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Mediterranean diet could help protect against premature mortality in older population
August 31 2018. A study reported on August 31, 2018 in the British Journal of Nutrition revealed a lower risk of dying during an 8-year period among older men and women who consumed a Mediterranean-style diet.
The study included data from individuals over the age of 65 years who were enrolled in the Moli-sani Study (which involved residents of Italy’s Molise region) plus additional same-aged subjects from 6 other epidemiologic studies, resulting in a total of 12,000 subjects. Marialaura Bonaccio and colleagues at the Department of Epidemiology and Prevention of theInstitute for Research, Hospitalization and Health Care (I.R.C.C.S.) Neuromed, in Pozzilli, Italy, and her colleagues found a lower risk of death from any cause over an 8-year follow-up period among subjects who had greater adherence to a Mediterranean diet in comparison with those whose adherence was low.
"The novelty of our research is to have focused our attention on a population over 65 years old,” explained Dr Bonaccio. “We already knew that the Mediterranean diet is able to reduce the risk of mortality in the general population, but we did not know whether it would be the same specifically for elderly people. Now data from Moli-sani Study clearly show that a traditional Mediterranean-like diet, (rich in fruit, vegetables, fish, pulses, olive oil and cereals, low in meat and dairy products, with moderate wine consumption during meals), is associated with 25% reduction of all-cause mortality.”
“Through the technique of meta-analysis, we could confirm that a higher adherence to the Mediterranean diet lowers overall mortality risk in a dose-response, progressive, way,” added Licia Iacoviello of the Laboratory of Molecular and Nutritional Epidemiology at Neuromed. “In other words, the more you follow the Mediterranean diet, the greater the gain in terms of mortality risk reduction.”
“Because I’m happy . . .”
August 29 2018. If you ask certain older people why they managed to live so long, they just might echo the refrain of a popular Pharrell Williams song and tell you it’s because they’re happy, according to a report appearing on August 27, 2018 in the British Geriatrics Society journal Age and Ageing.
The current study included 4,478 Singapore residents aged 60 and older who enrolled in a longitudinal survey during 2009. Subjects were questioned upon enrollment concerning how often in the previous week they felt happy, enjoyed life, and were hopeful concerning the future. Responses to these questions were used to generate a happiness score and a binary happiness variable that characterized the subjects as happy or unhappy. Subjects were followed until the end of 2015.
During the follow-up period, 20% of subjects judged as unhappy died, compared to 15% of the happy people. Each 1-point increase on the 0-6-point happiness score was associated with a 9% reduction in the risk of mortality from any cause. The results were consistent among both men and women and among those categorized as young-old and old-old (defined as aged 75 years or older).
"The findings indicate that even small increments in happiness may be beneficial to older people's longevity," commented senior author Rahul Malhotra, who is the head of research at Duke-NUS' Centre for Ageing Research and Education in Singapore. "Therefore individual-level activities as well as government policies and programs that maintain or improve happiness or psychological well-being may contribute to a longer life among older people."
"The consistency of the inverse association of happiness with mortality across age groups and gender is insightful - men and women, the young-old and the old-old, all are likely to benefit from an increase in happiness,” coauthor June May-Ling Lee concluded.
Omega-3 fatty acid supplementation could help with cognitive depression
August 27 2018. An article appearing on August 8, 2018 in the Journal of the American College of Cardiology: Heart Failure reported the outcome of a pilot study that found an association between supplementation with the omega-3 fatty acids EPA and DHA and reduced cognitive depression in heart failure patients. Cognitive depression is characterized by subjective symptoms such as pessimism and sadness, while somatic depression includes physical manifestations that include fatigue and sleep disturbances.
The study included 108 patients with a major depressive disorder, chronic heart failure and low blood levels of omega-3 fatty acids. Participants received fish oil containing EPA and DHA, a high EPA supplement or a placebo daily for 12 weeks. Blood samples collected before and after treatment were evaluated for red blood cell EPA and DHA, the Omega-3 Index and other factors.
Omega-3 values increased in both the EPA/DHA and EPA only groups, while the placebo group showed little change. Higher omega-3 Index values were associated with lower cognitive depression scores. Social functioning as evaluated by a general health survey significantly improved with EPA/DHA supplementation and showed a tendency toward improvement in the high EPA group.
"This was a study in already depressed individuals, which meant the researchers are looking to high-dose (although it could have been higher) omega-3 supplements to improve depressive symptoms, like a drug," noted coauthor William S. Harris, PhD. "Generally, we think of the function of omega-3s as preventative rather than as treatment. If used as treatment, the dose must be fairly high (4 grams is a typical 'drug' dose) and blood levels must be measured.”
