JA, Wang Q.

Sci Rep. 2016 Jan 13;6:19351. doi: 10.1038/srep19351.

PMID: 26758416

Free PMC Article


participants with no live birth had higher risk of all-cause mortality (RR= 1.19, 95% CI = 1.03-1.38; I(2) = 96.7%, P < 0.001) compared with participants with one or more live births. Nonlinear dose-response association was found between parity and all-cause mortality (P for non-linearity < 0.0001).


Role of a plausible nuisance contributor in the declining obesity-mortality risks over time.

Mehta T, Pajewski NM, Keith SW, Fontaine K, Allison DB.

Exp Gerontol. 2016 Sep 17. pii: S0531-5565(16)30347-3. doi: 10.1016/j.exger.2016.09.015. [Epub ahead of print]

PMID: 27649888


Change in hazard ratios for simulated data in NHANES III compared to observed estimates from NHANES I ... On average, hazard ratios for NHANES III based on simulated mortality data were 29.3% lower than the estimates from NHANES I using observed mortality follow-up. This reduction accounted for roughly three-fourths of the apparent decrease in the obesity-mortality association observed in a previous analysis of these data.


Meat, fish, poultry, and egg intake at diagnosis and risk of prostate cancer progression.

Wilson KM, Mucci LA, Drake BF, Preston MA, Stampfer MJ, Giovannucci EL, Kibel AS.

Cancer Prev Res (Phila). 2016 Sep 20. pii: canprevres.0070.2016. [Epub ahead of print]

PMID: 27651069


men treated with radical prostatectomy ... Total red meat intake was marginally associated with risk of high grade disease (Gleason =/>4+3; Adjusted odds ratio [OR] top vs. bottom quartile: 1.66, 95% confidence interval [CI]: 0.93-2.97, p-trend=0.05), as was very high intake of eggs (OR top decile vs. bottom quartile: 1.98, 95% CI: 1.08-3.63, p-trend=0.08). Well-done red meat was associated with advanced disease =/>pT3; OR top vs. bottom quartile: 1.74, 95% CI: 1.05-2.90, p-trend=0.01). Intakes of red meat, fish, and eggs were not associated with progression. Very high poultry intake was inversely associated with progression (HR top decile vs. bottom quartile: 0.19, 95% CI: 0.06-0.63, p=trend=0.02). Substituting 30 g/day of poultry or fish for total or unprocessed red meat was associated with significantly lower risk of recurrence. Lower intakes of red meat and well-done red meat and higher intakes of poultry and fish are associated with lower risk of high grade and advanced prostate cancer and reduced recurrence risk, independent of stage and grade.

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Nutrient Intake Is Associated with Longevity Characterization by Metabolites and Element Profiles of Healthy Centenarians.

Cai D, Zhao S, Li D, Chang F, Tian X, Huang G, Zhu Z, Liu D, Dou X, Li S, Zhao M, Li Q.

Nutrients. 2016 Sep 19;8(9). pii: E564.

PMID: 27657115


short chain fatty acids (SCFAs)… centenarians from Bama county (China)-a famous longevous region-and elderly people aged 80-99 from the longevous region and a non-longevous region. … centenarians showed a distinct metabolic pattern. Seven characteristic components closely related to the centenarians were identified, including acetic acid, total SCFA, Mn, Co, propionic acid, butyric acid and valeric acid. Their concentrations were significantly higher in the centenarians group (p < 0.05). Additionally, the dietary fiber intake was positively associated with butyric acid contents in feces (r = 0.896, p < 0.01), and negatively associated with phenol in urine (r = -0.326, p < 0.01).


The mTORC1-Signaling Pathway and Hepatic Polyribosome Profile Are Enhanced after the Recovery of a Protein Restricted Diet by a Combination of Soy or Black Bean with Corn Protein.

Márquez-Mota CC, Rodriguez-Gaytan C, Adjibade P, Mazroui R, Gálvez A, Granados O, Tovar AR, Torres N.

Nutrients. 2016 Sep 20;8(9). pii: E573.

PMID: 27657118


mechanistic target of rapamycin (mTORC1)-signaling pathway in: (1) healthy; and (2) protein restricted rats. (1) In total, 200 rats were divided into eight groups and fed one of the following diets: 20% casein ©, soy (S), black bean (B), B + Corn (BCr), Pea (P), spirulina (Sp), sesame (Se) or Corn (Cr). Rats fed C or BCr had the highest body weight gain; rats fed BCr had the highest pS6K1/S6K1 ratio; rats fed B, BCr or P had the highest eIF4G expression; (2) In total, 84 rats were fed 0.5% C for 21 day and protein rehabilitated with different proteins. The S, soy + Corn (SCr) and BCr groups had the highest body weight gain. …  BCr or SCr are the best proteins for dietary protein rehabilitation due to the significant increase in body weight, activation of the mTORC1-signaling pathway in liver and muscle, and liver polysome formation.


Hypogonadism alters cecal and fecal microbiota in male mice.

Harada N, Hanaoka R, Hanada K, Izawa T, Inui H, Yamaji R.

Gut Microbes. 2016 Sep 22:0. [Epub ahead of print]

PMID: 27656762


Low testosterone levels increase the risk for cardiovascular disease in men and lead to shorter life spans. Our recent study showed that androgen deprivation via castration altered fecal microbiota and exacerbated risk factors for cardiovascular disease, including obesity, impaired fasting glucose, excess hepatic triglyceride accumulation, and thigh muscle weight loss in high-fat diet (HFD)-fed male mice. However, when mice were administered antibiotics that disrupted the gut microbiota, castration did not increase cardiovascular risks or decrease the ratio of dried feces to food intake. Here, we show that changes in cecal microbiota (e.g., an increased Firmicutes/Bacteroidetes ratio and number of Lactobacillus species) were consistent with changes in feces and that there was a decreased cecal content secondary to castration in HFD mice. Castration increased rectal body temperature and plasma adiponectin, irrespective of diet. Changes in the gut microbiome may provide novel insight into hypogonadism-induced cardiovascular diseases.


Bone Density Loss Is Associated with Blood Cell Counts.

Valderrábano RJ, Lui LY, Lee J, Cummings SR, Orwoll ES, Hoffman AR, Wu JY; Osteoporotic Fractures in Men (MrOS) Study Research Group.

J Bone Miner Res. 2016 Sep 21. doi: 10.1002/jbmr.3000. [Epub ahead of print]

PMID: 27653240


Bone health and hematopoiesis may have greater interdependency than previously recognized. This article is protected by copyright. All rights reserved.


Intestinal adaptations to a combination of different diets with and without endurance exercise.

Daniels JL, Bloomer RJ, van der Merwe M, Davis SL, Buddington KK, Buddington RK.

J Int Soc Sports Nutr. 2016 Sep 14;13:35. eCollection 2016.

PMID: 27651751

Free Article


Rats fed the western diet gained more weight (P < 0.05) due to more fat mass (P < 0.05), with a similar response for the sedentary compared with the exercised rats in each diet group (P < 0.05). The https://en.wikipedia.org/wiki/Daniel_Fast rats had longer and heavier intestines with deeper crypts with villi that were wider (P < 0.05), but not taller. Despite increased energetic demands, the exercised rats had shorter and lighter intestines with shorter villi (P < 0.05).

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Dietary rapamycin supplementation reverses age-related vascular dysfunction and oxidative stress, while modulating nutrient-sensing, cell cycle, and senescence pathways.

Lesniewski LA, Seals DR, Walker AE, Henson GD, Blimline MW, Trott DW, Bosshardt GC, LaRocca TJ, Lawson BR, Zigler MC, Donato AJ.

Aging Cell. 2016 Sep 22. doi: 10.1111/acel.12524. [Epub ahead of print]

PMID: 27660040


glucose tolerance improved in old mice, but was impaired in young mice, after rapamycin supplementation (both P < 0.05). Aging increased mTOR activation in arteries evidenced by elevated S6K phosphorylation (P < 0.01), and this was reversed after rapamycin treatment in old mice (P < 0.05). Aging was also associated with impaired endothelium-dependent dilation (EDD) in the carotid artery (P < 0.05). Rapamycin improved EDD in old mice (P < 0.05). Superoxide production and NADPH oxidase expression were higher in arteries from old compared to young mice (P < 0.05), and rapamycin normalized these (P < 0.05) to levels not different from young mice. Scavenging superoxide improved carotid artery EDD in untreated (P < 0.05), but not rapamycin-treated, old mice. While aging increased large artery stiffness evidenced by increased aortic pulse-wave velocity (PWV) (P < 0.01), rapamycin treatment reduced aortic PWV (P < 0.05) and collagen content (P < 0.05) in old mice.


Association between Serum Fibroblast Growth Factor 21 and Mortality among Patients with Coronary Artery Disease.

Li Q, Zhang Y, Ding D, Yang Y, Chen Q, Su D, Chen X, Yang W, Qiu J, Ling W.

J Clin Endocrinol Metab. 2016 Sep 23:jc20162308. [Epub ahead of print]

PMID: 27662438


Spline plots displayed a U-shaped association between serum FGF21 levels and all-cause as well as CVD mortality among CAD patients. Compared to serum FGF21 quartile 2, groups at quartile 1, 3 and 4 had higher risk for all-cause and CVD mortality. Patients in the serum FGF21 quartile 4 had a 1.95-fold (95% confidence intervals [CI] 1.25-3.02) risk of all-cause mortality and a 2.50-fold (95% CI 1.43-4.38) risk of CVD mortality compared with those in quartile 2.


Spinal Manipulation Vs Sham Manipulation for Nonspecific Low Back Pain: A Systematic Review and Meta-analysis.

Ruddock JK, Sallis H, Ness A, Perry RE.

J Chiropr Med. 2016 Sep;15(3):165-83. doi: 10.1016/j.jcm.2016.04.014. Epub 2016 May 25.

PMID: 27660593


spinal manipulation (SM) … the SM group had improved symptoms compared with participants receiving sham treatment (standardized mean difference = - 0.36; 95% confidence interval, - 0.59 to - 0.12).


[The below paper is not pdf-availed.]

Alcohol consumption and mortality after breast cancer diagnosis: The health and functioning in women study.

Din N, Allen IE, Satariano WA, Demb J, Braithwaite D.

Breast Dis. 2016 Jul 28;36(2-3):77-89.

PMID: 27662274

decreased risk of other-cause mortality was associated with low alcohol drinking (0.75-3.75 drinks/week; HR = 0.61, 95% CI = 0.47-0.78), moderate volume alcohol drinking (4.00-9.75 drinks/week; HR = 0.57, 95% CI = 0.39-0.85) and low frequency (0.75-3.75 drinks/week) beer and wine intake (HR = 0.69, 95% CI = 0.50-0.96 and HR = 0.68, 95% CI = 0.52-0.88 respectively). Although the risk of breast cancer-specific mortality was not statistically significantly associated with moderate (4.00-9.75 drinks/week) and high volume (10.00-36.00 drinks/week) alcohol drinking in the overall cohort (HR = 1.43, 95% CI = 95% 0.97-2.12 and HR = 1.53, 95% CI = 0.87-2.70 respectively), there was a positive association of alcohol consumption with breast cancer-specific mortality among current smokers (HR = 1.92, 95% CI = 1.03-3.57; Pinteraction = 0.04).


Sugars and risk of mortality in the NIH-AARP Diet and Health Study.

Tasevska N, Park Y, Jiao L, Hollenbeck A, Subar AF, Potischman N.

Am J Clin Nutr. 2014 May;99(5):1077-88. doi: 10.3945/ajcn.113.069369. Epub 2014 Feb 19.

PMID: 24552754

Free PMC Article


In fully adjusted models (fifth quartile compared with first quartile), all-cause mortality was positively associated with the intake of total sugars [hr (95% CI): 1.13 (1.06, 1.20); P-trend < 0.0001], total fructose [1.10 (1.04, 1.17); P-trend < 0.0001], and added fructose [1.07 (1.01, 1.13); P-trend = 0.005) in women and total fructose [1.06 (1.01, 1.10); P-trend = 0.002] in men. In men, a weak inverse association was found between other-cause mortality and dietary added sugars (P-trend = 0.04), sucrose (P-trend = 0.03), and added sucrose (P-trend = 0.006). Investigation of consumption of sugars by source showed that the positive association with mortality risk was confined only to sugars from beverages, whereas the inverse association was confined to sugars from solid foods.


[Thanks for the heads-up, Matt.]

Longer lifespan in male mice treated with a weakly estrogenic agonist, an antioxidant, an α-glucosidase inhibitor or a Nrf2-inducer.

Strong R, Miller RA, Antebi A, Astle CM, Bogue M, Denzel MS, Fernandez E, Flurkey K, Hamilton KL, Lamming DW, Javors MA, de Magalhães JP, Martinez PA, McCord JM, Miller BF, Müller M, Nelson JF, Ndukum J, Rainger GE, Richardson A, Sabatini DM, Salmon AB, Simpkins JW, Steegenga WT, Nadon NL, Harrison DE.

Aging Cell. 2016 Oct;15(5):872-84. doi: 10.1111/acel.12496. Epub 2016 Jun 16.

PMID: 27312235

Free Article



lifelong treatment … nordihydroguaiaretic acid (NDGA) ... 17-α-estradiol at a threefold higher dose robustly extended both median and maximal lifespan, but still only in males. The male-specific extension of median lifespan by NDGA was replicated at the original dose, and using doses threefold lower and higher. The effects of NDGA were dose dependent and male specific but without an effect on maximal lifespan. Protandim, a mixture of botanical extracts that activate Nrf2, extended median lifespan in males only. Metformin alone, at a dose of 0.1% in the diet, did not significantly extend lifespan. Metformin (0.1%) combined with rapamycin (14 ppm) robustly extended lifespan ... The α-glucosidase inhibitor, acarbose, at a concentration previously tested (1000 ppm), significantly increased median longevity in males and 90th percentile lifespan in both sexes, even when treatment was started at 16 months.


[The below paper is not pdf-availed.]

Insulin-like growth factor-related components and the risk of liver cancer in a nested case-control study.

Adachi Y, Nojima M, Mori M, Matsunaga Y, Akutsu N, Sasaki S, Endo T, Kurozawa Y, Wakai K, Tamakoshi A; for JACC Study.

Tumour Biol. 2016 Sep 23. [Epub ahead of print]

PMID: 27662841

Neither IGF1 nor the molar ratio of IGF1/IGFBP3 was correlated with hepatoma risk. After adjustment for hepatitis viral infection, body mass index, smoking, and alcohol intake, a higher molar difference of (IGFBP3 - IGF1) was associated with a decreased hepatoma risk more than IGFBP3 alone (p for trend <0.001 and = 0.003, respectively). People in the highest quartile had a lower risk (OR = 0.098; 95 % confidence interval = 0.026-0.368). In subgroup analyses of males and females, the molar difference was associated with a decreased hepatoma risk (p for trend <0.05). In non-elderly individuals, the difference was inversely correlated with the incidence of hepatoma (p for trend <0.01).


Impact of physical activity category on incidence of cardiovascular disease: Results from the 10-year follow-up of the ATTICA Study (2002-2012).

Tambalis KD, Panagiotakos DB, Georgousopoulou EN, Mellor DD, Chrysohoou C, Kouli GM, Tousoulis D, Stefanadis C, Pitsavos C; ATTICA Study Group.

Prev Med. 2016 Sep 20. pii: S0091-7435(16)30281-X. doi: 10.1016/j.ypmed.2016.09.023. [Epub ahead of print]

PMID: 27663426


physical activity (PA) … CVD risk of individuals who reported being sufficiently active and highly active were decreased by 58% (95% CI: 0.30, 0.58) and 70% (95% CI: 0.15, 0.56), when compared to those who were inactive/insufficiently active, respectively. Men had nearly two-fold increase in risk of CVD (95% CI: 1.62, 2.18) versus women. Stratified analysis by gender, revealed that sufficiently active men, had 52% (95% CI: 0.24, 0.97) reduced risk of CVD incidence when compared to inactive males, while, for women, the role of PA lost significance following adjusting for lifestyle factors.


Resveratrol Supplementation and Oxidative/Anti-Oxidative Status in Patients with Ulcerative Colitis: A Randomized, Double-Blind, Placebo-controlled Pilot Study.

Samsamikor M, Daryani NE, Asl PR, Hekmatdoost A.

Arch Med Res. 2016 May;47(4):304-309. doi: 10.1016/j.arcmed.2016.07.003.

PMID: 27664491


ulcerative colitis (UC) … 500 mg/day resveratrol … malondialdehyde (MDA), superoxide dismutase (SOD), and total anti-oxidant capacity (TAC) ... Serum SOD (122.28 ± 11.55 to 125.77 ± 10.97) and TAC (9.87 ± 1.51-11.97 ± 1.61) increased, whereas serum MDA (5.62 ± 1.18-3.42 ± 1.01) decreased significantly in resveratrol group (p <0.001). Moreover, resveratrol supplementation significantly decreased disease activity and increased the quality of life (p <0.001).

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[Diet was quite effective.]

Association Between Lowering LDL-C and Cardiovascular Risk Reduction Among Different Therapeutic Interventions: A Systematic Review and Meta-analysis

Michael G. Silverman, MD1; Brian A. Ference, MD, MPhil, MSc2; Kyungah Im, PhD1; Stephen D. Wiviott, MD1; Robert P. Giugliano, MD, SM1; Scott M. Grundy, MD, PhD3; Eugene Braunwald, MD1; Marc S. Sabatine, MD, MPH1

JAMA. 2016;316(12):1289-1297. doi:10.1001/jama.2016.13985.


for major vascular events per 1-mmol/L (38.7-mg/dL) reduction in LDL-C level was 0.77 (95% CI, 0.71-0.84; P < .001) for statins and 0.75 (95% CI, 0.66-0.86; P = .002) for established nonstatin interventions that work primarily via upregulation of LDL receptor expression (ie, diet, bile acid sequestrants, ileal bypass, and ezetimibe) (between-group difference, P = .72). For these 5 therapies combined, the RR was 0.77 (95% CI, 0.75-0.79, P < .001) for major vascular events per 1-mmol/L reduction in LDL-C level. ... The achieved absolute LDL-C level was significantly associated with the absolute rate of major coronary events (11 301 events, including coronary death or MI) for primary prevention trials (1.5% lower event rate [95% CI, 0.5%-2.6%] per each 1-mmol/L lower LDL-C level; P = .008) and secondary prevention trials (4.6% lower event rate [95% CI, 2.9%-6.4%] per each 1-mmol/L lower LDL-C level; P < .001).


Coffee and cancer risk: A meta-analysis of prospective observational studies.

Wang A, Wang S, Zhu C, Huang H, Wu L, Wan X, Yang X, Zhang H, Miao R, He L, Sang X, Zhao H.

Sci Rep. 2016 Sep 26;6:33711. doi: 10.1038/srep33711.

PMID: 27665923


Inverse associations were observed on oral, pharyngeal, colon, liver, prostate, endometrial cancer and melanoma, with RR 0.69 (95% CI = 0.48-0.99, I2 = 73.4%, P = 0.044), 0.87 (95% CI = 0.78-0.96, I2 = 28.4%, P = 0.007), 0.46 (95% CI = 0.37-0.57, I2 = 0%, P = 0), 0.89 (95% CI = 0.84-0.93, I2 = 30.3%, P = 0.003), 0.73 (95% CI = 0.67-0.80, I2  = 0%, P = 0) and 0.89 (95% CI = 0.80-0.99, I2  = 0%, P = 0.031) respectively. However, the relative risk for lung cancer is 2.18 (95% CI = 1.26-3.75, I2  = 63.3%, P = 0.005). The summary relative risk for increment of 2 cups of coffee were RR = 0.73, 95% CI = 0.67-0.79 for liver cancer, RR = 0.97, 95% CI = 0.96-0.98 for prostate cancer and RR = 0.88, 95% CI = 0.85-0.92 for endometrial cancer.


Providing Flaxseed Oil but Not Menhaden Oil Protects against OVX Induced Bone Loss in the Mandible of Sprague-Dawley Rats.

Longo AB, Ward WE.

Nutrients. 2016 Sep 24;8(10). pii: E597.

PMID: 27669296


alpha-linolenic acid (ALA) … flaxseed oil, possibly through its high ALA content, provides protection against the OVX-induced alveolar bone loss in rats.


[The below paper is pdf-availed.]

The Impact of a Healthy Lifestyle on Future Physical Functioning in Midlife Women.

Sternfeld B, Colvin A, Stewart A, Dugan S, Nackers L, El Khoudary SR, Huang MH, Karvonen-Gutierrez C.

Med Sci Sports Exerc. 2016 Sep 23. [Epub ahead of print]

PMID: 27669444


In multivariable analyses, the time for the 4 M walk was 0.06 secs faster (p=0.001) for every 1 point increase in the HLS. The time for the repeated chair stands was significantly shorter by about 0.20 seconds. Neither grip strength nor balance problems were significantly associated with the HLS (p=.28, p=0.19 respectively). The model examining the individual health behaviors showed that only physical activity was significantly associated with physical performance.


[The below paper is pdf-availed.]

Voluntary Running Attenuates Metabolic Dysfunction in Ovariectomized Low-Fit Rats.

Park YM, Padilla J, Kanaley JA, Zidon T, Welly RJ, Britton SL, Koch LG, Thyfault JP, Booth FW, Vieira-Potter VJ.

