Paternal grandfather's high access to food may indicate higher mortality risk in grandsons

Potato harvesting in Kristinebergsparken, Stockholm, early 1900's. Credit: Svenska Dagbladet, unknown photographer/Stockholmskällan

A paternal grandfather's access to food during his childhood is associated with mortality risk, especially cancer mortality, in his grandson, shows a large three-generational study from Stockholm University. The reason might be epigenetic – that environmental exposures in one generation may influence health outcomes in following generations.

12 dec 2018--If a paternal grandfather had good access to food and experienced unusually high yields as a young boy, his grandson – but not granddaughter – has a higher mortality risk, the study shows. Especially high was the risk of cancer mortality. The researchers traced approximately 9,000 grandparents and examined the mortality of their grandchildren, more than 11,000 individuals. "Paternal grandfather's access to food predicts all-cause and cancer mortality in grandsons" is published in the journal Nature Communications.
"The results are very clear when it comes to the correlation between a grandfather's access to food and his grandson's mortality. A previous Swedish smaller study, the Overkalix study, showed the same result. However, we have been unable to determine other correlations over the generations," says Denny Vågerö, one of the authors of the paper and professor at the Department of Public Health Sciences, Stockholm University.
Previous research has suggested that the pre-pubertal, slow growth period (ages 9-12) is particularly vulnerable to nutritional effects. Denny Vågerö and colleagues' new study confirms this is true when it comes to men. However, there is no difference in mortality risk between grandsons whose paternal grandfather had low or average access to food.
Accounting for social factors, such as education, family size and income, the correlation between access to food and mortality in grandsons was enhanced.
The researchers do not claim to explain the causal relationship but believe that epigenetics might be the key.
"Introduction of chemical pesticides was limited in the end of the 1800's and it's not likely that it would have led to new, large-scale mutations. Therefore, the most reasonable explanation would be that boys', but not girls', germ line cells are open for epigenetic change such as nutritional effects, during pre-puberty. If that is the case, these changes might be passed on to following generations, something that is also shown in animal experiments. However, more research is needed, both in epidemiology and molecular biology," says Denny Vågerö.
The study, "Paternal grandfather's access to food predicts all-cause and cancer mortality in grandsons," expands on Uppsala Birth Cohort Multigeneration Study. Grandparents (9,039) have been traced and regional data on the yields of harvests have been used to determine the grandparents' access to food during their childhood, 1874-1910. These results were followed up by data on mortality from 1961-2015 for their grandchildren (11,561).
The study has been published in Nature Communications on December 6, 2018.

More information: Denny Vågerö et al. Paternal grandfather's access to food predicts all-cause and cancer mortality in grandsons, Nature Communications (2018). DOI: 10.1038/s41467-018-07617-9


Provided by Stockholm University

Index predicts 10-, 14-year mortality in older adults

13 mar 2017—An 11-factor index predicts 10- and 14-year mortality with excellent calibration and discrimination among community-dwelling U.S. adults aged ≥65 years, according to a study published online Feb. 21 in the Journal of the American Geriatrics Society.

Mara A. Schonberg, M.D., M.P.H., from Beth Israel Deaconess Medical Center in Boston, and colleagues examined the performance of an index in predicting 10- and 14-year mortality for community-dwelling adults aged ≥65 years from the 1997 to 2000 National Health Interview Surveys. Data were included for 16,063 and 8,027 respondents from the original development and validation cohorts. Risk scores were calculated based on the presence or absence of 11 factors that make up the index. Model calibration was examined by computing the 10- and 14-year mortality estimates with the Kaplan Meier method.
The researchers found that 14-year mortality was 23 percent for participants with risk scores of 0 to 4, compared with 89 percent for those with risk score of 13+. In both cohorts, the C-index was 0.73 and 0.72 for predicting 10- and 14-year mortality, respectively. Overall, 18.4 and 60.2 percent of those aged 65 to 74 years and ≥75 years had more than 50 percent risk of mortality in 10 years.
"Information on long-term prognosis is needed to help clinicians and older adults make more informed person-centered medical decisions and to help older adults plan for the future," the authors write.

More information: Abstract

180,000 deaths worldwide may be associated with sugary soft drinks

Sugar-sweetened sodas, sports drinks and fruit drinks may be associated with about 180,000 deaths around the world each year, according to research presented at the American Heart Association's Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism 2013 Scientific Sessions.

21 mar 2013--Sugar-sweetened beverages are consumed throughout the world, and contribute to excess body weight, which increases the risk of developing diabetes, cardiovascular diseases and some cancers. Using data collected as part of the 2010 Global Burden of Diseases Study, the researchers linked intake of sugar- sweetened beverages to 133,000 diabetes deaths, 44,000 deaths from cardiovascular diseases and 6,000 cancer deaths. Seventy-eight percent of these deaths due to over-consuming sugary drinks were in low and middle-income countries, rather than high-income countries.

