July 2011 ~ Health News Report

Gout prevalence swells in US over last 2 decades

1:07 PM

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Increase in obesity and hypertension are likely contributors

A new study shows the prevalence of gout in the U.S. has risen over the last twenty years and now affects 8.3 million (4%) Americans. Prevalence of increased uric acid levels (hyperuricemia) also rose, affecting 43.3 million (21%) adults in the U.S. Greater frequency of obesity and hypertension may be associated with the jump in prevalence rates according to the findings now available in Arthritis & Rheumatism, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology (ACR).

Gout, an inflammatory arthritis triggered by crystallization of uric acid within the joints, causes severe pain and swelling. Medical evidence suggests that gout is strongly associated with metabolic syndrome—a group of health conditions characterized by central obesity, insulin resistance, high blood pressure and blood lipid issues—and may lead to heart attack, diabetes and premature death. Prior research found that gout incidence in the U.S. more than doubled from the 1960s to 1990s.

"Our study aim was to determine if the prevalence of gout and hyperuricemia among U.S. adults has continued to climb in the new millennium," said Dr. Hyon Choi, Professor of Medicine in the Section of Rheumatology and the Clinical Epidemiology Unit at Boston University School of Medicine in Massachusetts and senior investigator of the present study.

Researchers analyzed data from the latest U.S. National Health and Nutrition Examination Survey (NHANES) which was conducted in 2007 and 2008, comparing the data with those from previous NHANES surveys (1988-1994). There were 5,707 participants who completed the most recent NHANES survey which included questions regarding history of gout diagnosed by a healthcare professional. Researchers defined hyperuricemia as serum urate level greater than 7.0 mg/dL in men and 5.7 mg/dL in women.

Results from the nationally-representative sample of adult Americans suggest gout and hyperuricemia remain prevalent in the U.S. and compared to earlier NHANES data was 1% and 3% higher, respectively. After adjusting for obesity or hypertension, the differences in prevalence rates were substantially lessened. Further analysis revealed that gout prevalence was higher in men (6%) compared to women (2%); hyperuricemia occurred in 21.2% of men and 21.6% of women.

Dr. Choi concluded, "We found that the prevalences of gout and hyperuricemia continue to be substantial in the U.S. adult population. Improvements in managing modifiable risk factors, such as obesity and hypertension, could help prevent further escalation of gout and hyperuricemia among Americans."

1:06 PM

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Study suggests US Dietary Guideline for upper limit of sugar consumption is too high

A recent study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM) found that adults who consumed high fructose corn syrup for two weeks as 25 percent of their daily calorie requirement had increased blood levels of cholesterol and triglycerides, which have been shown to be indicators of increased risk for heart disease.

The American Heart Association recommends that people consume only five percent of calories as added sugar. The Dietary Guidelines for Americans 2010 suggest an upper limit of 25 percent or less of daily calories consumed as added sugar. To address this discrepancy in recommended consumption levels, researchers examined what happened when young overweight and normal weight adults consumed fructose, high fructose corn syrup or glucose at the 25 percent upper limit.

"While there is evidence that people who consume sugar are more likely to have heart disease or diabetes, it is controversial as to whether high sugar diets may actually promote these diseases, and dietary guidelines are conflicting," said the study's senior author, Kimber Stanhope, PhD, of the University of California, Davis. "Our findings demonstrate that several factors associated with an elevated risk for cardiovascular disease were increased in individuals consuming 25 percent of their calories as fructose or high fructose corn syrup, but consumption of glucose did not have this effect."

In this study, researchers examined 48 adults between the ages of 18 and 40 years and compared the effects of consuming 25 percent of one's daily calorie requirement as glucose, fructose or high fructose corn syrup on risk factors for cardiovascular disease. They found that within two weeks, study participants consuming fructose or high fructose corn syrup, but not glucose, exhibited increased concentrations of LDL cholesterol, triglycerides and apolipoprotein-B (a protein which can lead to plaques that cause vascular disease).