Med Sci Sports Exerc. 2016 Sep 23. [Epub ahead of print]

PMID: 27669449


high fat diet (HFD) … Female rats selectively bred for low (LCR) and high (HCR) intrinsic aerobic capacity … sedentary (SED) or voluntary wheel running (EX) … EX reduced body weight and adiposity in LCR rats (-10% and -50%, respectively; P<0.05) and, unexpectedly, increased these variables in HCR rats (+7% and +37%, respectively; P<0.05) compared to their respective SED controls, likely due to dietary overcompensation. Wheel running volume was ~5-fold greater in HCR than LCR rats, yet EX enhanced insulin sensitivity equally in LCR and HCR rats (P<0.05). This EX-mediated improvement in metabolic function was associated with gene up-regulation of skeletal muscle IL-6&-10. EX also increased resting energy expenditure, skeletal muscle mitochondrial content (oxidative phosphorylation complexes and citrate synthase activity), and AMPK activation similarly in both lines (all P <0.05).


The relationship between peripheral blood mononuclear cells telomere length and diet - unexpected effect of red meat.

Kasielski M, Eusebio MO, Pietruczuk M, Nowak D.

Nutr J. 2016 Jul 14;15(1):68. doi: 10.1186/s12937-016-0189-2.

PMID: 27418163

Free PMC Article


Among nine food types (cereal, fruits, vegetables, diary, red meat, poultry, fish, sweets and salty snacks) and eight beverages (juices, coffee, tea, mineral water, alcoholic- and sweetened carbonated beverages) only intake of red meat was related to T/S ratio. Individuals with increased consumption of red meat have had higher T/S ratio and the strongest significant differences were observed between consumer groups: "never" and "1-2 daily" (p = 0.02).


Impact of menaquinone-4 supplementation on coronary artery calcification and arterial stiffness: an open label single arm study.

Ikari Y, Torii S, Shioi A, Okano T.

Nutr J. 2016 May 12;15(1):53. doi: 10.118

PMID: 27175730


coronary artery calcification (CAC) … menaquinone (MK)-4 … brachial ankle pulse wave velocity (baPWV). … before and 1 year after MK-4 therapy. ... Baseline CAC and baPWV were 513 ± 773 and 1834 ± 289 cm/s, respectively. At 1 year following MK-4 supplementation, the values were 588 ± 872 (+14 %) and 1821 ± 378 cm/s (-0.7 %), respectively. In patients with high PIVKA-2, -18 % annual reduction of baPWV was observed. … benefits of MK-4 supplementation were only observed in patients with vitamin K insufficiencies correlated with high PIVKA-2 baseline levels, reducing baPWV but not CAC.


A dietary cholesterol challenge study to assess Chlorella supplementation in maintaining healthy lipid levels in adults: a double-blinded, randomized, placebo-controlled study.

Kim S, Kim J, Lim Y, Kim YJ, Kim JY, Kwon O.

Nutr J. 2016 May 13;15(1):54. doi: 10.1186/s12937-016-0174-9.

PMID: 27177615

Free PMC Article


34 participants ingested 510 mg of dietary cholesterol from three eggs … we observed a preventive action of Chlorella in maintaining serum TC versus placebo levels (3.5 % versus 9.8 %, respectively; P = 0.037) and LDL-C versus placebo levels (1.7 % versus 14.3 %, respectively; P = 0.012) against excessive dietary cholesterol intake and in augmenting HDL-C versus placebo levels (8.3 % versus 3.8 %, respectively).

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Age-specific prognostication after out-of-hospital cardiac arrest - The ethical dilemma between 'life-sustaining treatment' and 'the right to die' in the elderly.
Sulzgruber P, Sterz F, Poppe M, Schober A, Lobmeyr E, Datler P, Keferböck M, Zeiner S, Nürnberger A, Hubner P, Stratil P, Wallmueller C, Weiser C, Warenits AM, van Tulder R, Zajicek A, Buchinger A, Testori C.
Eur Heart J Acute Cardiovasc Care. 2016 Sep 26. pii: 2048872616672076. [Epub ahead of print]
PMID: 27669729
… There was an increasing rate of 30-day mortality (+21.8%, p < 0.001) and unfavourable neurological outcome (+18.8%, p < 0.001) with increasing age among age groups. Established predictive variables lost their prognostic potential with increasing age, even after adjusting for potential confounders. Independently, an initially shockable electrocardiogram proved to be directly associated with survival, with an adjusted hazard ratio (HR) of 2.04 (95% confidence interval (CI) 1.89-2.38, p = 0.003) for >85-year-olds. Frailty was directly associated with mortality (HR 1.22, 95% CI 1.01-1.51, p = 0.049), showing a 30-day survival of 5.6% and a favourable neurological outcome of 1.1% among elderly individuals.

Gut microbiota signatures of longevity.
Kong F, Hua Y, Zeng B, Ning R, Li Y, Zhao J.
Curr Biol. 2016 Sep 26;26(18):R832-R833. doi: 10.1016/j.cub.2016.08.015.
PMID: 27676296
The higher
gut microbial diversity and enrichment
of several potentially benefi cial
bacterial taxa in long-living people
from two independent studies reveal
a healthier gut microbiota in this
special group of people and indicate
a link between healthy aging and gut

Prospective comorbidity-matched study of Parkinson's disease and risk of mortality among women.
Winter AC, Rist PM, Buring JE, Kurth T.
BMJ Open. 2016 Sep 26;6(9):e011888. doi: 10.1136/bmjopen-2016-011888.
PMID: 27670518
… PD was associated with more than a twofold increased risk of all-cause mortality among women. Results are similar to those observed among men.

 [The below paper is pdf-availed.]
Association of depression and anxiety status with 10-year cardiovascular disease incidence among apparently healthy Greek adults: The ATTICA Study.
Kyrou I, Kollia N, Panagiotakos D, Georgousopoulou E, Chrysohoou C, Tsigos C, Randeva HS, Yannakoulia M, Stefanadis C, Papageorgiou C, Pitsavos C; ATTICA Study investigators.
Eur J Prev Cardiol. 2016 Sep 26. pii: 2047487316670918. [Epub ahead of print]
PMID: 27671771
… reported depression and anxiety levels were positively and independently associated with the 10-year CVD incidence, with depression markedly increasing the CVD risk by approximately fourfold (adjusted odds ratio (95% confidence interval) 3.6 (1.3, 11) for depression status; 1.03 (1.0, 1.1) for anxiety levels).

Urinary citrate, an index of acid-base status, predicts bone strength in youths and fracture risk in adult females.
Esche J, Johner S, Shi L, Schönau E, Remer T.
J Clin Endocrinol Metab. 2016 Sep 27:jc20162677. [Epub ahead of print]
PMID: 27676395
… the strongly diet-dependent biomarker urinary potential renal acid load (uPRAL)… urinary citrate excretion was positively associated with various parameters of bone quality and geometry (p<0.05). Fracture risk in adult females, but not in males, was inversely associated with urinary citrate and positively with uPRAL (p<0.05).

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The role of background diet on the effects of eicosapentaenoic acid and docosahexaenoic acid supplementation in healthy pre-menopausal women: a randomized, cross-over, controlled study.

Gomes MA, Jia X, Kolenski I, Duncan AM, Meckling KA.

Lipids Health Dis. 2016 Sep 29;15(1):168.

PMID: 27687127


... The two diet phases (habitual and low-fat) were separated by a washout phase, each lasting 3 menstrual cycles. During each diet phase, women were supplemented with 1.2 g eicosapentaenoic acid + docosahexaenoic acid per day. RESULTS: Red blood cell fatty acid composition indicated that more eicosapentaenoic acid and docosahexaenoic acid was incorporated in the low-fat diet than the habitual diet, though both diet phases resulted in significant increases in the omega-3 to omega-6 ratio. In the context of omega-3 supplementation in breast cancer risk reduction, we also measured fatty acid incorporation into nipple aspirate fluid. Similar changes to red blood cells were noted in nipple aspirate fluid, with higher incorporation of eicosapentaenoic acid in the low-fat diet phase.


[The below paper is pdf-availed.]




Cardiovascular benefits from ancient grain bread consumption: findings from a double-blinded randomized crossover intervention trial.

Sereni A, Cesari F, Gori AM, Maggini N, Marcucci R, Casini A, Sofi F.

Int J Food Sci Nutr. 2016 Aug 9:1-7. [Epub ahead of print]

PMID: 27687519

… the ancient varieties were shown to result in a significant reduction of total cholesterol, low-density lipoprotein (LDL)-cholesterol and blood glucose, whereas no significant differences during the phase with the modern variety were reported. Moreover, a significant increase in circulating endothelial progenitor cells were reported after the consumption of products made from the ancient "Verna" variety. …


N Engl J Med. 2016 Jun 23;374(25):2430-40. doi: 10.1056/NEJMoa1503840. Epub 2016 Apr 13.

Body-Mass Index in 2.3 Million Adolescents and Cardiovascular Death in Adulthood.

Twig G, Yaniv G, Levine H, Leiba A, Goldberger N, Derazne E, Ben-Ami Shor D, Tzur D, Afek A, Shamiss A, Haklai Z, Kark JD.

PMID: 27074389

DOI: 10.1056/NEJMoa1503840


… there was a graded increase in the risk of death from cardiovascular causes and all causes that started among participants in the group that was in the 50th to 74th percentiles of BMI (i.e., within the accepted normal range). Hazard ratios in the obese group (≥95th percentile for BMI), as compared with the reference group in the 5th to 24th percentiles, were 4.9 (95% confidence interval [CI], 3.9 to 6.1) for death from coronary heart disease, 2.6 (95% CI, 1.7 to 4.1) for death from stroke, 2.1 (95% CI, 1.5 to 2.9) for sudden death, and 3.5 (95% CI, 2.9 to 4.1) for death from total cardiovascular causes … Hazard ratios for death from cardiovascular causes in the same percentile groups increased from 2.0 (95% CI, 1.1 to 3.9) during follow-up for 0 to 10 years to 4.1 (95% CI, 3.1 to 5.4) during follow-up for 30 to 40 years; during both periods, hazard ratios were consistently high for death from coronary heart disease. Findings persisted in extensive sensitivity analyses.

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Teenagers at upper end of normal body weight have higher mortality in adult life, study shows.

Mayor S.

BMJ. 2016 Apr 17;353:i2192. doi: 10.1136/bmj.i2192. No abstract available.

PMID: 27091881


Adolescents at the upper end of the range for normal body

weight have higher cardiovascular and all cause mortality in

young adulthood or midlife, shows a large follow-up study that

found an even higher risk in people who were overweight or

obese in their teenage years.1

Researchers followed up 2.3 million Israeli adolescents (mean

age 17.3 ± 0.4 years) for 40 years, looking at deaths in relation

to baseline body mass index (BMI). Study participants were

included in a national database that collected medical

information before mandatory military service, including height

and weight measurements made from 1967 to 2010. They were

then followed up for 30 to 40 years.

During 42 297 007 person years of follow-up, 32 127 deaths

were recorded, of which nearly one in 10 (32 127; 9.1%) were

from cardiovascular causes. Results showed the lowest rates of

all cause mortality in adolescents with BMI values between the

25th and 49th percentiles.

The rate of cardiovascular death increased in people with BMI

between the 50th and 74th percentiles in their teenage years.

The risk of death from coronary heart disease in later life was

50% higher in this group than in those with the lowest BMI

values between the 5th and 24th percentiles (hazard ratio 1.5

(95% confidence interval 1.3 to 1.8)) after adjusting for sex,

age, height, birth year, and sociodemographic factors. The risk

of death from all cardiovascular and all other causes was also

raised in the higher BMI group.

The risk of death was even higher in people who had been

overweight or obese in adolescence. Teenagers who were obese

(>95th BMI percentile) had a risk of death from coronary heart

disease in adulthood nearly five times higher than those between

the lowest BMI percentiles (4.9 (3.9 to 6.1)).

“An increased BMI in late adolescence, even within the currently

accepted normal range, was strongly associated with

cardiovascular mortality in young adulthood or midlife,” said

the researchers, led by Gilad Twig, of the Sheba Medical Center

in Tel HaShomer, Israel. And obesity during adolescence was

associated with a substantially increased risk of cardiovascular

events in middle age, particularly death from coronary heart

disease, they added.

The researchers acknowledged that a limitation of their study

was the lack of adult measures of BMI, but they said that their

results supported previous studies showing an association

between obesity in adolescence and the future risk of death from

coronary heart disease.


Associations of the Transforming Growth Factor β/Smad Pathway, Body Mass Index, and Physical Activity With Breast Cancer Outcomes: Results From the Shanghai Breast Cancer Study.

Su Y, Cai H, Zheng Y, Qiu Q, Lu W, Shu XO, Cai Q.

Am J Epidemiol. 2016 Sep 19. pii: kww015. [Epub ahead of print]

PMID: 27651382


… presence of nuclear pSmad2 in breast cancer cells was inversely associated with overall and disease-free survival, predominantly among participants with lower body mass index (BMI; weight (kg)/height (m)2) and a moderate level of physical activity. However, the test for multiplicative interaction produced a significant result only for BMI (for disease-free survival and overall survival, adjusted hazard ratios were 1.79 and 2.05, respectively). In 535 earlier-stage (T1-2, N0) invasive cancers, nuclear pSmad2 was associated with improved survival among persons with higher BMI (overall survival: adjusted hazard ratio = 0.27, 95% confidence interval: 0.09, 0.86). The cytoplasmic pattern of TGF-β type II receptor expression in cancer cells was significantly associated with a lower survival rate but was not modified by BMI or physical activity. …


Age and Sex Differences in Body Mass Index as a Predictor of Hip Fracture: A NOREPOS Study.

Søgaard AJ, Holvik K, Omsland TK, Tell GS, Dahl C, Schei B, Meyer HE.

Am J Epidemiol. 2016 Sep 14. pii: kww011. [Epub ahead of print]

PMID: 27630142


… women with BMI <22 had a hazard ratio of 1.38 (95% confidence interval (CI): 1.18, 1.60) for hip fracture, as compared with women with BMI 22-24.9; and women with BMI ≥30 had a hazard ratio of 0.57 (95% CI: 0.49, 0.66). Corresponding results in men were hazard ratio = 1.66 (95% CI: 1.35, 2.05) and hazard ratio = 0.77 (95% CI: 0.62, 0.96), respectively. Below age 70 years, there was no further decrease in fracture risk at BMIs of 25 or more, while in women aged 70-79 years, the risk continued to decrease with increasing BMI. The associations between risk factors and hip fracture were similar in strength across BMI strata.

Edited by AlPater
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Contribution of uric acid to cancer risk, recurrence, and mortality.

Fini MA, Elias A, Johnson RJ, Wright RM.

Clin Transl Med. 2012 Aug 15;1(1):16. doi: 10.1186/2001-1326-1-16.

PMID: 23369448

Free PMC Article



[The below paper is not pdf-availed.]

The relationship between micronutrient status and sleep patterns: a systematic review.

Ji X, Grandner MA, Liu J.

Public Health Nutr. 2016 Oct 5:1-15.

PMID: 27702409

… researchers generally supported a potential role of micronutrients, particularly Fe and Mg, in the development of sleep stages among infants and in reversing age-related alterations in sleep architecture in older adults. Micronutrient status has also been linked to sleep duration, with sleep duration positively associated with Fe, Zn and Mg levels, and negatively associated with Cu, K and vitamin B12 levels. …


Lycopene, Lutein and Zeaxanthin May Reduce Faecal Blood, Mucus and Pus but not Abdominal Pain in Individuals with Ulcerative Colitis.

Głąbska D, Guzek D, Zakrzewska P, Włodarek D, Lech G.

Nutrients. 2016 Sep 30;8(10). pii: E613.

PMID: 27706028



Soluble Fiber with High Water-Binding Capacity, Swelling Capacity, and Fermentability Reduces Food Intake by Promoting Satiety Rather Than Satiation in Rats.

Tan C, Wei H, Zhao X, Xu C, Zhou Y, Peng J.

Nutrients. 2016 Oct 2;8(10). pii: E615.

PMID: 27706095


… soluble fiber (SF) with high water-binding capacity (WBC), swelling capacity (SC)  … control diet or diet containing 2% konjac flour (KF), pregelatinized waxy maize starch (PWMS) plus guar gum (PG), and PWMS starch plus xanthan gum (PX) for three weeks, with the measured values of SF, WBC, and SC in the four diets following the order of PG > KF > PX > control. … short-chain fatty acids (SCFAs) ... KF and PG groups reduced the food intake, mainly due to the decreased feeding behavior and increased satiety, as indicated by decreased meal numbers and increased inter-meal intervals. Additionally, KF and PG groups increased concentrations of acetate acid, propionate acid, and SCFAs in the cecal contents.


[The below papers are not pdf-availed.]

Diet and Headache: Part 1.

Martin VT, Vij B.

Headache. 2016 Oct;56(9):1543-1552. doi: 10.1111/head.12953.

PMID: 27699780



… Caffeine withdrawal and administration of MSG (dissolved in liquid) has the strongest evidence for triggering attacks of headache as evidenced by multiple positive provocation studies. Aspartame has conflicting evidence with two positive and two negative provocation studies. Observational studies provide modest evidence that gluten- and histamine-containing foods as well as alcohol may precipitate headaches in subgroups of patients. Two of three randomized controlled trials reported that an elimination diet of IgG positive foods significantly decreased frequency of headache/migraine during the treatment as compared to baseline time period.


Diet and Headache: Part 2.

Martin VT, Vij B.

Headache. 2016 Oct;56(9):1553-1562. doi: 10.1111/head.12952.

PMID: 27699772


… Low fat and high omega-3/low omega-6 fatty diets decrease the frequency of attacks of migraine and/or other headache disorders ... A ketogenic diet was more effective than a standard diet in reducing the frequency of migraine … dietary consumption of folate was inversely associated with the frequency of migraine attacks in persons with migraine with aura that have the C variant of the methylene tetrahydrofolate reductase gene. …


Training Enhances Immune Cells Mitochondrial Biosynthesis, Fission, Fusion, and Their Antioxidant Capabilities Synergistically with Dietary Docosahexaenoic Supplementation.

Busquets-Cortés C, Capó X, Martorell M, Tur JA, Sureda A, Pons A.

Oxid Med Cell Longev. 2016;2016:8950384.

PMID: 27698953

Free Article


… 8-week training and docosahexaenoic acid (DHA) supplementation (1.14 g/day) … peripheral blood mononuclear cells (PBMCs) from sportsmen. ... Nutritional intervention significantly increased the DHA content in erythrocyte membranes from the experimental group. No significant differences were reported in terms of circulating PBMCs, Mn-superoxide dismutase protein levels, and their capability to produce reactive oxygen species. The proteins related to mitochondrial dynamics were, in general, increased after an 8-week training and this increase was enhanced by DHA supplementation. …


Fructose intake and risk of gout and hyperuricemia: a systematic review and meta-analysis of prospective cohort studies.

Jamnik J, Rehman S, Blanco Mejia S, de Souza RJ, Khan TA, Leiter LA, Wolever TM, Kendall CW, Jenkins DJ, Sievenpiper JL.

BMJ Open. 2016 Oct 3;6(10):e013191. doi: 10.1136/bmjopen-2016-013191.

PMID: 27697882

Free Article


… an average of 17 years of follow-up. No eligible studies assessed incident hyperuricemia as an outcome. Fructose consumption was associated with an increase in the risk of gout (RR=1.62, 95% CI 1.28 to 2.03, p<0.0001) with no evidence of interstudy heterogeneity (I2=0%, p=0.33) when comparing the highest (>11.8% to >11.9% total energy) and lowest (<6.9% to <7.5% total energy) quantiles of consumption ...


Evidence from prospective cohort studies does not support current dietary fat guidelines: a systematic review and meta-analysis.

Harcombe Z, Baker JS, Davies B.

Br J Sports Med. 2016 Oct 3. pii: bjsports-2016-096550. doi: 10.1136/bjsports-2016-096550.

PMID: 27697938


… RR from meta-analysis for total fat intake and CHD deaths was 1.04 (95% CI 0.98 to 1.10). The RR from meta-analysis for saturated fat intake and CHD deaths was 1.08 (95% CI 0.94 to 1.25). …


Competing interests ZH receives income from writing and from two small self-employment businesses: The Harcombe Diet Co. and Columbus Publishing.



Coffee consumption and risk of all-cause, cardiovascular, and cancer mortality in smokers and non-smokers: a dose-response meta-analysis.

Grosso G, Micek A, Godos J, Sciacca S, Pajak A, Martínez-González MA, Giovannucci EL, Galvano F.

Eur J Epidemiol. 2016 Oct 3.

PMID: 27699514


… decreased all-cause [relative risk (RR) = 0.86, 95 % confidence interval (CI) = 0.82, 0.89)] and CVD mortality risk (RR = 0.85, 95 % CI = 0.77, 0.93) for consumption of up to 4 cups/day of coffee, while higher intakes were associated with no further lower risk. When analyses were restricted only to non-smokers, a linear decreased risk of all-cause (RR = 0.94, 95 % CI = 0.93, 0.96), CVD (RR = 0.94, 95 % CI = 0.91, 0.97), and cancer mortality (RR = 0.98, 95 % CI = 0.96, 1.00) for 1 cup/day increase was found. The search for other potential confounders, including dose-response analyses in subgroups by gender, geographical area, year of publication, and type of coffee, showed no relevant differences between strata.


Life-Space Mobility and Mortality in Older Women: Prospective Results from the Study of Osteoporotic Fractures.

Mackey DC, Lui LY, Cawthon PM, Ensrud K, Yaffe K, Cummings SR.

J Am Geriatr Soc. 2016 Oct 3. doi: 10.1111/jgs.14474.

