Wednesday, September 30, 2015

A walk around the office can reverse vascular dysfunction caused by hours at a computer

A walk around the office can reverse vascular dysfunction caused by hours at a computer
Jaume Padilla, Ph.D., an assistant professor of nutrition and exercise physiology at the University of Missouri School of Medicine Credit: Justin Kelley/MU Health
Across the country, many employees are seated at desks for the majority of an eight-hour workday. As technology creates an increase in sedentary lifestyles, the impact of sitting on vascular health is a rising concern. 

30 sept 2015--Now, researchers from the University of Missouri School of Medicine have found that when a person sits for six straight hours, vascular function is impaired—but by walking for just 10 minutes after a prolonged period of sitting, vascular health can be restored.
"It's easy for all of us to be consumed by work and lose track of time, subjecting ourselves to prolonged periods of inactivity," said Jaume Padilla, Ph.D., an assistant professor of nutrition and exercise physiology at the MU School of Medicine and lead author of the study. "However, our study found that when you sit for six straight hours, or the majority of an eight-hour work day, blood flow to your legs is greatly reduced. We also found that just 10 minutes of walking after sitting for an extended time reversed the detrimental consequences."
During the study, the researchers compared the vascular function of 11 healthy young men before and after a period of prolonged sitting. The findings indicated that blood flow in the popliteal—an artery in the lower leg—was greatly reduced after sitting at a desk for six hours. Researchers then had the participants take a short walk, and found that 10 minutes of self-paced walking could restore the impaired vascular function and improve blood flow.
"When you have decreased blood flow, the friction of the flowing blood on the artery wall, called shear stress, is also reduced," Padilla said. "Moderate levels of shear stress are good for arterial health, whereas low levels of shear stress appear to be detrimental and reduce the ability of the artery to dilate. Dilation is a sign of vascular health. The more the artery can dilate and respond to stimuli, the healthier it is."
Many workplaces are sedentary environments, and the researchers said it's important that people understand the effects of sitting on their vascular health. By breaking up desk time with a short walk, workers can offset the harm caused to vascular blood vessels.
"Studies have shown that sitting less can lead to better metabolic and cardiovascular health," Padilla said. "However, more research is needed to determine if repeated periods of reduced vascular function with prolonged sitting lead to long-term vascular complications."

The study, "Impact of Prolonged Sitting on Lower and Upper Limb Micro- and Macrovascular Dilator Function," recently was published in Experimental Physiology, the peer-reviewed scientific journal of The Physiological Society.

Provided by University of Missouri-Columbia

Tuesday, September 29, 2015

Unsaturated fats, high-quality carbs lower risk of heart disease

Heart diagram. Credit: Wikipedia
While eliminating saturated fats can improve heart health, a new study shows that it makes a difference which foods are used in their place. A study published today in the Journal of the American College of Cardiology shows that replacing saturated fats with unsaturated fats and high-quality carbohydrates has the most impact on reducing the risk of heart disease. When saturated fats were replaced with highly processed foods, there was no benefit.

29 sept 2015--Previous research looked at the association between consumption of saturated fatty acids and the risk of coronary heart disease, but did not specify the replacement for saturated fat - such as unsaturated fats or the type of dietary carbohydrate. This is one of the first studies to distinguish between polyunsaturated fatty acids, monounsaturated fatty acids, and carbohydrates from whole grains or refined starches and added sugars.
"Many physicians could benefit from more in-depth nutritional knowledge to help them counsel their patients on changing their dietary practices in a way that will impact their health. In particular, we found that when study participants consumed less saturated fats, they were replacing them with low-quality carbohydrates such as refined grains that are not beneficial to preventing heart disease," said Frank B. Hu, M.D., Ph.D., study author and professor of nutrition and epidemiology at the Harvard T.H. Chan School of Public Health.
"Our findings suggest that when patients are making lifestyle changes to their diets, cardiologists should encourage the consumption of unsaturated fats like vegetable oils, nuts, and seeds, as well as healthy carbohydrates such as whole grains," Hu said.
Editor-in-Chief of the Journal of the American College of Cardiology, Valentin Fuster, M.D., Ph.D., FACC, further elaborated on the important role clinicians play in helping patients make healthy lifestyle choices. "All physicians and medical personnel who interact with patients should speak with them about the benefits of consuming unsaturated fats and healthy carbohydrates," Fuster said.
Researchers analyzed data from the Nurses' Health Study, a cohort of 121,701 female nurses enrolled in 1976, and the Health Professionals Follow-up Study, a cohort of 51,529 men enrolled in 1986. For this study, researchers followed 84,628 women and 42,908 men who were free of diabetes, cardiovascular disease and cancer and documented 7,667 incidents of coronary heart disease.
Participants provided information on diet, lifestyle, medical history, and newly diagnosed diseases through questionnaires at baseline and every two to four years for 24 to 30 years. The questionnaire asked how often and in what quantity specific foods had been consumed in the past year and to specify the types of fats or oil used for frying, baking and at the table. The questionnaire was validated against biomarkers of dietary fatty acids.
Researchers noted that participants generally replaced calories from saturated fatty acids with calories from low-quality carbohydrates—such as white bread or potatoes—rather than calories from unsaturated fats found in vegetable oils, nuts and seeds or high-quality carbohydrates like those in whole grains. Replacing 5 percent of energy intake from saturated fats with an equivalent intake from either polyunsaturated fats, monounsaturated fats, or carbohydrates from whole grains was associated with 25 percent, 15 percent, and 9 percent lower risk of coronary heart disease, respectively. However, replacing 5 percent of energy intake from saturated fats with carbohydrates from refined starches or sugars was not associated with either increased or decreased risk of coronary heart disease.
Examples of the kinds of changes that Hu said could result in reduced risk of heart disease:
  • Cooking with healthy fats such as canola oil, olive oil or other vegetable oils instead of butter, lard, and hard margarine.
  • Exchanging snacks like potato chips and cookies for peanuts, almonds and olives.
  • Making sandwiches with a whole wheat bun, avocados and chicken breast instead of large amounts of cheese and processed meats.
Study limitations included the observational nature that did not allow the study to prove causality and self-reported diet questionnaires cannot be completely accurate. However, the authors stated that their results were broadly consistent with those from randomized clinical trials, and the diet questionnaire was validated against fatty acid biomarkers.
In an accompanying editorial, Robert A. Vogel, M.D., Cardiology Section at the Department of Veterans Affairs Medical Center in Denver, said, "Healthfulness clearly lies in the quality or type of both fat and carbohydrate."
The study and editorial are part of a comprehensive Population Health Promotion issue of the Journal of the American College of Cardiology focusing on issues that broadly impact public health and the prevention of cardiovascular disease and related conditions. Population health is a strategic priority of the American College of Cardiology, which recently brought together experts from around the world to address issues such as smoking and nutrition in the context of developing public health strategies for improving population health.

More information: "Saturated fat as compared to unsaturated fats and sources of carbohydrates in relation to risk of coronary heart disease: A prospective cohort study," Yanping Li, Adela Hruby, Adam M. Bernstein, Sylvia H. Ley, Dong D. Wang, Stephanie E. Chiuve, Laura Sampson, Kathryn M. Rexrode, Eric B. Rimm, Walter C. Willett, Frank B. Hu, Journal of the American College of Cardiology, online September 28, 2015, DOI: 10.1016/j.jacc.2015.07.055

Provided by American College of Cardiology

Monday, September 28, 2015

Most elderly people satisfied with support

A longitudinal study of advanced ageing has found that most elderly people are satisfied with the relationships they have with family and friends.

