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Fish Beats Wolf: Omega 3s Reduce Fatigue in Lupus Patients
By Kristen Schepker
For ZenMedica Newsletter
A daily dose of omega-3 fatty acids can improve quality of life and reduce fatigue in patients with systemic lupus erythematosus (SLE), according to a study
by researchers at the University of Texas-Southwestern Medical Center, Dallas.
The symptoms and severity of lupus can differ broadly from individual to individual. Fatigue, chronic pain and depression are among its most common features, with fatigue affecting more than 80% of all lupus patients.
Previous research indicates that people with lupus have low levels of serum omega-3s, which are known to promote healthy brain function and mood regulation (Wu, T. et al. PLoS ONE. 2012; 7(6): e37210, Kidd, P. Alt Med Rev. 2007; 12(3): 207-227). Numerous clinical trials have explored fish oil supplementation as a possible treatment for lupus in general, though results vary widely.
Researchers have observed positive effects of omega-3s on depressive symptoms and overall quality of life in lupus patients (Grosso, G. et al. PLoS One. 2014; 9(5): e96905). But despite the high prevalence of fatigue associated with lupus, the impacts of omega-3s on this aspect of the disease have never been the focus of a clinical trial. .
In addition to the existing research on omega-3s and depression, there are also data from a metabolomics study showing reduced markers of energy generation and amplified markers of oxidative stress and inflammation – indicators that correlate with fatigue – in SLE patients (Wu, T. et al. PLoS ONE. 2012; 7(6): e37210). These alterations, “may manifest physically and mentally as ill-defined symptoms of fatigue, generalized pain, and depressed mood.”
The new study brings a “novel assessment of fish oil’s effect on quality of life, fatigue, and a large panel of soluble mediators” to the existing body of lupus research.
Cristina Arriens and colleagues of the Division of Rheumatic Diseases, at the University of Texas looked specifically at lupus-related fatigue in a cohort of 50 patients with SLE treated at outpatient rheumatology and nephrology clinics affiliated with the UT center in Dallas. The patients were between the ages of 18-64 years; 32 of the original 50 completed the full 6-month trial.
Key exclusion criteria included allergy to fish or fish oil; current use of fish oil or use within two months; warfarin or heparin use; and pregnancy. Participants continued receiving standard medical care throughout the trial from their primary physicians, who were blinded to the patients’ treatment groups (Arriens, C. et al. Nutr J. 2015; 14(82)).
During the study, patients took either a daily fish oil supplement (Metagenics) comprised of six capsules/day equaling 2.25g EPA and 2.25g DHA, or a visually identical olive oil placebo (six capsules/day, purified [refined, not extra-virgin] olive oil). The participants were allowed to divide their daily intake into one or two doses per day as desired.
At the end of the six month trial, they found that subjects in the fish oil group showed a trend in improvement on the Energy/fatigue subscale of the Rand SF-36 (median 10.00 [IQR – 1.25 – 21.25]) as compared to the placebo group (-2.50 [-6.25 – 11.25], p?=?0.092).
Similarly, the fish oil group also did better on the SF-36 Emotional well-being subscale (16.00 [-1.00 – 33.00] vs. (4.00 [-5.00 – 14.00], p?=?0.070). Higher scores in these two areas are “indicative of better quality of life or fatigue,” the researchers note.
While Fatigue Severity Scale scores remained similar between both groups (fish oil -0.056 [-1.500 – 0.500] vs. placebo 0.222 [-0.556-0.667], p?=?0.350), the fish oil patients showed greater improvements in global disease activity, as measured by the Physician Global Assessment (-0.550 [-1.275- – 0.100] vs. (0.50 [-0.200-0.350]), p?=?0.015).
Objective biochemical measures also indicated a change for the better in the fish oil group. The authors noted improvements in a number of biomarkers of inflammation. The Erythrocyte Sedimentation Rate (ESR), “an accepted measure of systemic inflammation,” reduced significantly in the fish oil group as compared to the placebo group (-5.0 [-39.0- -2.5] vs. 4.5 [0.0-19.0], p?=?0.008).
“Among the cytokines/chemokines/growth factors studied, we observed an increase in the level of IL-13,” a T-cell secreted anti-inflammatory cytokine, in patients who took the fish oil supplement (-3.89 [-17.37-38.55] vs. placebo -16.86 [-46.25-2.31], p?=?0.033). Dr. Arriens and colleagues also saw a drop in IL-12, a pro-inflammatory cytokine that is elevated in SLE patients (fish oil -16.13 [-78.50-26.37] vs. placebo 8.54 [-14.16-113.35], p?=?0.058).
Though the study was limited in size, the authors conclude that many “positive indications…for quality of life, fatigue, disease activity, and inflammation biomarkers” in the test group align with previous studies pointing to fish oil’s numerous potential benefits in SLE treatment.
Fish oil supplements are widely available, relatively inexpensive, and generally safe: it makes good clinical sense to consider them as an adjunct modality in the care of people with SLE and possibly other forms of lupus.
Men Face Greater Risk of Cardiac Arrest: Study
By Steven Reinberg
Men are significantly more likely to have their heart stop suddenly than women are, a new study finds.
About one in nine men will suffer a cardiac arrest before the age of 70, compared to about one in 30 women. At age 45, men have nearly an 11 percent lifetime risk of sudden cardiac death, compared with a 3 percent risk among women of the same age, researchers report.
“Most of these deaths are occurring prematurely — before age 70 — which means that this is a very important and largely preventable cause of death that’s really affecting families in a devastating way,” said lead researcher Dr. Donald Lloyd-Jones. He is chair of preventive medicine at Northwestern University Feinberg School of Medicine, in Chicago.
About 450,000 Americans die from sudden cardiac death each year, and most never have any symptoms of a heart problem, he said. Men are especially at risk because heart disease tends to develop earlier in men than in women, Lloyd-Jones explained.
“We need to get more serious about screening men for risk factors for cardiac arrest,” he said. The major risk factors include smoking, high blood pressure, high cholesterol and diabetes.
“Know your numbers, especially your blood pressure, but also know your cholesterol or whether you have diabetes,” he said. “At 50, men should also have a baseline electrocardiogram, which might reveal heart problems.”
For the study, Lloyd-Jones and his colleagues examined data on more than 5,200 men and women, aged 28 to 62, who took part in the long-running Framingham Heart Study, which began in 1948.
That study looked at four major risk factors for heart trouble — blood pressure, cholesterol, smoking and diabetes. None of the participants had a heart problem at the start of the study. Because most of those in the study were white, the findings cannot necessarily be applied to other groups, the researchers cautioned.
Over decades of follow-up, 375 people died from a cardiac arrest. The risk for sudden cardiac death was even higher — 12 percent — among men who had two or more risk factors, the researchers found.
In addition, high blood pressure alone or in combination with other risk factors was linked to a higher risk of sudden cardiac death. High blood pressure was the single most accurate predictor of cardiac arrest for both men and women, Lloyd-Jones said.
Dr. Michael Sayre, a professor of emergency medicine at the University of Washington in Seattle, said that “men have more risk factors, such as smoking and high blood pressure, putting them at risk for cardiac arrest.” He wasn’t involved in the new study.
However, the number of cardiac arrests has dropped dramatically because more people are controlling their blood pressure, cholesterol and blood sugar, and have quit smoking, he added.
“In our system, over 30 years, the number of cardiac arrests is less than half of what it used to be,” Sayre said.
“We used to have 300 of these a year, and now there’s closer to 100,” he said. “Even though we are doing better than we did 15 years ago, there are still too many [cardiac arrests]. We can do better.”
Many people confuse cardiac arrest with a heart attack, which is when part of the heart is damaged after being deprived of oxygen, usually because of a blocked artery. Cardiac arrest is the sudden and complete stoppage of the heart.
The findings were published June 29 in the Journal of the American Heart Association.
A study in the June 22 issue of the same journal found another difference between men and women when it comes to cardiac arrest. Women who survive cardiac arrest are less likely than men to get aggressive lifesaving care at the hospital, those researchers reported.
In that study, women treated for cardiac arrest were 25 percent less likely to have an angiography — imaging to look for blocked heart arteries. Women were also 29 percent less likely to undergo angioplasty, a technique to open blocked arteries, the study found.
“Although we have made a lot of improvement in treating patients with cardiac arrest over the last decade, there is room for improvement, especially in women,” said lead researcher Dr. Luke Kim, an assistant professor of medicine at Weill Cornell Medical College in New York City.
Long Work Hours May Hurt Your Health
By Kathleen Doheny
Years of working long hours may help you climb the career ladder, but those hours may take a steep toll on your health — and that’s especially true for women, new research says.
“People who habitually put in a lot of long hours for many years, even decades, are really running an increased risk of potentially seeing chronic disease later in life,” said study researcher Allard Dembe. He’s a professor of health services management and policy at the College of Public Health at Ohio State University.
The link between long work hours and disease ”seems to be present a bit in men but is tremendously more evident in women,” said Dembe. While the study cannot prove cause and effect, he said, the associations were strong in women.
When the researchers compared men who worked more than 60 hours a week to those who worked 30 to 40, they found those who worked the longer hours had more than twice the risk of getting osteoarthritis or rheumatoid arthritis.
But men’s risk for other chronic or serious diseases didn’t go up substantially. In fact, those who worked 41 to 50 hours had a lower risk of heart disease, lung disease and depression, researchers noted.
But when the study compared women who worked 30 to 40 hours a week to those who worked more than 60 hours a week, women who worked more had substantially higher rates of disease. Women who worked 60 or more hours had more than three times the risk of heart disease, non-skin cancer and diabetes, nearly three times the risk of asthma, and nearly four times the risk of arthritis, the study showed.
The risks for women began to climb when they worked more than 40 hours and escalated above 50 hours. The gender differences were surprising, Dembe said, as was the strength of the increased risks he found for women.
The study included information on the working habits of nearly 7,500 U.S. men and women over more than three decades. Most of the study volunteers were over 50 toward the end of the study.
The researchers then looked to see if there was any link between work hours and the diagnosis of eight different diseases. These included heart disease, non-skin cancer, arthritis, diabetes, chronic lung disease, asthma, depression and high blood pressure, the study said.
Twenty-eight percent of those in the study worked 30 to 40 hours weekly. Most people — 56 percent — in the study worked 41 to 50 hours a week, the study said. Thirteen percent put in 51 to 60 hours weekly, while 3 percent toiled for 60 hours or more a week, the study found.
Dembe could not explain why more work hours seemed to have such an impact on women’s health, but believes that women’s multiple roles are at the root. “My speculation is, they have to balance all these other roles, parenting, child care, domestic responsibilities, worrying about everyone’s health care,” he said.
Working the long hours can interfere with sleep and keep the body in a constant state of stress, Dembe said.
The study findings make sense, said cardiologist Dr. Nieca Goldberg. She’s medical director of the Joan H. Tisch Center for Women’s Health at New York University Langone Medical Center, in New York City.