PMID: 27696354


… life-space mobility (extent, frequency, independence of movement) and mortality in … Women (N = 1,498) aged 75 to 102 (mean 87.6) followed from 2006 to 2015. … scored from 0 (daily restriction to bedroom) to 120 (daily trips outside town without assistance) ... all-cause mortality (Ptrend < .001). Women with the lowest level of life-space (0-20 points) had a risk of all-cause mortality that was 2.4 times as high (95% confidence interval (CI) = 1.5-4.0) as that of women with the highest level (81-120 points); women with life-space scores between 21 and 60 had a risk of all-cause mortality that was 1.5 times as high as that of women with the highest level. Each standard deviation decrease in life-space was associated with a 1.2 times greater (95% CI = 1.1-1.4) risk of all-cause mortality. Women unable to travel beyond their neighborhood without assistance had a risk of all-cause mortality that was 1.4 times (95% CI = 1.1-1.7) as high as that of women who could travel beyond their neighborhood without assistance. Results were similar for noncancer, cardiovascular, and other mortality and did not change after controlling for underlying disease or living arrangement.


Effect of plate size on meal energy intake in normal weight women.

Ayaz A, Akyol A, Cetin C, Besler HT.

Nutr Res Pract. 2016 Oct;10(5):524-529.

PMID: 27698960


Free Article


… aged 19-25 years … Visual analogue scale (VAS) scores on sensory and satiety … There was no evidence that use of a smaller plate size reduced energy or specific macronutrient intake during the free choice lunch meal. Multiple visits to the serving table were not associated with energy or macronutrient intake. Plate size did not affect VAS scores during the test days.


Obesity in older adults and life expectancy with and without cardiovascular disease.

Dhana K, Berghout MA, Peeters A, Ikram MA, Tiemeier H, Hofman A, Nusselder W, Kavousi M, Franco OH.

Int J Obes (Lond). 2016 Jun 14. doi: 10.1038/ijo.2016.94. [Epub ahead of print]

PMID: 27163746


… aged 55 years and older ... Obesity was associated with an increased risk of CVD among men (HR 1.57 (95% confidence interval (CI) 1.17, 2.11)) and women (HR 1.49 (95% CI 1.19, 1.86)), compared with normal weight individuals. Overweight and obesity were not associated with mortality in men and women without CVD. Among men with CVD, obesity compared with normal weight, was associated with a lower risk of mortality (HR 0.67 (95% CI 0.49, 0.90)). Overweight and obesity did not influence total life expectancy. However, obesity was associated with 2.6 fewer years (95% CI -4.8, -0.4) lived free from CVD in men and 1.9 (95% CI -3.3, -0.9) in women. Moreover, men and women with obesity lived 2.9 (95% CI 1.1, 4.8) and 1.7 (95% CI 0.6, 2.8) more years suffering from CVD compared with normal weight counterparts. …


Mediterranean diet and mortality risk in metabolically healthy obese and metabolically unhealthy obese phenotypes.

Park YM, Steck SE, Fung TT, Zhang J, Hazlett LJ, Han K, Merchant AT.

Int J Obes (Lond). 2016 Jul 19. doi: 10.1038/ijo.2016.114. [Epub ahead of print]

PMID: 27339604


… Mediterranean Diet Scores (MDS) … metabolically healthy obese (MHO) phenotype (0 or 1 metabolic abnormality) or metabolically unhealthy obese (MUO) phenotype … In MHO individuals, the multivariable-adjusted hazard ratio (HR) of all-cause mortality in the highest tertile compared with the first tertile of MDS was 0.44 (95% confidence interval (CI), 0.26-0.75; P for trend <0.001), after adjustment for potential confounders. A five-point (1 s.d.) increment in the adherence to MDS was associated with a 41% reduction in the risk of all-cause mortality (HR, 0.59; 95% CI, 0.37-0.94). Similar findings were obtained when we restricted our analyses to those with or without prevalent diabetes mellitus and hypertension. We did not observe mortality risk reduction in either individuals with MUO phenotype or all obese participants combined.


Obesity but not high-fat diet impairs lymphatic function.

García Nores GD, Cuzzone DA, Albano NJ, Hespe GE, Kataru RP, Torrisi JS, Gardenier JC, Savetsky IL, Aschen SZ, Nitti MD, Mehrara BJ.

Int J Obes (Lond). 2016 Jun 21. doi: 10.1038/ijo.2016.96. [Epub ahead of print]

PMID: 27200507



Daytime napping and increased risk of incident respiratory diseases: symptom, marker, or risk factor?

Leng Y, Wainwright NW, Cappuccio FP, Surtees PG, Hayat S, Luben R, Brayne C, Khaw KT.

Sleep Med. 2016 Jul;23:12-15. doi: 10.1016/j.sleep.2016.06.012.

PMID: 27692271


… daytime napping was associated with an increase in the overall respiratory disease incidence risk (hazard ratio (HR) = 1.32, 95% confidence interval (CI) 1.15, 1.52 for napping <1 h; HR = 1.54, 95% CI 1.14, 2.09 for napping ≥1 h). This association was more pronounced for lower respiratory diseases, especially for the risk of chronic lower respiratory diseases (HR = 1.52, 95% CI: 1.18, 1.96 for napping <1 h; HR = 1.72, 95% CI: 1.01, 2.92 for napping ≥1 h, overall p = 0.003). …


Intake of different types of dairy and its prospective association with risk of type 2 diabetes: The Rotterdam Study.

Brouwer-Brolsma EM, van Woudenbergh GJ, Oude Elferink SJ, Singh-Povel CM, Hofman A, Dehghan A, Franco OH, Feskens EJ.

Nutr Metab Cardiovasc Dis. 2016 Aug 10. pii: S0939-4753(16)30136-3. doi: 10.1016/j.numecd.2016.08.003.

PMID: 27692560



    •Total dairy consumption was not associated with T2DM risk in older adults.

    •Results did not change when total dairy intake was split according to fat content.

    •Results did not change when total dairy intake was split according to processing type.

    •Results did not change when total dairy intake was split according to product type.

    •Stratified analyses did not suggest effect modification by age, sex, or BMI.


The Trans-Pacific Partnership: Is It Everything We Feared for Health?

Labonté R, Schram A, Ruckert A.

Int J Health Policy Manag. 2016 Apr 17;5(8):487-496. doi: 10.15171/ijhpm.2016.41.

PMID: 27694662

pdf from: http://www.ijhpm.com/article_3186_0.html

… potential implications of changes to intellectual property rights (IPRs), sanitary and phytosanitary measures (SPS), technical barriers to trade (TBT), investor-state dispute settlement (ISDS), and regulatory coherence provisions on a range of issues, including access to medicines and health services, tobacco and alcohol control, diet-related health, and domestic health policy-making. …


[The below paper is pdf-availed.]

Soya milk exerts different effects on plasma amino acid responses and incretin hormone secretion compared with cows' milk in healthy, young men.

Sun L, Tan KW, Siow PC, Henry CJ.

Br J Nutr. 2016 Oct;116(7):1216-1221.

PMID: 27609509

… in random order with isovolumetric (322 ml) control water, soya milk and cows' milk. Plasma total amino acid concentrations increased 30 min after test meals consumption and were higher after soya milk (230 %) and cow milk (240 %) consumption compared with water. Cows' milk ingestion induced higher branched-chain amino acids (BCAA) (40 %) than soya milk. Postprandial incretin concentrations increased after meal consumption. Cows' milk meal was accompanied by higher incremental AUC (iAUC) (170 %) for glucagon-like peptide-1 (GLP-1) compared with soya milk and control (P=0·06). However, glucose-dependent insulinotropic polypeptide (GIP) concentrations increased to significantly greater levels after soya milk consumption (iAUC 60 % higher) compared with cows' milk and control. Consumption of both soya and cows' milk with carbohydrates induced a similar reduction in glycaemic response through a different mechanism, beyond insulin action. Plasma amino acids (alanine and arginine), and incretins in particular (GIP was stimulated), may be involved in the hyperinsulinaemia after soya milk meals. However, BCAA and GLP-1 release may be responsible for the reduced glycaemia after cows' milk consumption by delaying gastric emptying. This could be the result of different milk protein/amino acid composition, but also differences in milk carbohydrate composition (i.e. lactose v. sucrose). It can be concluded that soya milk is a good alternative to cows' milk with regard to glycaemic regulation, with different mechanisms involved.



Association of Hormonal Contraception With Depression.

Skovlund CW, Mørch LS, Kessing LV, Lidegaard Ø.

JAMA Psychiatry. 2016 Sep 28. doi: 10.1001/jamapsychiatry.2016.2387. [Epub ahead of print]

PMID: 27680324


... Compared with nonusers, users of combined oral contraceptives had an RR of first use of an antidepressant of 1.23 (95% CI, 1.22-1.25). Users of progestogen-only pills had an RR for first use of an antidepressant of 1.34 (95% CI, 1.27-1.40); users of a patch (norgestrolmin), 2.0 (95% CI, 1.76-2.18); users of a vaginal ring (etonogestrel), 1.6 (95% CI, 1.55-1.69); and users of a levonorgestrel intrauterine system, 1.4 (95% CI, 1.31-1.42). For depression diagnoses, similar or slightly lower estimates were found. The relative risks generally decreased with increasing age. Adolescents (age range, 15-19 years) using combined oral contraceptives had an RR of a first use of an antidepressant of 1.8 (95% CI, 1.75-1.84) and those using progestin-only pills, 2.2 (95% CI, 1.99-2.52). Six months after starting use of hormonal contraceptives, the RR of antidepressant use peaked at 1.4 (95% CI, 1.34-1.46). When the reference group was changed to those who never used hormonal contraception, the RR estimates for users of combined oral contraceptives increased to 1.7 (95% CI, 1.66-1.71). …

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Variation and the spice of life.

Leslie RD, Jerram S.

Am J Clin Nutr. 2016 Oct;104(4):955-956. No abstract available.

PMID: 27629055


4. Estimating the reliability of glycemic index values and potential sources of methodological and biological variability.

Matthan NR, Ausman LM, Meng H, Tighiouart H, Lichtenstein AH.

Am J Clin Nutr. 2016 Oct;104(4):1004-1013.

PMID: 27604773


glycemic index (GI) … area under the curve (AUC) … GI value for white bread was 62 ± 15 when calculated by using the recommended method. Mean intra- and interindividual CVs were 20% and 25%, respectively. Increasing sample size, replication of reference and test foods, and length of blood sampling, as well as AUC calculation method, did not improve the CVs. Among the biological factors assessed, insulin index and glycated hemoglobin values explained 15% and 16% of the variability in mean GI value for white bread, respectively ...


Using cognitive behaviour therapy to explore resilience in the life-stories of 16 UK centenarians.

Hutnik N, Smith P, Koch T.

Nurs Open. 2016 Feb 23;3(2):110-118.

PMID: 27708821


… Resilience comprised the ability to frame difficult life events in positive terms, accept what cannot be changed, manage worry and anxiety effectively, develop psychological flexibility in the face of change and continually seek opportunities for growth and development. …


Gender Differences in Sleep Disturbance among Elderly Koreans: Hallym Aging Study.

Quan SA, Li YC, Li WJ, Li Y, Jeong JY, Kim DH.

J Korean Med Sci. 2016 Nov;31(11):1689-1695. doi: 10.3346/jkms.2016.31.11.1689.

PMID: 27709844


... alcohol increases the odds for poor sleep (odds ratio [OR] = 3.35, 95% confidence interval [CI] = 1.11-10.10) in males. In females, lack of exercise was the major risk factor of poor sleep as they are 4.46 times more likely to suffer from low sleep quality than those who exercise regularly (95% CI=1.56-13.75). Stress was also a risk factor for poor sleep. It was 5.60 times higher in the "always have stress" group than the "do not have stress" group (95% CI = 1.54-20.34). ...


[How can they make such a mistake in their Conclusion?  The below paper is not pdf-availed.]

Vegetarianism and breast, colorectal and prostate cancer risk: an overview and meta-analysis of cohort studies.

Godos J, Bella F, Sciacca S, Galvano F, Grosso G.

J Hum Nutr Diet. 2016 Oct 6. doi: 10.1111/jhn.12426. Review.

PMID: 27709695

... None of the analyses showed a significant association of vegetarian diet and a lower risk of either breast, colorectal, and prostate cancer compared to a non-vegetarian diet. By contrast, a lower risk of colorectal cancer was associated with a semi-vegetarian diet (RR = 0.86, 95% confidence interval = 0.79-0.94; I2 = 0%, Pheterogeneity = 0.82) and a pesco-vegetarian diet (RR = 0.67, 95% confidence interval = 0.53, 0.83; I2 = 0%, Pheterogeneity = 0.46) compared to a non-vegetarian diet. The subgroup analysis by cancer localisation showed no differences in summary risk estimates between colon and rectal cancer. ...


Mechanistic modeling of hemoglobin glycation and red blood cell kinetics enables personalized diabetes monitoring.

Malka R, Nathan DM, Higgins JM.

Sci Transl Med. 2016 Oct 5;8(359):359ra130.

PMID: 27708063


... glycated hemoglobin (HbA1c) in diabetic patients’ blood provides the best estimate of the average blood glucose concentration over the preceding 2 to 3 months. It is therefore essential for disease management and is the best predictor of disease complications. ... We combined a mechanistic mathematical model of hemoglobin glycation and red blood cell kinetics with large sets of within-patient glucose measurements to derive patient-specific estimates of nonglycemic determinants of HbA1c, including mean red blood cell age. We found that between-patient variation in derived mean red blood cell age explains all glucose-independent variation in HbA1c. We then used our model to personalize prospective estimates of average glucose and reduced errors by more than 50% in four independent groups of greater than 200 patients. The current standard of care provided average glucose estimates with errors >15 mg/dl for one in three patients. Our patient-specific method reduced this error rate to 1 in 10. ...



Exposing the exposures responsible for type 2 diabetes and obesity

By Paul W. Franks, Mark I. McCarthy

Science 07 Oct 2016 : 69-73




[Most papers in the issue are free full-texts.]


The Lancet Volume 388, Issue 10053, 8–14 October 2016, Pages 1447


Refers To

        K Srinath Reddy

        Global Burden of Disease Study 2015 provides GPS for global health 2030

        The Lancet, Volume 388, Issue 10053, 8–14 October 2016, Pages 1448-1449


        Kevin Watkins

        Longer lives and unfinished agendas on child survival

        The Lancet, Volume 388, Issue 10053, 8–14 October 2016, Pages 1450-1452


        Devi Sridhar

        Making the SDGs useful: a Herculean task

        The Lancet, Volume 388, Issue 10053, 8–14 October 2016, Pages 1453-1454


        John Maurice

        Measuring progress towards the SDGs—a new vital science

        The Lancet, Volume 388, Issue 10053, 8–14 October 2016, Pages 1455-1458


        GBD 2015 Mortality and Causes of Death Collaborators

        Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015

        The Lancet, Volume 388, Issue 10053, 8–14 October 2016, Pages 1459-1544


        GBD 2015 Disease and Injury Incidence and Prevalence Collaborators

        Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015

        The Lancet, Volume 388, Issue 10053, 8–14 October 2016, Pages 1545-1602


        GBD 2015 DALYs and HALE Collaborators

        Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015

        The Lancet, Volume 388, Issue 10053, 8–14 October 2016, Pages 1603-1658


        GBD 2015 Risk Factors Collaborators

        Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015

        The Lancet, Volume 388, Issue 10053, 8–14 October 2016, Pages 1659-1724


        GBD 2015 Child Mortality Collaborators

        Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015

        The Lancet, Volume 388, Issue 10053, 8–14 October 2016, Pages 1725-1774


        GBD 2015 Maternal Mortality Collaborators

        Global, regional, and national levels of maternal mortality, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015

        The Lancet, Volume 388, Issue 10053, 8–14 October 2016, Pages 1775-1812


        GBD 2015 SDG Collaborators

        Measuring the health-related Sustainable Development Goals in 188 countries: a baseline analysis from the Global Burden of Disease Study 2015

        The Lancet, Volume 388, Issue 10053, 8–14 October 2016, Pages 1813-1850

The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) brings together the most recent epidemiological data according to year, age, and sex from 195 countries and territories. In a continuation of the partnership between The Lancet and the Institute for Health Metrics and Evaluation (IHME), this year marks the first of an annual commitment to publish the four capstone GBD papers—on global mortality, years lived with disability, disability-adjusted life-years, and risk factors—in a single issue. 2015 also represents a key milestone in the global health and development community, with the end of the Millennium Development Goals (MDGs) era and the launch of the 17 Sustainable Development Goals (SDGs). Two health-related MDGs—maternal and child mortality—are subjected to systematic analysis in this issue, and a third companion study aims to define baseline measurements for health-related SDGs.

The GBD provides a window into the most pressing challenges and commendable achievements of the collective endeavour to transform human health and wellbeing. Although globally life expectancy has increased since 1980, conflict and interpersonal violence has driven its stagnation or decrease in many regions, with male life expectancy in Syria decreasing by 11·3 years between 2005 and 2015. The combination of socioeconomic development and an ageing population is contributing to declines in some risk exposures, such as childhood undernutrition, but increases in others, such as low physical activity and high body-mass index. Fundamentally, the GBD is about systematising everything we know about descriptive epidemiology to produce the most reliable global health statistics to date. This is the science of making data meaningful. As such, each iteration produces not only a worldwide update on disease burden, but, just as importantly, drives advances in the methods used to produce robust measurements and comparisons. Publication of the GBD in an academic journal is part of a deliberate effort to build a scientific discipline of estimation that is subjected to peer-review and public scrutiny. It is this scientific rigour that makes the GBD an essential basis for achieving quantifiable progress in global health.

At a national level, the GBD estimates support countries by enabling them to measure successes, identify important gaps, make comparisons with other countries, and set new priorities. These estimates are an important tool for policy makers, non-governmental organisations, practitioners, and other stakeholders. Recent methodological refinements have increased the granularity of estimates available for individual countries, increasing the ability to target resources to where they are needed most. China, Mexico, and the UK included the first subnational level analyses in GBD 2013, with GBD 2015 expanding these analyses to also include several other countries such as Brazil, South Africa, Japan, and India.

At the global level, the GBD functions as an accountability tool. Too often, high-level targets, commitments, and goals pay scant attention to approaches for measuring their real-world impact. Indeed, approaches for collecting and analysing data are scattered across the 17 SDGs and their individual targets and indicators, and are often found at the bottom of the priority list. The Socio-demographic Index (SDI) is among the most important technological developments of GDB 2015. As a new indicator derived from measures of educational attainment, fertility rate, and per capita income, this index is critical to measuring the impact of public health interventions by separating secular trends that are driven by socioeconomic development from overall progress. In the baseline analysis for the SDGs, GBD 2015 produced a health-related SDG index for each country and examined its relationship with the SDI, finding that some countries, including several in western Europe and Latin America, had SDG indices that were higher than expected on the basis of SDI alone, whereas others, such as the USA and India, performed poorer than expected. These findings indicate that progress in health is achievable beyond the flow-on effects of development status.

Despite the gains made by 2015, considerable challenges remain. Crucially, the global health community needs to move beyond assessing individual health-related SDGs to investigating the links between different goals. There can be little doubt that factors such as education, access to clean water and sanitation, gender equality, and peace, justice, and strong civil institutions all have a profound impact on health. What is less clear, however, is how to analyse and measure these relationships. But measure them we must. Because what you don't measure you don't know, and what you don't know you can't act on. Good science is the start.


Measuring progress towards the SDGs—a new vital science

Lancet Volume 388, Issue 10053, 8–14 October 2016, Pages 1455–1458

John Maurice

A new statistical methodology has emerged to gauge progress towards reaching the 2030 deadline of the UN's Sustainable Development Goals. John Maurice reports.

With 193 member states to serve, the UN system can hardly be simple. Witness the 17 Sustainable Development Goals (SDGs), which, after more than 2 years of negotiations, the UN launched in 2015 and which came with a complement of 169 targets to be met by 2030 and 231 indicators for measuring progress in meeting the targets. As one development observer pointed out, “the SDGs and the assessment of their progress…are incredibly complex even for the most astute development and health experts”. In comparison, with only 18 targets and 48 indicators, the eight Millennium Development Goals (MDGs) that preceded the SDGs were child's play.

The complexity of the SDGs has left many members of the global health and development community wondering whether assessing progress towards reaching the SDGs is doable. The work reported in today's Lancet by a team of researchers enlisted by the Institute for Health Metrics and Evaluation (IHME), a global health research centre housed at the University of Washington in Seattle, WA, USA, shows that the task is doable, at least for most of the health-related indicators chosen by the UN.

New indices

The data used for this work come from the 2015 edition of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), which covers 188 countries. The team used these data to estimate how 33 of the 47 health SDG indicators have been performing between 1990 and 2015. The indicators include such measurable parameters as maternal mortality ratios, the proportion of births attended by skilled personnel, the incidence of several infectious and non-communicable diseases, the risk of ill health associated with environmental, behavioural, and metabolic factors, the proportion of the population covered by essential health services, death rates from road traffic injuries, and so on. To facilitate comparisons between countries, the IHME team gave each indicator an index score, from zero, for countries furthest from the SDG goals, to 100 for those closest to them.

The team also developed a health-related SDG index, which gives a summary measure of the progress being achieved on the 33 health-related indicators. To measure the influence the MDGs might have had on current trends, the team constructed two sub-indices—an MDG index covering the health-related SDG indicators that had also been used to chart progress towards the MDGs and a non-MDG index for SDG health-related indicators that had not been used in the MDG days. To complete the SDG monitoring toolbox the research team created a Socio-demographic Index (SDI) to judge to what extent the performance of a country in progressing towards the SDG health targets differs from what might have been expected, given its degree of development. The SDI uses the country's income per capita, education levels, and total fertility rates to define its overall degree of development.