28 sept 2015--More than 90 percent of people were satisfied most or all of the time in their relationships with family and friends. Forty-one percent of Māori reported being satisfied all of the time with the kinds of relationships they had with their family and a further 55 percent were satisfied most of the time
Almost two-thirds (63 percent) of non-Māori were satisfied with family relationships all of the time and a further 33 percent were satisfied most of the time.
The findings are from a population-based sample of Māori (aged 80 to 90 years) and non-Māori (aged 85 years), living in the Bay of Plenty, who are taking part in the longitudinal study of advanced ageing, called Life and Living in Advanced Age: a Cohort Study in New Zealand - Te Puāwaitanga O Ngā Tapuwae Kia Ora Tonu (LiLACS NZ).
More than 80 percent of those in advanced age reported having someone to provide them with emotional support – for men this was usually their spouse and for women, their daughter.
The study revealed that fewer people who lived alone reported having someone to give emotional support (78 percent) than those who lived with their spouse (84 percent) or with others 84 percent).
More Māori, particularly those in areas of high socioeconomic deprivation, reported an unmet need for emotional support than non-Māori.
Study director, Professor Ngaire Kerse from the University of Auckland's School of Population Health, says " It is reassuring that most people in advanced age feel supported emotionally and are satisfied with their relationships. We have found that there are a small proportion of people (disproportionately more of the group who were living with others), who feel they could do with more support, and this was surprising."
The study report described the prevalence of people in advanced age receiving emotional support, who gives that support and the satisfaction that people in advanced age feel about their relationships with family and friends; by ethnicity, gender, socioeconomic deprivation and living arrangement. The report included people living in the community and those in residential care.
Significantly more men (17 percent) than women (10 percent) reported that they did not need emotional support.
For those who did appreciate emotional support; for men the person most helpful in giving emotional support was their spouse; recorded as 41 percent of Māori men and 56 percent of non-Māori men.
Daughters were most helpful in giving emotional support for 42 percent of Māori women and 40 percent of non-Māori women.
Forty-five percent of people in advanced age lived alone and 33 percent lived with only their spouse or partner. Significantly more women (57 percent) lived alone than men (30 percent) and significantly more Māori lived with others (33 percent) than non-Māori (15 percent).
In the study, an unmet need for emotional support was greater among Maori people in advanced age.
The study asked people whether they "could have used more emotional support than they received". Overall, 10 percent said that they could have used more emotional support.
The report also noted that significantly more Māori (16 percent) than non-Māori (5 percent) reported an unmet need for emotional support. There were more Māori women (15 percent) than non-Māori women (7 percent) who reported an unmet need for emotional support. The difference for men was not statistically significant (possibly due to the smaller number of men in the sample).
Seventeen percent of people living with others reported unmet need for emotional support. Of those who lived with others as well as their spouse, 19 percent reported unmet need for emotional support; among those who lived with others but not their spouse 17 percent reported unmet need.
In contrast, of those living only with their spouse, six percent had an unmet need for emotion support while for those living alone, nine percent reported unmet need for emotional support.

The LiLACS NZ Study
  • Sample: 932 people of advanced age; Māori aged 80–90 years and non-Māori aged 85 years living in the Bay of Plenty and Lakes District Health Boards region. Non-Māori are 90 percent NZ European, 9 percent other European and 1 percent other. Participant numbers vary slightly according to topic being discussed.
  • Mode: Standardised home-based interview and standardised nursing assessment, repeated annually. Hospitalisation and mortality outcomes data were obtained, with permission, by matching the NHI with nationally held hospitalisation data from the Ministry of Health.
  • Timing: Results refer to the population sample recruited in the first wave of data gathering in 2010.
  • Funding: LiLACS NZ was originally funded by a programme grant from the Health Research Council of New Zealand. Ngā Pae o te Māramatanga, Heart Foundation NZ, Oakley Mental Health Foundation, Auckland Medical Research Foundation, the Faculty of Medical and Health Sciences also provided project support. The University of Auckland, the Rotorua Energy Trust and the Ministry of Health have funded LiLACS NZ from 2013.
  • Representation: The study is strengthened by the extensive breath of domains investigated and is designed to engage with a full cohort of Māori allowing equal explanatory power for separate analyses. The findings for Māori and non-Māori may not be generalizable beyond the Bay of Plenty region. However, the overall response rate in the first wave is consistent with other longitudinal studies of ageing; 56 percent of all Māori and 59 percent of all non-Māori who were invited participated. In gender and age the sample engaged was similar in proportion to the population of the area and the population of New Zealand. Although all age-eligible older adults were sought and invited, lower enrolments than expected from residential care facilities limits separate analyses of frailer participants.
More information: For more information, see the LiLACS NZ webpage: and other Ministry of Health short reports.

Provided by University of Auckland

Sunday, September 27, 2015

Guideline developed for supraventricular tachycardia

Guideline developed for supraventricular tachycardia
27 sept 2015--—Recommendations have been developed for the management of adult patients with supraventricular tachycardia (SVT). The guideline was published online Sept. 23 in the Journal of the American College of Cardiology.
Richard L. Page, M.D., from the University of Wisconsin School of Medicine in Madison, and colleagues conducted an extensive evidence review to develop recommendations on management of adults with all types of SVT other than atrial fibrillation.
The researchers note that the prevalence of SVT is about 2.25 per 1,000 persons in the general population. SVT is often diagnosed in the emergency department. Modes of presentation include documented SVT, palpitations, chest pain, syncope, atrial fibrillation, and sudden cardiac death; the need to differentiate symptoms of SVT from those of panic and anxiety disorders is a confounding factor in diagnosis.
"The overall goal of the guideline is to provide clinicians with the tools needed to successfully diagnose and treat patients with supraventricular tachycardia upon presentation in the inpatient or outpatient setting," Page said in a statement.
Several members of the writing committee and reviewers disclosed financial ties to the pharmaceutical and medical device industries.

More information: Full Text (subscription or payment may be required)

Saturday, September 26, 2015

Negative spiritual beliefs associated with more pain and worse physical, mental health

Individuals who blame karma for their poor health have more pain and worse physical and mental health, according to a new study from University of Missouri researchers. Targeted interventions to counteract negative spiritual beliefs could help some individuals decrease pain and improve their overall health, the researchers said.

26 sept 2015--"In general, the more religious or spiritual you are, the healthier you are, which makes sense," said Brick Johnstone, a neuropsychologist and professor of health psychology in the MU School of Health Professions. "But for some individuals, even if they have even the smallest degree of negative spirituality – basically, when individuals believe they're ill because they've done something wrong and God is punishing them – their health is worse."
Johnstone and his colleagues studied nearly 200 individuals to find out how their spiritual beliefs affected their health outcomes. Individuals in the study had a range of health conditions, such as cancer, traumatic brain injury or chronic pain, and others were healthy. The researchers divided the individuals into two groups: a negative spirituality group that consisted of those who reported feeling abandoned or punished by a higher power, and a no negative spirituality group that consisted of people who didn't feel abandoned or punished by a higher power. Participants answered questions about their emotional and physical health, including physical pain.
Those in the negative spirituality group reported significantly worse pain as well as worse physical and mental health while those with positive spirituality reported better mental health. However, even if individuals reported positive spiritual beliefs, having any degree of negative spiritual belief contributed to poorer health outcomes, the researchers found.
"Previous research has shown that about 10 percent of people have negative spiritual beliefs; for example, believing that if they don't do something right, God won't love them," Johnstone said. "That's a negative aspect of religion when people believe, 'God is not supportive of me. What kind of hope do I have?' However, when people firmly believe God loves and forgives them despite their shortcomings, they had significantly better mental health."
Individuals with negative spiritual beliefs also reported participating in religious practices less frequently and having lower levels of positive spirituality and forgiveness. Interventions that help combat negative spiritual beliefs and promote positive spiritual beliefs could help some individuals improve their pain and their mental health, Johnstone said.
The study, "Relationships Between Negative Spiritual Beliefs and Health Outcomes for Individuals With Heterogeneous Medical Conditions," was published in the Journal of Spirituality in Mental Health.

More information: "Relationships Between Negative Spiritual Beliefs and Health Outcomes for Individuals With Heterogeneous Medical Conditions." DOI: 10.1080/19349637.2015.1023679

Provided by University of Missouri-Columbia

Friday, September 25, 2015

Researcher explores the science of aging

Researcher explores the science of aging
The longest-lived human on record didn't make it much past 120 years. That's nothing compared to the ocean quahog, a fist-sized clam found off the coast of Maine. "They can live 500 years or longer," says Steven Austad, Ph.D., chair of the Department of Biology in the UAB College of Arts and Sciences and associate director of the UAB Comprehensive Center for Healthy Aging. "They've been sitting out there on the sea floor since before Shakespeare was born."

25 sept 2015--Austad's research focuses on understanding the underlying causes of aging at the molecular level. Although his studies take him in many fascinating directions, it's the ancient clams that everyone remembers. "I'm known in the field as the guy who works with weird animals," Austad says.
So what do animals like the quahog know about healthy aging that we don't? That question drives Austad's studies in comparative gerontology, which look to long-lived animals to identify new molecular targets to help humans.
Photos of ocean quahog, rough-eye rockfish, and red sea urchinLive long and prosper: Meet a few of the stars of comparative gerontology, with the maximum reported age for each species. Austad is working on a book called Methuselah's Zoo, which he describes as "a natural history of successful aging." It will include profiles of his favorite 500-year-old clams, but also 200-year-old whales and 40-year-old bats.

Protein power
Clams—technically, bivalve mollusks—live longer than any other animal group; more than a dozen species have lifespans of a century or more. But they are not all masters of aging. Austad's lab is studying mitochondrial function, protein stability and stress resistance across seven species of clams, with lifespans ranging from one year to the ocean quahog's 500-plus years.
Austad's research has convinced him that one key to slowing aging is to protect the proteins inside our cells. "Proteins make everything work in the cell, and to do that, they have to be folded precisely like origami," Austad says. "But as we get older they get battered about, and ultimately lose that precise shape."
That's why Austad is so excited by what he's found in ocean quahogs. "They keep their proteins in shape century after century," he says. When Austad takes human proteins and adds them to a mix of tissues from the clams, "they become more stable, less likely to unfold." His lab is now working to identify exactly what is protecting the clams' proteins. That mechanism could point to a potential treatment for aging, along with new therapies for Alzheimer's disease and other conditions caused by protein misfolding, Austad notes.