“In their larger follow-up study, I would recommend they choose just one of the supplements (probably the pure EPA product) and increase the dose and duration of the study," he added.
Deficient vitamin D levels predict premature mortality in chronic heart failure patients
August 24 2018. Vitamin D deficiency could increase the risk of dying prematurely among people with chronic heart failure caused by left ventricular systolic dysfunction, according to a study reported on August 18, 2018 in the European Journal of Nutrition.
The current investigation included 1,802 men and women with left ventricular systolic dysfunction who attended a heart failure clinic in England. Participants underwent electrocardiographic evaluations and measurement of serum 25-hydroxyvitamin D levels at the beginning of the study.
Seventy-three percent of the participants had deficient vitamin D levels of less than 20 nanograms per milliliter (ng/mL). Deficiency was more common among men and subjects with diabetes, lower serum sodium levels, higher heart rates, and a greater need for diuretic drugs.
During a 4-year average follow-up period, participants who were not deficient in vitamin D had a 19% lower risk of mortality from any cause than deficient subjects. Each 2.72-fold increase in serum 25-hydroxyvitamin D was associated with a 14% reduction in the risk of mortality during follow-up.
In their discussion of the findings, the authors observe that vitamin D-parathyroid axis abnormalities directly affect many cells, include those of the heart muscle. Vitamin D deficiency and elevated parathyroid hormone levels can result in calcium loading with heart muscle cell and skeletal muscle contractile dysfunction, cellular hypertrophy, oxidative stress, immune activation and endothelial dysfunction.
“Based upon these data and our previous work demonstrating improvements in cardiac function, it is possible that vitamin D3 supplementation could improve outcomes in patients with heart failure due to left ventricular systolic dysfunction,” Richard M. Cubbon of the University of Leeds and colleagues conclude.
Higher vitamin D levels associated with lower risks of liver cancer and death from chronic liver disease
August 22 2018. A study reported on August 16, 2018 in the journal Cancer Epidemiology, Biomarkers & Prevention found an association between higher circulating 25-hydroxyvitamin D [25(OH)D] levels and lower risks of liver cancer and mortality from chronic liver disease. According to authors Gabriel Y. Lai of the Division of Cancer Control and Population Sciences at the National Cancer Institute and colleagues, a link between decreased vitamin D levels and chronic liver disease and liver cancer has been observed in laboratory investigations, yet there have been few epidemiologic studies that have evaluated the associations.
The study included 854 Finnish male smokers enrolled in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study whose vitamin D levels were measured in blood serum samples collected upon enrollment. Two hundred-two patients were diagnosed with liver cancer and 225 subjects died from liver disease during a follow-up period approaching 25 years. Four hundred twenty-seven subjects without liver disease or liver cancer served as controls.
Among subjects with deficient serum 25(OH)D concentrations of less than 10 nanograms per milliliter (ng/mL) there was a 91% higher adjusted risk of liver cancer and a 67% greater risk of dying from chronic liver disease compared to those whose levels were greater than 20 ng/mL. Similar associations were observed after excluding subjects with diabetes, hepatitis B or hepatitis C.
“Our results suggest a possible preventive role for vitamin D against liver cancer and chronic liver disease,,” Dr Lai and colleagues conclude. “Future studies are needed to evaluate associations of vitamin D with liver cancer and liver disease in other populations, particularly those with a different constellation of risk factors.”
NAD+ restoration could boost repair of acute kidney injury
August 20 2018. An article that appeared on August 20, 2018 in Nature Medicine reported the findings of a team led by Samir M. Parikh, MD, of a potential benefit for vitamin B3 in acute kidney injury. Vitamin B3 is a precursor of nicotinamide adenine dinucleotide (NAD+), a form of vitamin B3 produced in the body which is found in every human cell.
Up to 10% of hospitalized adults in the U.S. experience acute kidney injury, which leads to a build-up of blood waste products and, in some cases, death. By studying acute kidney injury in mice, Dr Parikh and colleagues found that the animals’ urine contained high levels of quinolinate, which is an intermediate in the pathway for producing NAD+. The finding suggested blockage of the pathway at the enzyme QPRT that converts quinolinate to NAD+, which could help explain NAD+ depletion observed during acute kidney injury. By genetically modifying mice to express lower levels of QPRT without kidney injury, the team observed decreased levels of NAD+, higher urinary quinolinate levels and greater kidney injury susceptibility.