Creating accountability

“I think this work is important”, IHME director Christopher Murray tells The Lancet, “because it provides a baseline for all the health-related indicators for which we have data. That baseline allows us to know where the world is and where each country is with regard to development goals and that knowledge is a critical component of accountability.”

“Our work is saying that the health-related SDGs are not some abstract pie-in-the-sky idea. We're saying they are important signposts that can be measured and monitored and with regular annual monitoring these signposts will contribute to creating national and global accountability for progress. With this work we are doing, we are making a first critical step to committing countries to act. Users of our analysis need to review the results with respect to their specific needs and then act on them. With such a monitoring system that we've constructed I think there is more chance of action and of creating accountability.”

Asked if the system has been field tested, Murray points out that it is the work of hundreds of researchers from around the world. “We've had about 1800 investigators from more than 120 countries working on the results of our analysis to see if they make sense. Moreover, many of our collaborators are in government or government research institutions, so there's been a lot of ground-proofing that's been going on even before we got to the point of sending our report for publication.”


Meta-analysis of Egg Consumption and Risk of Coronary Heart Disease and Stroke.

Alexander DD, Miller PE, Vargas AJ, Weed DL, Cohen SS.

J Am Coll Nutr. 2016 Oct 6:1-13.

PMID: 27710205



This work was partially supported by the Egg Nutrition Center.

... Key Teaching Points: • The role of egg consumption in the risk of stroke and coronary heart disease has come under scrutiny over many years. • A comprehensive meta-analysis of prospective cohort studies that reported risk estimates for egg consumption in association with CHD or stroke was performed on the peer-reviewed epidemiologic literature through August 2015. • Overall, summary associations indicate that intake of up to 1 egg daily may be associated with reduced risk of total stroke. • Overall, summary associations show no clear association between egg intake and increased or decreased risk of CHD. • Eggs are a relatively low-cost and nutrient-dense whole food that provides a valuable source of protein, essential fatty acids, antioxidants, choline, vitamins, and minerals.


[My intake level on October 3/2016 was 6300 mg, 136% potassium; 1260 mg, 97% sodium.]

  Meta‐Analysis of Potassium Intake and the Risk of Stroke

  Marco Vinceti, Tommaso Filippini, Alessio Crippa, Agnès de Sesmaisons,

  Lauren A. Wise, and Nicola Orsini

  J Am Heart Assoc. 2016;5:e004210. Originally published October 6, 2016. doi: 10.1161/JAHA.116.004210


... Relative to the lowest category of potassium intake, the highest category of potassium intake was associated with a 13% reduced risk of stroke (RR=0.87, 95% CI 0.80–0.94) in the blood pressure–adjusted analysis. Summary RRs tended to decrease when original estimates were unadjusted for blood pressure. Analysis for stroke subtypes yielded comparable results. In the spline analysis, the pooled RR was lowest at 90 mmol of potassium daily intake (RRs=0.78, 95% CI 0.70–0.86) in blood pressure–adjusted analysis, and 0.67 (95% CI 0.57–0.78) in unadjusted analysis.

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[The below paper is pdf-availed.]


Decreased Skeletal Muscle Mass and Risk Factors of Sarcopenic Dysphagia: A Prospective Observational Cohort Study.

Maeda K, Takaki M, Akagi J.

J Gerontol A Biol Sci Med Sci. 2016 Oct 5. pii: glw190.

PMID: 27707804


... The participants' mean age was 83.2 ± 8.0 years; 63% were women. Of the surviving 82 patients, 63 (77%) had sarcopenia and 21 (26%) developed dysphagia, all of whom had sarcopenia (p = .002). Most variables were risk factors for dysphagia on univariate analysis. Decreased skeletal muscle index (odds ratio [OR] 24.0, 95% confidence interval [CI] 3.6-159.0, p = .001), Barthel Index (OR 12.9, 95% CI 2.1-78.4, p = .005), and body mass index (OR 11.4, 95% CI 1.8-70.5, p = .009) were independent predictors of dysphagia in the multivariate analysis.


Dietary patterns and the risk of CVD and all-cause mortality in older British men.

Atkins JL, Whincup PH, Morris RW, Lennon LT, Papacosta O, Wannamethee SG.

Br J Nutr. 2016 Oct;116(7):1246-1255.

PMID: 27620002


... three interpretable dietary patterns: 'high fat/low fibre' (high in red meat, meat products, white bread, fried potato, eggs), 'prudent' (high in poultry, fish, fruits, vegetables, legumes, pasta, rice, wholemeal bread, eggs, olive oil) and 'high sugar' (high in biscuits, puddings, chocolates, sweets, sweet spreads, breakfast cereals). ... The 'high-fat/low-fibre' dietary pattern was associated with an increased risk of all-cause mortality only, after adjustment for confounders (highest v. lowest quartile; hazard ratio 1·44; 95 % CI 1·13, 1·84). Adherence to a 'high-sugar' diet was associated with a borderline significant trend for an increased risk of CVD and CHD events. The 'prudent' diet did not show a significant trend with cardiovascular outcomes or mortality. ...


Skin Cancer-The Importance of Prevention.

Linos E, Katz KA, Colditz GA.

JAMA Intern Med. 2016 Oct 1;176(10):1435-1436. doi: 10.1001/jamainternmed.2016.5008. No abstract available.

PMID:  27459394



Screening for Skin Cancer in Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.

Wernli KJ, Henrikson NB, Morrison CC, Nguyen M, Pocobelli G, Blasi PR.

JAMA. 2016 Jul 26;316(4):436-47. doi: 10.1001/jama.2016.5415. Review.

PMID: 27458949



[The below paper is pdf-availed.]

Change in Bone Mineral Density Is an Indicator of Treatment-Related Antifracture Effect in Routine Clinical Practice: A Registry-Based Cohort Study.

Leslie WD, Majumdar SR, Morin SN, Lix LM.

Ann Intern Med. 2016 Jul 19. doi: 10.7326/M15-2937. [Epub ahead of print]

PMID: 27428723


During a mean of 9.2 years, 910 (13.7%) women developed incident fractures, including 198 with hip fractures. After adjustment for baseline fracture probability, women with a detectable decrease in total hip BMD compared with stable BMD had an absolute increase of 2.9% (95% CI, 1.5% to 4.4%) and 5.5% (CI, 2.8% to 8.1%) in the 5- and 10-year cumulative incidence of any fracture, respectively. In contrast, risk for any fracture in women with a detectable increase in total hip BMD was 1.3% (CI, 0.4% to 2.2%) and 2.6% (CI, 0.7% to 4.5%) lower after 5 and 10 years, respectively. Consistent results were seen for change in femoral neck and lumbar spine BMD and across a range of subgroup analyses. ...


[Oh, good.  The pdf can be viewed from a Google search of the title and opening the www.dssimon.com/MM/ACP...diet/Mediterranean_Diet_with_No_Fat_Restrictions.pdf icon.


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

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

Ann Intern Med. 2016 Jul 19. doi: 10.7326/M16-0361. [Epub ahead of print]

PMID: 27428849

… There was inconsistent, minimal, or no evidence pertaining to any other outcome, including adherence, hypertension, cognitive function, kidney disease, rheumatoid arthritis, and quality of life.


"The PREDIMED (Prevencion con Dieta Mediterranean) study was a low-risk-of-bias trial that randomly assigned 7447 participants to a Mediterranean diet with supplemental extra-virgin olive oil, a Mediterranean diet supplemented with nuts, or a low-fat control

diet (19). Both intervention diets included recommendations

for 5 of the 7 components that made up our

Mediterranean diet definition; grain and dairy products

were not specifically recommended. After an average

follow-up of 4.8 years, participants in the 2 Mediterranean

diet groups combined had a 29% reduction in

major cardiovascular events (myocardial infarction,

stroke, or cardiovascular death) compared with the

control group (HR, 0.71 [95% CI, 0.56 to 0.90]) (19), but

all-cause mortality was the same (4.7%) in both groups

(HR, 0.89 [CI, 0.71 to 1.12]) (19). In a medium-risk-of bias

substudy of participants who did not have type 2

diabetes at baseline (3541 participants), the incidence

of type 2 diabetes was lower in the 2 Mediterranean

diet groups combined than in the control group (HR,

0.70 [CI, 0.54 to 0.92]) (20).

A second, smaller trial (medium risk of bias) randomly

assigned 429 residents of 14 geriatric hostels in

Hong Kong to a diet containing 2 of the 7 Mediterranean

diet components (fruits and vegetables and fish)

or to a usual diet and followed them for 33 months (21).

Thirteen percent of enrollees in the Mediterranean diet

group died, compared with 11% in the control group

(RR, 1.19 [CI, 0.72 to 1.98])."


Fish consumption, fish oils, and cardiovascular events: still waiting for definitive evidence.

Ridker PM.

Am J Clin Nutr. 2016 Oct;104(4):951-952. No abstract available.

PMID: 27629056


The author is listed as a co-inventor on patents related to the use of inflammatory

biomarkers in the diagnosis and treatment of cardiovascular disease

and diabetes that have been licensed to AstraZeneca and Siemens.


Serum calcium and its complex association with incident type 2 diabetes.

Chatterjee R, Lin PH.

Am J Clin Nutr. 2016 Oct;104(4):957-958. No abstract available.

PMID: 27629050



Serum calcium and incident type 2 diabetes: the Atherosclerosis Risk in Communities (ARIC) study.

Rooney MR, Pankow JS, Sibley SD, Selvin E, Reis JP, Michos ED, Lutsey PL.

Am J Clin Nutr. 2016 Oct;104(4):1023-1029.

PMID: 27510541


... Participants in the highest compared with lowest calcium quintile were at greater risk of incident diabetes after adjustment for demographic and lifestyle factors [hr (95% CI): 1.34 (1.14, 1.57); P-trend across quintiles <0.0001] and with further adjustment for waist circumference and body mass index [1.26 (1.07, 1.48); P-trend = 0.004]. Additional adjustment for biomarkers on the metabolic pathway (e.g., 25-hydroxyvitamin D, parathyroid hormone, phosphorus) had little impact. The calcium-diabetes association was statistically significant in blacks [1.48 (1.11, 1.98); P-trend = 0.002] but not whites [1.17 (0.96, 1.43); P-trend = 0.17] after adjustment for adiposity. In whites, CaSR gene SNP rs1801725 was associated with serum calcium but not with risk of diabetes. ...


Hypercalcemia, hypercalciuria, and kidney stones in long-term studies of vitamin D supplementation: a systematic review and meta-analysis.

Malihi Z, Wu Z, Stewart AW, Lawes CM, Scragg R.

Am J Clin Nutr. 2016 Oct;104(4):1039-1051.

PMID: 27604776


... kidney stones were reported in only 9 trials with a tendency for fewer subjects reporting stones in the vitamin D arm than in the placebo arm (RR: 0.66, 95% CI: 0.41, 1.09; P = 0.10). In 37 studies, hypercalcemia was shown with increased risk shown for the vitamin D group (RR: 1.54; 95% CI: 1.09, 2.18; P = 0.01). Similar increased risk of hypercalciuria was shown in 14 studies for the vitamin D group (RR: 1.64; 95% CI: 1.06, 2.53; P = 0.03). In subgroup analyses, it was shown that the effect of vitamin D supplementation on risk of hypercalcemia, hypercalciuria, or kidney stones was not modified by baseline 25-hydroxyvitamin D, vitamin D dose and duration, or calcium co-supplementation. ...


High red meat intake and all-cause cardiovascular and cancer mortality: is the risk modified by fruit and vegetable intake?

Bellavia A, Stilling F, Wolk A.

Am J Clin Nutr. 2016 Oct;104(4):1137-1143.

PMID: 27557655


... Compared with participants in the lowest quintile of total red meat consumption, those in the highest quintile had a 21% increased risk of all-cause mortality (HR: 1.21; 95% CI: 1.13, 1.29), a 29% increased risk of CVD mortality (HR: 1.29; 95% CI: 1.14, 1.46), and no increase in the risk of cancer mortality (HR: 1.00; 95% CI: 0.88, 1.43). Results were remarkably similar across amounts of FV consumption, and no interaction between red meat and FV consumption was detected. ...

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[The below paper is not pdf-availed.]

Restricting dietary sodium reduces plasma sodium response to exercise in the heat.

Koenders EE, Franken CP, Cotter JD, Thornton SN, Rehrer NJ.

Scand J Med Sci Sports. 2016 Oct 7. doi: 10.1111/sms.12748.

PMID: 27714955


... to determine whether dietary sodium affects plasma sodium concentration [Na+ ] during exercise in the heat, when water intake nearly matches mass loss. Endurance-trained men (n = 9) participated in this crossover experiment. Each followed a low-sodium (lowNa) or high-sodium (highNa) diet for 9 days with 24-h fluid intakes and urine outputs measured before experimental trials (day 10). The trials were ≥2 week apart. Trials comprised 3 h (or if not possible to complete, to exhaustion) cycling (55% VO2max ; 34 °C, 65% RH) with water intake approximating mass loss. ... Urine [Na+ ] was lower on lowNa 24 h prior to (31 ± 24, 76 ± 30 mmol/L, P = 0.027) and during trials (10 ± 10, 52 ± 32 mmol/L, P = 0.004). Body mass was lower on lowNa (79.6 ± 8.5, 80.5 ± 8.9, P = 0.03). Plasma [Na+ ] was lower on lowNa before (137 ± 2, 140 ± 3, P = 0.007) and throughout exercise (P = 0.001). Sweat [Na+ ] was unaffected by diet (54.5 ± 40, 54.5 ± 23 mmol/L, P = 0.99). Heart rate and core temperature were higher on lowNa (P ≤ 0.001). Despite decreased urinary sodium losses, plasma sodium was lower on lowNa, with decreased mass indicating (extracellular) water may have been less, explaining greater heart rate and core temperature. General population health recommendations to lower salt intake may not be appropriate for endurance athletes, particularly those training in the heat. ...


[The pdf can be opened from the http://www.seq.es/component/content/1330?task=view URL.]

Seasonal influenza in octogenarians and nonagenarians admitted to a general hospital: epidemiology, clinical presentation and prognostic factors.

Ramos JM, García-Navarro MM, González de la Aleja MP, Sánchez-Martínez R, Gimeno-Gascón A, Reus S, Merino E, Rodríguez-Díaz JC, Portilla J.

Rev Esp Quimioter. 2016 Oct 7. pii: ramos07oct2016.

PMID: 27714398

... 219 patients were diagnosed with influenza in the study period: 55 (25.1%) were ≤64 years-old; 77 (35.2%) were aged 65-79; 67 (30.6%) were aged 80-89 years; and 20 (9.1%) were aged ≥90 years. ... mortality was higher in those aged 80 or over (adjusted odds ratio [ORa] 9.2, 95% confidence interval [CI] 1.65-51.1), those who had acquired the flu in a long-term care facility (ORa 11.9, 95% CI 1.06-134), and those with hyperlactataemia (ORa 1.89, 95% CI 1.20-3.00). ...


Self-perceived uselessness is associated with lower likelihood of successful aging among older adults in China.

Gu D, Brown BL, Qiu L.

BMC Geriatr. 2016 Oct 6;16(1):172.

PMID: 27716182


... independence in activities of daily living (ADL), independence in instrumental activities of daily living (IADL) ... self-perceived uselessness was negatively associated with successful aging among older adults aged 65 or older. Specifically, compared to never having self-perceived uselessness, always having such a perception was associated with 16-42 % lower odds of being ADL independent, IADL independent, cognitively unimpaired, and having good life satisfaction and good self-rated health. Often or sometimes having such a perception also reduced odds of aging successfully, although such reductions were less pronounced. The associations were similar among the oldest-old aged 80 or older with one exception for the case of IADL independence.



Diet Quality and Mortality Risk in Metabolically Obese Normal-Weight Adults.

Mark Park YM, Fung TT, Steck SE, Zhang J, Hazlett LJ, Han K, Lee SH, Merchant AT.

Mayo Clin Proc. 2016 Oct;91(10):1372-1383. doi: 10.1016/j.mayocp.2016.06.022.

PMID: 27712636


... Dietary Approaches to Stop Hypertension (DASH)-style diet, the Healthy Eating Index (HEI), and mortality risk in metabolically obese normal-weight (MONW) adults. ... participants without known cardiovascular disease and cancer at baseline were included in this prospective cohort study. Metabolic obesity was defined as having 2 or more of the following: high glucose, blood pressure, triglyceride, C-reactive protein, and insulin resistance values and low high-density lipoprotein cholesterol levels; metabolic healthy status was defined as having 0 or 1 of these metabolic derangements. ... in MONW individuals, a 1-SD increment in adherence to a DASH diet (2 points) or HEI (14 points) was significantly associated with reductions (17% [hazard ratio (HR), 0.83; 95% CI, 0.72-0.97] and 22% [hr, 0.78; 95% CI, 0.68-0.90], respectively) in the risk of all-cause mortality, after adjustment for potential confounders. The corresponding HRs for cardiovascular disease mortality were 0.72 (95% CI, 0.55-0.94) and 0.79 (95% CI, 0.65-0.97), respectively. In addition, reduction of cancer mortality was observed with 1-SD increment of HEI (HR, 0.63; 95% CI, 0.46-0.88). However, no association was observed in the MHNW phenotype. Sensitivity analyses suggested relationships robust to different definitions of MONW and also dose responses with the number of metabolic derangements. ...


Hormone-replacement therapy: current thinking.

Lobo RA.

Nat Rev Endocrinol. 2016 Oct 7. doi: 10.1038/nrendo.2016.164. Review.

PMID: 27716751 DOI: 10.1038/nrendo.2016.164


... hormone-replacement therapy (HRT) ... coronary heart disease (CHD) and mortality. More recently, randomized trials, including the Women's Health Initiative (WHI), studying mostly women many years after the onset of menopause, showed no such benefit and, indeed, an increased risk of CHD and breast cancer, which led to an abrupt decrease in the use of HRT. Subsequent reanalyzes of data from the WHI with age stratification, newer randomized and observational data and several meta-analyses now consistently show reductions in CHD and mortality when HRT is initiated soon after menopause. HRT also significantly decreases the incidence of various symptoms of menopause and the risk of osteoporotic fractures, and improves quality of life. In younger healthy women (aged 50-60 years), the risk-benefit balance is positive for using HRT, with risks considered rare. ... HRT should be primarily oestrogen-based, no particular HRT regimen can be advocated.


Sodium Intake and All-Cause Mortality Over 20 Years in the Trials of Hypertension Prevention.

Cook NR, Appel LJ, Whelton PK.

J Am Coll Cardiol. 2016 Oct 11;68(15):1609-1617. doi: 10.1016/j.jacc.2016.07.745.

PMID: 27712772


... randomized to sodium reduction or control ... nonsignificant 15% lower risk in the active intervention (hazard ratio {HR}: 0.85; 95% confidence interval [CI]: 0.66 to 1.09; p = 0.19). ... There was a direct linear association between average sodium intake and mortality, with an HR of 0.75, 0.95, and 1.00 (references) and 1.07 (p trend = 0.30) for <2,300, 2,300 to <3,600, 3,600 to <4,800, and ≥4,800 mg/24 h, respectively; and with an HR of 1.12 per 1,000 mg/24 h (95% CI: 1.00 to 1.26; p = 0.05). There was no evidence of a J-shaped or nonlinear relationship. The HR per unit increase in sodium/potassium ratio was 1.13 (95% CI: 1.01 to 1.27; p = 0.04).



Food processing and structure impact the metabolizable energy of almonds.

Gebauer SK, Novotny JA, Bornhorst GM, Baer DJ.

Food Funct. 2016 Sep 28.

PMID: 27713968


... metabolizable energy (ME) ... ME (kcal g-1) of whole natural almonds (4.42), whole roasted almonds (4.86), and chopped almonds (5.04) was significantly lower than predicted with Atwater factors (P < 0.001); ME of almond butter (6.53 kcal g-1) was similar to predicted (P = 0.08). The ME of whole roasted and chopped almonds was lower than almond butter (P < 0.0001). ME of whole natural almonds was lower than whole roasted almonds (P < 0.05). ...


[The below paper is not pdf-availed.]

Effects of DHA Supplementation on Hippocampal Volume and Cognitive Function in Older Adults with Mild Cognitive Impairment: A 12-Month Randomized, Double-Blind, Placebo-Controlled Trial.

Zhang YP, Miao R, Li Q, Wu T, Ma F.

J Alzheimers Dis. 2016 Oct 1.

PMID: 27716665


... there was a significant difference in the Full-Scale Intelligence Quotient (ηp2 = 0.084; p = 0.039), Information (ηp2 = 0.439; p = 0.000), and Digit Span (ηp2 = 0.375; p = 0.000) between DHA-treated versus the placebo group. In addition, there were significant differences in volumes of left hippocampus (ηp2 = 0.121, p = 0.016), right hippocampus (ηp2 = 0.757, p = 0.008), total hippocampus (ηp2 = 0.124, p = 0.023), and global cerebrum (ηp2 = 0.145, p = 0.032) between the two groups. ... DHA supplementation (2 g/day) for 12 months ...


[The below paper is not pdf-availed.]

Effects of Tooth Loss and the Apolipoprotein E ɛ4 Allele on Mild Memory Impairment in the Fujiwara-kyo Study of Japan: A Nested Case-Control Study.

Okamoto N, Morikawa M, Amano N, Yanagi M, Takasawa S, Kurumatani N.

J Alzheimers Dis. 2016 Oct 1.