“These women [who log long work weeks] are not taking care of themselves,” Goldberg speculated. “Maybe they are not going to screening tests [such as mammograms].” Working long hours and taking care of a family may leave little time to prepare meals, she said, so these women may be eating and serving their family fast food or other takeout that is unhealthy.
Women working long hours who are single mothers may have even more responsibilities and stress, she said.
So, what can women do to protect their health? “Obviously, people need to work and pay their rent,” Goldberg said. However, she tells women who work long hours to step back and take stock. Is there something they can cut out? Perhaps doing less volunteer work until the work load on the job declines?
Goldberg said taking some time for yourself every day is crucial. That could mean getting some exercise, reading a book, watching TV or even just sitting doing deep breathing. “Clear your head,” she said.
The study was published in the Journal of Occupational and Environmental Medicine.
Baby Your Baby With Sunscreen
By Robert Preidt
Be sure your summer plans include a big dose of sun protection for your baby’s thinner and more delicate skin, a pediatrician recommends.
The best way to protect babies is to avoid direct sun exposure, especially between 10 a.m. and 2 p.m., said Dr. Jay Joo, a pediatrician at UCLA Health.
If that’s not possible, then make sure the baby has a wide-brimmed hat and long pants and long-sleeved shirts made of lightweight materials. Sunglasses are a good idea, too, if the baby will wear them, Joo added in a news release from the University of California, Los Angeles.
A small amount of sunscreen can be applied to the hands and other exposed areas of skin on babies up to 6 months of age. Apply a tiny bit first to make sure the sunscreen doesn’t irritate their skin, he suggested.
Liberal amounts of sunscreen can be used on babies over 6 months of age and older children, Joo said.
Apply broad-spectrum sunscreen with an SPF of 30. Put the sunscreen on your baby at least 15 minutes before going outside, and reapply every two hours and after the baby swims or sweats, Joo said.
If your baby does get too much sun, a cool compress or a calamine or aloe-based lotion may help with the discomfort, Joo suggested.
Women More Prone to Anxiety Than Men, Review Finds
By Steven Reinberg
Struggling with anxiety? Then odds are you’re a woman and you live in either North America or Western Europe.
That’s the conclusion of a new British study that found that women are twice as likely to suffer from anxiety as men.
Moreover, people in North America and Western Europe are more prone to anxiety disorders than those from other parts of the world. In North America, nearly eight of 100 people suffer from anxiety — the most in the world. In East Asia, it’s fewer than three in 100 — the lowest, the review authors noted.
“Anxiety is important and shouldn’t be overlooked,” said lead researcher Olivia Remes, who’s with the department of public health and primary care at the University of Cambridge’s Strangeways Research Laboratory. “Sometimes people think that anxiety is just a part of their personality or that there’s nothing they can do about it, but there is.”
Anxiety disorders are characterized by excessive worry, fear and avoidance of potentially stressful situations, such as social gatherings.
“There are treatments, including psychological treatments and medication, and other things people can do to help their mental health, such as physical activity, meditation and yoga,” Remes said.
For the review, Remes and her colleagues looked at more than 1,200 previously published studies about anxiety, and focused on 48 of them.
The investigators found that from 1990 to 2010, the overall number of people with an anxiety disorder remained about the same — approximately four out of every 100.
Women were nearly twice as likely as men to have an anxiety disorder (9 percent). And as many as 10 percent of men and women under 35 had an anxiety disorder, the researchers found.
It’s not known why women seem more prone to anxiety, but it could be differences in brain chemistry between the two genders, Remes suggested.
Women are also more likely to suffer from other mental health problems, such as depression, she said. In addition, men may also be less likely to report mental health problems.
It’s not known why young people are more likely to develop anxiety. It might be that older people are better able to hide their anxiety, Remes said.
In addition, those suffering from other health problems are more likely to have anxiety disorders, with as many as 70 percent reporting anxiety among their physical ills, the review found.
Among people with heart disease, for example, about 11 percent living in Western countries have an anxiety disorder, especially women, Remes said. People with multiple sclerosis are the most affected, with as many as 32 percent reporting an anxiety disorder.
In addition, obsessive-compulsive disorder (OCD), which is an anxiety disorder, may sometimes only affect women during pregnancy and after giving birth, the researchers found. Only one in 100 in the general population is affected by OCD. But, among pregnant women, the number is doubled and slightly higher than that among women right after giving birth, the review showed.
In the United States, anxiety disorders are estimated to cost $42 billion a year. In the European Union, more than 60 million people suffer from anxiety disorders in a given year, according to background information in the report.
Remes and her colleagues also found that information for some populations was lacking or of poor quality. This was particularly true for certain communities, such as native populations in North America, Australia and New Zealand.
“Anxiety can be expressed differently in other cultures,” Remes said. “For example, social anxiety in the West — people are worried that people are always looking at them, being critical — they are extremely self-conscious, whereas people in Asian cultures are afraid of causing others offense.”
Dr. Jeffrey Borenstein is president and CEO of the Brain and Behavior Research Foundation in New York City. He said more research is needed on anxiety disorders and treatments that are culturally sensitive.
“Anxiety disorder hasn’t gotten the attention it should,” he said.
“There are effective treatments, including talk therapy, medication and lifestyle changes,” Borenstein said. “There are a number of steps people can take to help their condition.”
The study findings were published in the June issue of the journal Brain and Behavior.
Exercise May Cut Risk of 13 Cancers, Study Suggests
By Dennis Thompson
Exercise may significantly reduce your risk for many types of cancer, including some of the most lethal forms of the disease, a large review suggests.
Working out for even a couple of hours a week appears to shrink the risk of breast, colon and lung cancer, said researchers who looked at 1.4 million adults.
“Those are three of the four major cancers that affect Americans today,” said Marilie Gammon. She is a professor of epidemiology with the University of North Carolina at Chapel Hill Gillings School of Public Health.
And fitness buffs, take heart — your cancer risk appears to continue to decline as you rack up hours of physical activity, with no apparent upper plateau, said study lead author Steven Moore, an investigator with the U.S. National Cancer Institute.
“The more activity, the more the benefit,” Moore said. “As people did more, their risk continued to lower.”
It should be noted, however, that the study only found an association between exercise and reduced cancer risk; it did not prove a cause-and-effect relationship.
In the study, regular exercise wound up being linked to a reduced risk of 13 cancers in all, the researchers said. The others were leukemia, myeloma and cancers of the esophagus, liver, kidney, stomach, endometrium, rectum, bladder, and head and neck.
Current federal guidelines for exercise — 150 minutes of moderate-intensity activity a week, or 75 minutes of vigorous activity — are aimed at heart health but also serve well for cancer prevention, Moore said.
Moderate-intensity exercise involves pursuits such as brisk walking or tennis, while vigorous intensity exercise involves heart-pumping activities such as jogging or swimming laps, according to the U.S. Office of Disease Prevention and Health Promotion.
For this study, Moore and his colleagues focused on leisure-time physical activity performed outside work or household chores. “This is voluntary physical activity typically done to improve health,” he said.
About half of all American adults don’t meet the federal minimum recommendation for exercise, the study authors said in background information.
Prior research has linked exercise to reduced risk of breast and colon cancer, but no study has attempted to look at the effect of physical activity on many different types of cancer, Moore said.
The researchers pooled data from 12 U.S. and European studies to create a database of 1.4 million adults, aged 19 to 98. They then examined whether self-reported physical activity made a difference in risk of 26 cancers.
Exercise was associated with a reduced risk for half of the cancers considered by the investigators, and that reduction remained significant for nearly all, even after accounting for factors such as obesity and smoking history.
Overall, a higher level of physical activity was associated with a 7 percent lower risk of total cancer, the researchers reported.
The range of reduced risk ran from 42 percent for esophageal cancer to 10 percent for breast cancer, the study authors said. For colon and lung cancer, risk was lowered 16 percent and 26 percent, respectively, the findings suggested.
“This suggests that physical activity may have a role to play in population-wide cancer prevention efforts,” Moore said.
The findings were published online May 16 in the journal JAMA Internal Medicine.
No one is certain why exercise seems to help fend off cancer, Moore and Gammon said, but there are some leading theories.
Physical activity reduces levels of hormones, such as estrogen, that have been linked to different cancers, and helps control levels of insulin and insulin-like growth factor, Moore said.
People who work out also tend to have lower levels of inflammation, Moore said. Their cells appear to be subject to less oxidative stress, and are more capable of repairing damaged DNA that might cause cancer, said Gammon, co-author of an editorial accompanying the study.
Gammon said she was most pleased with the 42 percent risk reduction found in esophageal cancer.
“That’s pretty amazing, because it’s a very deadly tumor,” she said. “I think the average length of survival is 11 to 12 months after you’re diagnosed.”
Other very deadly cancers that appear to become less common with exercise include those of the liver, stomach, kidney, and head and neck, Gammon said.
“Having a strategy to help reduce risk of those cancers is very good, because your outlook is not optimal once you’re diagnosed,” she said.
5 Warning Signs of Stroke
By Mary Elizabeth Dallas
Knowing five sudden and severe warning signs of stroke can help save lives and reduce the number of people living with disabilities, a stroke expert says.
” ‘Sudden’ and ‘severe’ are key words, but if in doubt, do not take chances,” Dr. Doojin Kim, a neurologist at UCLA Medical Center in Santa Monica, said in a hospital news release.
The American Stroke Association urges anyone who notices the following sudden and severe signs of stroke to immediately dial 911:
- Sudden numbness or weakness in the face, arm or leg (especially on one side of the body).
- Sudden confusion or trouble speaking or understanding speech.
- Sudden vision problems in one or both eyes.
- Sudden difficulty walking or dizziness, loss of balance or problems with coordination.
- Severe headache with no known cause.
Stroke is the leading cause of adult disability in the United States. People having a stroke need immediate medical attention to improve the effectiveness of treatment and reduce their risk for death or long-term side effects, Kim explained.
“If someone has an ischemic stroke — the type in which a brain artery becomes blocked or restricted — the effects often can be reversed or drastically reduced if treatment is started within three hours,” said Kim. “But if they’re unsure or they wait to see if symptoms will go away, the window of opportunity for effective treatment can close.”
However, the warning signs or symptoms of stroke may go unrecognized. Part of the problem is that many people think strokes happen to “other people,” Kim said.
“Stroke is occurring more and more often in younger people,” he said. “It’s still more common in those in their senior years, but just because someone is middle-aged or even younger doesn’t mean they can’t have a stroke.”
Strokes are more common among women than men, the American Stroke Association reports. Black people are also at higher risk than whites, Kim said.
People with a family history of stroke are also at greater risk of stroke, said Kim. This risk factor can’t be changed. But, there are ways people can reduce their risk for stroke, he advised, including:
- Exercising regularly.
- Maintaining a normal weight.
- Following a healthy diet.
- Maintaining healthy cholesterol levels.
- Keeping blood pressure in check.
Also, don’t smoke.
“Although most people have heard the list of risk factors before, it never hurts to provide a reminder because we often think, ‘It can’t happen to me.’ The reality is, it can,” Kim said.