"In the U.S., our research shows that about 25,000 deaths in 2010 were linked to drinking sugar-sweetened beverages," said Gitanjali M. Singh, Ph.D., co-author of the study and a postdoctoral research fellow at the Harvard School of Public Health in Boston, Mass.

Researchers calculated the quantities of sugar-sweetened beverage intake around the world by age and sex; the effects of this consumption on obesity and diabetes; and the impact of obesity and diabetes-related deaths. Of nine world regions, Latin America/Caribbean had the most diabetes deaths (38,000) related to the consumption of sugar-sweetened beverages in 2010. East/Central Eurasia had the largest numbers of cardiovascular deaths (11,000) related to sugary beverage consumption in 2010. Among the world's 15 most populous countries, Mexico—one of the countries with the highest per-capita consumption of sugary beverages in the world—had the highest death rate due to these beverages, with 318 deaths per million adults linked to sugar-sweetened beverage intake.

Japan, one of the countries with lowest per-capita consumption of sugary beverages in the world, had the lowest death rate associated with the consumption of sugary beverages, at about 10 deaths due to per million adults.

"Because we were focused on deaths due to chronic diseases, our study focused on adults. Future research should assess the amount of sugary beverage consumption in children across the world and how this affects their current and future health," Singh said.

The Global Burden of Disease Study 2010 is an international, collaborative, systematic effort to quantify the global distribution and causes of major diseases, injuries and health risk factors.

The American Heart Association recommends adults consume no more than 450 calories per week, from sugar-sweetened beverages, based on a 2,000 calorie diet and offers tips on how Life's Simple 7™ can help you make better lifestyle choices and eat healthier.

Provided by American Heart Association

New clinical tool assesses health risks for older adults

A UC San Francisco team has developed a tool that can help determine – and perhaps influence – senior citizens' 10-year survivability rates.

06 mar 2013--The simple checklist helps doctors assess health risks that influence the longevity of older adults, and according to the authors, could be an opportunity for seniors to really engage with their primary care provider in having informed discussions about their health care maintenance.

The UCSF team created a 12-item "mortality index" based on data of more than 20,000 adults over the age of 50 from 1998 until 2008, from the Health and Retirement Study (HRS), a nationally-representative sample of independently living U.S. adults. The point system was based on their risk factors and survival rate at the end of 10 years.

Their findings will be published Tuesday, March 5, in the Journal of the American Medical Association (JAMA).

Calculating medical risk can be an inexact science, especially for older adults. Many factors from environmental to chronic diseases can help determine how long a person lives.

"The most important thing we found was the risk factors that go into estimating shorter intermediate survival are very similar to risk factors that go into estimating the likelihood of longer-term survival," said first author Marisa Cruz, MD, a clinical fellow with the UCSF School of Medicine. "We also found that building a tool that clinicians can use to estimate that likelihood of longer-term survival requires considering many different types of risk factors.

"Not one particular risk factor tells you whether or not you are likely to survive but a host of attributes about your life and your medical conditions will give you a clearer picture," she said.

Points for Risk Factors

The clinical tool operates on a point system, and the total determines a patient's 10-year risk of mortality. For example, age, gender and medical conditions were given specific points. Adults between the ages of 60 and 64 received one point, for example, compared to those over the age of 85 who received seven points. Health risks such as current tobacco use, non-skin cancers, chronic lung disease and heart failure each were assigned two points.

"It's an easily usable simple model with only 12 factors. The clinician can ask the patient 'yes' or 'no' questions about his or her health and functional status and then can then go over how the patient could benefit from certain medical interventions," Cruz said.

The ability to complete cognitive or motor skills such as managing one's finances or walking several blocks also was factored into the equation. The difficulty in performing each aptitude generated one to two points.

"The goal of the study is to build a clinical tool that can be used in any setting," Cruz said. "So you want to have these kinds of models to be able to be generally applicable to a primary care provider no matter where they are."

This current research builds on a study that senior author Sei Lee, MD, MAS, assistant professor with the UCSF Division of Geriatrics, did in 2006. He and his team looked at factors that were most likely to influence intermediate term life expectancy.

"We looked at things like what factors are most predictive of someone's likelihood of surviving for four years," he said. "The new study takes that research even further by helping doctors be able to counsel patients on what clinical interventions are most likely to benefit them."

A National Sample

Researchers could not determine any difference in outcome based on geography or ethnicity. Theoretically, someone from Louisiana would have the same outcome as someone from Maine with similar risk factors.