"These results suggest that consumption of sugar may promote heart disease," said Stanhope. "Additionally our findings provide evidence that the upper limit of 25 percent of daily calories consumed as added sugar as suggested by The Dietary Guidelines for American 2010 may need to be re-evaluated."

1:05 PM

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Study shows building muscle can lower person's risk of insulin resistance

A recent study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM) found that the greater an individual's total muscle mass, the lower the person's risk of having insulin resistance, the major precursor of type 2 diabetes.

With recent dramatic increases in obesity worldwide, the prevalence of diabetes, a major source of cardiovascular morbidity, is expected to accelerate. Insulin resistance, which can raise blood glucose levels above the normal range, is a major factor that contributes to the development of diabetes. Previous studies have shown that very low muscle mass is a risk factor for insulin resistance, but until now, no study has examined whether increasing muscle mass to average and above average levels, independent of obesity levels, would lead to improved blood glucose regulation.

"Our findings represent a departure from the usual focus of clinicians, and their patients, on just losing weight to improve metabolic health," said the study's senior author, Preethi Srikanthan, MD, of the University of California, Los Angeles (UCLA). "Instead, this research suggests a role for maintaining fitness and building muscle. This is a welcome message for many overweight patients who experience difficulty in achieving weight loss, as any effort to get moving and keep fit should be seen as laudable and contributing to metabolic change."

In this study, researchers examined the association of skeletal muscle mass with insulin resistance and blood glucose metabolism disorders in a nationally representative sample of 13,644 individuals. Participants were older than 20 years, non-pregnant and weighed more than 35 kg. The study demonstrated that higher muscle mass (relative to body size) is associated with better insulin sensitivity and lower risk of pre- or overt diabetes.

"Our research shows that beyond monitoring changes in waist circumference or BMI, we should also be monitoring muscle mass," Srikanthan concluded. "Further research is needed to determine the nature and duration of exercise interventions required to improve insulin sensitivity and glucose metabolism in at-risk individuals."

12:07 PM

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The study this story is based on is available from ScholarsArchive@OSU: http://bit.ly/nNir7E

A growing body of evidence suggests that antioxidants may have significant value in addressing infertility issues in both women and men, including erectile dysfunction, and researchers say that large, specific clinical studies are merited to determine how much they could help.

A new analysis, published online in the journal Pharmacological Research, noted that previous studies on the potential for antioxidants to help address this serious and growing problem have been inconclusive, but that other data indicates nutritional therapies may have significant potential.

The researchers also observed that infertility problems are often an early indicator of other degenerative disease issues such as atherosclerosis, high blood pressure and congestive heart failure. The same approaches that may help treat infertility could also be of value to head off those problems, they said.

The findings were made by Tory Hagen, in the Linus Pauling Institute at Oregon State University, and Francesco Visioli, lead author of the study at the Madrid Institute for Advanced Studies in Spain.

“If oxidative stress is an underlying factor causing infertility, which we think the evidence points to, we should be able to do something about it,” said Hagen, the Jamieson Chair of Healthspan Research in the Linus Pauling Institute. “This might help prevent other critical health problems as well, at an early stage when nutritional therapies often work best.”

The results from early research have been equivocal, Hagen said, but that may be because they were too small or did not focus on antioxidants. Laboratory and in-vitro studies have been very promising, especially with some newer antioxidants such as lipoic acid that have received much less attention.

“The jury is still out on this,” Hagen said. “But the problem is huge, and the data from laboratory studies is very robust, it all fits. There is evidence this might work, and the potential benefits could be enormous.”

The researchers from Oregon and Spain point, in particular, to inadequate production of nitric oxide, an agent that relaxes and dilates blood vessels. This is often caused, in turn, by free radicals that destroy nitric oxide and reduce its function. Antioxidants can help control free radicals. Some existing medical treatments for erectile dysfunction work, in part, by increasing production of nitric oxide.

Aging, which is often associated with erectile dysfunction problems, is also a time when nitric oxide synthesis begins to falter. And infertility problems in general are increasing, scientists say, as more people delay having children until older ages.