CALM Connection: A Chocolate Every Day May Keep Stress at Bay
Courtesy of Organic Connections
Willy Wonka was definitely onto something. Chocolate does make everything more fun and less stressful, and science may explain why.
Researchers had subjects eat a mere 1.4 ounces of dark chocolate daily. At the end of just two weeks, those who had rated themselves as highly stressed at the start had lower blood and urine levels of stress hormone cortisol, as well as decreased “fight-or-flight” hormones known as catecholamines. It’s chocolates’ naturally high levels of the mineral magnesium that’s responsible for this stress-less benefit.
So feel good about keeping some organic dark chocolate on hand, and imbibing. It’s important though to opt for chocolate with 70 percent or higher cocoa content. Also, look for dark chocolate that’s sweetened with plant-based sweeteners like stevia instead of refined sugar which can deplete magnesium.
Night Shift Work May Be Tough on a Woman’s Heart
By Steven Reinberg
Women who work rotating night shifts may face a slightly increased risk of heart disease, a new study suggests.
“We saw a modest increased risk of heart disease associated with longer duration of rotating night shift work, which appears to wane after stopping shift work,” said lead researcher Celine Vetter. She is an instructor in medicine at Brigham and Women’s Hospital in Boston.
That increased risk ranged from 15 percent to 18 percent when compared to women who did not work rotating night shifts, the study found.
But the more time that elapsed after quitting such night shift work, the lower the risk for heart disease, Vetter said. And this “further supports the hypothesis that the risk of coronary heart disease associated with shift work might wane over time when women stopped working [such] shifts. This is a new finding,” she said.
Rotating night shift work was defined as three or more night shifts per month, in addition to day and evening shifts.
The report was published April 26 in the Journal of the American Medical Association.
While the study can’t prove that working rotating night shifts causes heart disease, the results are in line with previous findings, Vetter noted.
“It is possible that different work schedules might carry a different risk. And we have very little information on exact schedules, as well as work start and end times,” she added.
“Future studies are needed that collect that level of detail so we can better understand which aspects of shift work are most critical,” Vetter said. “We also do not well understand who is at highest risk.”
Individual characteristics, such as chronotype — an individual’s built-in biological rhythm — and variations in sleep patterns and quality might affect the risk, the researchers suggested.
“Although only a small number of women had an increased risk, and even though the absolute risk associated with shift work is small, and the contribution of shift work to coronary heart disease is modest, this is a modifiable factor, and changing schedules might help prevent coronary heart disease,” Vetter said.
To pinpoint the effect of shift work on heart disease, Vetter and her colleagues collected data on nearly 189,000 women who took part in the Nurses’ Health Study I and II. All of the women in the study reported their lifetime exposure to rotating night shift work.
The women also reported their heart health, including whether they had an angiogram that found heart-related chest pain, a heart attack, or procedures such as angioplasty, heart bypass surgery or stents.
The researchers used medical records and death certificates to confirm any self-reported heart attacks or deaths. The women also completed questionnaires about their known risk factors for heart disease every two to four years throughout the 24-year study period. Over that time, more than 10,000 women developed heart disease, the findings showed.
To isolate the effect of shift work, the investigators took into account a number of known risk factors for heart disease, such as smoking, poor diet, lack of physical activity and weight. Even after controlling for these risk factors, a modest increase in the risk of heart disease was seen with longer duration of rotating night shift work.
“Rotating night shift work has been previously shown to be associated with an increased risk of diabetes and cardiovascular [heart] disease,” said Dr. Gregg Fonarow. He is a professor of cardiology at the University of California, Los Angeles, and was not involved with the new study.
“The mechanisms behind this association between night shift work and cardiovascular events, along with identification of strategies to mitigate this risk, require further study,” he said.
Retirement Can Be Golden for Your Health
By Don Rauf
Although aging may mean more physical problems, retirement can help people lead healthier lives, a new study from Australia suggests.
Researchers found that when folks retire they tend to increase their physical activity, sit less and sleep more soundly.
“Our study paints a positive picture of retirement,” said lead researcher Dr. Melody Ding, a senior research fellow at the University of Sydney’s School of Public Health. “Retirees [in the study] were acquiring a healthier lifestyle. Factors that may have contributed to this include availability of time to be physically active and removal from sedentary jobs and work-related stress.”
Whether or not these results would be the same in the United States isn’t clear. “Retirement and the health benefits of retirement could be very context-specific,” she said.
“Life expectancy in Australia — 82.1 years — is a few years longer than that in the United States — 78.7, and there are also different social welfare and health care systems,” Ding said. “All of these factors may limit the ‘generalizability’ of our findings to the U.S.”
The study tracked about 25,000 Australians. The average age of those still working was just over 54. During slightly more than three years of follow-up, about 3,100 of the study participants retired.
After retirement, study participants reported increased physical activity levels of about an hour and half a week. Retirees also sat around less — cutting their sedentary time down by just over an hour each day. And, compared to when they were working, those who retired slept an average of 11 minutes more each day, the research revealed.
The study authors also noted that about half of the women smokers quit after retirement.
No significant link was found between retirement status and alcohol use or eating fruit and vegetables.
The average age for retirement in the United States is 62, according to a 2014 Gallup poll. Ding said the average retirement age in Australia is just over 63 years.
“I think it is important to plan for retired life with a positive mindset,” she said. “Some people get anxious about retirement because they may lose a sense of purpose.”
Ding recommended pursuing hobbies, volunteering or spending time with loved ones as ways to keep a sense of purpose. She added that retirees might incorporate a social component into a healthy lifestyle, such as catching up with a friend during a walk.
One study participant — a 89-year-old retired bank manager — told the researchers, “I have more time in my retirement and I am happily busy. I keep fit by dancing four times a week and walking.”
To keep his mind active, this retiree teaches computer skills. The message on his answering machine: “I am out enjoying my retirement.”
Rachel Johnson is a professor of nutrition at the University of Vermont. “It was encouraging that many of the retirees in this study opted to spend time being more physically active,” said Johnson, who is also chair of the American Heart Association Nutrition Committee. “Being active is important to preventing heart disease and stroke.”
The American Heart Association recommends at least 150 minutes per week of moderate exercise or 75 minutes per week of vigorous exercise (or a combination of moderate and vigorous activity) to improve overall heart health.
Older adults will also experience benefits if they divide their exercise time into two or three segments of 10 to 15 minutes a day, Johnson said. She also suggested that older people try these tips to get and keep active:
- Walk a dog.
- Walk at the mall when the weather is too hot or too cold.
- Walk, jog in place or use the treadmill at a gym while you watch your favorite 30-minute show.
- Park the car far from your destination and walk.
- Take the stairs.
- Trade after-dinner dessert for an after-dinner walk.
Ding added that retirement is a good time for doctors to talk to their patients about making positive lifestyle changes that could add years to their life.
The study findings were published recently in the American Journal of Preventive Medicine.
Exercise May Counter Harms From Too Much Sitting, Study Says
By Robert Preidt
Regular exercise helps counteract the harmful health effects of too much sitting, a new British study suggests.
“This research is significant because it demonstrates yet again why physical activity and exercise is so important. It shows that people who spend large amounts of time not moving, either through work, leisure or lifestyle, can counteract some of the negative effects of sedentary behavior by regularly exercising,” study co-author Kishan Bakrania, a University of Leicester researcher, said in a university news release.
Researchers analyzed data from a 2008 national health survey of adults in England. They grouped people according to their levels of physical activity and sitting time.
Adults who sat a lot and didn’t get any exercise had more heart disease and diabetes risk factors than those who spent a lot of time sitting but got regular exercise, the researchers said.
They also found that people who spent less time sitting had higher levels of “good” HDL cholesterol, even if they didn’t get regular exercise.
“By suggesting that being physically active may offset some of the deleterious consequences of routinely engaging in high levels of sedentary behavior, this study further emphasizes the importance of physical activity in the promotion and maintenance of health,” said lead researcher Thomas Yates, from the Leicester Diabetes Centre and the University of Leicester.
However, this was a so-called observational study and further research is needed to confirm these findings, he added.
The study was published online recently in the journal BMC Public Health.
Mediterranean Diet May Help Lower Hip Fracture Risk in Older Women
By Robert Preidt
Eating a Mediterranean diet may at least slightly lower an older woman’s risk for hip fracture, a new study suggests.
Women who most closely followed a Mediterranean diet — one high in fruits, vegetables, nuts, legumes and whole grains — had a 20 percent lower risk for hip fractures compared to women who didn’t follow this regimen, the researchers found.
The study couldn’t prove cause-and-effect, however. And the researchers stressed that the absolute reduction in risk of a hip fracture for any one woman was still pretty slight — only about a third of one percent.
Nevertheless, “these results support the notion that following a healthy dietary pattern may play a role in the maintenance of bone health in postmenopausal women,” concluded a research team led by Dr. Bernhard Haring of the University of Wurzburg in Germany.
The study was published online March 28 in the journal JAMA Internal Medicine.
One expert in the United States believes that diet can be very important to bone health as people age. However, which diet might be best remains unclear, according to Dr. Michael Hepinstall.
Research “generally supports the idea that adequate nutrition has health benefits that may extend to a lower risk of hip fractures,” said Hepinstall, an orthopedic surgeon at the Lenox Hill Hospital Center for Joint Preservation & Reconstruction, in New York City.
“Nevertheless, the results of this study are not convincing enough to confirm that the Mediterranean diet is best, nor do they suggest that an individual adopting a Mediterranean diet can be confident that they have taken adequate measures to reduce fracture risk,” he said.
In the study, the German team examined the link between diet and bone health in more than 90,000 healthy American women, whose average age was 64. They were tracked for nearly 16 years.
While the team found a slight trend in favor of the Mediterranean diet and a lower risk of hip fracture in particular, the diet did not seem to lower the odds for fractures overall.
There was a bit of good news for people already on the diet, Hepinstall noted. While the Mediterranean diet typically has lower amounts of dairy products than other regimens, that did not seem to harm bone health, he said.
What does help to strengthen women’s bones as they age? According to Hepinstall, low-impact, weight-bearing exercise is encouraged, including tai chi.
“Physicians also typically recommend adequate dietary calcium intake, with supplemental calcium and vitamin D for those who are deficient,” he added. Medications are also prescribed when osteoporosis is diagnosed.
Simple safety measures can also cut the odds of fractures linked to falls, Hepinstall said. Regular vision checks are key, and “within the home, we advise patients to keep an uncluttered path to the bathroom, use a night light, remove throw rugs and other potential sources of falls,” he said.
Less Than 3 Percent of Americans Live a Healthy Lifestyle
By Robert Preidt
Do you get a moderate amount of exercise, eat right, keep from piling on fat and avoid smoking? Congratulations, you’re among the 2.7 percent of Americans who do so, according to a new study.
Researchers say that, unfortunately, the other 97.3 percent of American adults get a failing grade on healthy lifestyle habits.
The study looked at data on more than 4,700 people who took part in the U.S. National Health and Nutrition Survey. The researchers assessed how many people followed four general “principles of healthy living” — a good diet, moderate exercise, not smoking and keeping body fat under control.