Enter the hydra
In addition to clams, Austad studies a tiny freshwater creature called a hydra, which is basically immortal. Or so scientists once thought, until they found one particular species of hydra that begins to age rapidly under the right combination of environmental conditions.
"Under certain conditions, this hydra turns on a symphony of genes that prevent aging; under others, it does not," Austad says. His lab is working to discover the molecular mechanisms that get switched on, or off, as the hydra's environment changes. "These kinds of studies are a way to quickly identify new genes that might be targets for new drugs to keep people healthy longer," Austad says.
He adds that the opportunities for collaborative, translational work in the Comprehensive Center for Healthy Aging, which brings together a wide range of basic and applied scientists from schools across campus, helped draw him to UAB.

Living longer—and better
This is a very exciting time to study aging, says Austad, who is in a position to survey the field as the scientific director for the American Federation for Aging Research. "We're making an incredible amount of progress," he says. "We know a lot of things from animal work that will slow aging by 20 percent, and that's the difference between being healthy for 60 years and being healthy for over 70 years."
Living longer wouldn't be much fun if you got progressively sicker, but "what we're finding is that, if you treat the underlying causes of aging, you can push back cancer, heart disease, blindness, hearing loss—all of these diseases associated with aging," says Austad.
One particularly intriguing lead, being followed by Austad and other researchers worldwide, is the drug rapamycin, which is FDA-approved to prevent rejection after organ transplants. A series of studies, from yeast, worms and mice, have shown that rapamycin can extend lifespan as well.
Rapamycin has "almost miraculous" effects against aging in mice, Austad says. "It prevents cancer, heart disease, Alzheimer's—a whole host of things." His lab is now working to understand how administering rapamycin at different points in an animal's life affects the aging process.

Curb your enthusiasm?
Despite these exciting findings, caution is required, Austad notes. "Nothing I have learned so far has changed my behavior," he says. "I don't take a bunch of pills; I'm not even tempted to take rapamycin at this point." For one reason, rapamycin has several side effects in mouse studies, including an elevated incidence of cataracts, loss of glucose sensitivity and testicular atrophy. Austad believes that the right dosing and formulation could overcome these issues in humans, but "we still don't know what the best dose is," he says.
At the moment, the best advice about healthy aging "is still the boring stuff your mother already told you," Austad says. "'Eat the right foods; don't eat too much; exercise.' But come back in 10 years and it will be a different answer."

Provided by University of Alabama at Birmingham

Thursday, September 24, 2015

Some forms of dizziness after getting up may signal bigger problems

People who get dizzy several minutes after standing up may be at risk of more serious conditions and even an increased risk of death, according to new research published in the September 23, 2015, online issue of Neurology, the medical journal of the American Academy of Neurology.

24 sept 2015--Feeling dizzy, faint or light-headed after standing due to a sudden drop in blood pressure can be a minor problem due to medication use or dehydration. But when it happens often, it can be a sign of a more serious condition called orthostatic hypotension, which is defined as a drop in blood pressure within three minutes of sitting or standing.
"Our study looked at delayed orthostatic hypotension, when the drop in blood pressure happens more than three minutes after standing or sitting up," said study author Christopher Gibbons, MD, with Harvard Medical School in Boston and a Fellow with the American Academy of Neurology. "Our findings suggest that more than half of people with the delayed form of this condition will go on to develop the more serious form of this disease. This is also the first study to date suggesting the disease is a milder form of the more common and serious disorder."
For the study, researchers reviewed the medical records of 165 people with an average age of 59 who completed nervous system testing and were followed for 10 years. Of those, 48 were diagnosed with delayed orthostatic hypotension, 42 had orthostatic hypotension and 75 did not have either condition.
The study found that over 10 years, 54 percent of participants with delayed orthostatic hypotension progressed to orthostatic hypotension and 31 percent developed a degenerative brain disease such as Parkinson's or dementia with Lewy bodies.
The rate of death over 10 years was 29 percent for people with delayed orthostatic hypotension, 64 percent for those with orthostatic hypotension (the more serious form of the disease) and 9 percent in people without either condition. The death rate over 10 years for those with the delayed condition who progressed to orthostatic hypotension was 50 percent.
People with delayed orthostatic hypotension who also had diabetes at the beginning of the study were more likely to develop the full condition than those without diabetes.
Many of the people with the delayed condition that did not develop the full condition were taking medications that may have affected their blood pressure, such as diuretics, antidepressants and high blood pressure drugs.
"Our findings may lead to earlier recognition, diagnosis and treatments of this condition and possibly other underlying diseases that may contribute to early death," said Gibbons.
Gibbons said limitations of the study included that it was a retrospective review of data collected earlier and that participants were all referred to a specialized center for tests of the autonomic nervous system and may not reflect the overall community.

Provided by American Academy of Neurology

Wednesday, September 23, 2015

New study maps the progression of Parkinson's disease within the brain

New study maps the progression of Parkinson's disease within the brain
Credit: Braak et al., Neurobiology of Aging (2003) 24:197-211 (left panel) and Alain Dagher (right panel).
Scientists at the Montreal Neurological Institute and Hospital -The Neuro, at McGill University and the McGill University Health Centre, have made advances in understanding the process involved in the progression and spread of Parkinson's disease (PD) within the brain.

23 sept 2015--The study, published in September issue of eLife Journal, focused on understanding the process that drives the disease's progression by mapping the distribution and degree of atrophy, characteristic of the disease, in certain brain regions and identify the paths leading the spread from affected to healthy tissue.
"Past studies have failed to consistently demonstrate regional brain atrophy in earlier stages of the disease due to samples of subjects that were too small and to methods that were less sensitive in detecting all aspects of the disease's impact on the brain. We now have the means to map the disease with greater sensitivity than previously possible," says Dr. Alain Dagher, senior author of the study.
The researchers had access to an unprecedented number of MRI scans and clinical data through the open source Parkinson's Progression Markers Initiative (PPMI) database. Thanks to this wealth of data, researchers were able to analyse MRI scans which show the structure of the brains of 230 people in the early stages of Parkinson's disease and compare them to those from age-matched healthy individuals. This allowed them to identify the set of brain regions that show atrophy in the early stages of the disease.
"The atrophy pattern on MRI is compatible with a disease process that spreads via brain networks - something that had never been shown in human patients before, and would support the hypothesis that PD is caused by a "toxic agent" that spreads trans-neuronally," says Dr. Alain Dagher.
The findings add new evidence to the hypothesis that brain cells in Parkinson's patients might deteriorate according to a prion-like mode of disease propagation, in which a toxic agent spreads from brain cell to brain cell utilizing the normal connections of the brain. Similar mechanisms have been proposed for diseases ranging from Alzheimer's Disease to Bovine Spongiform Encephalopathy. The process would involve the spread of alpha-synuclein, a toxic misfolded protein with the ability to make copies of itself and infect neighbouring cells while traveling through the brain's neuronal highways.
The patients who were enrolled in this study will continue to be evaluated on a yearly basis providing researchers with more data to continue mapping how the disease progresses throughout the brain and furthering our understanding of its causes.
Current treatment options help control or minimize symptoms including tremors, slowness of movement, stiffness or rigidity, and loss of balance. The findings of this study hold exciting therapeutic implications. In the longer term, it will help researchers develop new techniques to assess the efficacy of drugs that could target the culprit protein and might eventually lead to treatments that will prevent, slow, halt or even reverse the progression of PD.

More information:

Provided by McGill University Health Centre

Tuesday, September 22, 2015

One in three people born in 2015 will develop dementia, new analysis shows

Alzheimer's disease
Diagram of the brain of a person with Alzheimer's Disease. Credit: Wikipedia/public domain.
Alzheimer's Research UK has renewed its call for urgent action on dementia as new analysis estimates that one in three people born this year will develop the condition during their lifetime.
The findings, revealed on World Alzheimer's Day (21 September), foreshadow a looming national health crisis as the UK population ages, and underlines the need for global efforts to develop new treatments to succeed.