“Infertility is multifactorial and we still don’t know the precise nature of this phenomenon,” Visioli said.

If new approaches were developed successfully, the researchers said, they might help treat erectile dysfunction in men, egg implantation and endometriosis in women, and reduce the often serious and sometimes fatal condition of pre-eclampsia in pregnancy. The quality and health of semen and eggs might be improved.

As many as 50 percent of conceptions fail and about 20 percent of clinical pregnancies end in miscarriage, the researchers noted in their report. Both male and female reproductive dysfunction is believed to contribute to this high level of reproductive failure, they said, but few real causes have been identified.

“Some people and physicians are already using antioxidants to help with fertility problems, but we don’t have the real scientific evidence yet to prove its efficacy,” Hagen said. “It’s time to change that.”

Some commonly used antioxidants, such as vitamins C and E, could help, Hagen said. But others, such as lipoic acid, are a little more cutting-edge and set up a biological chain reaction that has a more sustained impact on vasomotor function and health.

Polyphenols, the phytochemicals that often give vegetables their intense color and are also found in chocolate and tea, are also of considerable interest. But many claims are being made and products marketed, the researchers said, before the appropriate science is completed – actions that have actually delayed doing the proper studies.

“There’s a large market of plant-based supplements that requires hard data,” Visioli said. “Most claims are not backed by scientific evidence and human trials. We still need to obtain proof of efficacy before people invest money and hope in preparations of doubtful efficacy.”

12:42 PM

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Blueberries are among the nutrient-rich foods being studied by UAB Comprehensive Cancer Center investigators exploring the link between disease and nutrition. Dieticians there say as little as a cup a day can help prevent cell damage linked to cancer.

Why are blueberries considered healthful? They're full of antioxidants, flavonoids and other vitamins that help prevent cell damage. "Antioxidants protect cells by stabilizing free radicals and can prevent some of the damage they cause," says Laura Newton M.A.Ed., R.D., an associate professor in the Department of Nutrition Sciences at the University of Alabama at Birmingham.

Free radicals, atoms that contain an odd number of electrons and are highly reactive, can cause cellular damage, one of the factors in the development of cancer; many believe a diet filled with fruits and vegetables may help reduce the risk. "Studies suggest that antioxidants may help prevent the free-radical damage associated with cancer," says Newton, a licensed dietician who often works with cancer patients.
Blueberries also are rich in vitamin C, which helps the immune system and can help the body to absorb iron. “Vitamin C also helps to keep blood vessels firm, offering protection from bruising,” Newton says.

Blueberry juice and other products may be nutritious but often contain less fiber than the whole fruit, and added sugar or corn syrup may decrease their nutritional value. Consuming fresh, raw blueberries provides the most benefits; the average serving size of raw blueberries is one cup, which contains about 80 calories.

Blueberry season is in full swing, and now is the perfect time to stock up on this delicious, nutritious fruit from farms located here in Alabama. “They can be frozen, so store some in the freezer to enjoy year round,” says Newton. “To freeze blueberries, put them in a single layer on a cookie sheet. Freeze them and then transfer to an airtight bag or container and store. Rinse them with water prior to using.”

12:40 PM

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High-dose vitamin D relieves joint and muscle pain for many breast cancer patients taking estrogen-lowering drugs, a new study shows.

High-dose vitamin D relieves joint and muscle pain for many breast cancer patients taking estrogen-lowering drugs, according to a new study from Washington University School of Medicine in St. Louis.

The drugs, known as aromatase inhibitors, are commonly prescribed to shrink breast tumors fueled by the hormone estrogen and help prevent cancer recurrence. They are less toxic than chemotherapy, but for many patients, the drugs may cause severe musculoskeletal discomfort, including pain and stiffness in the hands, wrists, knees, hips, lower back, shoulders and feet.

“About half of patients can experience these symptoms,” says Antonella L. Rastelli, MD, assistant professor of medicine and first author of the study published online in the journal Breast Cancer Research and Treatment. “We don’t know exactly why the pain occurs, but it can be very debilitating — to the point that patients decide to stop taking aromatase inhibitors.”