“The behavior standards we were measuring for were pretty reasonable, not super high. We weren’t looking for marathon runners,” said study senior author Ellen Smit, an associate professor at the OSU College of Public Health and Human Sciences, in Corvallis.
In fact, the standards used in the study are typical of lifestyle advice given by doctors to their patients, Smit’s team said. People who adhere to those four behaviors can help reduce their risk of many health problems, including type 2 diabetes, heart disease and cancer.
Unfortunately, less than 3 percent of the adults in the study achieved all four of the healthy living measures, the researchers found.
Overall, 71 percent of the adults surveyed did not smoke, 38 percent ate a healthy diet, 10 percent had a normal body fat percentage and 46 percent got sufficient amounts of physical activity.
Sixteen percent had three of the healthy lifestyle behaviors, 37 percent had two, 34 percent had one and 11 percent had none.
Among the other findings: women were more likely than men to not smoke and to eat a healthy diet, but they were less likely to have adequate physical activity levels. And when it came to race, Mexican-Americans were more likely to eat a healthy diet than blacks or whites.
The study was conducted by researchers at Oregon State University, the University of Mississippi and the University of Tennessee-Chattanooga.
In terms of public health, the findings are disappointing, Smit said in an OSU news release.
“This is pretty low, to have so few people maintaining what we would consider a healthy lifestyle,” she said. “This is sort of mind boggling. There’s clearly a lot of room for improvement.”
Further research is needed to identify ways to get American adults to adopt more healthy lifestyle habits, the experts said.
The study was published March 21 in the journal Mayo Clinic Proceedings.
Heavy Coffee Drinkers Show Lower Risk of Multiple Sclerosis
By Amy Norton
People who drink a lot of coffee may have a lower risk of developing multiple sclerosis (MS), a new large study suggests.
Researchers found that among more than 6,700 adults, those who downed about six cups of coffee a day were almost one-third less likely to develop MS than non-drinkers were.
And the link was not explained away by factors such as people’s age, education or income levels, or smoking and drinking habits.
Nor is anyone suggesting that people drink more java to ward off the disease, said lead researcher Anna Hedstrom, of the Karolinska Institute in Stockholm, Sweden.
She said the findings do add to evidence that coffee “may have beneficial effects on our health” — but there is no way to make any specific recommendations.
Elaine Kingwell, a researcher at the University of British Columbia, in Vancouver, Canada, agreed.
There could still be other explanations for the coffee-MS connection, she said. Plus, past studies looking at this same question have come to inconsistent conclusions, explained Kingwell, who wrote an editorial published with the study. It appeared March 3 in the Journal of Neurology, Neurosurgery & Psychiatry.
All of that said, there is reason to believe coffee could protect against MS, both Hedstrom and Kingwell noted.
In previous research, scientists have found that caffeine can protect lab mice from developing an MS-like condition — by blocking part of the inflammatory process that damages nerves in the brain and spine.
In humans, MS arises when the immune system mistakenly attacks the protective sheath around nerve fibers in the brain and spinal cord. Depending on where the damage occurs, people can suffer muscle weakness, numbness, vision problems and difficulty with balance and coordination.
A number of studies have linked higher coffee intake to lower risk of diseases that involve degeneration in brain cells, including Parkinson’s disease and Alzheimer’s. When it comes to MS, the evidence has been mixed, possibly, in part, because many studies have been small, Hedstrom explained.
So, her team looked at two study groups: a Swedish group that included 1,620 people with MS and 2,788 without the disease; and a U.S. group of 1,159 MS patients and 1,172 adults free of the disease.
Overall, people who’d averaged 30 ounces of coffee a day — around six standard cups — were almost one-third less likely to have MS than non-drinkers were.
The results were similar when the researchers looked at people’s coffee habits five to 10 years before their MS symptoms had begun (or, for people without MS, coffee habits during that same time period).
But, Kingwell said, there are issues with relying on people’s recollection of their diet years ago. And if some people with MS had stopped drinking coffee because of their symptoms, that could affect their memory of their earlier habits, she added.
“There is not enough evidence here to suggest that people should drink several cups of coffee per day,” Kingwell said.
Still, she added, the findings are “interesting” and warrant more research. If researchers can figure out why coffee, or possibly caffeine, is tied to MS, Kingwell said, that could give clues about the underlying causes of the disease or possibly lead to new treatments.
Ovarian Cancer Is More Than One Disease: Report
By Robert Preidt
Ovarian cancer isn’t a single disease, but rather a number of different malignancies involving the ovaries, an expert U.S. panel says.
Evidence suggests that many ovarian cancers begin in other tissues, such as the fallopian tubes, and eventually spread to the ovaries. In other cases, cancers arise from cells not considered to be part of the ovaries, a report from the U.S. National Academies of Sciences, Engineering, and Medicine said. The report was mandated by Congress.
The authors noted there are “surprising gaps” in knowledge about ovarian cancer. They called for additional research to learn more about the causes and improve prevention, early detection, treatment and management of the disease.
“While progress has been made in ovarian cancer research over the past few decades, much remains to be learned,” Jerome Strauss III, chair of the report committee, said in an academy news release. Strauss is also executive vice president for medical affairs and dean of Virginia Commonwealth University School of Medicine, in Richmond.
“The more that is understood about the basic biology of various types of ovarian cancers, such as where they originate in the body, the more rapidly we can move toward advances in prevention, screening, early detection, diagnosis, treatment and supportive care,” he explained.
Each year, more than 21,000 women in the United States are diagnosed with ovarian cancer, the researchers said. And, more than 14,000 women die from the disease each year, they added. The five-year survival rate is less than 50 percent, the researchers noted.
Early ovarian cancer doesn’t have any distinctive symptoms. There’s also no effective screening test for ovarian cancer. About two-thirds of these patients are diagnosed in the late states of the disease, when the cancer has already spread to other parts of the body, the report authors said.
The report also found that the quality of care for ovarian cancer patients varied widely across the nation. Several groups have developed standard-of-care guidelines, but less than half of ovarian cancer patients receive that recommended care, the research revealed.
The report found two main predictors of a better outcome for women with ovarian cancer. One was being treated by a gynecologic oncologist. The other was receiving treatment at a hospital that handles a large number of such cases. However, many patients don’t have access to such care, the report authors said.
To reduce disparities in care, they recommended that doctors and scientists look for ways to ensure consistent use of the current suggested standards of care.
The report also said that better methods of identifying women at high risk for ovarian cancer could improve prevention and early detection. For example, there are strong links between ovarian cancer and a family history of the disease, specific inherited genetic mutations such BRCA1 and BRCA2, and certain hereditary cancer syndromes, the authors noted.
Seven Steps Toward a Healthier Heart
By Robert Preidt
Heart disease is the leading cause of death for U.S. adults, but a healthy lifestyle can reduce that risk, a heart expert says.
The American Heart Association calls its prevention tips “Life’s Simple 7” because they’re easy to understand and follow, said Dr. Ravi Dave. He is director of the cardiac catheterization lab at the University of California, Los Angeles Medical Center, in Santa Monica.
And because February is American Heart Month, and there’s “no better time to focus on heart disease and kick-start your New Year’s resolution to lose weight, eat better and start exercising,” Dave said in a university news release.
Walk or exercise in other ways for at least 30 minutes five times a week to lower your risk for heart disease, diabetes and stroke.
Control your cholesterol. “Lowering and controlling blood-cholesterol levels will help prevent buildup in your arteries and reduce your risk of blockages that can lead to heart attacks and strokes,” Dave said.
Follow a low-fat, high-fiber diet that includes fruits and vegetables, whole grains, fish and other lean proteins.
Manage high blood pressure, which is a risk factor for heart disease and stroke. Keeping blood pressure under control through exercise, medication, or both can help reduce wear and tear on your heart and other organs.
Watch your weight. “Carrying too much weight, especially around your mid-section, puts you at higher risk for high blood pressure, diabetes and high cholesterol, known risk factors for heart disease,” Dave said. “Even modest weight loss reduces your risk of these health issues.”
Keep your blood sugar under control through diet and exercise. High blood sugar levels put you at risk for diabetes, which boosts the chances of heart disease and stroke.
Don’t smoke. “It’s the single best thing you can do for your heart — and your overall health,” Dave said.
Cholesterol in Eggs May Not Hurt Heart Health: Study
By Alan Mozes
The once-maligned egg may not be a heart breaker after all, new research suggests.
Finnish researchers say that even carriers of a gene — called APOE4 — that increases sensitivity to dietary cholesterol don’t seem to have anything to fear when it comes to the impact of eggs, or any other dietary cholesterol, on heart health.
The findings followed the 20-year plus tracking of dietary habits among more than 1,000 middle-aged Finnish men. All were heart healthy at the study’s start, and about a third carried the APOE4 gene, the researchers said.
“It is quite well known that dietary cholesterol intake has quite a modest impact on blood cholesterol levels, and cholesterol or egg intakes have not been associated with a higher risk of heart disease in most studies,” said study author Jyrki Virtanen. He is an adjunct professor in nutritional epidemiology with the University of Eastern Finland Institute of Public Health and Clinical Nutrition in Kuopio, Finland.
“However, dietary cholesterol intake has a greater impact on blood cholesterol levels among those with [APOE4],” Virtanen added. “So it was assumed that cholesterol intake might have a stronger impact on heart disease risk among those people. However, our study did not find an increased risk even among those carrying [APOE4].”
Although the study didn’t find a link between dietary cholesterol and adverse heart health, the study authors said they weren’t able to prove that dietary cholesterol doesn’t have a significant impact on cardiovascular disease. For example, one limitation of the study the authors noted was that they only collected dietary information at the start of the study, and had no way of knowing if people’s diets changed over time.
Virtanen and his colleagues report their findings in the Feb. 10 issue of the American Journal of Clinical Nutrition. The University of Eastern Finland provided funding for the study, and Virtanen added that there was no funding from egg industry sources.
Finland has a higher-than-average number of APOE4 carriers, with about a third of the population affected, the researchers said. But little is known about whether or not dietary cholesterol intake might affect the hearts of people with the APOE4 gene, the study authors noted.
The new research included people between the ages of 42 and 60. On average, the average dietary cholesterol consumed was 398 milligrams (mg), the study found. No one reported consuming more than one egg per day, on average. One medium-sized egg has approximately 200 mg of cholesterol, the study authors said.
At the end of the 21-year tracking period, 230 of the men had experienced a heart attack. But, the study authors determined that neither egg habits, nor overall cholesterol consumption, had any bearing on heart attack risk or the risk for hardening of the arterial walls.
Virtanen noted that none of the research participants had heart disease or diabetes at the study’s launch. “[And] there is some study data from other study populations that egg or cholesterol intakes may increase the risk of heart disease among diabetics,” he said. “So our study is not a ‘license’ to eat as much cholesterol or eggs as one likes.”
He added that “there might well be a point when cholesterol or egg intakes may become so high that they may increase the risk of heart disease. However, in our study we could not assess what might be too much, because we did not have enough people with extremely high intakes.”