Higher urinary quinolinate levels were detected in humans who underwent major surgery or were hospitalized in an intensive care unit. The team subsequently evaluated the effects of orally administered vitamin B3 in a Phase 1 pilot study involving 41 cardiac surgery patients.
"We were able to detect a drop in NAD+ in the urine of high-risk patients who were either in an intensive care unit or undergoing a major surgery and found that oral vitamin B3 could safely elevate NAD+ in high-risk patients," Dr Parikh reported. "These findings are very early, but the results suggest that we could one day have a noninvasive test for NAD+ status and perhaps even treat acute kidney injury by boosting NAD+ levels."
Men’s greater oxidative stress burden could result in lower nitric oxide levels
August 17 2018. The August 31, 2018 issue of Bioscience Reports revealed the findings of Dr Jennifer C. Sullivan and colleagues of a negative impact of higher oxidative stress levels on the ability to produce nitric oxide in male rats. Higher nitric oxide levels help lower blood pressure by relaxing the blood vessels and increasing the kidneys' excretion of sodium. The research could help explain why men, who have greater oxidative stress levels, tend to have higher blood pressure than premenopausal females.
Acting on previous findings of greater nitric oxide bioavailability in female rats in comparison with males, Dr Sullivan and her associates hypothesized that an oxidative stress-induced deficiency of tetrahydrobiopterin (BH4, a cofactor required for nitric oxide generation) results in lower kidney levels of the enzyme nitric oxide synthase (NOS, an enzyme that catalyzes the production of nitric oxide). "BH4 has to be there," Dr Sullivan noted. "We found that oxidative stress makes a big difference in BH4 levels."
Using male and female spontaneously hypertensive rats, the team measured BH4 levels in the innermost part of the kidney. "We found BH4 levels were higher in the hypertensive females than the hypertensive males," reported Dr Sullivan, of the Department of Physiology at the Medical College of Georgia at Augusta University. "If we don't understand why females have more nitric oxide, we can't do things to potentiate our ability to make it.
Administration of the synthetic antioxidant tempol to male and female rats for 2 weeks lowered levels of the damaging oxidant compound peroxynitrite only in males. Tempol eliminated gender differences in BH4 and nitric oxide synthase in the kidney medulla. “Targeting BH4 may serve as a novel therapeutic pathway for the treatment of hypertension in both sexes,” the authors conclude.
Broccoli compound may help maintain colon health
August 15 2018. An article appearing on August 14, 2018 in the journal Immunity suggests a role for broccoli and other vegetables belonging to the Brassica genus in helping to maintain intestinal health and prevent colon cancer.
When these vegetables are consumed, a compound known as indole-3-carbinol (I3C) is formed, which activates the aryl hydrocarbon receptor (AhR) protein that carries signals to immune cells and epithelial cells. Researchers Amina Metidji of the Francis Crick Institute and colleagues determined that this protein is important for repairing damage to the epithelial cells that line the intestinal tract.
"We studied genetically modified mice that cannot produce or activate AhR in their guts and found that they readily developed gut inflammation which progressed to colon cancer," Dr Metidji explained. "However, when we fed them a diet enriched with I3C, they did not develop inflammation or cancer. Interestingly, when mice whose cancer was already developing were switched to the I3C-enriched diet, they ended up with significantly fewer tumors which were also more benign."
"Seeing the profound effect of diet on gut inflammation and colon cancer was very striking," commented senior author Gitta Stockinger. "We often think of colon cancer as a disease promoted by a Western diet rich in fat and poor in vegetable content, and our results suggest a mechanism behind this observation. Many vegetables produce chemicals that keep AhR stimulated in the gut. We found that AhR-promoting chemicals in the diet can correct defects caused by insufficient AhR stimulation. This can restore epithelial cell differentiation, offering resistance to intestinal infections and preventing colon cancer.”
“Now that we've demonstrated the mechanistic basis for this in mice, we're going to investigate these effects in human cells and people,” Dr Gitta added. “In the meantime, there's certainly no harm in eating more vegetables!"
Greater dietary antioxidant capacity linked with improvement in menopausal symptoms
August 13 2018. The November-December 2018 issue of Nutrition reported the results of a study that found a reduction in menopausal symptoms among women with higher dietary total antioxidant capacity.
“To our knowledge, there is no previous report that investigated the association between dietary total antioxidant capacity and menopausal symptoms,” authors Maryam Abshirini, MSc, of Tehran University of Medical Sciences and colleagues announce.