"The goal of health care in general is to improve people's lives but I think that this project and this model in particular are meant to be able to make sure that people live the highest quality life they can," Cruz said. "Any interventions that we do in the name of promoting health must yield more benefit than harm."

"There are national guidelines that most providers are very familiar with like getting a colonoscopy every 10 years or getting a mammogram every two years. I think those are excellent and well-founded and well-studied guidelines," Cruz said. "But I do think that there are some variability in tailoring that to your particular situation, so there's benefit to engaging your primary care provider and asking, 'Does this make sense for me?'"

Provided by University of California, San Francisco

For under-75s, living alone tied to higher mortality risk

For adults younger than 75 years of age, living alone is a significant predictor of all-cause mortality, according to a study published online Jan. 14 in JAMA Internal Medicine.

17 jan 2013—For adults younger than 75 years of age, living alone is a significant predictor of all-cause mortality, according to a study published online Jan. 14 in JAMA Internal Medicine.

To examine the correlation between living alone and the risk of mortality among community-dwelling adults, Bamini Gopinath, Ph.D., from the University of Sydney in Australia, and colleagues assessed self-reported health status using the 36-Item Short-Form Survey from 3,486 participants in the Blue Mountains Eye Study (BMES) population-based cohort (aged 49 years and older). Participants who reported living with nobody or living with pets were classified as living alone. Australian National Death Index data were used to confirm deaths.

The researchers found that, over 10 years of follow-up, 21.2 percent of participants died. For the overall cohort, living alone was not associated with total mortality after multivariable adjustment. Living alone was associated with a significantly increased risk of all-cause mortality (15.0 versus 11.4 percent; multivariate-adjusted hazard ratio, 1.36) in participants younger than 75 years. Living alone was not associated with total mortality or cardiovascular diseasemortality in those aged 75 years or older.

"In the BMES, living alone was a significant predictor of all-cause mortality among those younger than 75 years, independent of self-perceived health status and socioeconomic and medical covariates," the authors write.

More information: Full Text (subscription or payment may be required) 
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Too Much Sleep or Too Little Increases Mortality Risk

HELSINKI, Finland, Oct. 1 -- Sleep excesses one way or the other can carry a roughly 20% greater mortality risk over two decades, investigators here found.
Men, in particular, had a significant increase in the associations between natural death and both stable long and stable short sleep, Christer Hublin, M.D., Ph.D., of the Finnish Institute of Occupational Health, and colleagues, reported in issue of Sleep.
The findings add to evidence of sleep's impact on health and mortality but also show that the association is complicated. "The exact mechanisms [of the association] remain unclear, and they should be assessed in experimental settings and other longitudinal studies," Dr. Hublin and colleagues concluded.
"Although the effect of sleep on mortality is fairly modest compared to . . . smoking or components of the metabolic syndrome, it is still of considerable significance as it is associated with several common disorders such as cardiovascular diseases and diabetes," they added.
Studies published over the past 20 years have generally revealed a U-shaped curve association between sleep length and mortality, with the lowest mortality associated with about seven hours of sleep, the authors stated.
Multiple studies have revealed an increased mortality risk in association with prolonged sleep (eight hours or more). In contrast, the impact of short sleep on mortality has tended to decrease after adjustment for other factors known to be associated with mortality, such as smoking, alcohol use, and physical inactivity.
Dr. Hublin and colleagues reviewed data from the Finnish Twin Cohort, involving 21,268 twins ages 18 and older who completed questionnaires between 1975 and 1981. The questionnaires included items related to sleep habits.
On the basis of the survey responses, participants were categorized as:
Short sleepers (less than seven hours)
Average sleepers
Long sleepers (more than eight hours)
Sleeping well
Sleeping fairly well
Sleeping fairly poorly or poorly
Nonusers, infrequent users, or frequent users of hypnotics or tranquilizers
Proportional hazard models were used to calculate hazard ratios for mortality during 1982 to 2003 by sleep-related variables and their combinations. The primary findings were increased mortality risks associated with:
Short sleep-men +26% and women +21%
Long sleep-men +24% and women +17%
Frequent hypotnotic use-men +31%, women +39%
Snoring as a covariate did not change the results. The effect of sleep on mortality varied by age, and the strong effects were seen in young men.
Overall, sleep length and quality changed in about a third of participants in the study during the period reviewed. The change in sleep patterns manifested in an impact on mortalilty. Among men stable short sleep was associated with a 34% increase in natural deaths and stable long sleep with a 29% increase. During 1975 to 1981, stable short sleepers had a 62% increase in the risk of death from external causes.
The authors reported no disclosures. The study was supported by the Academy of Finland Center of Excellence in Complex Disease Genetics. Primary source: SleepSource reference: Hublin C et al. "Sleep and mortality: a population-based 22-year follow-up study." Sleep 2007;30:epub.