Lona Sandon is a registered dietitian and assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center at Dallas. She said that while “everything in moderation” is the way to go, “people can feel confident about adding eggs, including the yolk, into their daily diet.”
“Eggs are a powerhouse of nutrition,” she said, “with much of that nutrition found in the yolk. The yolk has vitamin D, essential fats, choline, lutein, zeaxanthin, and more. Good for bones, good for the brain, and good for the eyes. [And] the white is a high quality protein, as well as a source of B vitamins.”
Dietary cholesterol doesn’t have as much of an impact on blood cholesterol levels as was previously thought, Sandon added. She also noted that the American Heart Association dropped its daily cholesterol limit recommendations years back. Instead, saturated fat and sugars are a more likely culprit in terms of heart disease risk, she said, alongside insufficient exercise.
“[So] an egg a day in the context of a healthy diet pattern does not appear to pose a risk for heart disease or impact dietary cholesterol according to current research,” she said. “[But] an egg a day on top of buttery biscuits and gravy is not the way to go.”
Healthier Diets May Be Cutting Heart, Diabetes Risks in U.S. Teens
By Maureen Salamon
The severity of metabolic syndrome — a cluster of health risk factors such as belly fat and poor cholesterol levels — among U.S. teens has been improving, and researchers believe that healthier diets may be the reason why.
Metabolic syndrome increases the risk of heart disease, stroke and type 2 diabetes. The study found marked changes in two of the risk factors: a drop in blood fats known as triglycerides, and an increase in HDL (“good”) cholesterol.
But not all the news from the study was good. Teen obesity levels rose during the 13-year study period. The investigators also found no changes in average physical activity levels.
“While we don’t know for sure why these improvements occurred, we saw that over time, children have eaten healthier diets, eating fewer calories overall, less carbohydrates and more food with unsaturated fat,” said study author Dr. Mark DeBoer.
“This supports the important idea that changes to your lifestyle choices are the key to improving cardiovascular risk status,” he added. DeBoer is an associate professor of pediatrics in the division of pediatric endocrinology at University of Virginia.
The study was published online Feb. 9 and in the March print edition of the journal Pediatrics.
A diagnosis of metabolic syndrome means someone has at least three out of five risk factors. Those risk factors include: excessive belly fat; high blood pressure; elevated fasting blood sugar; high triglyceride levels; and low levels of high-density lipoprotein (HDL) cholesterol. More than one-third of American adults have metabolic syndrome, the American Heart Association says.
Study data came from the U.S. National Health and Nutrition Examination Survey completed between 1999 and 2012. The researchers had information on over 5,000 teens. All were between 12 and 19 years old, the study authors said.
The rate of metabolic syndrome among the teens held steady during the study period. But the severity of the syndrome decreased, the researchers found.
Along with improvements in triglyceride levels and HDL cholesterol, the teens’ overall calorie and carbohydrate intake declined. The study also found that the teens were eating more unsaturated fats. These are considered a healthy type of fat.
The results occurred over a time period when dietitians recommended lowering carbohydrate consumption and recognized the health benefits of eating plans such as the Mediterranean diet. This type of diet emphasizes eating plant-based foods and unsaturated fats from sources such as olive oil and nuts, DeBoer said.
“Our hope is that if these dietary trends continue, that there will eventually be a reversal of obesity as well,” he said.
One U.S. nutrition expert called the new findings “really exciting.”
“It seems like maybe we’re at a turning point,” said Penny Kris-Etherton, a registered dietitian and professor of nutrition at Penn State University. “It might take a while to see statistically significant decreases in metabolic syndrome in adolescents, but it seems we’re seeing some of the benefits now that will hopefully continue to have an impact.”
She added that she hopes these changes in diet might eventually lead to lower rates of metabolic syndrome, not just lessened severity.
But, Kris-Etherton said improving rates of metabolic syndrome and obesity needs to include more than individuals making wise food choices and incorporating physical activity into their daily lives.
“We have to rely on the food industry to help make healthier foods,” she added. “It would be great if the food industry reformulated products and introduced new products that are healthier,” she suggested.
Sitting for Hours May Raise Your Type 2 Diabetes Risk
By Steven Reinberg
Sitting for long stretches might boost your risk for type 2 diabetes, even if you exercise, researchers report.
Each extra hour in a sedentary position — whether working on the computer or lounging in the recliner — seems to increase your odds of type 2 diabetes by 22 percent, the study authors said.
“We found that people with diabetes spend more time sitting than people without diabetes — about 26 minutes more” a day, said lead researcher Julianne van der Berg, from Maastricht University in the Netherlands.
However, she cautioned that the link between sitting and diabetes is only an association, and doesn’t prove that sitting causes type 2 diabetes. “We cannot have any conclusions about cause and effect,” she said.
These findings are independent of any high-intensity exercise, such as running or swimming, van der Berg added.
“We all know that physical activity is important, but now we see that sitting is a bad thing,” van der Berg said. “The more you sit, the higher the risk [for type 2 diabetes], regardless of how much you exercise.”
Why sedentary behavior may play a role in the development of type 2 diabetes isn’t yet known, she said.
But given the high prevalence of type 2 diabetes worldwide and the large amounts of time people spend being sedentary, studies like this are important, van der Berg and colleagues added.
The report was published online Feb. 2 in the journal Diabetologia.
Diabetes means your blood sugar levels are higher than normal. Untreated, the disease can lead to heart and kidney disease, blindness and limb amputations.
Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City, said many factors increase someone’s risk for type 2 diabetes, including a genetic predisposition for the disease.
Inactivity and diet are known factors for raising the risk, he said. “It is not only the time we spend in front of the TV or computer, it is also the type of food and or snack we consume when sitting in front of the screens that increases the risk,” he said.
For the new report, researchers collected data on nearly 2,500 adults, average age 60, who were part of a population-based study in the Netherlands.
To clock time spent in a sedentary position, participants wore an accelerometer for eight days. During that time, van der Berg’s team calculated daily sedentary time, the number of sedentary breaks, prolonged sedentary periods — 30 minutes or more — and the average length of these sedentary periods. Participants also had their blood sugar checked.
The investigators found that 56 percent of the participants had normal blood sugar; 15 percent had elevated blood sugar, and 29 percent had type 2 diabetes.
People with type 2 diabetes had the most sedentary time — up to 26 more minutes daily — compared to those with elevated or normal blood sugar, the researchers said.
However, no connection between the number of breaks from being sedentary, the number of prolonged breaks or the length of breaks and diabetes was found, according to the report.
“This study shows that in order to avoid or delay diabetes — independent of high-intensity physical activity — people at risk should be aware of and avoid, or reduce, the amount of sedentary time,” Zonszein said.
‘Standing Desks’ in Classrooms May Kickstart Kids’ Activity
By Maureen Salamon
Parents who worry that too much sitting might harm their children’s health may have a new ally: “standing desks” in the classroom.
A new research review reports that use of the desks at school helped kids get more active.
The researchers also found that standing desk use was tentatively linked to better classroom behavior and greater energy expenditure among children, although the results were mixed — stemming from varied studies.
“There’s a lot of research out there about integrating standing desks into the workplace that generally found favorable impacts on reduced sitting time and increasing standing time,” said study author Karl Minges, a doctoral candidate at the Yale School of Nursing in Orange, Conn.
“In the student population … it seemed to be a natural fit,” said Minges. “Our research adds to that evidence, showing schools can be a good place to introduce interventions to improve students’ health as well as their minds.”
The review was published online Jan. 22 in the journal Pediatrics.
Minges and his colleagues reviewed eight international studies. The studies included schoolchildren aged 5 to 18. Desk designs included both adjustable sit-to-stand desks, which permitted the use of a stool, and standing desks, which didn’t have a stool.
While the eight study designs varied greatly, half showed that sitting time among students using the standing desks decreased about one hour each day. Two studies showed a significant increase — up to nearly 31 percent — in the proportion of time children spent standing each school day.
Other results indicated children using standing desks logged more than one hour a day less of television viewing and computer use, reported far more time spent “walking around,” and had more frequent bouts of activity compared to children using traditional desks.
“One study said that more than 32 additional calories per hour were burned [using standing desks], which would be the equivalent of 225 additional calories per school day, similar to [total calories burned while] roller skating or skateboarding after school,” Minges said.
Decreasing sedentary time among children is a widespread goal for health promotion and obesity prevention efforts in children and adolescents, the study authors said.
In the United States, obesity rates among children aged 6 to 11 grew from 7 percent in 1980 to nearly 18 percent in 2012. In Americans aged 12 to 19, obesity rates increased from 5 percent to 21 percent in the same time period, according to the U.S. Centers for Disease Control and Prevention.
Experts noted that the review’s findings weren’t surprising, but said more research is needed to pinpoint actual health benefits to children from using standing desks.
“It shows promise, but it’s too early to say that this type of intervention would have a major public health impact,” said Dr. David Paul, chair of pediatrics at Christiana Care Health System in Wilmington, Del.
“It’s a compelling idea and a compelling intervention,” Paul said. “But we’re going to have to wait until larger studies are undertaken to see if there’s an impact on decreasing obesity and type 2 diabetes, the things we’d want to see.”
James Sallis is a professor of family medicine and public health, and director of active living research at the University of California, San Diego. Sallis said he hopes the research will spur school officials to invest in some standing desks and observe how students respond.
“This really seems like it could be an affordable intervention that could have real benefits for children, so I’d encourage schools to at least try it out,” said Sallis.
Women May Have Better Flu Defenses
By Robert Preidt
When it comes to fending off the flu, women may have an advantage over men, new research suggests.
The study found that the female sex hormone estrogen helps keep the flu virus somewhat at bay, which may help explain why flu appears to be harder on men than women.
The findings may also lead to new flu treatments, the researchers said.
In experiments with nasal cells from women and men, the researchers found that estrogen seems to limit the ability of the flu virus to replicate.
Less replication of the virus means that an infected person has less severe symptoms and is less likely to spread the flu to others, said lead investigator Sabra Klein, of Johns Hopkins University in Baltimore.
“Other studies have shown that estrogens have antiviral properties against HIV, Ebola and hepatitis viruses. What makes our study unique is twofold,” Klein said in a news release from the American Physiological Society.
“First, we conducted our study using primary cells directly isolated from patients, allowing us to directly identify the sex-specific effect of estrogens,” she said.
“Second, this is the first study to identify the estrogen receptor responsible for the antiviral effects of estrogens, bringing us closer to understanding the mechanisms mediating this conserved antiviral effect of estrogens,” she added.
It’s possible this effect is hard to see in the general population because estrogen levels vary throughout the month in women who haven’t gone through menopause, Klein suggested.
“But, premenopausal women on certain kinds of birth control or post-menopausal women on hormone replacement may be better protected during seasonal influenza epidemics,” Klein said.
Therapeutic estrogen — used to treat infertility and menopausal symptoms — may also offer some protection against flu, she added.
The study was published online recently in the American Journal of Physiology — Lung Cellular and Molecular Physiology.