22 sept 2015--Dementia affects 850,000 people in the UK and is caused by brain diseases, most commonly Alzheimer's, which result in the loss of brain cells and impair the brain's ability to function properly. Early symptoms can include problems with memory and thinking, but as brain cell death becomes more widespread, physical functions such as walking and even swallowing can be affected. Currently there are no treatments able to stop or slow Alzheimer's disease or other dementias in their tracks.
With age the biggest risk factor for dementia, the number of people living with the condition is expected to rise as the population ages and life expectancy increases. The latest research, commissioned by Alzheimer's Research UK and carried out by the Office of Health Economics, set out to calculate the number of people born today who could be expected develop the condition during their lifetime. The analysis took into account life expectancy estimates for people born in 2015, as well as estimates of dementia incidence in men and women of different ages. The report estimates that:
  • 32% of people born in the UK 2015, or one in three, will develop dementia during their lifetime
  • 27% of males born in 2015 will develop the condition
  • 37% of females born in 2015 will develop the condition
Previous research from the team estimated that a treatment capable of delaying the onset of dementia by five years would reduce the number of dementia cases by a third. As the UK's leading dementia research charity, Alzheimer's Research UK has launched several major initiatives to help speed up the development of new treatments, including a network of Drug Discovery Institutes and a Global Clinical Trials Fund.
Amanda Franks, from Swindon, a Champion of Alzheimer's Research UK, whose mum Cathy was diagnosed with early-onset Alzheimer's six years ago, said:
"My mum was only 58 when she was diagnosed with early-onset Alzheimer's. Up until then we had no idea this devastating disease could affect someone so young. Simple day-to-day tasks like making a cup of tea, getting dressed and eating soon became a huge challenge for Mum. Dad cared for her at home with family help for five years by which time things were getting out of hand with her violent behaviour and hallucinations – life became extremely stressful.
"As a mum myself, I would dearly love to see preventions and new treatments found to defeat Alzheimer's disease and other dementias, giving hope to people now and future generations. These new statistics are terrifying but they will open everyone's eyes to the enormity of the situation. Research can beat dementia and, with more investment, Alzheimer's Research UK can drive the next breakthrough so urgently needed."
Dr Matthew Norton, Head of Policy at Alzheimer's Research UK, said:
"These figures underline a stark reality: as people are living longer, more and more people will develop dementia in the future if action is not taken now to tackle the condition. It's wonderful news that each generation is living longer than the last, but it's important to ensure that people can enjoy these extra years in good health. Dementia is our greatest medical challenge and if we are to beat it, we must invest in research to find new treatments and preventions. If we could delay the onset of dementia by five years, we could reduce the number of people living with the condition by a third. Research has the power to transform lives, and our actions now will help determine the future for children born today. The hundreds of thousands of families affected by dementia now deserve to know that we are fighting for them."

Provided by Alzheimer's Research UK

Monday, September 21, 2015

Eat spicy, live longer? Study says yes

Eat spicy, live longer? Study says yes
Chili peppers — and other foods that taste hot and spicy — might help you live longer, according to a new study. Active ingredients in the peppers, like capsaicin, help protect against some diseases. Credit: Thinkstock
Like a fiery finish to dinner? Then you'll be glad to know that a recent study suggests people who eat hot, spicy foods regularly may live longer.

21 sept 2015--Tulane University epidemiologist Dr. Lu Qi co-led the study of more than 500,000 Chinese adults over seven years. The results indicated that participants who ate foods flavored with chili peppers every day reduced their risk of premature dying by 14 percent, as compared to people who ate chili peppers less than once a week.
But apparently you don't have to indulge every day.
"Even among those who consumed spicy foods less frequently [one to two days a week], the beneficial effects could be observed. Indeed, moderate increase of spicy foods would benefit," someone's health, says Qi, who is the HCA Regents Distinguished Chair and Professor of Epidemiology.
In China, chili pepper is a popular spice, and participants reported eating their peppers fresh, dried and in sauce or oil. In the United States, hot pepper sauce has increased in popularity over the last decade, according to market research. Other spicy foods like horseradish, black pepper, garlic and ginger also may offer similar benefits.
"There also is preliminary data from other studies showing such potential," Qi says, noting that his study did not address those foods and that more research is needed on them.
The study was published in The BMJ (formerly the British Medical Journal).
Chili peppers contain capsaicin and other ingredients that may protect your health. Studies show capsaicin decreases appetite, may reduce risk of obesity and may offer antibacterial properties. It also may help protect against diabetes, cardiovascular disease, cancer and other conditions. Chili peppers improve inflammation and reduce blood pressure and oxidative stress, Qi adds.
Even though capsaicin's benefits look promising, he recommends more research. Meantime, if you want extra zing in your life, let chili peppers do the work.

More information: "Consumption of spicy foods and total and cause specific mortality: population based cohort study." BMJ 2015; 351 doi:

Provided by Tulane University

Sunday, September 20, 2015

Fruit and vegetables aren't only good for a healthy body—they protect your mind too

Credit: Anna Langova/Public Domain
Eating a Mediterranean diet or other healthy dietary pattern, comprising of fruit, vegetables, legumes, and nuts and low in processed meats, is associated with preventing the onset of depression, according to research published in the open access journal BMC Medicine. A large study of 15,093 people suggests depression could be linked with nutrient deficits.

20 sept 2015--Following extensive research into diet and its effect on our physical health, researchers are now exploring the link between nutrition and mental health. This is the first time that several healthy dietary patterns and their association with the risk of depression have been analyzed together.
The researchers compared three diets; the Mediterranean diet, the Pro-vegetarian Dietary Pattern and Alternative Healthy Eating Index-2010. Participants used a scoring system to measure their adherence to the selected diet, i.e. the higher the dietary score indicated that the participant was eating a healthier diet.
Food items such as meat and sweets (sources of animal fats: saturated and trans fatty acids) were negatively scored, while nuts, fruits and vegetables (sources of omega-3 fatty acids, vitamins and minerals respectively) were positively scored.
Lead researcher, Almudena Sanchez-Villegas, University of Las Palmas de Gran Canaria, says "We wanted to understand what role nutrition plays in mental health, as we believe certain dietary patterns could protect our minds. These diets are all associated with physical health benefits and now we find that they could have a positive effect on our mental health."
"The protective role is ascribed to their nutritional properties, where nuts, legumes, fruits and vegetables (sources of omega-3 fatty acids, vitamins and minerals) could reduce the risk of depression."
The study included 15,093 participants free of depression at the beginning of the study. They are former students of the University of Navarra, Spain, registered professionals from some Spanish provinces and other university graduates. All are part of the SUN (Seguimiento Universidad de Navarra) Project, a cohort study started on 21st December 1999. The cohort has been used to identify dietary and lifestyle determinants of various conditions, including diabetes, obesity and depression.
Questionnaires to assess dietary intake were completed at the start of the project and again after 10 years. A total of 1,550 participants reported a clinical diagnosis of depression or had used antidepressant drugs after a median follow-up of 8.5 years.
The Alternative Healthy Eating Index-2010 was associated with the greatest reduction of risk of depression but most of the effect could be explained by its similarity with the Mediterranean Diet. Thus, common nutrients and food items such as omega-3 fatty acids, vegetables, fruits, legumes, nuts and moderate alcohol intake present in both patterns (Alternative Healthy Eating Index-2010 and Mediterranean diet) could be responsible for the observed reduced risk in depression associated with a good adherence to the Alternative Healthy Eating Index-2010.
Almudena Sanchez-Villegas says, "A threshold effect may exist. The noticeable difference occurs when participants start to follow a healthier diet. Even a moderate adherence to these healthy dietary patterns was associated with an important reduction in the risk of developing depression. However, we saw no extra benefit when participants showed high or very high adherence to the diets.
So, once the threshold is achieved, the reduced risk plateaus even if participants were stricter with their diets and eating more healthily. This dose-response pattern is compatible with the hypothesis that suboptimal intake of some nutrients (mainly located in low adherence levels) may represent a risk factor for future depression."
A limitation of this study was that the results are based on self-reported dietary intake and a self-reported clinical diagnosis of depression. More research is needed to predict the role of nutrient intake for neurophysiological requirements and identify whether it is minerals and vitamins or proteins and carbohydrates that cause depression.

More information: A longitudinal analysis of diet quality scores and the risk of incident depression in the SUN Project. Almudena Sanchez-Villegas, Patricia Henriquez-Sanchez, Miguel Ruiz- Canela, Francisca Lahortiga, Patricio Molero, Estefania Toledo and Miguel A Martinez-Gonzalez BMC Medicine 2015 DOI: 10.1186/s12916-015-0428-y