The study included 400 middle-aged women who had been menopausal for at least a year and had not used hormone replacement therapy during the six months prior to the beginning of the study. Dietary antioxidant capacity was calculated from food frequency questionnaire responses. Menopause Rating Scale questionnaires provided information concerning hot flashes, sleep problems, muscle and joint problems, depression, irritability, anxiety, exhaustion, poor concentration and more.
Higher dietary total antioxidant capacity was associated with a decrease in total menopause symptoms, bodily symptoms and psychologic symptoms compared to low antioxidant capacity. When specific symptoms were analyzed, higher dietary total antioxidant capacity was associated with a reduction in hot flashes and sweating, sleep problems, anxiety, exhaustion and poor concentration.
The authors note that the main contributors to the diet’s antioxidant capacity were tea, fruit, vegetables and juices, which are sources of vitamins as well as phytochemicals with antioxidant properties. Antioxidant-rich diets are also sources of plant-derived estrogens that could bind to the estrogen receptor to reduce hot flash severity and frequency. Antioxidants also have the ability to modulate inflammation, which has been associated with hot flashes.
“Dietary total antioxidant capacity is inversely associated with menopausal symptoms, which could be of particular significance for somatic and psychological symptoms,” the authors conclude. “These findings indicate that dietary total antioxidant capacity could be an important basis for developing an effective dietary measure for reducing menopausal symptoms.”
How young do you feel?
August 10 2018. Research reported on August 9 at the 2018 convention of the American Psychological Association suggests that subjective age—how old we feel at a given time—could be shaped by the level of control we believe to have over our own lives.
"Research suggests that a younger subjective age, or when people feel younger than their chronological age, is associated with a variety of positive outcomes in older individuals, including better memory performance, health and longevity," stated presenter Jennifer Bellingtier, PhD, of Friedrich Schiller University in Germany. "Our research suggests that subjective age changes on a daily basis and older adults feel significantly younger on days when they have a greater sense of control."
The study included 116 participants between the ages 60 to 90 years and 106 participants aged 18 to 36. Surveys completed daily for nine days queried the subjects concerning the level of control they believed they had over the activities they participated in each day and how old they felt.
Dr Bellingtier, along with colleague Shevaun Neupert, PhD, of North Carolina State University, observed an association between subjective age and level of control perceived by older, but not younger participants.
"Shaping the daily environment in ways that allow older adults to exercise more control could be a helpful strategy for maintaining a youthful spirit and overall well-being," Dr Bellingtier commented. "For example, some interventions could be formal, such as a regular meeting with a therapist to discuss ways to take control in situations where individuals can directly influence events, and how to respond to situations that they cannot control. Smartphone apps could be developed to deliver daily messages with suggestions for ways to enhance control that day and improve a person's overall feeling of control."
"Rotten egg" gas may not be so rotten when it comes to cellular aging
August 8 2018. The July 19, 2018 issue of the journal Aging published the finding of researchers at the University of Exeter of an ability of three compounds to reduce senescence in human endothelial (blood vessel) cells in a laboratory study. The compounds (designated AP39, AP123 and RT01) selectively deliver small amounts of hydrogen sulfide (a potentially hazardous gas characterized by the smell of rotten eggs), to the cells' mitochondria, where it helps reduce senescence in old and damaged cells. "As human bodies age, they accumulate old (senescent) cells that do not function as well as younger cells," explained coauthor Lorna Harries, of the University of Exeter Medical School. "This is not just an effect of ageing - it's a reason why we age."
Administration of the compounds to cultured endothelial cells resulted in as much as a 50% decline in senescent cell load. The researchers determined that the expression of cellular components known as splicing factors SRSF2 and HNRNPD can be targeted by hydrogen sulfide. "Our data suggest that SRSF2 and HNRNPD may be implicated in endothelial cell senescence, and can be targeted by exogenous hydrogen sulfide," they conclude.
"Nearly half of the aged cells we tested showed signs of rejuvenating into young cell models," Dr Harries reported. "The compounds developed at Exeter have the potential to tweak the mechanisms by which this aging of cells happens."
"Our compounds provide mitochondria in cells with an alternative fuel to help them function properly," added coauthor Matt Whiteman. "Many disease states can essentially be viewed as accelerated aging, and keeping mitochondria healthy helps either prevent or, in many cases using animal models, reverse this. Our current study shows that splicing factors play a key role in determining how our compounds work."