Because the drugs reduce cancer recurrence, finding a way to help patients stay on them is important for long-term, relapse-free survival, according to Rastelli. Aromatase inhibitors are prescribed to post-menopausal women for at least five years and often longer after a breast cancer diagnosis. There is some evidence that patients who experience the drugs’ side effects are less likely to see their cancer return, providing even more incentive to help these patients continue taking them.

It was Rastelli’s colleague, Marie E. Taylor, MD, assistant professor of radiation oncology, who first noticed that patients on aromatase inhibitors who experienced this pain found some relief from high doses of vitamin D.

So Rastelli’s group recruited 60 patients who reported pain and discomfort associated with anastrozole, one of three FDA-approved aromatase inhibitors. The patients they studied also had low vitamin D levels. Half the group was randomly assigned to receive the recommended daily dose of vitamin D (400 international units) plus a 50,000-unit vitamin D capsule once a week. The other half received the daily dose of 400 units of vitamin D plus a weekly placebo. All subjects received 1,000 milligrams of calcium daily throughout the study.

Patients in the study reported any pain they experienced through three different questionnaires. They were asked to quantify their pain intensity, as well as report how much the pain altered their mood, affected their work and interfered with relationships and daily activities. The results show that patients receiving high-dose vitamin D every week reported significantly less musculoskeletal pain and also were less likely to experience pain that interfered with daily living.

“High-dose vitamin D seems to be really effective in reducing the musculoskeletal pain caused by aromatase inhibitors,” Rastelli says. “Patients who get the vitamin D weekly feel better because their pain is reduced and sometimes goes away completely. This makes the drugs much more tolerable. Millions of women worldwide take aromatase inhibitor therapy, and we may have another ‘tool’ to help them remain on it longer.”

Like anastrozole used in this study, the other two FDA-approved aromatase inhibitors, letrozole and exemestane, also cause musculoskeletal pain. Given the similar side effects, Rastelli says patients on these drugs may also benefit from high-dose vitamin D.

The vitamin used in this study is a plant-derived type called vitamin D2. Rastelli says it achieves the best results when given weekly because the body metabolizes it within seven to 10 days. Rastelli and her colleagues did not use high-dose vitamin D3, which remains in the body longer.

“This was a very carefully conducted study, and the placebo control makes the findings quite compelling,” says Matthew J. Ellis, MD, PhD, the study’s senior author and director of the Breast Cancer Program at the Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis. “We should follow up these findings further to determine the most efficacious and safe approach to vitamin D supplementation in our breast cancer patients.”

Since vitamin D helps the body absorb calcium, too much of it can cause high levels of calcium in the urine, which may increase the risk of kidney stones. Such possible side effects emphasize the importance of tracking patients’ urine calcium levels while taking high-dose vitamin D.

“It’s important to monitor the patients, but overall it appears to be very safe,” Rastelli says. “Because vitamin D2 is eliminated from the body so quickly, it’s very hard to overdose.”

In addition to relieving pain, the group wanted to examine whether vitamin D could protect against the bone loss often seen in patients taking aromatase inhibitors. The researchers measured each patient’s bone density at the beginning of the study and again after six months.

Perhaps because of its role in calcium absorption, high-dose vitamin D did appear to help maintain bone density at the neck of the femur, the top of the thighbone near the hip joint. Although the result did not reach statistical significance, Rastelli calls the result promising and worth further studies.

“It’s great that we have something as simple as vitamin D to help patients alleviate some of this pain,” Rastelli says. “It’s not toxic — it doesn’t cause major side effects. And if it is actually protecting against bone loss, that’s even better.”

10:52 AM

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Depending on the total dosage of zinc and the composition of lozenges,
zinc lozenges may shorten the duration of common cold episodes by up to
40%, according to a study published in the Open Respiratory Medicine
Journal.