Provided by BioMed Central

Friday, September 18, 2015

Team reports major breakthrough in understanding Alzheimer's disease

Trinity researchers report major breakthrough in understanding Alzheimer's disease
A human donor Alzheimer's disease brain tissue stained with an agent called 'congo-red', which allows for the visualization of amyloid-beta plaques (red) in the brain and surrounding blood vessels. Blue stains show the nuclei of the cells in the brain. Credit: Dr Matthew Campbell, 2015
18 sept 2015--Scientists at Trinity College Dublin have shed light on a fundamental mechanism underlying the development of Alzheimer's disease, which could lead to new forms of therapy for those living with the condition.
Alzheimer's is the most common form of dementia globally and affects up to 40,000 people in Ireland today. It is the fourth leading cause of death in individuals over the age of 65 and it is the only cause of death among the top ten that cannot be prevented, cured or even slowed down.
The condition is classically associated with memory loss. However, other symptoms and warning signs include difficulty performing familiar tasks, problems with language such as forgetting phrases or words, and changes in mood, behaviour and personality.
The research, published this week in leading international journal, Science Advances, was supported by Science Foundation Ireland (SFI) and the US-based charity, Brightfocus Foundation.
Alzheimer's disease is characterized, in part, by the build-up of a small protein ('amyloid-beta') in the brains of patients. Impaired clearance of this protein appears to be a major factor in the build-up of plaques, and then in the disease process itself. While the mode by which amyloid-beta is cleared remains unclear, it is evident that it needs to be removed from the brain via the bloodstream.
Unlike blood vessels anywhere else in the body, those in the brain have properties that strictly regulate what gets in and out of the delicate tissue - this is what is known as the blood-brain barrier (BBB). The BBB functions as a tightly regulated site of energy and metabolite exchange between the brain tissue and the bloodstream.
"We have shown that distinct components of these blood vessels termed tight junctions are altered in Alzheimer's disease. We think that this alteration could be an entrained mechanism to allow for the clearance of toxic amyloid-beta from the brain in those living with Alzheimer's disease," said postdoctoral researcher in Trinity's School of Genetics and Microbiology, Dr James Keaney, who spearheaded the study.
Working with the Dublin Brain Bank, which is based in Beaumont Hospital, the researchers from Trinity examined brain tissues of individuals who were affected by Alzheimer's disease during their lifetime and then compared results to those observed in model systems in the laboratory.
Research Assistant Professor in Genetics at Trinity, Dr Matthew Campbell, added: "Our recent findings have highlighted the importance of understanding diseases at the molecular level. The concept of periodic clearance of brain amyloid-beta across the BBB could hold tremendous potential for Alzheimer's patients in the future. The next steps are to consider how this might be achieved.
"Given the recent advances in clinical trials of anti-amyloid beta antibodies, we hope our findings may lead to improved and adjunctive forms of therapy for this devastating condition."

More information: "Autoregulated paracellular clearance of amyloid-ß across the blood-brain barrier,"

Provided by Trinity College Dublin

Tai Chi linked to improved physical capacity in certain common long term conditions

The ancient Chinese exercise Tai Chi is linked to improved physical capacity among older adults with certain common long term conditions, indicates a pooled analysis of the available evidence, published online in the British Journal of Sports Medicine.

18 sept 2015--Among people with breast cancer, heart failure, osteoarthritis and chronic obstructive pulmonary disease (COPD), these improvements were not at the expense of worsening pain or breathlessness, the findings show.
Tai Chi consists of slow, gentle, flowing movements that aim to boost muscle power, balance, and posture. It also includes mindfulness, relaxation, and breath control.
The researchers wanted to find out how effective Tai Chi was in long term conditions that are common among older adults. So they trawled electronic research databases for relevant studies published up to 2014, on the use of Tai Chi in people with cancer, osteoarthritis, heart failure, and COPD.
They wanted to find out if Tai Chi relieved symptoms, and improved physical capacity and quality of life in all four long term conditions.
Out of 1102 articles, 33, involving 24 studies and 1584 participants, were suitable for inclusion; 21 studies were included in the pooled analysis.
The average age of participants ranged from the mid 50s to the early 70s, while the average length of the Tai Chi training programme was 12 weeks, with most sessions lasting an hour. Tai Chi training was usually offered two to three times weekly.
The results showed that Tai Chi was associated with trends, or definite improvement, in physical capacity and muscle strength in most or all four long term conditions.
This included improvements in the six minute walking test; muscle strength, as measured by bending and stretching the knees; the time it takes to get up and move known as the TUG test; and quality of life.
Tai Chi was also associated with an improvement in the symptoms of pain and stiffness in osteoarthritis and in breathlessness in COPD. And it was associated with improved sit to stand times among patients with osteoarthritis.
This is an observational study so no definitive conclusions can be drawn about cause and effect, added to which the only cancer included in the analysis was breast cancer.
But the findings back those of previous research, and provide a reasonable starting point to look at the value of exercise programmes, such as Tai Chi, for people with several co-existing long term conditions, say the researchers.
"Tai Chi can improve some physical performance outcomes in four chronic conditions...but not at the expense of worsening pain or dyspnoea [breathlessness]," they write, adding that it "may provide a suitable exercise stimulus for people with several comorbidities," and could be used as a complementary therapy in some long term conditions.

More information: The effect of Tai Chi on four chronic conditions—cancer, osteoarthritis, heart failure and chronic obstructive pulmonary disease: a systematic review and meta-analyses, British Journal of Sports MedicineDOI: 10.1136/bjsports-2014-094388

Provided by British Medical Journal

Thursday, September 17, 2015

Alzheimer's disease consists of three distinct subtypes, according to study

Alzheimer's disease
Diagram of the brain of a person with Alzheimer's Disease. Credit: Wikipedia/public domain.
Alzheimer's disease, long thought to be a single disease, really consists of three distinct subtypes, according to a UCLA study. The finding could lead to more highly targeted research and, eventually, new treatments for the debilitating neurological disorder, which robs people of their memories.

17 sept 2015--The study further found that one of the three variations, the cortical subtype, appears to be fundamentally a different condition than the other two, said Dr. Dale Bredesen, the study's author, a UCLA professor of neurology and member of the Easton Laboratory for Neurodegenerative Disease Research.
"Because the presentation varies from person to person, there has been suspicion for years that Alzheimer's represents more than one illness," said Bredesen, who also is the founding president of the Buck Institute for Research on Aging. "When laboratory tests go beyond the usual tests, we find these three distinct subtypes.
"The important implications of this are that the optimal treatment may be different for each group, there may be different causes, and, for future clinical trials, it may be helpful to study specific groups separately."
The subtypes are:
  • Inflammatory, in which markers such as C-reactive protein and serum albumin to globulin ratios are increased.
  • Non-inflammatory, in which these markers are not increased but other metabolic abnormalities are present.
  • Cortical, which affects relatively young individuals and appears more widely distributed across the brain than the other subtypes of Alzheimer's. It typically does not seem to cause memory loss at first, but people with this subtype of the disease tend to lose language skills. It is often misdiagnosed, typically affects people who do not have an Alzheimer's-related gene and is associated with a significant zinc deficiency.
The findings of the two-year study, which involved metabolic testing of 50 people, appear in the current issue of the peer-reviewed journal Aging.
No effective therapy for Alzheimer's exists. And scientists have yet to completely identify the cause, although multiple studies have pointed to metabolic abnormalities such as insulin resistance, hormonal deficiencies and hyperhomocysteinemia, a condition characterized by an abnormally high level of an amino acid in the blood.
In a 2014 paper, Bredesen showed that making lifestyle, exercise and diet changes designed to improve the body's metabolism reversed cognitive decline in nine out of 10 patients with early Alzheimer's disease or its precursors.
The current finding grew out of an extensive evaluation of the data from last year's study, and it could eventually help scientists pinpoint more precise targets for treatments—the same approach that has led to major advances in treating other diseases.
For example, Bredesen explained, researchers have recently been able to develop precise treatments for cancer by sequencing tumor genomes and comparing them to the patients' genomes to better understand what drives the formation and growth of tumors.
"However, in Alzheimer's disease, there is no tumor to biopsy," Bredesen said. "So how do we get an idea about what is driving the process? The approach we took was to use the underlying metabolic mechanisms of the disease process to guide the establishment of an extensive set of laboratory tests, such as fasting insulin, copper-to-zinc ratio and dozens of others."
Going forward, Bredesen and his team will seek to determine whether the subtypes have different underlying causes, and whether they respond differently to potential treatments.
The need for a new approach to treat Alzheimer's is urgent. It is the most common age-related dementia, and the number of people with the disease in the U.S. is expected to increase to 15 million in 2050, from nearly 6 million today. The cost to treat people in the U.S. with Alzheimer's and other dementias is expected to be $226 billion in 2015 alone, and could reach $1.1 trillion in 2050.

More information: "Metabolic profiling distinguishes three subtypes of Alzheimer's disease." Aging, Vol 7, No 8, pp 595-600, Published: 08/31/15.

Provided by University of California, Los Angeles

Wednesday, September 16, 2015

Study reveals connection between fitness level, brain activity, and executive function

Credit: Human Brain Project
The aging process is associated with declines in brain function, including memory and how fast our brain processes information, yet previous research has found that higher levels of cardiorespiratory fitness in older adults leads to better executive function in the brain, which helps with reasoning and problem solving. Higher cardiorespiratory fitness levels have also been found to increase brain volume in key brain regions.