PMID: 27716671


... mild memory impairment (MMI) ... median number of teeth at baseline was significantly lower in MMI participants (n = 179) than in controls (n = 358) (MMI: median 21.0, interquartile range 10.0-25.0 versus controls: 24.0, 14.0-27.0). After adjustment for demographics, vascular risk factors, and APOEɛ4 allele, the multivariate adjusted odds ratio (OR) of ≤8 teeth was 1.97 (95% confidence interval [CI], 1.13-3.44) compared to 25-32 teeth. Participants with both the presence of at least 1 APOEɛ4 allele and ≤8 teeth had a higher risk of MMI compared with those with neither (OR, 2.82; 95% CI, 1.15-6.91). Those with either risk factor alone did not have a higher risk of MMI.


A lower number of teeth is related to risk of MMI. This may be primarily true for those individuals with an APOEɛ4 allele.

Edited by AlPater
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Rosner, Hillary (AUTHOR)

Scientific American. Sep 2016, Vol. 315 Issue 3, p70-75.






Recently, at a wedding reception, I polled some friends about immortality. Suppose you could upload your brain tomorrow and live forever as a human-machine hybrid, I asked an overeducated couple from San Francisco, parents of two young daughters. Would you do it? The husband, a 42-year-old M.D.-Ph.D., didn’t hesitate before answering yes. His current research, he said, would likely bear fruit over the next several centuries, and he wanted to see what would come of it. “Plus, I want to see what the world is like 10,000 years from now.” The wife, a 39-year-old with an art history doctorate, was also unequivocal. “No way,” she said. “Death is part of life. I want to know what dying is like.”


I wondered if his wife’s decision might give the husband pause, but I diplomatically decided to drop it. Still, the whole thing was more than simply dinner-party fodder. If you believe the claims of some futurists, we’ll sooner or later need to grapple with these types of questions because, according to them, we are heading toward a postbiological world in which death is passé—or at least very much under our control.


The most well-imagined version of this transcendent future is Ray Kurzweil’s. In his 2005 best-selling book The Singularity Is Near, Kurzweil predicted that artificial intelligence would soon “encompass all human knowledge and proficiency.” Nanoscale brain-anning technology will ultimately enable “our gradual transfer of our intelligence, personality, and skills to the nonbiological portion of our intelligence.” Meanwhile billions of nanobots inside our bodies will “destroy pathogens, correct DNA errors, eliminate toxins, and perform many other tasks to enhance our physical well-being. As a result, we will be able to live indefinitely without aging.” These nanobots will create “virtual reality from within the nervous system.” Increasingly, we will live in the virtual realm, which will be indistinguishable from that anemic universe we might call “real reality.”


Based on progress in genetics, nanotechnology and robotics and on the exponential rate of technological change, Kurzweil set the date for the singularity— when nonbiological intelligence so far exceeds all human intelligence that there is “a profound and disruptive transformation in human capability”—at 2045. Today a handful of singulatarians still hold to that date, and progress in an aspect of artificial intelligence known as deep learning has only encouraged them.


Most scientists, however, think that any manifestation of our cyborg destiny is much, much farther away. Sebastian Seung, a professor at the Princeton


Neuroscience Institute, has argued that uploading the brain may never be possible. Brains are made up of 100 billion neurons, connected by synapses; the entirety of those connections make up the connectome, which some neuroscientists believe holds the key to our identities. Even by Kurzweilian standards of technological progress, that is a whole lot of connections to map and upload. And the connectome might be only the beginning: neurons can also interact with one another outside of synapses, and such “extrasynaptic interactions” could turn out to be essential to brain function. If so, as Seung argued in his 2012 book Connectome: How the Brain’s Wiring Makes Us Who We Are, a brain upload might also have to include not just every connection, or every neuron, but every atom. The computational power required for that, he wrote, “is completely out of the question unless your remote descendants survive for galactic timescales.”


Still, the very possibility of a cyborg future, however remote or implausible, raises concerns important enough that legitimate philosophers are debating it in earnest. Even if our technology fails to achieve the full Kurzweilian vision, augmentation of our minds and our bodies may take us part of the way there— raising questions about what makes us human.


I ask David Chalmers, a philosopher and co-director of the Center for Mind, Brain and Consciousness at New York University who has written about the best way to upload your brain to preserve your self-identity, whether he expects he will have the opportunity to live forever. Chalmers, who is 50, says he doesn’t think so—but that “absolutely these issues are going to become practical possibilities sometime in the next century or so.”


Ronald Sandler, an environmental ethicist and chair of the department of philosophy and religion at Northeastern University, says talking about our cyborg future “puts a lot of issues in sharp relief. Thinking about the limit case can teach you about the near-term case.”


And, of course, if there is even the remote possibility that those of us alive today might ultimately get to choose between death or immortality as a cyborg, maybe it’s best to start mulling it over now. So putting aside the question of feasibility, it is worth pausing to consider more fundamental questions. Is it desirable? If my brain and my consciousness were uploaded into a cyborg, who would I be? Would I still love my family and friends? Would they still love me? Would I, ultimately, still be human?


One of the issues philosophers think about is how we treat one another. Would we still have the Golden Rule in a posthuman world? A few years ago Sandler co-authored a paper, “Transhumanism, Human Dignity, and Moral Status,” arguing that “enhanced” humans would retain a moral obligation to regular humans. “Even if you become enhanced in some way, you still have to care about me,” he tells me. Which seems hard to argue with—and harder still to believe would come to pass.


Other philosophers make a case for “moral enhancement”—using medical or biomedical means to give our principles an upgrade. If we’re going to have massive intelligence and power at our disposal, we need to ensure Dr. Evil won’t be at the controls. Our scientific knowledge “is beginning to enable us to directly affect the biological or physiological bases of human motivation, either through drugs, or through genetic selection or engineering, or by using external devices that affect the brain or the learning process,” philosophers Julian Savulescu and Ingmar Persson wrote recently. “We could use these techniques to overcome the moral and psychological shortcomings that imperil the human species.”


In an op-ed this past May in the Washington Post entitled “Soon We’ll Use Science to Make People More Moral,” James Hughes, a bioethicist and associate provost at the University of Massachusetts Boston, argued for moral enhancement, saying it needs to be voluntary rather than coercive. “With the aid of science, we will all be able to discover our own paths to technologically enabled happiness and virtue,” wrote Hughes, who directs the Institute for Ethics and Emerging Technologies, a progressive transhumanist think tank. (For his part, Hughes, 55, a former Buddhist monk, tells me that he would like to stay alive long enough to achieve enlightenment.)


There is also the question of how we might treat the planet. Living forever, in whatever capacity, would change our relationship not just to one another but to the world around us. Would it make us more or less concerned about the environment? Would the natural world be better or worse for it?


The singularity, Sandler points out to me, describes an end state. To get there would involve a huge amount of technological change, and “nothing changes our relationship with nature more quickly and robustly than technology.” If we are at the point where we can upload human consciousness and move seamlessly between virtual and non-virtual reality, we will already be engineering nearly everything else in significant ways. “By the time the singularity would occur, our relationship with nature would be radically transformed already,” Sandler says.


Although we would like to believe otherwise, in our current mere mortal state we remain hugely dependent on—and vulnerable to—natural systems. But in this future world, those dependencies would change. If we didn’t need to breathe through lungs, why would we care about air pollution? If we didn’t need to grow food, we would become fundamentally disconnected from the land around us.


Similarly, in a world where the real was indistinguishable from the virtual, we might derive equal benefit from digitally created nature as from the great outdoors. Our relationship to real nature would be altered. It would no longer be sensory, physical. That shift could have profound impacts on our brains, perhaps even the silicon versions. Research shows that interacting with nature affects us deeply—for the better. A connection to nature, even at an unconscious level, may be a fundamental quality of being human.


If our dependence on nature falls away, and our physical ability to commune with nature diminishes, then “the basis for environmental concern will shift much more strongly to these responsibilities to nature for its own sake,” Sandler says. Our capacity for solving environmental problems—engineering the climate, say—will be beyond what we can imagine today. But will we still feel that nature has intrinsic value? If so, ecosystems might fare better. If not, other species and the ecosystems they would still rely on might be in trouble.


Our relationship to the environment also depends on the question of timescales. From a geologic perspective, the extinction crisis we are witnessing today might not matter. But it does matter from the timeline of a current human life. How might vastly extended life spans “change the perspective from which we ask questions and think about the nonhuman environment?” Sandler asks. “The timescales really matter to what reasonable answers are.” Will we become more concerned about the environment because we will be around for so long? Or will we care less because we will take a broader, more geologic view?


“It’s almost impossible to imagine what it will be like,” Sandler says, “but we can know that the perspective will be very, very different.”


Talk to experts about this stuff for long enough, and you fall down a rabbit hole; you find yourself having seemingly normal conversations about absurd things. “If there were something like an X-Men gene therapy, where they can shoot lasers out of their eyes or take over your mind,” Hughes says to me at one point, then people who want those traits should have to complete special training and obtain a license.


“Are you using those examples to make a point, or are they actual things you believe are coming?” I ask.


“In terms of how much transhumanists talk about these things, most of us try not to freak out newbies too much,” he replies obliquely. “But once you’re past shock level 4, you can start talking about when we’re all just nanobots.”


When we’re all just nanobots, what will we worry about? Angst, after all, is arguably one of our defining qualities as humans. Does immortality render angst obsolete? If I no longer had to stress about staying healthy, paying the bills, and how I’ll support myself when I’m too old and frail to travel around writing articles, would I still be me? Or would I simply be a placid, overly contented … robot? For that matter, what would I daydream about? Would I lose my ambition, such as it is? I mean, if I live forever, surely that Great American Novel can wait until next century, right?


Would I still be me? Chalmers believes this “is going to become an extremely pressing practical, not just philosophical, question.”


On a gut level, it seems implausible that I would remain myself if my brain was uploaded—even if, as Chalmers has prescribed, I did it neuron by neuron, staying conscious throughout, becoming gradually 1 percent silicon, then 5, then 10 and onward to 100. It’s the old saw about Theseus’s ship—replaced board by board with newer, stronger wood. Is it or isn’t it the same afterward? If it’s not the same, at what point does the balance tip?


“A big problem,” Hughes says, “is you live long enough and you’ll go through so many changes that there’s no longer any meaning to you having lived longer. Am I really the same person I was when I was five? If I live for another 5,000 years, am I really the same as I am now? In the future, we will be able to share our memories, so there will be an erosion of the importance of personal identity and continuity.” That sounds like kind of a drag.


Despite the singularity’s utopian rhetoric, it carries a tinge of fatalism: this is the only route available to us; merge with machines or fade away—or worse. What if I don’t want to become a cyborg? Kurzweil might say that it’s only my currently flawed and limited biological brain that prevents me from seeing the true allure and potential of this future. And that the choices available to me—any type of body, any experience in virtual reality, limitless possibilities for creative expression, the chance to colonize space—will make my current biological existence seem almost comically trivial. And anyway, what’s more fatalistic than certain death?


Nevertheless, I really like being human. I like knowing that I’m fundamentally made of the same stuff as all the other life on Earth. I’m even sort of attached to my human frailty. I like being warm and cuddly and not hard and indestructible like some action-film super-robot. I like the warm blood that runs through my veins, and I’m not sure I really want it replaced by nanobots.


Some ethicists argue that human happiness relies on the fact that our lives are fleeting, that we are vulnerable, interdependent creatures. How, in a human-machine future, would we find value and meaning in life?


“To me, the essence of being human is not our limitations … it’s our ability to reach beyond our limitations,” Kurzweil writes. It’s an appealing point of view. Death has always fundamentally been one of those limitations, so perhaps reaching beyond death makes us deeply human?


But once we transcend it, I’m not convinced our humanity remains. Death itself doesn’t define us, of course—all living things die—but our awareness and understanding of death, and our quest to make meaning of life in the interim, are surely part of the human spirit.




Some scientists believe that one day technology will make it possible to achieve immortality by uploading our neural connections into robots’ bodies; others believe this is impossible.


Regardless, legitimate philosophers are engaged in a debate over how such an eventuality would change our humanity.


Their dialogue is important because even if the “singularity” falls short, human augmentation and improvements may raise similar issues.




That depends on the definition of ‘colonize.’ If landing robots qualifies, then we’ve already done it. If it means sending microbes from Earth and having them persist and maybe grow, then, unfortunately, it’s not unlikely that we’ve done that as well— possibly on Mars with the Phoenix spacecraft and almost certainly inside the Curiosity rover, which carries a heat source and was not fully baked the way Viking had been. If it means having humans live elsewhere for a longer period of time, but not reproduce, then that’s something that might happen within the next 50 years or so. (Even some limited degree of reproduction might be feasible, recognizing that primates will be primates.) But if the idea is to construct a self-sustaining environment where humans can persist indefinitely with only modest help from Earth—the working definition of a ‘colony,’ according to the various European colonies outside of Europe—then I’d say this is very far in the future, if it’s possible at all. We currently have a very inadequate understanding of how to build closed ecosystems that are robust to perturbation by introduced organisms or nonbiological events (Biosphere 2, for example), and I suspect that the contained ecosystem problem will turn out to be much more challenging than the vast majority of space colonization advocates realize. There are a wide range of technical problems to solve, another being air handling. We haven’t bothered to colonize areas underwater on Earth yet. It’s far more challenging to colonize a place where there’s hardly any atmosphere at all.”


CATHARINE A. CONLEY nasa planetary protection officer



My money’s on yes. We’ve found that planets around other stars are far more abundant and diverse than scientists imagined just a couple of decades ago. And we’ve also found that the crucial ingredient for life on this planet—water—is common in space. I’d say nature seems to have stacked the deck in favor of a wide range of planets, including Earth-like planets. We just have to look for them.”


AKI ROBERGE Research astrophysicist focusing on exoplanets at nasa Goddard Space Flight Center




I am not sure if there will be a cure, per se, but I am very hopeful that there will be a successful disease-modifying therapy for Alzheimer’s disease within the next decade. We have now started prevention trials that are testing biological interventions even before people show clinical symptoms of the disease. And we don’t have to cure Alzheimer’s— we just need to delay dementia by five to 10 years. Estimates show that a five-year delay in the terrible and expensive dementia stage of the disease would reduce Medicare dementia costs by nearly 50 percent. Most important, that would mean that many older people could die while out ballroom dancing rather than in nursing homes.”




It's time to embrace lifestyle medicine.

Ornish D.

Time. 2015 Feb 23-Mar 2;185(6-7):97. No abstract available.

PMID: 25928956


mel lefer’s cardiologist told him his

heart disease was so severe he was unlikely to

survive even a year. He was incapacitated by

chest pain up to 30 times a day. More than 28

years ago, I treated him with a program focusing

on diet, exercise, stress management and social

support—and he has remained angina-free

ever since. Tests showed that his heart disease

was reversing. He’s now 82 and leads a full life.

A convergence of forces has made so-called

lifestyle medicine the most compelling trend

in health care. Start with an aging population,

and add an economic imperative to control

spending and a political debate over how best

to do it. Then throw in evidence that lifestyle

changes can work as a treatment for some

chronic diseases—either in combination with

drugs and surgery or as an alternative—at a

much lower cost and without side effects.

For almost four decades, my colleagues

and I at the nonprofit Preventive Medicine

Research Institute and at the University of

California, San Francisco, have used science to

test low-tech, low-cost lifestyle interventions.

We landed on a simple prescription: a wholefoods-

and plant-based diet; stress-management

techniques, including yoga and meditation;

moderate exercise; and social support. In short:

eat well, move more, stress less and love more.

In randomized, controlled trials, we found

that lifestyle changes alone can often reverse

the progression of severe coronary heart disease.

They may begin to reverse Type 2 diabetes

and slow, stop or even reverse the progression

of early-stage prostate cancer.

Tens of millions of Americans have been

prescribed drugs to lower cholesterol, blood

pressure or blood sugar. When the patient asks,

“How long do I have to take these drugs?” the

reply is usually “Forever.” But when patients

make changes, they can often reduce or discontinue

medication under a doctor’s supervision.

These studies helped persuade Dr. Kim Williams,

the incoming president of the American

College of Cardiology, to go on a whole-foods and

plant-based diet instead of committing to

a lifetime of cholesterol-lowering drugs. As he

wrote, “Wouldn’t it be a laudable goal of the

American College of Cardiology to put ourselves

out of business within a generation or

two? Improving our lifestyles with improved

diet and exercise will help us get there.”

The costs—both human and financial—of

drugs and surgery are well documented. Randomized,

controlled trials have shown that stents

and angioplasties do not prolong life or prevent

heart attacks in most stable heart patients. Only

a small percentage of men who were treated

for early-stage prostate cancer with surgery or

radiation may benefit. Type 2 diabetes and prediabetes

affect almost half of Americans over age

20, yet drug treatments to lower blood sugar do

not prevent the onset and complications of diabetes

as well as lowering blood sugar with diet

and lifestyle does. And we found in a controlled

study that lifestyle changes lengthen telomeres,

thereby reversing aging on a cellular level.

Right now, 86% of the $3 trillion we spend

each year on health care in the U.S. is for

chronic diseases that can be treated through

lower-cost interventions. That’s one reason it

was a goal of Obamacare to radically change

the incentives for how doctors treat patients. In

a fee-for-service environment, more operations

and hospitalizations generate more revenue.

Under the Affordable Care Act, new models of

payment reward providers for better outcomes,

reducing avoidable procedures by aligning incentives

to encourage healthy lifestyles.

Lifestyle medicine is now reimbursable.

Medicare and many private insurers are covering

a lifestyle program for heart disease that my

team and I developed. This is a game changer,

because when reimbursement changes, so do

medical practice and even medical education.

This kind of medicine is not just about how

long we live but also how well. And because the

mechanisms of health are so dynamic, you’re

likely to feel so much better, so quickly. It reframes

the reason for making these changes

from fear of dying—to joy of living.




Is Heart Disease or Cancer the Leading Cause of Death in United States Women?

Pathak EB.

Womens Health Issues. 2016 Oct 4. pii: S1049-3867(16)30093-7. doi: 10.1016/j.whi.2016.08.002.

PMID: 27717539


... Asians and Pacific Islanders (A/PIs), and American Indians and Alaska Natives (AI/ANs)) ... The majority of heart disease deaths (51.6%) occurred among women 85 years or older, compared with 18.9% of female cancer deaths. The age-adjusted death rates (per 100,000 population) were 171 (95% confidence interval [CI], 170-171) for heart disease versus 177 (95% CI, 176-178) for cancer. For all racial and ethnic groups, cancer mortality was significantly higher than heart disease mortality among women younger than 80 years of age. For all ages combined, cancer deaths exceeded heart disease deaths among Hispanics, A/PIs, and AI/ANs. Black non-Hispanic women were the only racial/ethnic group who had a higher age-adjusted death rate for heart disease than for cancer: 224 (95% CI, 222-226) versus 207 (95% CI, 205-209).


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Low carbohydrate diet is associated with reduced risk of metabolic syndrome in Tehranian adults.

Mirmiran P, Asghari G, Farhadnejad H, Eslamian G, Hosseini-Esfahani F, Azizi F.

Int J Food Sci Nutr. 2016 Oct 9:1-8.

PMID: 27718762


... low carbohydrate diet (LCD) ... there was significant association between LCD score and fasting plasma glucose (β: -0.002, 95%CI: -0.005, -0.001), triglycerides (TGs) (β: -0.002, 95%CI: -0.004, -0.001), BP (β: -0.001, 95%CI: -0.002, 0.000), WC-BMI (β: -0.003, 95%CI: -0.005, -0.001) and MetS risk Z-scores (β: -0.015, 95%CI: -0.021, -0.002).



Riboflavin, MTHFR genotype and blood pressure: a personalized approach to prevention and treatment of hypertension.

McNulty H, Strain JJ, Hughes CF, Ward M.

Mol Aspects Med. 2016 Oct 6. pii: S0098-2997(16)30058-9. doi: 10.1016/j.mam.2016.10.002. Review.

PMID:  27720779


... cardiovascular disease (CVD... the folate-metabolizing enzyme methylenetetrahydrofolate reductase (MTHFR) among eight loci associated with blood pressure. Epidemiological studies, which provide a separate line of evidence to link this gene with blood pressure, show that the 677C→T polymorphism in MTHFR increases the risk of hypertension by 24-87% and CVD by up to 40%, albeit with a large geographical variation in the extent of excess disease risk suggestive of a gene-environment interaction. Emerging evidence indicates that the relevant environmental factor may be riboflavin, the MTHFR co-factor, via a novel and genotype-specific effect on blood pressure. Randomized trials conducted in hypertensive patients (with and without overt CVD) pre-screened for this polymorphism show that targeted riboflavin supplementation in homozygous individuals (MTHFR 677TT genotype) lowers systolic blood pressure by 6 to 13 mmHg, independently of the effect of antihypertensive drugs. ...



October 11, 2016

The Supplement Paradox -- Negligible Benefits, Robust Consumption

Pieter A. Cohen

JAMA. 2016;316(14):1453-1454. doi:10.1001/jama.2016.14252


Dietary supplements encompass a wide variety of products from vitamins, minerals, and botanicals to probiotics, protein powders, and fish oils.1 During the past 2 decades, a steady stream of high-quality studies evaluating dietary supplements has yielded predominantly disappointing results about potential health benefits, whereas evidence of harm has continued to accumulate. How consumers have responded to these scientific developments is not known. In this issue of JAMA,2 the report by Kantor and colleagues sheds light on this important question.