For treating the common cold, zinc lozenges are dissolved slowly in the
mouth. Interest in zinc lozenges started in the early 1980s from the
serendipitous observation that a cold of a young girl with leukemia
rapidly disappeared when she dissolved a therapeutic zinc tablet in her
mouth instead of swallowing it. Since then over a dozen studies have been
carried out to find out whether zinc lozenges are effective, but the
results of those studies have diverged.

Dr. Harri Hemila of the University of Helsinki, Finland, carried out a
meta-analysis of all the placebo-controlled trials that have examined the
effect of zinc lozenges on natural common cold infections. Of the 13 trial
comparisons identified, five used a total daily zinc dose of less than 75
mg and uniformly those five comparisons found no effect of zinc. Three
trials used zinc acetate in daily doses of over 75 mg, with the average
indicating a 42% reduction in the duration of colds. Five trials used zinc
salts other than acetate in daily doses of over 75 mg, with the average
indicating a 20% decrease in the duration of colds.

In several studies, zinc lozenges caused adverse effects, such as bad
taste, but there is no evidence that zinc lozenges might cause long term
harm. Furthermore, in the most recent trial on zinc acetate lozenges,
there were no significant differences between the zinc and placebo groups
in the occurrence of adverse effects although the daily dose of zinc was
92 mg. Dr. Hemila concluded that "since a large proportion of trial
participants have remained without adverse effects, zinc lozenges might be
useful for them as a treatment option for the common cold."

10:32 AM

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An extract of the herb St. John's Wort and a standard antidepressant medication both failed to outdo a placebo in relieving symptoms of minor depression in a clinical trial comparing the three. The results of this study, consistent with earlier research, do not in support the use of medications for mild depression.
Background

St. John's Wort is a plant whose yellow flowers have been the source of extracts used medicinally for centuries. It is widely used to treat depression, as a nutritional supplement in the United States, and as a prescription medication in Europe. Evidence from clinical trials of St. John's Wort has failed to show effectiveness for treatment of major depression; but research has raised the question as to whether the herb might offer benefit for people with less severe depression.
This Study

This study, focusing specifically on minor depression, was conducted by Mark Hyman Rapaport and colleagues at the Cedars-Sinai Medical Center and David Geffen School of Medicine in Los Angeles; the Massachusetts General Hospital, in Boston; and the University of Pittsburgh. Participants in the study had minor depression, defined as the presence of two to four symptoms used to diagnose major depression, with at least one symptom being depressed mood or anhedonia, a lack of pleasure in activities usually found enjoyable. Symptoms had to have been present for six months to two years. Subjects were randomly assigned to receive St. John's Wort, the antidepressant medication citalopram, or a placebo. Neither participants, nor the staff treating them, knew what treatment they took. Seventy-three subjects completed the trial.

Results from the trial showed that no treatment relieved depression more than any other; patients in all three of the treatment groups showed improvements in symptoms over the course of the study, and in measures of quality of life and psychological well-being.

Patients in all three treatment groups—including placebo—also frequently reported side effects. In addition, before treatment began in this study, more than half of participants responded positively when they were asked if they had any of a broad list of physical or psychological complaints. This finding suggests that it's important to assess both physical and psychological symptoms even before treatment begins; otherwise, many of these symptoms might be interpreted as medication-related.
Significance

While minor depression is by definition a milder condition than major depression, research suggests it has consequences for health and well-being that go beyond the symptoms themselves, including lost work days, social difficulties, and possibly a higher risk of developing future major depression.

The authors are careful to point out that the reason that there was no difference in benefit between St. John's Wort, citalopram, and placebo was not because the study was too small to detect a difference, but because participants taking placebo experienced substantial improvement in measures of depression and well-being—participation in the study had positive effects. In addition, participants taking all three treatments—even those on placebo—experienced side-effects. Fewer of the subjects taking St. John's Wort reported that side effects were distressing (40 vs. 60 percent); but St. John's Wort recipients reported more gastrointestinal and sleep problems than those receiving placebo.