16 sept 2015--A new study from a team at the Beckman Institute for Advanced Science and Technology at the University of Illinois reveals the connection between brain activation, cardiorespiratory fitness, and executive function in older adults, finding that dual-task processing in a core executive function brain region is associated with higher cardiorespiratory fitness and dual-task performance.
"Previous studies have shown that there's a relationship between cardiorespiratory fitness and behavioral performance in older adults. Other studies have looked at cardiorespiratory fitness and brain function, but really linking all three of those hasn't been quite been done as explicitly as we did in this paper," said Chelsea Wong, a M.D./Ph.D. student at the University of Illinois and first author on the paper, published in Frontiers in Aging Neuroscience.
The team, led by Art Kramer, Beckman Institute director and professor of psychology and neuroscience at Illinois, examined brain imaging and fitness level data from 128 adults between the ages of 59-80.
With functional magnetic resonance imaging (fMRI) scans gathered in the Beckman Institute's Biomedical Imaging Center, the researchers found that certain regions of the brain were activated more when performing two simultaneous tasks compared to a single task.
"The reason we looked at dual-task specifically is because it's a measure of executive function, which is required for multiple cognitive processes, such as working memory, task management, coordination, and inhibition," said Wong. "We know that as people age, executive function declines, so we found that with higher cardiorespiratory fitness, you can enhance executive function performance behaviorally as well as executive function-related brain activation."
The team found the overall relationship between cardiorespiratory fitness levels and higher executive function may be partially explained through activation in a region of the brain called the anterior cingulate cortex and the supplementary motor area (ACC/SMA).
"We analyzed areas of the brain that were activated while the participants were completing two tasks, and found that the ACC/SMA activation was associated with higher cardiorespiratory fitness. It's an important area for higher level functions, such as conflict monitoring, multitasking, and dual-task processing itself," said Wong.
"This research adds to our growing understanding of the relationship among physical activity and cognitive and brain function—and suggests that we can improve our brain health by changing our lifestyle even as we age," said Kramer.

Provided by Beckman Institute for Advanced Science and Technology

Tuesday, September 15, 2015

Diabetic women at 34 percent higher risk of heart attack than diabetic men as they age

New research presented at this year's annual meeting of the European Association for the Study of Diabetes in Stockholm shows that diabetic women are more at risk than diabetic men of having a heart attack and other complications as they age. The study is by Dr Giuseppe Seghieri, Regional Health Agency, Florence, Italy, and colleagues.

15 sept 2015--Previous research has revealed that diabetic women have a higher risk of cardiovascular events than diabetic men, when compared with the respective non-diabetic counterparts. However, it is unclear when this risk begins or how long it lasts. Thus the authors did a retrospective follow-up study along a period of eight years (from 2005 to 2012) of a cohort of diabetic patients living in Tuscany, a region of central Italy, comparing between genders the effect of age on diabetes related excess risk of hospitalisation for acute heart attack (acute myocardial infarction or AMI), ischemic stroke (IS), and congestive heart failure (CHF).
The authors pooled data from all Tuscan hospitals over the period 2005 to 2012, the general population registry of all inhabitants of Tuscany and a dataset containing the registry of all known diabetic patients from Tuscany. The effect of diabetes was separately measured in men and in women across this entire eight year period. In a total of 3,192,203 inhabitants aged more than 16 years (47% males), there were 24,605 hospitalisations for AMI (16,251 in men and 8,354 in women), 26,953 for IS (14,848 in men and 12,105 in women), 17,628 for CHF (8,403 in men and 9,225 in women).
After adjusting for age, the diabetes related excess risk, expressed as hazard ratio was, overall, significantly higher in women than in men hospitalised for AMI (2.63 times increased risk vs. 1.96 times for men, giving a relative increased risk of 34% in women). However the increased risk was overall similar between genders for those hospitalised for IS and CHF. After stratifying the population by age decades, however, diabetic women hospitalised for AMI had a significantly higher excess risk than diabetic men, along the entire age interval between decade 45-54 years up to age 75-84 years, with the highest difference found in age class 45-54 years (increased risk 5.83 times in women vs. 2.88 in men). In patients hospitalised for IS and CHF diabetic women had an excess risk higher than men from age 55-64 years up to 75-84 years, with the highest difference in age decade 55-64yr in both (4.14 v 3.05 for IS and 6.83 v 4.11 for CHF).
The authors conclude: "In this cohort of Tuscan population the excess risk of cardiovascular events linked with diabetes is significantly different between genders. With respect to AMI, diabetic women are more disadvantaged, compared to diabetic men, with a gender driven 'risk window' for women which mostly opens around menopausal age (45 years onwards). Regarding IS and CHF, it opens later, in the postmenopausal age (55 years and over), and to a lesser extent. All this should focus attention on a timely, gender oriented, prevention of cardiovascular events in people with diabetes."
They add: "The risk for heart attack is different to that from the risk of stroke or CHF: both stroke and CHF appear on average later in the life than heart attacks, at a time when the risk associated with diabetes becomes smaller and smaller: thus gender difference in diabetes linked excess risk is smaller for IS and CHF. In addition the global burden of risk of stroke and/or CHF is built up with other elements—including atrial fibrillation, hypertension, salt intake—which altogether reduce the importance of diabetes itself."

Provided by Diabetologia

Monday, September 14, 2015

Cocoa flavanols lower blood pressure and increase blood vessel function in healthy people

Cocoa flavanols lower blood pressure and increase blood vessel function in healthy people
Naturally occurring cocoa flavanols are largely destroyed by most cocoa processing methods. The cocoa flavanol drink test materials used in these studies supplied by Mars, Incorporated were extracted using a patented process from fresh cocoa beans. Credit: Mars, Incorporated
14 sept 2015--Two recently published studies in the journals Age and the British Journal of Nutrition (BJN) demonstrate that consuming cocoa flavanols improves cardiovascular function and lessens the burden on the heart that comes with the ageing and stiffening of arteries. The studies also provide novel data to indicate that intake of cocoa flavanols reduces the risk of developing cardiovascular disease (CVD).
As we age, our blood vessels become less flexible and less able to expand to let blood flow and circulate normally, and the risk of hypertension also increases. Arterial stiffness and blood vessel dysfunction are linked with cardiovascular disease—the number one cause of deaths worldwide. "With the world population getting older, the incidence of cardiovascular disease, heart attacks and stroke will only increase," says Professor Malte Kelm, Professor of Cardiology, Pulmonary Diseases and Vascular Medicine at University Hospital Düsseldorf and Scientific Director of FLAVIOLA. "It is therefore pivotal that we understand the positive impact diet can have on cardiovascular disease risk. As part of this, we want to know what role flavanol-containing foods could play in maintaining the health of the heart and blood vessels."
Cocoa flavanols are plant-derived bioactives from the cacao bean. Dietary intake of flavanols has been shown to have a beneficial effect on cardiovascular health but the compounds are often destroyed during normal food processing. Earlier studies have demonstrated that cocoa flavanol intake improves the elasticity of blood vessels and lowers blood pressure—but, for the most part, these investigations have focused on high-risk individuals like smokers and people that have already been diagnosed with conditions like hypertension and coronary heart disease. These two studies in Age and BJN are the first to look at the different effects dietary cocoa flavanols can have on the blood vessels of healthy, low-risk individuals with no signs or symptoms of cardiovascular disease.

Cocoa flavanols increase blood vessel flexibility and lower blood pressure
In the study published in Age,  They found that vasodilation was significantly improved in both age groups that consumed flavanols over the course of the study (by 33% in the younger age group and 32% in the older age group over the control intervention). In the older age group, a statistically and clinically significant decrease in systolic blood pressure of 4 mmHg over control was also seen.

Improving cardiovascular health and lowering the risk of CVD
In the second study, published in BJN, the researchers extended their investigations to a larger group (100) of healthy middle-aged men and women (35-60 years) with low risk of CVD. The participants were randomly and blindly assigned into groups that consumed either a flavanol-containing drink or a flavanol-free control drink, twice a day for four weeks. The researchers also measured cholesterol levels in the study groups, in addition to vasodilation, arterial stiffness and blood pressure.
"We found that intake of flavanols significantly improves several of the hallmarks of cardiovascular health," says Professor Kelm. In particular, the researchers found that consuming flavanols for four weeks significantly increased flow-mediated vasodilation by 21%. Increased flow-mediated vasodilation is a sign of improved endothelial function and has been shown by some studies to be associated with decreased risk of developing CVD. In addition, taking flavanols decreased blood pressure (systolic by 4.4 mmHg, diastolic by 3.9 mmHg), and improved the blood cholesterol profile by decreasing total cholesterol (by 0.2 mmol/L), decreasing LDL cholesterol (by 0.17 mmol/L), and increasing HDL cholesterol (by 0.1 mmol/L).
The researchers also calculated the Framingham Risk Score - a widely used model to estimate the 10-year cardiovascular risk of an individual - and found that flavanol intake reduced the risk of CVD. "Our results indicate that dietary flavanol intake reduces the 10-year risk of being diagnosed with CVD by 22% and the 10-year risk of suffering a heart attack by 31%," says Professor Kelm.
The combined results of these studies demonstrate that flavanols are effective at mitigating age-related changes in blood vessels, and could thereby reduce the risk of CVD in healthy individuals. The application of 10-year Framingham Risk Scores should be interpreted with caution as the duration of the BJN study was weeks not years and the number of participants was around 100, not reaching the scale of the Framingham studies. That being said, Professor Kelm comments that "the reduction seen in risk scores suggests that flavanols may have primary preventive potential for CVD." Other longer-term studies, such as the 5-year COcoa Supplement and Multivitamin Outcomes Study (COSMOS) of 18,000 men and women, are now underway to investigate the health potential of flavanols on a much larger scale.