To place the results of the study by Kantor et al in context, it is helpful to understand the regulatory changes predating their study. In the late 1980s, 36% of men and 48% of women used vitamins, minerals, and other supplements.3 These high consumption levels increased further after the passage of the Dietary Supplement Health and Education Act of 1994 (DSHEA), a law that continues to define supplement policy to this day. Under DSHEA, all supplements are assumed to be safe until the US Food and Drug Administration (FDA) detects evidence of harm,1 usually only after consumers have been extensively exposed to the product. The lax DSHEA requirements for proof of product safety led to a rapid increase in the number of supplements in the marketplace, from an estimated 4000 in 1994 to 55 000 in 2012.4 Dietary supplements had grown into a greater than $32 billion industry by 2012.5

The period Kantor and colleagues studied, 1999 through 2012, was an era of intense investigation into the health effects of supplements. The National Institutes of Health (NIH) invested more than $250 million to $300 million per year funding dietary supplement research.4,5 Many major clinical studies were published, but the results generally failed to demonstrate beneficial effects on health. According to a recent summary of this extensive investment: “most of the larger NIH-supported clinical trials of [dietary supplements] failed to demonstrate a significant benefit compared to control groups.”4 Prominent examples of high-quality studies published during this era and showing no benefits of supplements include an evaluation of multivitamins to prevent cancer and heart disease,6 echinacea to treat the common cold,7 St John’s wort to treat major depression,8 and vitamin E to prevent prostate cancer.9

At the same time, the health risks of supplements were also becoming better understood. In the late 1990s and early 2000s, supplements containing ephedra were linked to many serious adverse events including myocardial infarctions, seizures, strokes, and sudden deaths.10 By 2002, national poison centers were receiving more than 10 000 calls related to ephedra poisonings per year.10 Long-term risks began to be recognized as well, for example, beta-carotene supplements were found to actually increase the risk of lung cancer among smokers.11

Not all supplements, of course, lack evidence of efficacy. Many supplements, including vitamins, minerals, and probiotics, are important components of modern health care. Supplements are essential to treat vitamin and mineral deficiencies, and there are indications for multivitamins as well, for example, a specific combination of vitamins and minerals can delay progression of early age-related macular degeneration.12 But even supplements that are useful in treating certain conditions are frequently overused among the general population to “improve” or “maintain” health, and only about one-quarter of consumers use supplements based on the advice of their clinicians.13 For the majority of adults, supplements likely provide little, if any, benefit.

It might have been expected that the string of negative studies involving supplements, along with the increasing safety concerns, would have triggered a decrease in supplement use in the late 1990s and early 2000s. But this is not what Kantor and colleagues found. Instead, using cross-sectional data from 37 958 interviews obtained over 7 cycles of the National Health and Nutrition Examination Survey (NHANES), Kantor et al found that supplement use was stable during this period, with 52% (95% CI, 49%-54%) of US adults in the 1999-2000 survey and 52% (95% CI, 49%-55%) in the 2011-2012 survey reporting having used supplements in the prior 30 days.

Although overall supplement use remained constant, there were some noteworthy changes in use of specific supplements. Multivitamin use, for example, declined from 37% to 31%, and rates of vitamin C, vitamin E, and selenium use decreased, perhaps in response to research findings showing no benefit. Other products continued to be used at the same rate despite major studies demonstrating no benefit over placebo. Following the negative results of the Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT) published in 2006,14 use of glucosamine and chondroitin remained essentially the same in the 1999-2000 and 2011-2012 surveys. Other supplements increased in use during the study period, including omega-3 fatty acids, lycopene, vitamin D, and probiotics. Overall, major research findings sometimes appeared to lead to modest effects on consumption of individual supplements but had no effect on overall use of supplements.

Why would consumers continue to use supplements after high-quality trials found many of these products to be no more effective than placebos?

One factor may simply be that consumers are not aware of these negative results, and so continue to use the products they have been using for years. In these cases, the onus is on clinicians to inform patients when the evidence has changed. Other consumers might not have faith in the scientific process, in which case counseling is unlikely to result in significant changes in supplement use.

Another factor may be that these findings are counter-intuitive: avoiding a multivitamin seems to run counter to everything patients have been taught about the importance of consuming enough vitamins and minerals. Physicians can help remind patients that there is no benefit of obtaining vitamins from a pill rather than from conventional food.

A third factor is that the law affords manufacturers significant leeway to advertise supplements for a broad spectrum of conditions. DSHEA permits the promotion of supplements using “structure/function claims.” For example, claims such as “supplement X will preserve heart health” or “supplement Y will maintain mental alertness” are permitted without premarketing authorization from the FDA. Such claims must be accompanied by a disclaimer: “These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.”1 However, the disclaimer appears to have minimal effect on consumer understanding of the advertised claim.15

Moreover, even after high-quality studies that show no meaningful clinical differences between supplements and placebos are published, the law provides manufacturers latitude to continue advertising their products based on earlier, low-quality data. For example, Ginkgo biloba continues to be sold “to support mental sharpness” despite a large, high-quality NIH-funded study that found evidence to the contrary.16 In the study by Kantor et al, when the consumption of some products declined over time, consumption of other products increased and made up for the deficit. It might be that companies refocused advertising from one supplement to another. In response to research findings showing no substantial benefit for garlic and glucosamine, for example, manufacturers may have turned to preliminary findings to promote coenzyme Q10 for heart health or methylsulfonylmethane for joint health.

What are the conclusions from this new analysis? It is now well documented that more than half of US adults use supplements. Physicians should include supplements when they review medications with all patients and also consider supplements when symptoms raise the possibility of a supplement-related adverse effect. It is now known that many supplements contain pharmaceutically active botanicals, which can have important clinical effects. For example, red yeast rice, yohimbe, and caffeine all have pharmacological effects, and although ephedra has been banned, a variety of synthetic drugs have replaced ephedra as stimulants in many sports and weight loss supplements. Reporting suspected adverse effects of supplements is also critical. The FDA relies on physicians and consumers to report adverse events via MedWatch17 to remove hazardous supplements from the marketplace.

The current study by Kantor et al should also lead funders and legislators to reconsider their priorities with respect to supplements. Given the current regulatory framework, even high-quality research appears to have only modest effects on supplement use. Future efforts should focus on developing regulatory reforms that provide consumers with accurate information about the efficacy and safety of supplements and on improving mechanisms for identifying products that are causing more harm than good.


Trends in Dietary Supplement Use Among US Adults From 1999-2012

Elizabeth D. Kantor, PhD1; Colin D. Rehm, PhD2; Mengmeng Du, ScD1,3; et al Emily White, PhD3,4; Edward L. Giovannucci

JAMA. 2016;316(14):1464-1474. doi:10.1001/jama.2016.14403


… In this serial cross-sectional study of 37 958 adults using the nationally representative National Health and Nutrition Examination Survey, self-reported use of any supplement products remained stable, with 52% reporting use in both 1999-2012 and 2011-2012. Patterns varied by individual supplements; use of multivitamin/multimineral products decreased, with 37% reporting use in 1999-2000 and 31% reporting use in 2011-2012.

... Overall, the use of supplements remained stable between 1999 and 2012, with 52% of US adults reporting use of any supplements in 2011-2012 (P for trend = .19). This trend varied by population subgroup. Use of MVMM decreased, with 37% reporting use of MVMM in 1999-2000 and 31% reporting use in 2011-2012 (difference, −5.7% [95% CI, −8.6% to −2.7%], P for trend < .001). Vitamin D supplementation from sources other than MVMM increased from 5.1% to 19% (difference, 14% [95% CI, 12% to 17%], P for trend  < .001) and use of fish oil supplements increased from 1.3% to 12% (difference, 11% [95% CI, 9.1% to 12%], P for trend < .001) over the study period, whereas use of a number of other supplements decreased.


Exercise, anger may trigger heart attacks: McMaster study


... A large, international study ties heavy exertion while stressed or mad to a tripled risk of having a heart attack within an hour.



Physical Activity and Anger or Emotional Upset as Triggers of Acute Myocardial Infarction


Andrew Smyth, Martin O’Donnell, Pablo Lamelas, Koon Teo, Sumathy Rangarajan and Salim Yusuf and On behalf of the INTERHEART Investigators

Circulation. 2016;134:1059-1067, published online before print October 10, 2016


... acute myocardial infarction (AMI)... Of 12 461 cases of AMI 13.6% (n=1650) engaged in physical activity and 14.4% (n=1752) were angry or emotionally upset in the case period (1 hour before symptom onset). Physical activity in the case period was associated with increased odds of AMI (odds ratio, 2.31; 99% confidence interval [CI], 1.96–2.72) with a population-attributable risk of 7.7% (99% CI, 6.3–8.8). Anger or emotional upset in the case period was associated with an increased odds of AMI (odds ratio, 2.44; 99% CI, 2.06–2.89) with a population-attributable risk of 8.5% (99% CI, 7.0–9.6). There was no effect modification by geographical region, prior cardiovascular disease, cardiovascular risk factor burden, cardiovascular prevention medications, or time of day or day of onset of AMI. Both physical activity and anger or emotional upset in the case period were associated with a further increase in the odds of AMI (odds ratio, 3.05; 99% CI, 2.29–4.07; P for interaction <0.001).


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Habitual chocolate intake and type 2 diabetes mellitus in the Maine-Syracuse Longitudinal Study: (1975-2010): Prospective observations.

Crichton GE, Elias MF, Dearborn P, Robbins M.

Appetite. 2016 Oct 7. pii: S0195-6663(16)30520-7. doi: 10.1016/j.appet.2016.10.008.

PMID: 27725277


... Compared to participants who consumed chocolate more than once per week, those who never or rarely ate chocolate exhibited a significantly higher odds of having type 2 diabetes 5 years later (OR: 1.91, 95% CI: 1.03, 3.55, p = 0.04), after adjustment for cardiovascular, lifestyle and dietary factors including other polyphenol-rich beverages. However, individuals diagnosed with diabetes prior to the nutritional assessment consumed lower amounts of chocolate at the time of the dietary assessment. ...


Orthostatic Hypotension and the Long-Term Risk of Dementia: A Population-Based Study.

Wolters FJ, Mattace-Raso FU, Koudstaal PJ, Hofman A, Ikram MA; Heart Brain Connection Collaborative Research Group..

PLoS Med. 2016 Oct 11;13(10):e1002143. doi: 10.1371/journal.pmed.1002143.

PMID: 27727284


... Orthostatic hypotension (OH) ... systolic blood pressure (SBP) ... OH was associated with an increased risk of dementia (adjusted hazard ratio [aHR] 1.15, 95% CI 1.00-1.34, p = 0.05), which was similar for Alzheimer disease and vascular dementia. Similarly, greater SBP variability with postural change was associated with an increased risk of dementia (aHR per SD increase 1.08, 95% CI 1.01-1.16, p = 0.02), which was similar when excluding those who fulfilled the formal criteria for OH (aHR 1.08, 95% CI 1.00-1.17, p = 0.06). The risk of dementia was particularly increased in those with OH who lacked a compensatory increase in heart rate (within lowest quartile of heart rate response: aHR 1.39, 95% CI 1.04-1.85, p-interaction = 0.05). ...




Protozoan protects the gut

Nature 538, 142 (13 October 2016) doi:10.1038/538142b Published online

Many single-celled microorganisms are harmful, but others regulate the immune responses of their animal hosts to guard against infections.

Some such organisms, called protozoa, live in the intestine, but have not been as well studied as their disease-causing counterparts. Miriam Merad at the Icahn School of Medicine at Mount Sinai in New York City and her colleagues identified a previously unknown protozoan, Tritrichomonas musculis, in the intestines of some laboratory mice. When this microbe colonized the guts of other mice, the animals exhibited an inflammatory response that protected against pathogenic Salmonella bacteria. However, the animals also showed increased susceptibility to inflammatory intestinal disease and colon tumours.


Host-Protozoan Interactions Protect from Mucosal Infections through Activation of the Inflammasome.

Chudnovskiy A, Mortha A, Kana V, Kennard A, Ramirez JD, Rahman A, Remark R, Mogno I, Ng R, Gnjatic S, Amir ED, Solovyov A, Greenbaum B, Clemente J, Faith J, Belkaid Y, Grigg ME, Merad M.

Cell. 2016 Oct 6;167(2):444-456.e14. doi: 10.1016/j.cell.2016.08.076.

PMID: 27716507




Effects of Concurrent Depressive Symptoms and Perceived Stress on Cardiovascular Risk in Low‐ and High‐Income Participants: Findings From the Reasons for Geographical and Racial Differences in Stroke (REGARDS) Study

Jennifer A. Sumner, Yulia Khodneva, Paul Muntner, Nicole Redmond, Marquita W. Lewis, Karina W. Davidson, Donald Edmondson, Joshua Richman, and Monika M. Safford

J Am Heart Assoc. 2016;5:e003930. Originally published October 10, 2016.  doi: 10.1161/JAHA.116.003930


... cardiovascular disease (CVD) ... participants with both depressive symptoms and stress had the greatest elevation in risk of developing total CVD (hazard ratio 1.48, 95% CI 1.21–1.81) and all‐cause mortality (hazard ratio 1.33, 95% CI 1.13–1.56) but only for those with low income (<$35 000) and not high (≥$35 000) income. This pattern of results was not observed in models stratified by education.


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Calcium Intake From Diet and Supplements and the Risk of Coronary Artery Calcification and its Progression Among Older Adults: 10-Year Follow-up of the Multi-Ethnic Study of Atherosclerosis (MESA).

Anderson JJ, Kruszka B, Delaney JA, He K, Burke GL, Alonso A, Bild DE, Budoff M, Michos ED.

J Am Heart Assoc. 2016 Oct 11;5(10). pii: e003815.

PMID: 27729333


... cardiovascular disease (CVD) ... coronary artery calcification (CAC) ... At baseline, mean calcium intakes across quintiles were 313.3, 540.3, 783.0, 1168.9, and 2157.4 mg/day. Women had higher calcium intakes than men. After adjustment for potential confounders, among 1567 participants without baseline CAC, the relative risk (RR) of developing incident CAC over 10 years, by quintile 1 to 5 of calcium intake, were 1 (reference), 0.95 (0.79-1.14), 1.02 (0.85-1.23), 0.86 (0.69-1.05), and 0.73 (0.57-0.93). After accounting for total calcium intake, calcium supplement use was associated with increased risk for incident CAC (RR=1.22 [1.07-1.39]). No relation was found between baseline calcium intake and 10-year changes in log-transformed CAC among those participants with baseline CAC >0. ...


Intake of multivitamin supplements and incident asthma in Norwegian adults: the HUNT study.

Jiang L, Brumpton B, Langhammer A, Chen Y, Mai XM.

ERJ Open Res. 2015 Oct 6;1(2). pii: 00036-2015.

PMID: 27730154


... Intake of multivitamin supplements only was associated with an increased odds ratio for incident asthma (OR 1.55, 95% CI 1.12-2.13) after adjustment for a number of common confounding factors (model I). Similar odds ratios were found for intake of cod liver oil only and for intake of both supplements (1.59 and 1.73, respectively). ...


Disruption of the growth hormone receptor gene in adult mice increases maximal lifespan in females.

Junnila RK, Duran-Ortiz S, Suer O, Sustarsic EG, Berryman DE, List EO, Kopchick JJ.

Endocrinology. 2016 Oct 12:en20161649.

PMID: 27732088


Growth hormone (GH) and insulin like growth factor I (IGF-I) ... GHreceptor gene knockout (GHRKO) ... adult-onset GHRKO mice (aGHRKO) by disrupting the Ghr gene at 6 weeks of age. We found that aGHRKO mice replicate many of the beneficial effects observed in long-lived GHRKO mice. For example, aGHRKO mice, like GHRKO animals, displayed retarded growth and high adiposity with improved insulin sensitivity. Importantly, female aGHRKO animals showed an increase in their maximal lifespan, while the lifespan of male aGHRKO mice was not different from controls.


Targeting Oxidative Stress, Cytokines and Serotonin Interactions Via Indoleamine 2, 3 Dioxygenase by Coenzyme Q10: Role in Suppressing Depressive Like Behavior in Rats.

Abuelezz SA, Hendawy N, Magdy Y.

J Neuroimmune Pharmacol. 2016 Oct 11.

PMID: 27730347


... five groups; Control, CUMS, CUMS and CoQ10 (50,100 and 200 mg/kg/day i.p. respectively) groups. ... CoQ10 showed significant antidepressant efficacy, as evidenced by significantly decreased stress induced changes to forced swimming challenge and open field test, as well as attenuating raised corticosterone level and adrenal glands weight. The anti-oxidant effect of CoQ10 was exhibited ...


[The below paper is not pdf-availed.

A human model of dietary saturated fatty acid induced insulin resistance.

Koska J, Ozias MK, Deer J, Kurtz J, Salbe AD, Harman SM, Reaven PD.

Metabolism. 2016 Nov;65(11):1621-1628. doi: 10.1016/j.metabol.2016.07.015.

PMID: 27733250

... High caloric diets enriched with saturated fatty acids (SFA) or carbohydrates (CARB) ... were compared to a standard eucaloric American Heart Association (AHA) control diet ... SSPG was increased after a 24-h SFA diet (by 83±74% vs. control, n=38) in the entire cohort, which was comprised of participants with NGT (92±82%, n=22) or IGT (65±55%, n=16) (all p<0.001). SSPG was also increased after a single SFA breakfast (55±32%, p=0.008, n=7). The increase in SSPG was less pronounced after an overnight fast following a daylong SFA diet (24±31%, p=0.04, n=10), and further attenuated 24h after returning to the control diet (19±35%, p=0.09, n=11). SSPG was not increased after a 24-h CARB diet (26±50%, p=0.11, n=12).



Musculoskeletal Complaints (Pain and/or Stiffness) and Their Impact on Mortality in the General Population. The Tromsø Study.

Andorsen OF, Ahmed LA, Emaus N, Klouman E.

PLoS One. 2016 Oct 13;11(10):e0164341. doi: 10.1371/journal.pone.0164341.

PMID: 27736952


... (musculoskeletal complaints: MSCs) ... There was an increased risk of death among those with MSCs at baseline in the crude Cox regression model. However, the multivariable model revealed no significant association between MSCs at baseline and all-cause mortality by sex (women: hazard ratio

= 0.93, 95% confidence interval [CI]: 0.85-1.01; men: HR = 0.93, 95%CI: 0.85-1.01). Furthermore, no significant associations were found between widespread MSCs at baseline and all-cause mortality in multivariable models (women: HR = 0.90, 95%CI: 0.80-1.01; men HR = 0.87, 95%CI: 0.76-1.00). Analyses on cause-specific mortality did not reveal any significant results.



[The below paper is not pdf-availed.]

Effects of eicosapentaenoic acid and docosahexaenoic acid on cardiovascular disease risk factors: a randomized clinical trial.

Asztalos IB, Gleason JA, Sever S, Gedik R, Asztalos BF, Horvath KV, Dansinger ML, Lamon-Fava S, Schaefer EJ.

Metabolism. 2016 Nov;65(11):1636-1645. doi: 10.1016/j.metabol.2016.07.010.

PMID: 27733252

... healthy, normolipidemic subjects who received olive oil placebo 6g/d, EPA 600mg/d, EPA 1800mg/d, or DHA 600mg/d. ... Compared to placebo, the DHA group had significant decreases in postprandial triglyceride (TG) concentrations (-20%, -52.2mg/dL, P=0.03), significant increases in fasting and postprandial low-density lipoprotein cholesterol (LDL-C) (+18.4%, 17.1mg/dL, P=0.001), with no significant changes in inflammatory biomarkers. No significant effects were observed in the EPA 600mg/d group. The high-dose EPA group had significant decreases in lipoprotein-associated phospholipase A2 concentrations (Lp-PLA2) (-14.1%, -21.4ng/mL, P=0.003) ...


Effects of milk proteins on blood pressure: a meta-analysis of randomized control trials.

Hidayat K, Du HZ, Yang J, Chen GC, Zhang Z, Li ZN, Qin LQ.

Hypertens Res. 2016 Oct 13. doi: 10.1038/hr.2016.135.

PMID: 27733770


... blood pressure (BP)... milk protein interventions significantly lowered systolic BP by -3.33 mm Hg (95% confidence interval -5.62, -1.03) and diastolic BP by -1.08 mm Hg (95% confidence interval -3.38, -0.22). ...


Systematic Literature Review Shows That Appetite Rating Does Not Predict Energy Intake.

Holt GM, Owen LJ, Till S, Cheng Y, Grant VA, Harden CJ, Corfe BM.

Crit Rev Food Sci Nutr. 2016 Oct 13:0.

PMID: 27736161


... Appetite scores failed to correspond with EI in 51.3% of the total studies. Only 6% of all studies evaluated here reported a direct statistical comparison between appetite scores and EI. χ2 analysis demonstrated that any relationship between EI and appetite was independent of study type stratification by age, gender or sample size. ...


10-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Localized Prostate Cancer.

Hamdy FC, Donovan JL, Lane JA, Mason M, Metcalfe C, Holding P, Davis M, Peters TJ, Turner EL, Martin RM, Oxley J, Robinson M, Staffurth J, Walsh E, Bollina P, Catto J, Doble A, Doherty A, Gillatt D, Kockelbergh R, Kynaston H, Paul A, Powell P, Prescott S, Rosario DJ, Rowe E, Neal DE; ProtecT Study Group.

N Engl J Med. 2016 Oct 13;375(15):1415-1424.