Mammograms a Personal Decision for Women in Their 40s, Panel Says
By Dennis Thompson
Women in their 40s should talk with their doctors and then decide whether they need regular mammograms to screen for breast cancer before the recommended age of 50, according to updated U.S. health guidelines released Monday.
The finalized guidelines, released by the U.S. Preventive Services Task Force (USPSTF) and published simultaneously in the Annals of Internal Medicine, largely reiterate controversial recommendations that were first put into place in 2009.
They also suggest that women in their 40s should make a decision whether or not to receive mammograms every two years after talking about their individual risk factors with their doctors.
“We want to be able to empower women with the science, so they can understand the potential benefits as well as the potential harms, and make the decision that’s right for them based on their own values, preferences and personal health history,” Dr. Kirsten Bibbins-Domingo, vice chair of the task force and a professor at the University of California, San Francisco School of Medicine, said when a draft of the updated guidelines was released last April.
That clarification could mean that insurance companies will have to start picking up the check for screening women in their 40s, even though it’s not explicitly recommended, Dr. Richard Wender, chief cancer control officer for the American Cancer Society, said when the draft was released.
The U.S. Preventive Services Task Force is an independent, volunteer panel of national experts who regularly review the scientific evidence and make recommendations regarding health screening procedures and preventive medicine.
The task force faced stiff criticism in 2009 when it first raised the recommended age for regular mammogram screenings to the age of 50. Women aged 40 to 49 were encouraged to talk with their doctor about the best time to start regular, every-other-year mammography.
In the updated recommendations, the task force is standing by its 2009 guideline, noting that while the evidence shows that some women in their 40s will benefit from mammography, most will not, and some will be harmed.
But those guidelines continue to draw critics.
“If followed, new U.S. Preventive Services Task Force breast cancer screening recommendations will result in thousands of unnecessary deaths each year and thousands more women enduring extensive and expensive treatment than if their cancer had been found early by an annual mammogram,” the American College of Radiology and the Society of Breast Imaging, said in a joint statement released Monday.
The organizations added that they “continue to recommend that women get yearly mammograms starting at age 40.”
Bibbins-Domingo has said the original 2009 guideline was “widely misinterpreted” as being against mammograms for all women in their 40s.
“The new recommendation is the same grade, a C grade, recommending in favor of screening for women in their 40s, but recognizing that on balance there are benefits that outweigh the harms, but only by a smaller amount,” she said. “So therefore, women should be aware of both benefits and harms so they can make the decision that’s right for them.”
Wender agreed that the age recommendations are essentially the same.
“What’s different is the messaging, but I wouldn’t underestimate the importance of the messaging,” he said. “The task force was really clear and careful to say the discussion about having a mammogram between a clinician and a woman should begin at 40. I hope and anticipate that will help clarify the misperception that the task force was against screening for women 40 to 49.”
The most common harm from an unnecessary mammogram is a false-positive test, indicating that there is cancer where none exists, Bibbins-Domingo said. Women who receive a false positive have to undergo additional tests and procedures, and also must endure some anxiety until cancer is ruled out.
The most serious harm, however, can occur if a mammogram reveals a type of breast cancer that would not have threatened a woman’s health during her lifetime, she added. Women who are “overdiagnosed” have to undergo surgery and cancer therapy that can significantly diminish their quality of life while adding no extra years to their life span.
Wender agreed that the evidence shows that mammography becomes more beneficial as a woman ages.
“Starting at around 35, the risk of breast cancer goes up year by year until you’re basically around 60,” he said. “So at some point after 40, the benefit of screening starts to become substantially greater than the downsides associated with screening.”
The benefits of mammography also increase with age. Regular screening can prevent about four breast cancer deaths per 10,000 women in their 40s, but eight per 10,000 for women in their 50s and 21 per 10,000 for women in their 60s, according to the task force report.
In the report, the task force also showed that the harms associated with mammography steadily decrease with age. For example, there are more than 1,200 false positives for every 10,000 women who undergo mammography in their 40s; by their 50s, the false-positive rate declines to over 900 per 10,000 women, and for women in their 60s, the rate goes even further down to just over 800 per 10,000.
The American Cancer Society updated its guidelines last October, to recommend that women could wait until the age of 45 to start receiving annual mammograms. Previously, the cancer society had recommended yearly mammograms starting at age 40.
The task force’s updated guidelines also say the expert panel was unable to make a recommendation for or against the value of 3-D mammography screening, because there is not enough evidence to show whether it will save more lives and improve women’s health.
The task force also couldn’t say, based on the evidence available, whether additional screening tools like ultrasound or MRI could help women with dense breasts screen for cancer. Dense breasts are difficult to screen with standard mammography, and women with dense breasts are at increased risk of breast cancer, Bibbins-Domingo said.
Carbs Fuel Long Runs: Study
By Robert Preidt
Carbohydrates, not fats, are the main source of energy for long distance runners, a new study says.
The research from Australia included men who were competitive half-marathoners. They ran on a treadmill at 95 percent of their best half-marathon time until they were exhausted. The men ate before they ran, and were given nicotinic acid during the run to prevent their bodies from using fat stores.
Blocking the body’s access to fat didn’t affect how long the participants could run on the treadmill before they became exhausted, the researchers found. They also noted that a lack of access to fat didn’t affect the body’s use of carbohydrates, which contributed up to 91 percent of the total energy used by the runners.
The study was published recently in the Journal of Applied Physiology.
The findings show that muscles prefer carbohydrates as their fuel source during high-intensity, long-duration runs, according to study author Jill Leckey of the Mary MacKillop Institute of Health Research at Australian Catholic University in Melbourne.
“Competitive runners should focus on dietary strategies that will increase carbohydrate availability before and during competition to optimize race performance in events lasting up to 90 minutes in duration,” Leckey said in a journal news release.
This study focused on competitive runners, but the results can also apply to recreational runners, the researchers said.
“It’s the relative exercise intensity, for instance, the percentage of an individual’s maximal oxygen uptake or maximum heart rate, that determines the proportion of carbohydrate and fat fuels used by the exercising muscles, not simply the pace they are running,” Leckey said.
Type 2 Diabetes May Raise Dementia Risk, Especially in Women: Study
By Maureen Salamon
Women with type 2 diabetes may be at risk of developing a type of dementia resulting from damaged or blocked blood vessels to the brain, a new research review suggests.
Analyzing data from nearly 2.5 million participants in 14 studies, an international team of scientists found that women with type 2 diabetes may have a nearly 20 percent higher risk of developing vascular dementia than men with diabetes. Vascular dementia is characterized by memory, thinking and language difficulties due to reduced blood flow to the brain, according to the Alzheimer’s Association.
But the risk for any form of dementia was the same for both sexes — about 60 percent higher for diabetics than for people without the disease, according to the research, published online Dec. 17 in the journal Diabetes Care.
“It’s plausible that the same mechanisms that drive the greater excess risk of heart disease and stroke in women with diabetes … are also causing the excess risk of vascular dementia,” said study author Rachel Huxley, head of the School of Public Health at Curtin University in Perth, Australia.
“We still don’t fully understand why women with diabetes are at excess risk of vascular disease and it may be related to sex hormones,” Huxley added. “It may also be that blood glucose levels in women with diabetes are much more … difficult to control than in men with diabetes.”
But, the study didn’t prove that type 2 diabetes caused either type of dementia; it merely showed an association between the two conditions.
About 44 million people worldwide are affected by dementia. According to study documents, dementia symptoms stem from two main causes: Alzheimer’s disease, which isn’t caused by blood vessel damage, or vascular dementia, which is preventable. Lifestyle risk factors for vascular dementia include type 2 diabetes, smoking and obesity.
The new review built on research spanning more than a decade, Huxley said, looking at records from 2.3 million individuals without dementia and more than 102,000 dementia patients.
While the nearly 20 percent greater risk of vascular dementia was noted among women compared to men with diabetes, the risk for nonvascular dementia (predominantly Alzheimer’s disease) associated with having diabetes was roughly the same in both genders — but still 40 percent higher than for people without diabetes.
Huxley said it’s still not clear to scientists why type 2 diabetes may increase the chances of dementia, regardless of gender.
“It’s a good question but one to which we don’t have a definitive answer,” she said. “Some studies suggest that vessel damage in the brain caused by diabetes is an important factor.”
Dr. James Ellison, the Swank Foundation endowed chair in memory care and geriatrics at Christiana Care Health System in Wilmington, Del., said it’s well-known that diabetes damages blood vessels, and that aging of the blood vessels is a major contributor to the development of vascular dementia.
“But why it should be a more serious risk for women than men isn’t readily apparent,” said Ellison, who wasn’t involved in the new study. “The message to clinicians is to consider screening aggressively for diabetes and prediabetes and to be very attentive to women who are in higher risk groups, like women with gestational diabetes.” Gestational diabetes is pregnancy-related.
Huxley said people with diabetes shouldn’t panic about dementia, noting that many healthy lifestyle measures can offset risks.
“Individuals at risk of developing diabetes and those with overt diabetes can do many things to reduce their risk of dementia, such as quitting smoking, increasing the level of physical activity, eating a healthy diet, minimizing alcohol intake and even losing a few pounds,” she said.
“The take-home message is that for many people — with and without diabetes — dementia is not inevitable,” Huxley added. “Maintaining a healthy weight, watching what you eat and keeping your brain fit and active are some of the things that may reduce future risk of dementia. There’s some truth in the adage, ‘A healthy body equals a healthy mind.'”
Another Downside to Diabetes: Tooth Loss
By Steven Reinberg
The physical toll associated with type 2 diabetes includes tooth loss, a new study finds.
The risk of vision problems and amputations for people with diabetes is well-known. Now, research shows diabetics lose twice as many teeth on average as those without the disease.
“We have more evidence that [poor] oral health is related to diabetes,” said lead researcher Bei Wu, a professor of nursing and global health at Duke University in Durham, N.C.
Gum disease is a common complication of diabetes. About half of U.S. adults have gum disease, and its prevalence is even higher among diabetics, Wu said.
“The ultimate consequence of gum disease is tooth loss,” she added.
Why diabetes is linked to tooth loss hasn’t been clear, Wu said. What is clear is that the relationship is bidirectional, the study authors explained. On the one hand, diabetes raises the odds for poor dental health, while deteriorating teeth and gums are linked to worse overall health in people with diabetes.
The American Diabetes Association recommends that doctors refer their diabetic patients to a dentist, Wu said. “In reality, very few doctors are doing that,” she added.
Diabetic patients are normally referred to eye doctors, since diabetes is a major cause of vision loss. Foot exams are also recommended, because amputation resulting from poor circulation and nerve damage is a serious complication of diabetes.
“Foot care and eye care are on the top of their agenda, but dental care is not,” Wu said. “Diabetics need to have regular dental care.” The report was published in the December issue of the journal Preventing Chronic Disease.
Dr. Edmond Hewlett, a spokesman for the American Dental Association, welcomed the findings. “This study sheds light on two important and timely health issues: the connection between dental health and overall health; and health disparities — the degree to which diseases can affect some racial/ethnic groups more severely than others.”