When it comes to primary prevention, aspirin may not be "one dose fits all"
August 6 2018. The benefit of daily aspirin for people who have experienced a cardiovascular event such as heart attack are well established, yet the use of aspirin as a preventive among those who have never experienced such an event has met with only modest success and is not currently recommended for most individuals. However, in the August 4, 2018 issue of The Lancet, Peter M. Rothwell, MD, PhD, and colleagues report the findings of an analysis which revealed that the ability of aspirin to reduce cardiovascular events could be dependent upon a person's weight.
The analysis included data from 9 randomized, controlled trials that evaluated the effect of aspirin in primary prevention among a total of 102,621 participants. Seven of the trials investigated the effects of low dose (75-100 mg) aspirin and 2 investigated the effects of higher doses.
A pooled analysis of participants in low-dose aspirin trials found that the risk of experiencing a cardiovascular event among those who weighed less than 154 pounds was 25% lower for those who received aspirin compared to the control subjects. Low-dose aspirin did not benefit participants weighing 154 pounds or more. Higher dose aspirin was associated with a reduction in events only among participants who were at a higher weight.
The researchers suggest that primary prevention of cardiovascular events might be improved through the use of an optimal schedule of 75–100 mg aspirin for people weighing 110 to 154 pounds, 300–325 mg for those weighing 154 to 198 pounds, and 500 mg for those weighing at least 198 pounds.
"The substantial reductions in cardiovascular events and death at optimal doses for weight highlight the potential to improve effectiveness and argue for a more tailored dosing strategy," the authors conclude.
Higher omega-3 levels may protect against early preterm birth
August 3 2018. A study reported on August 3, 2018 in EBioMedicine revealed a higher risk of preterm birth among pregnant women who had low plasma levels of long chain omega-3 fatty acids during their first and second trimesters in comparison to women with higher levels.
The current study included data from women enrolled in the Danish National Birth Cohort. Blood samples from 348 women who had a full-term pregnancy and 376 women who gave birth prior to 34 weeks of gestation were analyzed for plasma levels of the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) during their first and second trimesters. Women whose levels of EPA plus DHA were among the lowest 20% of subjects (at 1.6% or less of total plasma fatty acids) had 10 times the risk of early preterm birth compared to those whose EPA and DHA levels were higher.
"At a time when many pregnant women are hearing messages encouraging them to avoid intake of fish altogether due to mercury content, our results support the importance of ensuring adequate intake of long chain omega-3 fatty acids in pregnancy,” commented lead author Sjurdur F. Olsen, who is an adjunct professor of Nutrition at Harvard T. H. Chan School of Public Health.
"An effect of this magnitude is rare, but the precision of the estimate is tight, which supports the reliability these findings,” added coauthor Jeremy Furtado, also of Harvard.
"Early preterm birth has immense health, economic, and emotional costs,” coauthor Andrew Thorne-Lyman noted. “Our findings are consistent with the results of most randomized trials of long chain omega-3 fatty acid supplements in pregnancy and support the importance of ensuring adequate intake of these nutrients during pregnancy, either through fish intake or supplements, to help prevent early preterm birth."
Folic acid supplements may protect children of mothers treated for epilepsy
August 1 2018. A study reported on August 1, 2018 in Neurology® found a protective effect for folic acid supplementation against a delay in language skills among children of women who were treated for epilepsy during pregnancy.
The study took place in Norway, whose government does not require grains to be fortified with folic acid. Three hundred thirty-five children of women who used epilepsy drugs during pregnancy and 104,222 children of mothers without the condition had their language skills assessed at 18 months and 3 years of age by their parents.
Among the children of mothers who did not take folic acid, 34% born to mothers treated for epilepsy had delayed language skills at 18 months, compared to 11% of the those whose mothers did not have epilepsy. In contrast, among children whose mothers used folic acid, 17% born to mothers treated for epilepsy experienced language delays at 18 months in comparison with 11% of children of nonepileptics. The benefit for folic acid was significant only when the supplements were used during the period beginning 4 weeks prior to pregnancy through the end of the first trimester.
“The apparently protective effect of taking folic acid supplements was striking,” noted coauthor Elisabeth Synnøve Nilsen Husebye, MD. “Half of the risk of having language delays at 18 months could be attributed to the lack of folic acid in children exposed to epilepsy drugs.”
"These results are important for women with epilepsy all over the world because many epilepsy drugs interact with the way folate is metabolized by the body, so we are still learning how much folic acid is needed for women with epilepsy and how it benefits their children," Dr Husebye stated.