Identifying effective and safe ways to treat minor depression remains an important goal; further research on non-pharmacologic treatment is needed to identify the optimal psychotherapies for minor depression.

This study was funded by the National Institute of Mental Health and the National Center for Complementary and Alternative Medicine, National Institutes of Health.
Reference

Rapaport, M.H., Nierenberg, A.A., Howland, R., Dording, C., Schettler, P.J., and Mischoulon, D. The treatment of minor depression with St. John's Wort or citalopram: Failure to show benefit over placebo. Journal of Psychiatric Research 45:931-941, 2011.

12:38 PM

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It’s no secret that exercise has numerous beneficial effects on the body. However, a bevy of recent research suggests that these positive effects also extend to the brain, influencing cognition. In a new review article, “Exercise, Brain and Cognition Across the Lifespan,” highlighting the results of more than a hundred recent human and animal studies on this topic, Michelle W. Voss, of the University of Illinois at Urbana-Champaign, and her colleagues show that both aerobic exercise and strength training play a vital role in maintaining brain and cognitive health throughout life. However, they also suggest that many unanswered questions remain in the field of exercise neuroscience—including how various aspects of exercise influence brain physiology and function and how human and animal studies relate to each other—and issue the call for further research to fill in these gaps.

Methodology

Using the findings from 111 recent studies, the researchers write a brief review showcasing the effects of aerobic exercise and strength training on humans ranging in age from children to elderly adults. They relate these findings to those in lab animals, such as rats and mice, which provide a window on the pathways through which exercise may enhance brain function.

Results

The review suggests that aerobic exercise is important for getting a head start during childhood on cognitive abilities that are important throughout life. For example, physical inactivity is associated with poorer academic performance and results on standard neuropsychological tests, while exercise programs appear to improve memory, attention, and decision-making. These effects also extend to young and elderly adults, with solid evidence for aerobic training benefiting executive functions, including multi-tasking, planning, and inhibition, and increasing the volume of brain structures important for memory. Although few studies have evaluated the effects of strength training on brain health in children, studies in older adults suggest that high-intensity and high-load training can improve memory.

Animal studies, primarily models that test the influence of aerobic exercise, suggest a variety of mechanisms responsible for these effects. For example, exercise appears to change brain structure, prompting the growth of new nerve cells and blood vessels. It also increases the production of neurochemicals, such as BDNF and IGF-1, that promote growth, differentiation, survival, and repair of brain cells.

Though this collection of studies clearly reveals the beneficial effects of exercise on the brain, it also highlights gaps in the scientific literature. For example, the review authors note that more research is needed on how exercise type might promote different effects on brain health and cognition. Similarly, they say, future research that integrates human and animal work will be necessary, such as studies that incorporate exercise over animals’ life spans to understand the effects of exercise at different time points, or human studies that include measures of BDNF, IGF-1, or other neurobiological markers.

Importance of the Findings

The reviewed studies suggest that both aerobic exercise and strength training can have significant positive effects on brain health and function, but more research is needed to better elucidate these effects.

“It is increasingly prevalent in the print media, television, and the Internet to be bombarded with advertisements for products and programs to enhance mental and physical health in a relatively painless fashion through miracle elixirs, computer-based training, or gaming programs, or brief exercise programs,” the authors say. “Although there is little convincing scientific evidence for such claims, there have been some promising developments in the scientific literature with regard to physical activity and exercise effects on cognitive and brain health.”

8:50 AM

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1. I'll try to remember this the next time I'm hit in a sensitive area while playing soccer:

Stand Tall To Reduce Pain

By simply adopting more dominant poses, people feel more powerful, in control and able to tolerate more distress. Out of the individuals studied, those who used the most dominant posture were able to comfortably handle more pain than those assigned a more neutral or submissive stance.

2. I am making a real effort to move around more at work and at home:

Too much sitting may be bad for your health

Lack of physical exercise is often implicated in many disease processes. However, sedentary behavior, or too much sitting, as distinct from too little exercise, potentially could be a new risk factor for disease.