Regular dental visits and good home care of the teeth and gums are important for the management of diabetes, added Hewlett, who is also a professor at University of California, Los Angeles, School of Dentistry.
Rates of diabetes, which steadily increased in the United States since the 1990s, have finally showed signs of slowing. This week, the U.S. Centers for Disease Control and Prevention reported 1.4 million new cases in 2014, compared to 1.7 million in 2009. In all, more than 22 million people are living with diabetes in the United States, most with type 2.
To assess trends in tooth loss, Wu and colleagues collected data on more than 37,000 people who took part in the U.S. National Health and Nutrition Examination Survey from 1971 through 2012.
Although tooth loss declined over the 40 years of the study, it remained more common among people with diabetes, Wu said.
Using an additional analysis, the researchers found that in 1999-2000, for example, people with diabetes were 34 percent less likely to have at least 21 teeth than those without the disease.
Wu said that the racial disparity in tooth loss might be due to the difficulty blacks traditionally have had in getting access to good dental care. Earlier research has also indicated that diabetics don’t take care of their teeth as well as others, the authors said in background notes.
One previous study reported that adults with diabetes were less likely to have seen a dentist within the past 12 months than those without diabetes, Wu’s team said.
“Research has demonstrated that . . . they do not brush and floss as often as people without diabetes,” the authors wrote. “Our study findings highlight the need to improve dental self-care and knowledge of diabetes risks among people with diabetes, especially among non-Hispanic blacks, who had more tooth loss and lost teeth at a higher rate.”
Keep Holiday Meals Festive and Safe
By Rudy Dotinga
Holiday parties and home-cooked meals offer plenty of opportunities for germs to find their way into food.
The U.S. Department of Agriculture’s Food Safety and Inspection Service offers advice about keeping food safe.
At the store:
- To prevent cross-contamination, separate raw meat, poultry and seafood from other foods in the grocery cart. Ask for these foods to be placed in separate bags at the checkout counter.
- Buy cold foods at the end of your shopping trip so they won’t get too hot on the way home.
While preparing food:
- Use separate cutting boards to cut raw meat and to cut vegetables, bread and other ready-to-eat items.
- To prevent cross-contamination, prepare uncooked recipes before cooking raw meat. Once these food items are prepared, separate them from meat dishes.
- Use a meat thermometer — not just an oven thermometer — to make sure dishes are property cooked to the appropriate internal temperature.
- Cook fresh beef, pork, veal and lamb to 145 degrees Fahrenheit. Other appropriate temperatures are 145 F for fish, 160 F for egg dishes, ground beef, veal and lamb, and 165 F for poultry.
When cooking for groups:
- Use chafing dishes and slow cookers to keep hot food hot (above 140 F) and use ice trays to keep cold food cold (below 40 F).
- Put perishable food in the trash after two hours.
While cooking a roast:
- Use separate cutting boards, plates and utensils for roast to avoid cross-contamination.
- Sanitize items that have touched raw meat, like cutting boards, by washing them with warm soap and water, or placing them in the dishwasher.
- Make sure the roast has reached 145 F by using a meat thermometer. Let all cuts of beef — plus pork, veal and lamb — rest for three minutes before cutting or eating.
The Physically Active Less Prone to Post-Heart Attack Depression
By Robert Preidt
Heart attack survivors who exercised for years prior to the event have a lower risk of developing depression, according to a new study.
Researchers looked at 189 people in Norway after their first heart attack. People who were physically active for 10 years before their heart attack were 20 percent less likely to be depressed after the event than those who were inactive, the investigators found.
The study also revealed that those who had been inactive but started exercising before their heart attack were less likely to be depressed than those who had been active but stopped exercising.
The findings were published recently in the American Journal of Medicine.
“Our results add strength to the evidence of a causal link between physical activity and mental health,” study first author Linda Ernstsen, of the Center for Exercise in Medicine at the Norwegian University of Science and Technology, said in a university news release.
“In fact, we do not know if the heart attack itself is related to the prevalence of depression or if it is the change in physical activity level that is the driving force behind our findings. More research is definitely needed in this area,” she added.
The findings reinforce the link between physical activity and depression, and highlight the need for people with or at risk for heart disease and/or depression to boost their physical activity levels, the researchers said.
Low-Fat Diets No Better Than Other Plans: Study
By Kathleen Doheny
Low-fat diets are often promoted as a superior way to lose weight, but they’re no more effective than other types of diets, a new review indicates.
“We found that low-fat diets were not more effective than higher-fat diets for long-term weight loss,” said study leader Deirdre Tobias, an associate epidemiologist at Harvard Medical School and Brigham and Women’s Hospital in Boston.
The key to success seems to have more to do with adherence than a specific weight-loss plan, Tobias said. “Being able to stick to a diet in the long term will probably predict whether or not a diet is successful for weight loss,” she said.
The new analysis was published online Oct. 30 in The Lancet Diabetes & Endocrinology journal. The research was supported by the American Diabetes Association and the U.S. National Institutes of Health.
In conducting their analysis, Tobias and her colleagues looked at 53 published studies involving more than 68,000 adults. Those on low-fat diets did lose weight. But, those on low-carbohydrate diets were slightly more than 2 pounds lighter than those on low-fat diets after a follow-up of at least one year. The average weight loss across all groups was 6 pounds, the researchers said.
The take-home message, Tobias said, is not to eat fatty foods with abandon. Rather, there are a variety of weight-loss plans and “there isn’t one that floats to the surface as the optimal diet for weight loss.”
She advised that anyone wanting to lose weight find a sound weight-loss program that fits their preferences and cultural needs.
The low-fat diets in the studies ranged from very low-fat, 10 percent or less of calories from fat, to more moderate plans that allowed 30 percent or less of calories from fat.
Connie Diekman is director of university nutrition at Washington University in St. Louis. She said, “The result of this study on diet composition and weight loss seems to support results that have been observed in other studies.
“The conclusion from this, and similar studies, is that weight loss is not a result of limiting one calorie nutrient over another, and that achieving weight loss is likely a matter of calorie control, in a manner that works for the individual,” she added.
Diekman said the study did have several limitations. Among them: many of the studies included in the review had “high levels of subjects drop out, making it difficult to know if the diet itself made adherence challenging.”
For successful weight loss, Diekman advises talking with a registered dietitian “who can design an eating plan for weight loss that meets your lifestyle.”
Add physical activity to your daily routine, she added, and think about weight loss as part of your long-term health goals, and not just a quick fix.
Feeling Extra Forgetful May Signal Dementia Ahead
By Tara Haelle
For some older women, feeling unusually forgetful may be a sign that dementia will develop later on, a new study suggests.
“We studied older women who noticed themselves having memory problems but who still performed normally on a standard test,” said Allison Kaup, an assistant professor of psychiatry at the University of California, San Francisco School of Medicine. “These findings raise the possibility that memory complaints in older adults may be a very early symptom of a memory disorder that is just starting to gradually develop.”
But Kaup stressed that common memory problems, such as forgetting names, do not indicate that a person will definitely develop dementia.
For the study, published online Oct. 28 in the journal Neurology, researchers tracked more than 1,100 women 65 and older who had normal brain function when the study began. Over the next 18 years, at four different times, the women answered the question, “Do you feel you have more problems with memory than most?”
“This simple question likely did not capture all the complexity that may be important in understanding an older individual’s concerns about their thinking skills,” Kaup said. “How to best measure subjective memory complaints is an important question that is still being researched.”
As the study ended, the women took several tests to determine whether they had dementia or what’s called mild cognitive impairment, the middle step between normal aging and dementia.
At the start of the study, 8 percent of the women answered yes to the question concerning memory problems. These women were almost twice as likely to have mild mental impairment or dementia 18 years later, even after investigators excluded those women with depression, the study found.
Among those who answered no at the start of the study, 38 percent developed mental impairment by the end of the study, compared with 53 percent who had answered yes, Kaup said.
Furthermore, women who answered yes to the question later on in the study also were found to have a higher risk of dementia, the findings showed.
The researchers found mental impairment in 65 percent of the women who said they were having memory problems four years before the end of the study. Among those who did not report memory difficulties four years before the study ended, only 34 percent developed cognitive (“thinking”) impairment, Kaup said.
The study findings suggest that women’s memory disorders could be identified sooner, said Dr. Luca Giliberto, an attending neurologist at Cushing Neuroscience Institute in Manhasset, N.Y.
“This could lead to further screening of these patients in order to figure out what type of cognitive impairment they bear,” said Giliberto, who was not involved in the study. “We are not necessarily talking about Alzheimer’s disease only.”
Some past studies have found similar results with men, Kaup said, but there is also some evidence that dementia may differ between men and women.
Other studies have also found similar correlations among different ethnic groups, Giliberto said, but the follow-up period for studies with men and various ethnic groups were usually much shorter.
“I cannot think of a specific reason why men should behave differently than women in this aspect, once all the other confounders are accounted for,” Giliberto said. “Only a similar study in men can answer the question.”
But the study’s results do not mean a woman is destined to develop dementia if she frequently forgets names or why she walked into the other room, Kaup said.
“It is important to remember that not all women who had memory complaints in our study went on to be diagnosed with memory or thinking impairment,” Kaup said. Almost half did not. “There may be a variety of reasons for someone to have memory complaints that do not necessarily lead to the development of a memory disorder like Alzheimer’s disease.”
Anxiety about losing one’s memory might even contribute to forgetfulness, suggested Giliberto.
“There are many reasons, in today’s busy and unforgiving times, why someone should have the feeling of not performing as well as their peers,” Giliberto said. “Over-worrying is certainly one of them. The message here is not to start worrying but just to be more vigilant.”
Loading Up on Fruit, Veggies in Early Adulthood Pays Off Later
By Robert Preidt
Young adults who eat more than five servings of fruits and vegetables a day have healthier hearts when they’re older, a new study finds.
Researchers divided more than 2,500 young adults into three groups based on how many fruits and vegetables they ate.
Twenty years later, CT scans showed that those who ate the most fruits and vegetables as young adults were 26 percent less likely to have calcified plaque in their arteries than those who ate the least. This plaque is associated with hardening of the arteries, which increases the risk of heart disease.
“People shouldn’t assume that they can wait until they’re older to eat healthy — our study suggests that what you eat as a young adult may be as important as what you eat as an older adult,” said study author Dr. Michael Miedema, senior consulting cardiologist and clinical investigator at the Minneapolis Heart Institute.
Women in the top third consumed an average of nearly nine servings of fruits and vegetables a day, while men in this group ate more than seven servings.
Among those in the bottom third, women averaged about three servings a day and men averaged about two-and-a-half servings.
The study was published Oct. 26 in the journal Circulation.
Previous research has found a strong link between higher consumptions of fruits and vegetables and lower heart disease risk among middle-age adults. However, this study is the first to show that eating more fruits and vegetables as a young adult can help protect the heart many years later, the researchers said.
Although the study doesn’t prove that greater fruit-and-vegetable intake alone led to the healthier arteries, the results appear promising, they added.