PMID: 27626136

Free Article


... prostate-specific antigen (PSA) testing ... There were 17 prostate-cancer-specific deaths overall: 8 in the active-monitoring group (1.5 deaths per 1000 person-years; 95% confidence interval [CI], 0.7 to 3.0), 5 in the surgery group (0.9 per 1000 person-years; 95% CI, 0.4 to 2.2), and 4 in the radiotherapy group (0.7 per 1000 person-years; 95% CI, 0.3 to 2.0); the difference among the groups was not significant (P=0.48 for the overall comparison). In addition, no significant difference was seen among the groups in the number of deaths from any cause (169 deaths overall; P=0.87 for the comparison among the three groups). Metastases developed in more men in the active-monitoring group (33 men; 6.3 events per 1000 person-years; 95% CI, 4.5 to 8.8) than in the surgery group (13 men; 2.4 per 1000 person-years; 95% CI, 1.4 to 4.2) or the radiotherapy group (16 men; 3.0 per 1000 person-years; 95% CI, 1.9 to 4.9) (P=0.004 for the overall comparison). Higher rates of disease progression were seen in the active-monitoring group (112 men; 22.9 events per 1000 person-years; 95% CI, 19.0 to 27.5) than in the surgery group (46 men; 8.9 events per 1000 person-years; 95% CI, 6.7 to 11.9) or the radiotherapy group (46 men; 9.0 events per 1000 person-years; 95% CI, 6.7 to 12.0) (P<0.001 for the overall comparison). ...


Patient-Reported Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer.

Donovan JL, Hamdy FC, Lane JA, Mason M, Metcalfe C, Walsh E, Blazeby JM, Peters TJ, Holding P, Bonnington S, Lennon T, Bradshaw L, Cooper D, Herbert P, Howson J, Jones A, Lyons N, Salter E, Thompson P, Tidball S, Blaikie J, Gray C, Bollina P, Catto J, Doble A, Doherty A, Gillatt D, Kockelbergh R, Kynaston H, Paul A, Powell P, Prescott S, Rosario DJ, Rowe E, Davis M, Turner EL, Martin RM, Neal DE; ProtecT Study Group.

N Engl J Med. 2016 Oct 13;375(15):1425-1437.

PMID: 27626365


... prostatectomy had the greatest negative effect on sexual function and urinary continence, and although there was some recovery, these outcomes remained worse in the prostatectomy group than in the other groups throughout the trial. The negative effect of radiotherapy on sexual function was greatest at 6 months, but sexual function then recovered somewhat and was stable thereafter; radiotherapy had little effect on urinary continence. Sexual and urinary function declined gradually in the active-monitoring group. Bowel function was worse in the radiotherapy group at 6 months than in the other groups but then recovered somewhat, except for the increasing frequency of bloody stools; bowel function was unchanged in the other groups. Urinary voiding and nocturia were worse in the radiotherapy group at 6 months but then mostly recovered and were similar to the other groups after 12 months. Effects on quality of life mirrored the reported changes in function. No significant differences were observed among the groups in measures of anxiety, depression, or general health-related or cancer-related quality of life. ...


Treatment or Monitoring for Early Prostate Cancer.

D'Amico AV.

N Engl J Med. 2016 Oct 13;375(15):1482-1483. No abstract available.

PMID: 27627134

Free Article


    The “best” initial approach to early (low-risk or intermediate-risk)1 prostate cancer remains unknown. Specifically, does active monitoring with the use of prostate-specific antigen (PSA) testing as opposed to treatment lead to increased metastasis and death from prostate cancer? If yes, then which treatment, radical prostatectomy or radiation with or without short-term (3 to 6 months) androgen-suppression therapy, minimizes metastasis and death from prostate cancer?

    Hamdy and colleagues now report in the Journal the results of a randomized comparison of three of these four approaches after a median follow-up of 10 years,2 and Donovan and colleagues present data on patient-reported health-related quality of life at 6 years of follow-up.3 Men were screened with PSA testing and presented at a median age of 62 years with favorable clinical characteristics: 76% had stage T1c (PSA-detected) disease, 77% and 21% had tumors with Gleason scores of 6 and 7, respectively (on a scale from 6 to 10, with higher scores indicating a worse prognosis), and the median PSA level was 4.6 ng per milliliter. Although a median follow-up of 10 years was too short to evaluate the primary outcome of prostate-cancer mortality in this favorable cohort (death from prostate cancer occurred in 8 of the 545 men assigned to active monitoring, 5 of the 553 men assigned to surgery, and 4 of the 545 men assigned to radiotherapy), it was adequate to evaluate the secondary outcome of the incidence of metastatic disease, defined as bony, visceral, or lymph-node metastasis on imaging or a PSA level above 100 ng per milliliter.

    Several important observations were made. First, men assigned to active monitoring were significantly more likely to have metastatic disease than those assigned to treatment (P=0.004 for the overall comparison), with an incidence that was more than twice as high (6.3 per 1000 person-years vs. 2.4 to 3.0 per 1000 person-years). There was also a trend toward decreased death from prostate cancer among men assigned to surgery (hazard ratio, 0.63; 95% confidence interval [CI], 0.21 to 1.93) or radiation and androgen-deprivation therapy (hazard ratio, 0.51; 95% CI, 0.15 to 1.69) versus active monitoring. Although further follow-up will determine whether these trends become significant, causality between an increase in metastatic disease and the use of active monitoring versus treatment was established. The clinical significance of this finding is that with the use of active monitoring, more men will have metastasis and the side effects of salvage treatment (meaning at least lifelong intermittent androgen-deprivation therapy), which are not inconsequential.4

    Second, within the prerandomization stratum of age, a near-significant interaction (P=0.09 for interaction) was observed given that men 65 years of age or older were more likely to die from prostate cancer if assigned to active monitoring than if assigned to treatment. This finding probably reflects the fact that advancing age is associated with higher-grade disease than disease identified at an initial biopsy5 owing to sampling error, resulting in undergrading, the risk of which rises with the increasing prostate-gland volume6 that occurs with advancing age.7 Should the interaction between age and death from prostate cancer among men assigned to treatment versus monitoring become significant, it would support recommending treatment as opposed to monitoring to otherwise healthy men 65 years of age or older with early prostate cancer who today are increasingly being placed on active surveillance,8 given that the reduction in death from prostate cancer (hazard ratio, 0.63; 95% CI, 0.36 to 1.09) in the Prostate Cancer Intervention versus Observation Trial (PIVOT) only trended toward significance (P=0.09).9 However, the increasing use of surveillance is already of potential concern, considering that men enrolled in PIVOT had a shorter life expectancy owing to coexisting disease than men of similar age entered into the Surveillance, Epidemiology, and End Results database.10

    Finally, a trend favoring radiation and short-course androgen-deprivation therapy over surgery was observed. Specifically, the point estimate for the hazard ratio for death from prostate cancer when comparing these two treatments was 0.80 (95% CI, 0.22 to 2.99). If this trend becomes significant, then one may consider radiation and androgen-deprivation therapy as a preferred option for otherwise healthy men 65 years of age or older with early prostate cancer for whom treatment as compared with monitoring may be more effective (P=0.09 for interaction) in reducing death from prostate cancer.

    For today, we can conclude on the basis of level 1 evidence2 that PSA monitoring, as compared with treatment of early prostate cancer, leads to increased metastasis. Therefore, if a man wishes to avoid metastatic prostate cancer and the side effects of its treatment,3 monitoring should be considered only if he has life-shortening coexisting disease such that his life expectancy is less than the 10-year median follow-up of the current study.2 In addition, given no significant difference in death due to prostate cancer with surgery versus radiation and short-course androgen-deprivation therapy, men with low-risk or intermediate-risk1 prostate cancer should feel free to select a treatment approach using the data on health-related quality of life3 and without fear of possibly selecting a less effective cancer therapy.


Age and Cardiovascular Risk Attributable to Apolipoprotein B, Low‐Density Lipoprotein Cholesterol or Non‐High‐Density Lipoprotein Cholesterol

Allan D. Sniderman, Shofiqul Islam, Matthew McQueen, Michael Pencina, Curt D. Furberg, George Thanassoulis, and Salim Yusuf

 J Am Heart Assoc. 2016;5:e003665. Originally published October 13, 2016.

  doi: 10.1161/JAHA.116.003665


... Non-high-density lipoprotein cholesterol (NHDL-C), apolipoprotein B (apoB), and LDL particle number (LDL-P) ... Discordance was defined as LDL-C greater than or equal to the median and the alternative measure less than the median, or vice versa. ... Despite high LDL-C correlations with NHDL-C, apoB, and LDL-P (r=0.910, 0.785, and 0.692; all P<0.0001), prevalence of LDL-C discordance as defined by median cut points was 11.6%, 18.9%, and 24.3% for NHDL-C, apoB, and LDL-P, respectively. Among women with LDL-C less than the median, coronary risk was underestimated for women with discordant (greater than or equal to the median) NHDL-C (age-adjusted hazard ratio, 2.92; 95% confidence interval, 2.33-3.67), apoB (2.48, 2.01-3.07), or LDL-P (2.32, 1.88-2.85) compared with women with concordant levels. Conversely, among women with LDL-C greater than or equal to the median, risk was overestimated for women with discordant (less than the median) NHDL-C (0.40, 0.29-0.57), apoB (0.34, 0.26-0.46), or LDL-P (0.42, 0.33-0.53). After multivariable adjustment for potentially mediating factors, including HDL cholesterol and triglycerides, coronary risk remained underestimated or overestimated by ≈20% to 50% for women with discordant levels.



Comment in

Are we moving towards concordance on the principle that lipid discordance matters?

Martin SS, Michos ED.

Circulation. 2014 Feb 4;129(5):539-41. doi: 10.1161/CIRCULATIONAHA.113.007207. Epub 2013 Dec 17. No abstract available.

PMID:  24345401

Free PMC Article



Transitions in Metabolic Risk and Long‐Term Cardiovascular Health: Coronary Artery Risk Development in Young Adults (CARDIA) Study

Venkatesh L. Murthy, Siddique A. Abbasi, Juned Siddique, Laura A. Colangelo, Jared Reis, Bharath A. Venkatesh, J. Jeffrey Carr, James G. Terry, Sarah M. Camhi, Michael Jerosch‐Herold, Sarah de Ferranti, Saumya Das, Jane Freedman, Mercedes R. Carnethon, Cora E. Lewis, Joao A. C. Lima, and Ravi V. Shah

J Am Heart Assoc. 2016;5:e003934. Originally published October 13, 2016. doi: 10.1161/JAHA.116.003934


... Coronary Artery Risk Development in Young Adults (CARDIA) ... Overall, individuals gained weight over time in CARDIA with statistically but not clinically different body mass index trend over time. Dysglycemia and dyslipidemia over time were highest in initially high or worsening trajectory groups. Divergence in metabolic trajectories occurred in early adulthood (before age 40), with 2 of 3 individuals experiencing an increase in metabolic risk over time. Membership in a higher‐risk trajectory (defined as initially high or worsening over time) was associated with greater prevalence and extent of coronary artery calcification, left ventricular mass, and decreased left ventricular strain at year 25. Importantly, despite similar rise in body mass index across trajectories over 25 years, coronary artery calcification and left ventricular structure and function more closely tracked risk factor trajectories.



Pneumonia Hospitalization Risk in the Elderly Attributable to Cold and Hot Temperatures in Hong Kong, China

Hong Qiu, Shengzhi Sun, Robert Tang, King-Pan Chan, and Linwei Tian

Am. J. Epidemiol. 2016 184: 555-569


... We observed significant nonlinear and delayed associations of both cold and hot temperatures with pneumonia in the elderly, with cold temperatures having stronger effect estimates. Among the 10.7% of temperature-related pneumonia hospitalizations, 8.7% and 2.0% were attributed to cold and hot temperatures, respectively. Most of the temperature-related burden for pneumonia hospitalizations in Hong Kong was attributable to cold temperatures, and elderly men had greater susceptibility.


Daily NO rhythms in peripheral clocks in aging male Wistar rats: protective effects of exogenous melatonin.

Vinod C, Jagota A.

Biogerontology. 2016 Sep 10. [Epub ahead of print]

PMID: 27614960


... Nitric Oxide (NO) ... Aging resulted in alteration of NO levels as well as phase of NO in both 12 and 24 months groups. Correlation analysis demonstrated loss of stoichiometric interaction between the various peripheral clocks with aging. Age induced alterations in NO daily rhythms were found to be most significant in liver and, interestingly least in lungs. Neurohormone melatonin, an endogenous synchroniser and an antiaging agent decreases with aging. We report further differential restoration with exogenous melatonin administration of age induced alterations in NO daily rhythms and mean levels in kidney, intestine and liver and the stoichiometric interactions between the various peripheral clocks.



Elevated extension of longevity by cyclically heat stressing a set of recombinant inbred lines of Drosophila melanogaster throughout their adult life.

Gomez FH, Sambucetti P, Norry FM.

Biogerontology. 2016 Aug 3. [Epub ahead of print]

PMID: 27488377


... recombinant inbred lines (RILs) ... In spite of the exceptionally high increase in longevity in a set of RILs, the same heat stress treatment reduced rather than increased longevity in other RILs ... The level of heat-induced hormesis showed a sexual dimorphism, with a higher number of lines exhibiting higher hormesis effects in males than in females. The new heat stress treatment in this study suggests that longevity can be further extended than previously suggested by applying a cyclic and mild stress throughout the life, depending on the genotype.



Protective role of the apolipoprotein E2 allele in age-related disease traits and survival: evidence from the Long Life Family Study.

Kulminski AM, Raghavachari N, Arbeev KG, Culminskaya I, Arbeeva L, Wu D, Ukraintseva SV, Christensen K, Yashin AI.

Biogerontology. 2016 Jul 22. [Epub ahead of print]

PMID: 27447179


... diseases of heart (HD ... Our analysis detected favorable associations of the ε2 allele with lower LDL-C levels, lower risks of HD, and better survival. The ε2 allele was associated with LDL-C in each gender and biodemographic cohort, including long-living individuals, offspring, and spouses, resulting in highly significant association in the entire sample (β = -7.1, p = 6.6 × 10-44). This allele was significantly associated with HD in long-living individuals and offspring (relative risk [RR] = 0.60, p = 3.1 × 10-6) but this association was not mediated by LDL-C. The protective effect on survival was specific for long-living women but it was not explained by LDL-C and HD in the adjusted model (RR = 0.70, p = 2.1 × 10-2). These results show that ε2 allele may favorably influence LDL-C, HD, and survival through three mechanisms. Two of them (HD- and survival-related) are pronounced in the long-living parents and their offspring; the survival-related mechanism is also sensitive to gender. The LDL-C-related mechanism appears to be independent of these factors. ...


Circulating IGF-1 deficiency exacerbates hypertension-induced microvascular rarefaction in the mouse hippocampus and retrosplenial cortex: implications for cerebromicrovascular and brain aging.

Tarantini S, Tucsek Z, Valcarcel-Ares MN, Toth P, Gautam T, Giles CB, Ballabh P, Wei JY, Wren JD, Ashpole NM, Sonntag WE, Ungvari Z, Csiszar A.

Age (Dordr). 2016 Aug;38(4):273-289.

PMID: 27613724


... We found that circulating IGF-1 deficiency is associated with decreased microvascular density and exacerbates hypertension-induced microvascular rarefaction both in the hippocampus and the neocortex. ...


Alternate-Day Fasting Poses No Threat to Bone Health

Krista Varady

North American Menopause Society (NAMS) 2016 Annual Meeting. Presented October 8, 2016


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Brown Adipose Tissue Function is Enhanced in Long-Lived, Male Ames Dwarf Mice.

Darcy J, McFadden S, Fang Y, Huber JA, Zhang C, Sun LY, Bartke A.

Endocrinology. 2016 Oct 14:en20161593.

PMID: 27740871


... core body temperature (Tco). Moreover, Ames dwarf mice have functionally altered epididymal white adipose tissue (eWAT) that improves, rather than impairs, their insulin sensitivity due to a shift from pro- to anti-inflammatory cytokine secretion. ... brown adipose tissue (BAT) ... histology and RT-PCR to demonstrate that Ames dwarf mice have enhanced BAT function. We also utilize interscapular BAT (iBAT) removal to demonstrate that BAT is necessary for Ames dwarf energy metabolism and thermogenesis, whereas it is less important for their normal littermates. Further, we show that Ames dwarf mice are able to compensate for loss of iBAT by utilizing their WAT depots as an energy source. These findings demonstrate enhanced BAT function in animals with GH and thyroid hormone deficiencies, chronic reduction of body temperature and remarkably extended longevity.


Ability of Self-Reported Frailty Components to Predict Incident Disability, Falls, and All-Cause Mortality: Results From a Population-Based Study of Older British Men.

Papachristou E, Wannamethee SG, Lennon LT, Papacosta O, Whincup PH, Iliffe S, Ramsay SE.

J Am Med Dir Assoc. 2016 Oct 11. pii: S1525-8610(16)30372-3. doi: 10.1016/j.jamda.2016.08.020.

PMID: 27742583


... a prospective cohort comprising older British men aged 71-92 years in 2010-2012. A follow-up questionnaire was completed in 2014. The discriminatory power for incident disability and falls was compared with the Fried frailty phenotype using receiver operating characteristic-area under the curve (ROC-AUC); for incident falls it was additionally compared with the FRAIL scale (fatigue, resistance, ambulation, illnesses, and loss of weight). ... A model including self-reported measures of slow walking speed, low physical activity, and exhaustion had a significantly increased ROC-AUC [0.68, 95% confidence interval (CI) 0.63-0.72] for incident disability compared with the Fried frailty phenotype (0.63, 95% CI 0.59-0.68; P value of ΔAUC = .003). A second model including self-reported measures of slow walking speed, low physical activity, and weight loss had a higher ROC-AUC (0.64, 95% CI 0.59-0.68) for incident falls compared with the Fried frailty phenotype (0.57, 95% CI 0.53-0.61; P value of ΔAUC < .001) and the FRAIL scale (0.56, 95% CI 0.52-0.61; P value of ΔAUC = .001). This model was also associated with an increased risk of mortality (Harrell's C = 0.73, Somer's D = 0.45; linear trend P < .001) compared with the Fried phenotype (Harrell's C = 0.71; Somer's D = 0.42; linear trend P < .001) and the FRAIL scale (Harrell's C = 0.71, Somer's D = 0.42; linear trend P < .001).



A score of low-grade inflammation and risk of mortality: prospective findings from the Moli-sani study.

Bonaccio M, Di Castelnuovo A, Pounis G, De Curtis A, Costanzo S, Persichillo M, Cerletti C, Donati MB, de Gaetano G, Iacoviello L.

Haematologica. 2016 Oct 14. pii: haematol.2016.144055.

PMID: 27742767



... A low-grade inflammation score was obtained from the sum of 10-tiles of plasmatic (C-reactive protein) and cellular (leukocyte and platelet counts, granulocyte/lymphocyte ratio) biomarkers of low-grade inflammation; higher levels indicated increased low- grade inflammation. ... As compared to subjects in the lowest quartile of the low-grade inflammation score, those in the highest category had a significant increased risk in overall mortality (HR=1.44; 1.17-1.77) independently of possible confounders, including presence of chronic diseases and a number of health-related behaviours. The magnitude of the association of low-grade inflammation with mortality was relatively higher in type 2 diabetic patients (HR=2.90; 1.74-4.84) and in individuals with history of cardiovascular disease (HR=2.48; 1.50-4.11) as compared to their counterparts free from the disease. ...


Benefits of the Mediterranean diet beyond the Mediterranean Sea and beyond food patterns.

Martínez-González MA.

BMC Med. 2016 Oct 14;14(1):157.

PMID: 27737657




Please see related article:


Prospective association of the Mediterranean diet with cardiovascular disease incidence and mortality and its population impact in a non-Mediterranean population: the EPIC-Norfolk study.

Tong TY, Wareham NJ, Khaw KT, Imamura F, Forouhi NG.

BMC Med. 2016 Sep 29;14(1):135.

PMID: 27679997

Free PMC Article



... population attributable fraction (PAF) ... Mediterranean diet score (MDS) ... cardiovascular diseases (CVD) ... The MDS based on the Mediterranean dietary pyramid was significantly associated with lower incidence of the cardiovascular outcomes, with hazard ratios (95 % confidence intervals) of 0.95 (0.92-0.97) per one standard deviation for incident CVD and 0.91 (0.87-0.96) for CVD mortality. Associations were similar for composite incident ischaemic heart disease and all-cause mortality. Other pre-existing MDSs showed similar, but more modest associations. PAF due to low dietary pyramid based MDS (<95th percentile) was 3.9 % (1.3-6.5 %) for total incident CVD and 12.5 % (4.5-20.6 %) for CVD mortality.



Dietary iron intake and breast cancer risk: modulation by an antioxidant supplementation.

Diallo A, Deschasaux M, Partula V, Latino-Martel P, Srour B, Hercberg S, Galan P, Fassier P, Guéraud F, Pierre FH, Touvier M.

Oncotarget. 2016 Oct 12. doi: 10.18632/oncotarget.12592.

PMID: 27738321


...the SU.VI.MAX trial (daily low-dose antioxidants vs. placebo). ... Dietary iron intake was associated with an increased breast cancer risk (HRT3vs.T1=1.67 (1.02-2.71), P-trend=0.04). This association was observed in the placebo group (HRT3vs.T1=2.80 (1.42-5.54), P-trend=0.003), but not in the antioxidant-supplemented group (P-trend=0.7, P-interaction=0.1). Besides, in the placebo group, the increased breast cancer risk associated with dietary iron intake was more specifically observed in women with higher lipid intake (P-trend=0.046). ... suggesting that breast cancer risk may be increased by iron-induced lipid peroxidation.



Exercising in the Fasted State Reduced 24-Hour Energy Intake in Active Male Adults.

Bachman JL, Deitrick RW, Hillman AR.

J Nutr Metab. 2016;2016:1984198.