Provided by University Hospital Düsseldorf

Sunday, September 13, 2015

Resveratrol impacts Alzheimer's disease biomarker

Skeletal formula of trans-resveratrol. Image: Wikipedia
The largest nationwide clinical trial to study high-dose resveratrol long-term in people with mild to moderate Alzheimer's disease found that a biomarker that declines when the disease progresses was stabilized in people who took the purified form of resveratrol.

13 sept 2015--Resveratrol is a naturally occurring compound found in foods such as red grapes, raspberries, dark chocolate and some red wines.
The results, published online today in Neurology, "are very interesting," says the study's principal investigator, R. Scott Turner, MD, PhD, director of the Memory Disorders Program at Georgetown University Medical Center. Turner, who treats patients at MedStar Georgetown University Hospital, cautions that the findings cannot be used to recommend resveratrol. "This is a single, small study with findings that call for further research to interpret properly."
The resveratrol clinical trial was a randomized, phase II, placebo-controlled, double blind study in patients with mild to moderate dementia due to Alzheimer's disease. An "investigational new drug" application was required by the U.S. Food and Drug Administration to test the pure synthetic (pharmaceutical-grade) resveratrol in the study. It is not available commercially in this form.
The study enrolled 119 participants. The highest dose of resveratrol tested was one gram by mouth twice daily—equivalent to the amount found in about 1,000 bottles of red wine.
John Bozza, 80, participated in the study. Five years ago, his wife, Diana, began noticing "something wasn't quite right." He was diagnosed with mild cognitive impairment, but only a year later, his condition progressed to mild Alzheimer's.
Diana, whose twin sister died from the same disease, says there are multiple reasons she and John decided to participate in the resveratrol study, and they now know he was assigned to take the active drug.
"I definitely want the medical community to find a cure," she says. "And of course I thought there's always a chance that John could have been helped, and who knows, maybe he was."
Patients, like John, who were treated with increasing doses of resveratrol over 12 months showed little or no change in amyloid-beta40 (Abeta40) levels in blood and cerebrospinal fluid. In contrast, those taking a placebo had a decrease in the levels of Abeta40 compared with their levels at the beginning of the study.
"A decrease in Abeta40 is seen as dementia worsens and Alzheimer's disease progresses; still, we can't conclude from this study that the effects of resveratrol treatment are beneficial," Turner explains. "It does appear that resveratrol was able to penetrate the blood brain barrier, which is an important observation. Resveratrol was measured in both blood and cerebrospinal fluid."
The researchers studied resveratrol because it activates proteins called sirtuins, the same proteins activated by caloric restriction. The biggest risk factor for developing Alzheimer's is aging, and studies with animals found that most age-related diseases—including Alzheimer's—can be prevented or delayed by long-term caloric restriction (consuming two-thirds the normal caloric intake).
Turner says the study also found that resveratrol was safe and well tolerated. The most common side effects experienced by participants were gastrointestinal-related, including nausea and diarrhea. Also, patients taking resveratrol experienced weight loss while those on placebo gained weight.
One outcome in particular was confounding, Turner notes. The researchers obtained brain MRI scans on participants before and after the study, and found that resveratrol-treated patients lost more brain volume than the placebo-treated group.
"We're not sure how to interpret this finding. A similar decrease in brain volume was found with some anti-amyloid immunotherapy trials," Turner adds. A working hypothesis is that the treatments may reduce inflammation (or brain swelling) found with Alzheimer's.
The study, funded by the National Institute on Aging and conducted with the Alzheimer's Disease Cooperative Study, began in 2012 and ended in 2014. GUMC was one of 21 participating medical centers across the U.S.
Further studies, including analysis of frozen blood and cerebrospinal fluid taken from patients, are underway to test possible drug mechanisms.
"Given safety and positive trends toward effectiveness in this phase 2 study, a larger phase 3 study is warranted to test whether resveratrol is effective for individuals with Alzheimer's—or at risk for Alzheimer's," Turner says.
Resveratrol and similar compounds are being tested in many age-related disorders including cancer, diabetes and neurodegenerative disorders. The study Turner led, however, is the largest, longest and highest dose trial of resveratrol in humans to date.

Provided by Georgetown University Medical Center

Saturday, September 12, 2015

Study backs more aggressive treatment of high blood pressure

Study backs more aggressive treatment of high blood pressure
A major new U.S. study shows treating high blood pressure more aggressively than usual cuts the risk of heart disease and death in people over age 50, the National Institutes of Health said Friday,
12 sept 2015--Aiming lower saves more lives when it comes to controlling high blood pressure, says a major new study that could spur doctors to more aggressively treat patients over 50.
Patients who got their blood pressure well below today's usually recommended level significantly cut their risk of heart disease and death, the National Institutes of Health announced Friday. The benefit was strong enough that NIH stopped the study about a year early.
"This study provides potentially life-saving information," declared Dr. Gary Gibbons, director of NIH's National Heart, Lung and Blood Institute.
Doctors have long debated how low blood-pressure patients need to go, especially as they get older. Friday's results are preliminary, and researchers stressed that they shouldn't alter patient care just yet. But if the full results pan out, they eventually could influence treatment guidelines.
"This study certainly supports that lower is better," said Dr. Mark Creager, president of the American Heart Association, who wasn't involved with the new study. He called the research a possible roadmap to treatment strategies "that will save a significant amount of lives."
About 1 in 3 adults in the U.S. has high blood pressure, raising the risk of heart attacks, stroke, kidney failure and other health problems.
Normal blood pressure is less than a measurement of 120 over 80. High blood pressure is diagnosed once that measurement reaches, or passes, 140 over 90. Only about half of diagnosed patients have their blood pressure under control.
Today's treatment guidelines are mixed but generally recommend getting that top number—called the systolic pressure—down to about 140 in generally healthy adults and to 130 in patients who also have kidney disease or diabetes.
The institute sponsored a nationwide study to test if that's the best goal, or if aiming lower would either help or harm. Starting in 2010, more than 9,300 high blood pressure patients were enrolled in the SPRINT study, the Systolic Blood Pressure Intervention Trial. Half received an average of about two medications with the goal of lowering their systolic pressure below 140. The other half received an average of three medications with the goal of getting below 120.
The more aggressively treated patients saw their risk of death drop by almost 25 percent compared to the less controlled patients, researchers said. And rates of cardiovascular problems dropped by almost 30 percent in the better-controlled group.
Researchers wouldn't give precise numbers, or information about side effects, data that's expected when the full study is published in a scientific journal by year's end.
But preliminary results suggest treatment was "extremely well tolerated," said SPRINT investigator Dr. Jackson Wright of Case Western Reserve University.
One question is whether older patients need to get their blood pressure as low as middle-aged patients do, or if doing so increases the seniors' risk of side effects including falls. Last year, an expert panel sparked debate by recommending that the treatment target for patients over 60 be a systolic pressure of 150.
The average age of SPRINT participants was 68, and a quarter of them were over 75. The heart association's Creager said doctors will examine closely how those older patients fared.
Researchers also will continue tracking SPRINT participants to see if kidney disease, brain function and dementia were affected by more aggressive care.
Meanwhile, what's the advice for patients now struggling to control their blood pressure?
"The important public health message is to speak with their health care providers," said NHLBI heart specialist Dr. George Mensah.
Everyone should know their blood pressure, added Creager, director of the Heart and Vascular Center at Dartmouth-Hitchcock Medical Center. Risks for heart disease begin gradually rising as blood pressure gets above 120, even if people never cross the line into full-blown hypertension.
Good diets, physical activity and keeping a healthy weight help avoid high blood pressure, and can help to lower it before medications are required or along with them.
But once high blood pressure is diagnosed, getting treatment is more important than the debate over how low to go, Creager said. That's an individual decision based on the person's overall health, and many people aren't reaching today's recommended levels.
"The worst thing people with high blood pressure can do is ignore it," he said.

Friday, September 11, 2015

Avoidable risk factors take an increasing toll on health worldwide

Credit: Vera Kratochvil/public domain
A wide range of avoidable risk factors to health - ranging from air pollution to poor diets to unsafe water - account for a growing number of deaths and a significant amount of disease burden, according to a new analysis of 79 risks in 188 countries.