“Our findings support public health initiatives aimed at increasing fruit and vegetable intake as part of a healthy dietary pattern,” Miedema said in a journal news release. “Further research is needed to determine what other foods impact cardiovascular health in young adults.”
Men’s, Women’s Hearts Age Differently
By Robert Preidt
The heart ages differently for women and men. And this suggests a possible need for gender-specific treatments, according to a study published Oct. 20 in the journal Radiology.
“The shape of the heart changes over time in both men and women, but the patterns of change are different. Men’s hearts tend to get heavier and the amount of blood they hold is less, while women’s hearts don’t get heavier,” study author Dr. John Eng, from Johns Hopkins University School of Medicine in Baltimore, said in a journal news release.
Researchers used MRIs to examine the hearts of nearly 3,000 people without heart disease in the United States. The participants underwent another MRI about 10 years later, when they were aged 54 to 94 years.
Both women and men had decreases in the volume of their left ventricle, the chamber of the heart that pumps blood throughout the body. However, the mass of the left ventricle increased in men and decreased slightly in women.
Increased mass can occur when the ventricle walls thicken from having to work harder to pump blood due to high blood pressure or other conditions, the researchers explained.
Further research is needed to learn more about these gender differences, but the findings suggest that varying treatment approaches may be needed for men and women with heart disease.
“We’ve been talking a lot lately about personalized medicine, and here’s an example where perhaps men and women might have to be treated differently,” Eng said.
The researchers also found that increased left ventricular mass was associated with higher blood pressure and body mass index (BMI), an estimate of body fat based on weight and height.
No Amount of Alcohol Safe During Pregnancy, Doctors Say
By Randy Dotinga
While some studies have hinted that a little alcohol might be harmless during pregnancy, a leading U.S. pediatricians’ group has issued a new warning that no amount of drinking is safe while pregnant.
“The only guarantee of having no effects from alcohol is no prenatal alcohol exposure,” said Dr. Janet Williams, a professor of pediatrics at the University of Texas Health Science Center and co-author of the new statement and report from the American Academy of Pediatrics (AAP).
It’s likely, she added, that future research will continue to show that “alcohol has subtle yet important lasting effects on academic performance, attention, behavior, cognition, memory, language skills, and visual and motor development.”
Physicians and researchers have been warning about the hazards of alcohol use during pregnancy for decades. Yet almost half of all women of childbearing age in the United States reported consuming alcohol within the past month, the researchers said, and nearly 8 percent of women continue to consume alcohol during pregnancy.
The AAP published its new statement in part to update health workers and the public, Williams said.
According to the new report, published online Oct. 19 in the journal Pediatrics, alcohol use during pregnancy can cause thinking and behavioral problems that last a lifetime. “No amount of alcohol intake should be considered safe,” the report stated, and “there is no safe trimester to drink alcohol.”
The report said that all forms of alcohol — beer, wine and liquor — pose similar risks. Getting quickly drunk, known as binge drinking, poses a higher risk in line with the extra amount of alcohol consumed, the report noted. According to Williams, binge drinking in women is defined as four or more standard drinks, typically within two hours.
Some studies published over the last few years have hinted that a small number of drinks during pregnancy could be safe. For example, research published in 2010 in the Journal of Epidemiology and Community Health found no extra behavioral or thinking risks from having one or two drinks a week.
However, “studies do not conclude that alcohol use is safe,” Williams said. Instead, they only show “that in certain study populations under certain conditions, there is or is not sufficient evidence of effect that can be attributable to alcohol exposure.”
Indeed, according to Janni Niclasen, an assistant professor of psychology at the University of Copenhagen who has studied alcohol and pregnancy, “With our current research methods, we will never be able to conclude from human studies whether there is a safe lower level below which drinking is not associated with any harm to the developing fetus.”
Of course, many women inadvertently drink alcohol without realizing that they’re pregnant. And alcohol often plays a role in sexual encounters aimed at producing a baby, including those that may occur when a woman doesn’t know she’s pregnant. So, should women of childbearing age always avoid alcohol?
Williams isn’t willing to go that far, and would only say that alcohol and pregnancy don’t go together. She added that some women, despite the findings of research, “continue to rationalize that their own alcohol use during pregnancy is sufficiently low or infrequent to be safe.”
Niclasen, the Denmark researcher, said women who are pregnant or trying to become pregnant should avoid all alcohol. “I am often called a moralist for having this perspective, but I think we need to focus on the development and future life of the unborn children,” she said.
Christina Chambers, a professor of pediatrics at the Center for Better Beginnings at the University of California, San Diego, offers this advice: “Women of childbearing age who drink alcohol should consider their pattern of drinking. For example, avoid binge drinking and avoid pregnancy as long as they are drinking. If pregnancy is planned, then alcohol can be discontinued.”
There may be no risk “if a woman has consumed small amounts of alcohol prior to knowing she is pregnant,” she said, but “the best advice is to avoid pregnancy if drinking and to avoid drinking if pregnant.”
According to both Williams and Chambers, alcohol use poses risks in all stages of pregnancy, and neither would say the risk is higher in certain stages.
Overall, Chambers said, the AAP’s statement “is an important stand to take, and hopefully it will lead to less stigma associated with [fetal alcohol spectrum disorders] and to more access to and uptake of prevention and treatment services.”
Fish Oils Relieve Depression In College Students
By Michael T. Murray, ND
What if in the treatment of depression, physicians quit relying on manipulating brain chemistry with drugs and focused instead on supporting brain chemistry? Based upon the results of a new study with fish oil supplementation conducted at the University of Pittsburgh, it seems that fewer college students would be depressed or need to be on antidepressant drugs.
Depression is a big issue in college students. According to recent surveys, 30 percent of undergraduate students have felt so depressed that it hindered their ability to function and 6 percent seriously consider suicide in the preceding 12 months. Given the relative ineffectiveness and possible adverse reactions to prescription antidepressant drugs, it is important to help these young adults with proper nutrition and supplementation. After all, you don’t become depressed because you are lacking Prozac or other antidepressant, but if you are lacking in something as essential as the long-chain fatty acids from fish oils, it could be a major cause of depression.
Fish oil supplements concentrated for the long-chain omega-3 fatty acids EPA and DHA that are free from lipid peroxides, heavy metals, environmental contaminants, and other harmful compounds have revolutionized nutritional medicine. A huge body of scientific evidence now shows that fish oil supplementation can prevent or benefit over 60 different health conditions, including depression and other brain-related disorder.
Studies have also reported that countries with high rates of fish oil consumption have low rates of depressive disorders.
The importance of omega-3 fatty acids to brain function relates to their role in the phospholipid composition of nerve cell membranes. Studies have shown that EPA and DHA influence:
- The fluidity of brain cell membranes.
- Neurotransmitter synthesis.
- Neurotransmitter binding.
- Signal transmission.
- The activity of key enzymes that break down neurotransmitters like serotonin, epinephrine, dopamine, and norepinephrine.
Fish oils concentrated for EPA and DHA have been shown to have positive effects for patients with depression and bipolar disorder (manic depression) when given at recommended dosage levels (e.g., 1,000 to 3,000 mg EPA+DHA), but these studies have primarily focused on older adults and typically have been in patients also taking a prescription antidepressant drug.
To evaluate the effects of fish oil supplementation in younger adults with depression, a double-blind study was conducted in 23 subjects (78 percent female) with an average age of 20 years. These subjects had significant depression as evident by a score of greater than 10 on a standard diagnostic questionnaire (Beck Depression Inventory [BDI]) and were NOT taking an antidepressant drug. The subjects were randomly assigned to a placebo (corn oil) or fish oil group (1.4 g EPA+DHA) of eicosapentaenoic and docosahexaenoic acids). The BDI was completed prior to supplementation and again at day 21.
Results demonstrated that there was a significant difference in depression status between groups. In those taking fish oils, 67 percent of the subjects no longer met criteria for being depressed, while only 20 percent in the placebo group were no longer depressed.
These results are quite significant and show that low dosage fish oil supplementation can produce very quick results in boosting mood. Despite the impressive results, my dosage recommendations for fish oils when being used for therapeutic purposes is 3,000 mg EPA+DHA. That dosage level would have produced even better results based upon previous studies in older subjects.
In addition, over the past few years I have featured several newsletters highlighting studies that reflect nutritional approaches for improving mood, brain health, memory, and/or the prevention of age-related mental decline. Here are the key areas of focus: reduce inflammation, control blood sugar levels, provide necessary building blocks with super nutrition, and protect the brain from damage by consuming antioxidants from the diet and through supplementation.
In regards to diet, the Mediterranean or New Nordic Diet look to be very helpful. In regards to supplementation, in addition to fish oils, there are three other primary recommendations:
#1. Take a high quality multiple vitamin and mineral supplement providing at least the recommended dietary intake for all vitamins and minerals.
#2. Take enough vitamin D3 (typically 2,000 to 5,000 IU daily) to elevate your blood levels to the optimal range (50 to 80 ng/ml).
#3. Take extra plant-based antioxidants such as flavonoid-rich extracts like grape seed or pine bark extract; curcumin (Theracurmin); a greens drink product; or resveratrol.
Dr. Michael T. Murray is one of the world’s leading authorities on natural medicine and the author of more than 30 bestselling books, including The Encyclopedia of Natural Medicine. He is a graduate and former faculty member, and serves on the Board of Regents, of Bastyr University in Seattle, Washington.
Move More to Prevent Heart Failure
By Robert Preidt
When it comes to preventing heart failure, the more exercise, the better.
How much more? A new study suggests maybe as much as two to four times the U.S. minimum recommended levels of 150 minutes of moderate physical activity a week.
The researchers reviewed 12 studies from the United States and Europe that included more than 370,000 people who were followed for an average of 15 years.
People who did two to four times more exercise than the U.S. minimum activity recommendations lowered their risk of heart failure by 20 percent and 35 percent, respectively, the researchers found.
The U.S. recommended minimum levels of exercise were associated with only a slight decrease in heart failure risk, the researchers found. The study was published Oct. 5 in the journal Circulation.
“Walking 30 minutes a day as recommended in the U.S. physical activity guidelines may not be good enough — significantly more physical activity may be necessary to reduce the risk of heart failure,” said senior study author Dr. Jarett Berry. He is an associate professor of internal medicine and clinical sciences at the University of Texas Southwestern Medical School in Dallas.
Overall, the more people exercised, the lower their risk of heart failure.
“Future physical activity guidelines should take these findings into consideration, and potentially provide stronger recommendations regarding the value of higher amounts of physical activity for the prevention of heart failure,” study lead author Dr. Ambarish Pandey, a cardiology fellow at University of Texas Southwestern Medical School, said in a journal news release.
Berry added: “If you look at the general population, we’ve had tremendous success in reducing coronary heart disease over the last 30 years. But heart failure rates have not declined enough. The findings from the present study suggest that higher levels of physical activity may help combat this growing burden of heart failure.”
In heart failure, the heart cannot supply adequate amounts of blood to the rest of body, resulting in shortness of breath and reduced ability to exercise, the researchers explained.