Sitting for long periods doubles risk of blood clots in the lungs

Fidgeting your way to fitness

Walking to the photocopier and fidgeting at your desk are contributing more to your cardiorespiratory fitness than you might think.

Researchers have found that both the duration and intensity of incidental physical activities (IPA) are associated with cardiorespiratory fitness. The intensity of the activity seems to be particularly important, with a cumulative 30-minute increase in moderate physical activity throughout the day offering significant benefits for fitness and long-term health.

Women who sit for long periods of time everyday are two to three times more likely to develop a life-threatening blood clot in their lungs than more active women,.

3. More good news about

A. Exercise, etc

Physical activity=lower rates of cognitive impairment

Engaging in regular physical activity is associated with less decline in cognitive function in older adults.

Over half of Alzheimer's cases may be preventable

The biggest modifiable risk factors for Alzheimer's disease are, in descending order of magnitude, low education, smoking, physical inactivity, depression, mid-life hypertension, diabetes and mid-life obesity.

Healthy lifestyle associated with low risk of sudden cardiac death in women

Adhering to a healthy lifestyle, including not smoking, exercising regularly, having a low body weight and eating a healthy diet, appears to lower the risk of sudden cardiac death in women

Soluble fiber, exercise reduce belly fat

All fat is not created equal. Unsightly as it is, subcutaneous fat, the fat right under the skin, is not as dangerous to overall health as visceral fat, the fat deep in the belly surrounding vital organs.

According to a new study by researchers at Wake Forest Baptist Medical Center, the way to zero in and reduce visceral fat is simple: eat more soluble fiber from vegetables, fruit and beans, and engage in moderate activity.

B. Red Wine

Red wine, grapes may protect against Alzheimer's disease

Red wine: Exercise in a bottle?

The "healthy" ingredient in red wine, resveratrol, may prevent the negative effects sedentary lifestyles have on people.

C. Positive Thinking

The secret to successful aging: Focus on the positive

Whether we choose to accept or fight it, the fact is that we will all age, but will we do so successfully? Aging successfully has been linked with the "positivity effect", a biased tendency towards and preference for positive, emotionally gratifying experiences.

Satisfaction with the components of everyday life appears protective against heart disease
D. Fish Oil

OMEGA-3 REDUCES ANXIETY AND INFLAMMATION IN HEALTHY STUDENTS

A new study gauging the impact of consuming more fish oil showed a marked reduction both in inflammation and, surprisingly, in anxiety among a cohort of healthy young people. The findings suggest that if young participants can get such improvements from specific dietary supplements, then the elderly and people at high risk for certain diseases might benefit even more.

E. Good fat vs. bad fat

Modified Fat Diet Key to Lowering Heart Disease Risk

The debate between good fat versus bad fat continues, as a new evidence review finds that a modified fat diet — and not a low fat diet — might be the real key to reducing one’s risk of heart disease.

A low fat diet replaces saturated fat — such as or animal or dairy fat — with starchy foods, fruits and vegetables, while a modified fat diet replaces saturated fat with monounsaturated and polyunsaturated fats, found in foods such as liquid vegetable oils, fish, nuts and seeds.

F. Alcohol

Mortality lower among moderate drinkers than among abstainers

There is a strong protective effect of moderate drinking on coronary heart disease and all-cause mortality. Non-drinkers had much higher risk of death than did almost all categories of subjects consuming alcohol.

Alcohol drinking in the elderly: Risks and benefits

The report was conspicuously lacking in a discussion of the important role that moderate drinking can play in reducing the risk of coronary heart disease, ischemic stroke, diabetes, dementia, and osteoporosis.

Evidence is also accumulating that shows that the risk of Alzheimer's disease and other types of dementia is lower among moderate drinkers than among abstainers. Neurodegenerative disorders are key causes of disability and death among elderly people. Epidemiological studies have suggested that moderate alcohol consumption, may reduce the incidence of certain age-related neurological disorders including Alzheimer's disease. Regular dietary intake of flavonoid-rich foods and/or beverages has been associated with 50% reduction in the risk of dementia, a preservation of cognitive performance with ageing,a delay in the onset of Alzheimer's disease and a reduction in the risk of developing Parkinson's disease.