11 sept 2015--High blood pressure was the number-one individual risk factor associated with global deaths in 2013, contributing to 10.4 million deaths around the world that year. High blood pressure's impact on mortality grew by 49.1% between 1990 - when it was also the number-one global risk - and 2013. While this risk heavily impacts both sexes, its increasing impact has been more dramatic for men than women. High blood pressure grew 39.9% for women and 59% for men. It was associated with the deaths of 5.4 million American males in 2013.
The risk factors examined in the study contributed to a total of 30.8 million deaths in 2013, up by one-fifth from 25.1 million deaths in 1990. The top risks associated with the deaths of both men and women are high blood pressure, smoking, high body mass index, and high fasting plasma glucose. But the greatest cumulative impact on health comes from poor diet. A combination of 14 dietary risk factors contributes to the highest number of deaths worldwide through ailments like ischemic heart disease, stroke, and diabetes. In 2013, 21% of total global deaths were attributed to these risks, which include diets low in fruit, whole grains, and vegetables, and diets high in red meat and sugar-sweetened beverages.
"There's great potential to improve health by avoiding certain risks like smoking and poor diet as well as tackling environmental risks like air pollution," said IHME Director Dr. Christopher Murray. "The challenge for policymakers will be to use what we know to guide prevention efforts and health policies."
The mix of leading risk factors contributing to deaths has changed significantly since 1990. Childhood undernutrition and unsafe water sources have dropped off the global top-10 list, while high cholesterol and alcohol use have replaced them as major contributors to poor health.
"Global, regional, and national comparative risk assessment of 79 behavioral, environmental and occupational, and metabolic risks or clusters of risks in 188 countries 1990-2013: a systematic analysis for the GBD 2013" examines the extent, pattern, and trends of risk factors' contributions to death and health loss across countries. Published in The Lancet on September 11, the study was conducted by an international consortium of researchers working on the Global Burden of Disease project and led by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.
Risks vary greatly for men and women. Smoking is a larger problem for males, ranking as the number-two risk and associated with 4.4 million deaths; for females it's number six and contributes to 1.4 million deaths. Alcohol use is a top 10-risk factor for male deaths, but it's not a leading cause for females.
Children also struggle with different risks than adults. For children under the age of 5, child undernutrition - encompassing children who are underweight, whose growth is stunted, and who suffer from wasting - was the number-one cause of death. Childhood undernutrition contributed to 1.3 million deaths in 2013, which accounts for 21.1% of total under-5 deaths. Countries with the highest proportion of under-5 deaths attributable to this risk were Chad, South Sudan, Democratic Republic of the Congo, Somalia, and Niger.
"While we have seen a tremendous growth in risk factors that contribute to non-communicable diseases like heart disease, pulmonary diseases, and diabetes, childhood undernutrition remains a huge challenge for some countries," said Dr. Mohammad Hossein Forouzanfar, Assistant Professor of Global Health at IHME and the paper's lead author.
The study examines which risk factors contribute to health loss as well as death. Researchers use DALYs, or disability-adjusted life years, to measure health loss. One DALY equals one lost year of healthy life and is measured by the sum of years of life lost to early death and years lived with disability. The leading risk factors associated with global health loss in 2013 were high systolic blood pressure, smoking, and high body mass index. This has changed significantly since 1990, with a number of risks related to non-communicable diseases rising in prominence. High blood pressure, which accounted for 8.5% of global DALYS in 2013, has moved up in rank, as has smoking, even though its prevalence has fallen in most countries.
Global data mask tremendous regional variations. In much of the Middle East and Latin America, high body mass index is the number-one risk associated with health loss. In South and Southeast Asia, household air pollution is a leading risk, and India also grapples with high risks of unsafe water and childhood undernutrition. Alcohol is the number-two risk in Russia, and smoking is the number-one risk in many high-income countries, including the United Kingdom. The most marked differences are found in sub-Saharan Africa, which, unlike other regions, is dominated by a toxic combination of childhood undernutrition, unsafe water and sanitation, unsafe sex, and alcohol use.
The study includes several risk factors - wasting, stunting, unsafe sex, no hand-washing with soap - in its analysis for the first time. Another first is the factoring of HIV into the calculation of intimate partner violence. The addition of wasting, which was associated with about one out of every five deaths in children under 5 in 2013, and stunting, which contributed to 3.5% of under-5 deaths, highlights the importance of child undernutrition as a risk factor. Unsafe sex took a huge toll on global health, contributing to 82.3% of HIV/AIDS deaths and 94% of HIV/AIDS deaths among 15- to 19-year-olds in 2013. This has a greater impact on South Africa than any other country; 37.9% of South African deaths were attributed to unsafe sex. The global burden of unsafe sex grew from 1990 and peaked in 2005.

Risks associated with the highest number of deaths globally for both sexes, 2013
1 High systolic blood pressure
2 Smoking
3 High body mass index
4 High fasting plasma glucose
5 Diet high in sodium
6 Diet low in fruits
7 Ambient particulate matter pollution
8 Household air pollution from solid fuels
9 High total cholesterol
10 Alcohol use

Risks associated with the highest number of deaths globally for men, 2013
1 High systolic blood pressure
2 Smoking
3 High body mass index
4 Diet high in sodium
5 High fasting plasma glucose
6 Alcohol use
7 Diet low in fruits
8 Ambient particulate matter pollution
9 Household air pollution from solid fuels
10 High total cholesterol

Risks associated with the highest number of deaths globally for women, 2013
1 High systolic blood pressure
2 High body mass index
3 High fasting plasma glucose
4 Diet high in sodium
5 Diet low in fruits
6 Smoking
7 High total cholesterol
8 Household air pollution from solid fuels
9 Ambient particulate matter pollution
10 Low glomerular filtration rate

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Provided by Institute for Health Metrics and Evaluation

Thursday, September 10, 2015

Injections may have passed on Alzheimer's 'seeds': study

Alzheimer's disease
Diagram of the brain of a person with Alzheimer's Disease. Credit: Wikipedia/public domain.
People injected with hormones extracted from cadaver brains in a long-abandoned procedure may have received "seeds" of Alzheimer's disease, said a study Wednesday, urging research into possible risks for "accidental" medical transmission.

10 sep 2015--Published in the journal Nature, the research claims to provide evidence for the hypothesis that the protein fragments which assemble into Alzheimer's-causing plaques, can be passed between humans via diseased tissue transfer.
But this did not mean that Alzheimer's was contagious, the study authors and independent commentators stressed.
"This relates to a very special situation where people have been injected with essentially extracts of human tissue," said co-author John Collinge of University College London (UCL).
"I don't think there needs to be any alarm that we're saying in any way that you can catch Alzheimer's Disease."
Further research, however, would be "prudent," he said during a telephone press briefing.
"We should think about whether there might be accidental routes in which these diseases might be transmitted by medical or surgical procedures."
While conducting research into an unrelated disease, Collinge and a team examined the brains of eight people who had received injections in childhood of a hormone to treat dwarfism.
The hormone had been extracted from pituitary glands harvested from thousands of human cadavers.
This practice was halted in 1985 when doctors realised it could transmit a variant of Creutzfeldt-Jakob disease (CJD)—the human version of "mad cow" disease. Eight subjects in the study in fact died from this ailment.
Too young
Collinge and colleagues, "very much to our surprise," found that seven of the eight had brain deposits of Alzheimer's-linked amyloid beta (Abeta) fragments—with four of them having high concentrations.
Strikingly the patients were 36-51 years old, whereas such deposits are normally seen in elderly people.
"We think the most likely explanation is that the growth hormone preparations with which these people were treated as children, in addition to being contaminated with CJD prions (a different protein type), was probably also contaminated with Abeta seeds."
Previous laboratory studies showed that Abeta in Alzheimer's-ridden brain tissue, when transferred to mice or monkeys, could infect the host animal brain—even when it had been injected into their abdomens.
"So there are mechanisms to transport these protein seeds to the brain," said Collinge.
"We don't know what they are, but clearly it can happen. So that's consistent with these seeds spreading from an intramuscular injection in the children to their brains."
Amyloid beta seeds, the team wrote, "are known, like prions, to adhere to metal surfaces and to resist... conventional hospital sterilisation."
Experts who were not part of the study underlined there was no evidence of any modern-day medical treatment, including dental surgery or blood transfusions, raising the Alzheimer's risk.
Cautious, not concerned
For the time being, "this paper should make us cautious but not overly concerned," said Simon Lovestone of the University of Oxford.
John Hardy, of UCL, added it seemed "relatively sure" that Abeta can be transferred by injection.
"Does it have implications for... blood transfusions: probably not, but this definitely deserves systematic epidemiological investigation," he said via the Science Media Centre (SMC) in London.
"Does it suggest Alzheimer's disease is infectious through contact? Almost certainly not."
The study authors said the eight fatalities in the study did not have the full-blown features of Alzheimer's—they were missing the "tangles" caused by a different protein called Tau.
It was impossible to know whether they would have gone on to develop the disease.
"I wouldn't want to cause alarm on this. I don't think anyone should delay or reconsider having surgery on the basis of these data at all," said Collinge.
"We've got no evidence that this is a risk to humans, but I think it would be prudent to do some research in this area going forward."
Some 30,000 people, mostly children with growth deficiency, received the hormone injections, of whom over 200 developed CJD.
The disease has a very long incubation period, and new diagnoses continue to be made.
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