PMID: 27738523



... Participants (12 active, white males, 20.8 ± 3.0 years old, VO2max: 59.1 ± 5.7 mL/kg/min) fasted (NoBK) or received breakfast (BK) and then ran for 60 minutes at 60%  VO2max. ... Total 24-hour (BK: 19172 ± 4542 kJ versus NoBK: 15312 ± 4513 kJ; p < 0.001) and evening (BK: 12265 ± 4278 kJ versus NoBK: 10833 ± 4065; p = 0.039) energy intake and RQ (BK: 0.90 ± 0.03 versus NoBK: 0.86 ± 0.03; p < 0.001) were significantly higher in BK than NoBK. Blood glucose was significantly higher in BK than NoBK before exercise (5.2 ± 0.7 versus 4.5 ± 0.6 mmol/L; p = 0.025). Hunger was significantly lower for BK than NoBK before exercise, after exercise, and before lunch. Blood glucose and hunger were not associated with energy intake. ...


Exposure to polychlorinated biphenyls and prostate cancer: population-based prospective cohort and experimental studies.

Ali I, Julin B, Glynn A, Högberg J, Berglund M, Johansson JE, Andersson SO, Andrén O, Giovannucci E, Wolk A, Stenius U, Åkesson A.

Carcinogenesis. 2016 Oct 7. pii: bgw105.

PMID: 27742691


... dietary PCB exposure was positively associated with high-grade prostate cancer, relative risk (RR) 1.35 [95% confidence interval (CI): 1.03-1.76] and with fatal prostate cancer, RR 1.43 (95% CI: 1.05-1.95), comparing the highest tertile with the lowest. ...

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Combinations of distinct long-chain polyunsaturated fatty acid species for improved dietary treatment against allergic bronchial asthma.

Beermann C, Neumann S, Fußbroich D, Zielen S, Schubert R.

Nutrition. 2016 Nov-Dec;32(11-12):1165-70. doi: 10.1016/j.nut.2016.04.004. Epub 2016 May 6.

PMID: 27297719


... For the early phase and milder forms of allergic asthma, dietary supplementation with long-chain polyunsaturated fatty acids (LCPUFA), predominantly fish oil-associated eicosapentaenoic (C20:5 ω-3) and docosahexaenoic acid (C22:6 ω-3), and distinct crop oil-derived fatty acids might provide a sustainable treatment strategy, as discussed in several studies. In addition to immune-controlling prostaglandins, leukotrienes, and thromboxanes, specialized proresolving mediators, such as lipoxins, resolvins, protectins, and maresins, are metabolized from different LCPUFA, which actively resolve inflammation. The aim of this review was to discuss the possible synergistic effects of ω-3 and ω-6 LCPUFA combinations concerning rebuilding fatty acid homeostasis in cellular membranes, modifying eicosanoid metabolic pathways, controlling inflammatory processes by focusing on resolving inflammation in the bronchoalveolar system on the cellular level, and helping to control clinical symptoms in bronchial asthma.


Multivitamin/mineral supplements: Rationale and safety - A systematic review.

Biesalski HK, Tinz J.

Nutrition. 2016 Mar 4. pii: S0899-9007(16)00115-5. doi: 10.1016/j.nut.2016.02.013. [Epub ahead of print] Review.

PMID: 27553772


... Multivitamin/mineral supplements (MVM) ... Only minor adverse effects (e.g., unspecific gastrointestinal symptoms) were reported in all studies. In particular, there were no significant differences between treatment and placebo groups. MVM use within the range of the dietary reference intake will not result in excess intake, even when including the impact of food and fortified food, and does not increase mortality. Taken together, these findings indicate that MVM can be safe for long-term use (more than 10 y).


Editorial support was provided by Peloton Advantage and funded by Pfizer.


Mortality prediction of a body shape index versus traditional anthropometric measures in an Iranian population: Tehran Lipid and Glucose Study.

Sardarinia M, Ansari R, Azizi F, Hadaegh F, Bozorgmanesh M.

Nutrition. 2016 May 18. pii: S0899-9007(16)30075-2. doi: 10.1016/j.nut.2016.05.004. [Epub ahead of print]

PMID: 27497518


... A body shape index (ABSI) based on waist circumference (WC) adjusted for height and weight ... waist-to-hip ratio (WHpR), and waist-to-height ratio (WHtR) ... ABSI was associated with all-cause mortality in a curvilinear fashion. ABSI was more strongly associated with all-cause mortality than were BMI, WC, and WHtR. Among women, however, WHpR was observed to be a stronger predictor of all-cause mortality than ABSI. Among both men and women, ABSI improved the risk classification based on other anthropometric measures, the only exception being WHpR. None of the anthropometric measures studied could add any value to the predictive ability of the Framingham's general cardiovascular disease algorithm.



Lipolysis and thermogenesis in adipose tissues as new potential mechanisms for metabolic benefits of dietary fiber.

Han SF, Jiao J, Zhang W, Xu JY, Zhang W, Fu CL, Qin LQ.

Nutrition. 2016 Jun 2. pii: S0899-9007(16)30079-X. doi: 10.1016/j.nut.2016.05.006. [Epub ahead of print]

PMID: 27461561


... white adipose tissue (WAT) and brown adipose tissue (BAT) of C57 BL/6 J mice fed a high-fat diet (HFD).


Male C57BL/6 J mice were fed normal chow diet (Chow), HFD, HFD plus oat fiber (H-oat), or HFD plus wheat bran fiber (H-wheat) for 24 wk. ...


At the end of the feeding period, body and adipose tissues weight in both H-oat and H-wheat groups were lower than in the HFD group. Mice in the H-oat and H-wheat groups showed an increasing trend in serum adiponectin level. Compared with the HFD group, cereal dietary fiber increased protein expressions involved in the lipolysis and browning process. Compared with the H-wheat group, H-oat was more effective in protein expressions of PKA, PGC-1 α, and UCP1 of the WAT samples. Compared with the H-oat group, H-wheat was more effective in protein expressions of PKA, ATGL, UCP1, β3AR, and FGF-21 of the BAT samples.

... cereal dietary fiber ... promoted WAT browning by activation of UCP1, and consequently reduced visceral fat mass in response to HFD feeding.



Dietary antioxidant capacity and risk for stroke in a prospective cohort study of Swedish men and women.

Colarusso L, Serafini M, Lagerros YT, Nyren O, La Vecchia C, Rossi M, Ye W, Tavani A, Adami HO, Grotta A, Bellocco R.

Nutrition. 2016 Jul 26. pii: S0899-9007(16)30129-0. doi: 10.1016/j.nut.2016.07.009. [Epub ahead of print]

PMID: 27667181


... nonenzymatic antioxidant capacity (NEAC) ...

Compared with women in the lowest quartile of NEAC, women in the highest quartile had a 27% lower incidence of total stroke (HR, 0.73; 95% CI, 0.53-0.99; Ptrend = 0.03) and 35% lower incidence of ischemic stroke (HR, 0.65; 95% CI, 0.43-0.99; Ptrend = 0.01). Among men, the relationship between NEAC and risk for stroke was not statistically significant and all HRs were close to unity.



Inflammatory and metabolic responses to dietary intervention differ among individuals at distinct cardiometabolic risk levels.

Monfort-Pires M, Ferreira SR.

Nutrition. 2016 Aug 9. pii: S0899-9007(16)30164-2. doi: 10.1016/j.nut.2016.07.021.

PMID: 27720273


... metabolic syndrome (MetS). The participants received two isocaloric breakfast interventions for 4 wk, with a 2-wk washout. The "Brazilian" breakfast was enriched with saturated fat, whereas the "modified" meal was enriched with unsaturated fatty acids and fibers. ... Frequencies of MetS increased after the Brazilian breakfast and decreased after the modified meal. Significant reduction in mean values of WC and diastolic blood pressure (DBP) and elevation in high-density lipoprotein cholesterol were detected at the end of the modified intervention. Participants with or without the MetS exhibited contrasting responses to the modified breakfast: respectively, significant changes in DBP levels (-3.7 ± 6.9 versus -0.5 ± 6.9 mm Hg; P < 0.05), plasma glucose (-3 ± 7.3 versus 3 ± 7.4 mg/dL; P < 0.05), and apolipoprotein-B (-0.1 ± 0.6 versus 0.2 ± 0.3 mg/mL; P < 0.05), interferon-γ (-0.6 ± 1.2 versus 0.1 ± 1.3 pg/mL; P < 0.05), and tumor necrosis factor-α concentrations (0.4 ± 3.6 versus -0.8 ± 2.8 pg/mL; P < 0.05) were observed.



Association between serum zinc and later development of metabolic syndrome in middle - aged and older men: the Kuopio Ischaemic Heart Disease Risk Factor Study

Teymoor Yary, Jyrki K. Virtanen, Anu Ruusunen, Tomi-Pekka Tuomainen, Sari Voutilainen

Nutrition DOI: http://dx.doi.org/10.1016/j.nut.2016.09.004

Publication stage: In Press Accepted Manuscript

Published online: September 20, 2016



    •Serum zinc was directly associated with the incidence of metabolic syndrome.

    •Serum zinc was inversely associated with high-density lipoprotein.

    •Serum zinc was directly associated with hypertension.

    •Serum zinc was directly associated with waist circumference.

... Those in the highest tertile of serum zinc had 84% higher risk (95% confidence interval (CI) 12-201%, P-trend across tertiles=0.015) to develop metabolic syndrome compared with those in the lowest tertile, after adjustment for several potential confounders. The association between serum zinc and incident metabolic syndrome was attenuated by adjustment for waist circumference, serum HDL cholesterol or hypertension. Serum zinc was also directly associated with higher waist circumference and hypertension and inversely associated with HDL cholesterol at the 11-y examinations. ...



1988 -- 537 pages

Nathan Pritikin



Not many people know that Nathan Pritikin's studies of the

medical literature in the area of the relationship of diet to

degenerative diseases culminated in the early '70's in the

writing of three comprehensive technical volumes covering the

many pathologies he believed were due to the high-fat Western

diet. Never before published, these dissertations--herein

printed as Parts I, II, and III corresponding to the original

three volumes--provided the fundamental source material for the

educational lectures he presented to thousands of lay people and

medical professionals who attended his residential centers and

health seminars, as well as for his popular books.

These writings are part of his remarkable legacy. Together,

they provide a view of the manner in which he selected many

hundreds of studies from the medical literature, and with unusual

insight and meticulous scholarship wove them together to build a

stunning thesis: that the high-fat, high-in-cholesterol, high-in simple

carbohydrates Western diet is responsible for a myriad of

degenerative conditions which are separate manifestations of the

same basic malady. Pritikin liked to make an analogy with

poisoning by a substance like arsenic, but, in this case, he

said, we were being poisoned by substances in our everyday diet

which in excess acted like toxins. In different individuals, or

even in the same individual, the degenerative conditions produced

could be atherosclerosis and coronary heart disease,

hypertension, adult-onset diabetes, certain cancers, and

conditions like gall bladder disease, gout, glaucoma, and


In the decade and a half since Nathan Pritikin perused the

medical literature searching for answers to the riddle of the

Western degenerative diseases, many additional important studies

have corroborated his basic conclusions, and his point of view

has won wide acceptance.

This small private printing places Nathan's writings in the

hands of a few libraries and individuals. It is dedicated with

gratitude to Dr. R. James Barnarq, Director of Research for the

Nathan Pritikin Research Foundation, for his valued contributions

in the design and supervision of research studies, and

especially for his assistance in the preparation and presentation

of the resultant data for publication in scientific journals.

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Physical activity and incident type 2 diabetes mellitus: a systematic review and dose-response meta-analysis of prospective cohort studies.

Smith AD, Crippa A, Woodcock J, Brage S.

Diabetologia. 2016 Oct 17. Review.

PMID: 27747395


... Our results suggest an overall non-linear relationship; using the cubic spline model we found a risk reduction of 26% (95% CI 20%, 31%) for type 2 diabetes among those who achieved 11.25 MET h/week (equivalent to 150 min/week of moderate activity) relative to inactive individuals. Achieving twice this amount of PA was associated with a risk reduction of 36% (95% CI 27%, 46%), with further reductions at higher doses (60 MET h/week, risk reduction of 53%). Results for the MMET h/week dose-response curve were similar for moderate intensity PA, but benefits were greater for higher intensity PA and smaller for lower intensity activity.



Effects of Ready-to-Eat-Cereals on Key Nutritional and Health Outcomes: A Systematic Review.

Priebe MG, McMonagle JR.

PLoS One. 2016 Oct 17;11(10):e0164931. doi: 10.1371/journal.pone.0164931.

PMID: 27749919



... ready-to eat cereal (RTEC) ... Consumption of RTEC is associated with a healthier dietary pattern, concerning intake of carbohydrates, dietary fiber, fat and micronutrients, however total sugar intake is higher. Persons consuming RTEC frequently (≥ 5 times/week) have a lower risk of inadequate micronutrient intake especially for vitamin A, calcium, folate, vitamin B 6, magnesium and zinc. Evidence from prospective studies suggests that whole grain RTEC may have beneficial effects on hypertension and type 2 diabetes. Consumption of RTEC with soluble fiber helps to reduce LDL cholesterol in hypercholesterolemic men and RTEC fortified with folate can reduce plasma homocysteine. ... Limitations are that results of observational studies were based on self-reported data and that many studies were funded by food-industry. ...


Longitudinal study of factors affecting taste sense decline in old-old individuals.

Ogawa T, Uota M, Ikebe K, Arai Y, Kamide K, Gondo Y, Masui Y, Ishizaki T, Inomata C, Takeshita H, Mihara Y, Hatta K, Maeda Y.

J Oral Rehabil. 2016 Oct 17. doi: 10.1111/joor.12454.

PMID: 27748531


... subjects aged 79 to 81 years ... males showed significantly greater declines in taste sensitivity for sweet and sour tastes than females. Additionally, subjects with lower cognitive scores showed a significantly greater taste decrease for salty in multivariate analysis. ...



What tweets say about our health


Twitter may not tell us what people are eating and doing, but it provides a sense of what people are saying

Thomson Reuters Posted: Oct 18, 2016 3:40 PM ET Last Updated: Oct 18, 2016 3:40 PM ET


Building a National Neighborhood Dataset From Geotagged Twitter Data for Indicators of Happiness, Diet, and Physical Activity

Quynh C Nguyen, Dapeng Li, Hsien-Wen Meng, Suraj Kath, Elaine Nsoesie, Feifei Li, Ming Wen

JMIR Public Health Surveill 2016 (Oct 17); 2(2):e158


... Machine labeled and manually labeled tweets had a high level of accuracy: 78% for happiness, 83% for food, and 85% for physical activity for dichotomized labels with the F scores 0.54, 0.86, and 0.90, respectively. About 20% of tweets were classified as happy. Relatively few terms (less than 25) were necessary to characterize the majority of tweets on food and physical activity. Data from over 70,000 census tracts from the United States suggest that census tract factors like percentage African American and economic disadvantage were associated with lower census tract happiness. Urbanicity was related to higher frequency of fast food tweets. Greater numbers of fast food restaurants predicted higher frequency of fast food mentions. Surprisingly, fitness centers and nature parks were only modestly associated with higher frequency of physical activity tweets. Greater state-level happiness, positivity toward physical activity, and positivity toward healthy foods, assessed via tweets, were associated with lower all-cause mortality and prevalence of chronic conditions such as obesity and diabetes and lower physical inactivity and smoking, controlling for state median income, median age, and percentage white non-Hispanic. ...


In vivo and in vitro evaluation for nutraceutical purposes of capsaicin, capsanthin, lutein and four pepper varieties.

Fernández-Bedmar Z, Alonso-Moraga A.

Food Chem Toxicol. 2016 Oct 13. pii: S0278-6915(16)30361-1. doi: 10.1016/j.fct.2016.10.011.

PMID: 27746329


... none of the tested substances were genotoxic except green hot pepper and capsaicin at the highest tested concentration (5 mg/mL and 11.5 μM respectively), ii) all tested substances except green hot pepper are antimutagenic against H2O2-induced damage, iii) only red sweet pepper significantly extend the lifespan and healthspan of D. melanogaster at 1.25 and 2.5 mg/mL, iv) all pepper varieties induce dose-depended cytotoxic effect in HL60 cells with different IC50, and v) all pepper varieties and capsaicin exerted proapoptotic effect on HL60 cells. ...


Back to the future: Hormone replacement therapy as part of a prevention strategy for women at the onset of menopause.

Lobo RA, Pickar JH, Stevenson JC, Mack WJ, Hodis HN.

Atherosclerosis. 2016 Oct 6. pii: S0021-9150(16)31408-3. doi: 10.1016/j.atherosclerosis.2016.10.005. Review.

PMID: 27745704


... The current data confirm a "timing" hypothesis for benefits and risks of HRT, showing that younger have many benefits and few risks, particularly if therapy is predominantly focused on the estrogen component. ... we propose that HRT should be considered as part of a general prevention strategy for women at the onset of menopause.


[My guess would be that plant protein intake significantly improved pulse pressure also.]

Dietary protein from different food sources, incident metabolic syndrome and changes in its components: An 11-year longitudinal study in healthy community-dwelling adults.

Shang X, Scott D, Hodge A, English DR, Giles GG, Ebeling PR, Sanders KM.

Clin Nutr. 2016 Oct 1. pii: S0261-5614(16)31264-X. doi: 10.1016/j.clnu.2016.09.024.

PMID: 27746001


... waist circumference (WC) ... Multivariate-adjusted odds ratios (ORs) (95% CI) of incident MetS for the highest compared with lowest quartile of percentage energy intake from total, animal and plant protein were 1.46 (1.01-2.10), 1.67 (1.13-2.48) and 0.60 (0.37-0.97), respectively. Positive associations with incident MetS were seen for protein from chicken (OR (95% CI): 1.37 (1.00, 1.87)) and red meat (OR (95% CI): 1.47 (1.01, 2.15)), while inverse associations with incident MetS were observed for protein from grains (OR (95% CI): 0.62 (0.40, 0.97)), legumes and nuts (OR (95% CI): 0.74 (0.53, 1.04)). Each 5% increment in energy intake from animal protein was associated with a 0.97 cm (95% CI: 0.50, 1.45) increase in WC, a 0.97 mmHg (95% CI: 0.13, 1.82) increase in systolic blood pressure, and a 0.94 kg (95% CI: 0.57, 1.32) increase in weight over 11 years. However, an inverse association between plant protein and change in WC (-1.38 cm (95% CI: -2.68, -0.07)) and weight (-1.97 kg (95% CI: -3.00, -0.94)) was identified. ...


[The below paper is not pdf-availed.]

An Umbrella Review of Nuts Intake And Risk of Cardiovascualr Disease.

Schwingshackl L, Hoffmann G, Missbach B, Stelmach-Mardas M, Boeing H.

Curr Pharm Des. 2016 Oct 10.

PMID: 27748190

... Only 4 out of 14 reported an AMSTAR score ≥8 (high methodological quality), whereas NutriGrade meta-evidence score varied between 2 (very low meta-evidence) and 7.9 (moderate meta-evidence). There is consistent evidence from intervention trials, reporting significant reductions for total cholesterol, and from observational studies that higher intakes of nuts were associated with reduced risk of cardiovascular disease and hypertension. On the other side no effect could be observed for stroke, HDL-cholesterol, and blood pressure in the normal range. ...


Prediction of the 20-year incidence of diabetes in older Chinese: Application of the competing risk method in a longitudinal study.

Liu X, Fine JP, Chen Z, Liu L, Li X, Wang A, Guo J, Tao L, Mahara G, Tang Z, Guo X.

Medicine (Baltimore). 2016 Oct;95(40):e5057.

PMID: 27749572



... aged ≥ 55 years ... (poor self-rated health status [subdistribution hazard ratio (SHR) = 1.73, P = 0.005], less physical activity [sHR = 1.39, P = 0.047], 55-65 years old [sHR = 4.37, P < 0.001], overweight [sHR = 2.15, P < 0.001] or obesity [sHR = 1.96, P = 0.003], and impaired fasting glucose [iFG] [sHR = 1.99, P < 0.001]) were significantly associated with incident diabetes. Model performance was moderate to excellent, as indicated by its bootstrap cross-validated discrimination C-index (0.74, 95% CI: 0.70-0.79) and calibration plot. ...


[The below paper is pdf-availed.]

Body weight and body composition in old age and their relationship with frailty.

Reinders I, Visser M, Schaap L.

Curr Opin Clin Nutr Metab Care. 2016 Sep 28.

PMID: 27749713

... REVIEW ... Based on current literature, observational studies on obesity and high waist circumference show most convincing results for an association with frailty. The independent role of muscle mass and muscle fat infiltration remains unclear, mainly due to a lack of studies and a lack of accurate measurement of body composition by computed tomography or MRI. Weight loss and exercise training intervention studies can be of benefit to frail older adults. ...


Fracture Risk in Relation to Serum 25-Hydroxyvitamin D and Physical Activity: Results from the EPIC-Norfolk Cohort Study.

Julian C, Lentjes MA, Huybrechts I, Luben R, Wareham N, Moreno LA, Khaw KT.

PLoS One. 2016 Oct 17;11(10):e0164160. doi: 10.1371/journal.pone.0164160.

PMID: 27749911



... men and women (aged 42-82 y ... fracture risk was 29% lower in those participants with 50 to 70 nmol/L compared with those in the lowest quintile (<30 nmol/L). Physical inactivity based on a single baseline assessment was not associated with fracture risk. Vitamin D status appeared inversely related to fractures in middle aged adults. In older adults, the relationship between vitamin D status and fracture risk was observed to be J-shaped. Clinical and public health practice in vitamin D supplementation could partially explain these findings, although definitive conclusions are difficult due to potential changes in exposure status over the long follow up period.

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