Further, scientific data are consistent in demonstrating that quality of life is better and total mortality is lower among moderate drinkers than among abstainers.

A particular interesting paper by White et al showed a direct dose-response relation between alcohol consumption and risk of death in women aged 16-54 and in men aged 16-34, whereas at older ages the relation is U shaped. These investigators used statistical models relating alcohol consumption to the risk of death from single causes to estimate the all-cause mortality risk for men and women of different ages. The authors state that their data suggest that women should INCREASE their intake to 3 units a day over age 75, and men rise from 3 units a day up to age 54 to 4 units a day up to age 84.

G. Vitamin D

Calcium Plus Vitamin D May Reduce Melanoma Risks

A combination of calcium and vitamin D may cut the chance of melanoma in half for some women at high risk of developing this life-threatening skin cancer.

Vitamin D can help elderly women survive

Vitamin D fights macular degeneration>

H. Salt not being such a problem after all

Cutting down on salt doesn't reduce your chance of dying

I. Aspirin

Higher daily dose of aspirin prevents heart attacks

J. Strawberries

Strawberries Fight Diabetes and Nervous System Disorders

A recent study from scientists at the Salk Institute for Biological Studies suggests that a strawberry a day (or more accurately, 37 of them) could keep not just one doctor away, but an entire fleet of them, including the neurologist, the endocrinologist, and maybe even the oncologist.

7:03 AM

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According to a study by Scott Wiltermuth, assistant professor of management organization at the USC Marshall School of Business, and Vanessa K. Bohns, postdoctoral fellow at the J.L. Rotman School of Management at the University of Toronto, adopting dominant versus submissive postures actually decreases your sensitivity to pain.

The study, "It Hurts When I Do This (or You Do That)" published in the Journal of Experimental Social Psychology, found that by simply adopting more dominant poses, people feel more powerful, in control and able to tolerate more distress. Out of the individuals studied, those who used the most dominant posture were able to comfortably handle more pain than those assigned a more neutral or submissive stance.

Wiltermuth and Bohns also expanded on previous research that shows the posture of a person with whom you interact will affect your pose and behavior. In this case, Wiltermuth and Bohns found that those adopting submissive pose in response to their partner's dominant pose showed a lower threshold for pain.

Fake it until you make it

While most people will crawl up into a ball when they are in pain, Bohn's and Wiltermuth's research suggests that one should do the opposite. In fact, their research suggests that curling up into a ball may make the experience more painful because it will make you feel like you have no control over your circumstances, which may in turn intensify your anticipation of the pain. Instead, try sitting or standing up straight, pushing your chest out and expanding your body. These behaviors can help create a sense of power and control that may in turn make the procedure more tolerable. Based on previous research, adopting a powerful, expansive posture rather than constricting your body, may also lead to elevated testosterone, which is associated with increased pain tolerance, and decreased cortisol, which may make the experience less stressful.

Keeping Your Chin Up Might Really Work to Manage Emotional Pain

While prior research shows that individuals have used pain relievers to address emotional pain, it is possible that assuming dominant postures may make remembering a breakup or some distressing emotional event less painful.

Caregivers Need to Let Go

Caregivers often try to baby those for whom they are caring to help make things easier and alleviate stress. In doing this, they force those they are caring for in a more submissive position -- and thus, according to this new research, possibly render their patients more susceptible to experiencing pain. Rather, this research suggests that caregivers take a more submissive position and surrender control to those who are about to undergo a painful procedure to lessen the intensity of the pain experienced.

12:54 PM

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Engaging in regular physical activity is associated with less decline in cognitive function in older adults, according to two studies published Online First by Archives of Internal Medicine, one of the JAMA/Archives journals. The articles are being released on July 19 to coincide with the International Conference on Alzheimer's Disease in Paris and will be included in the July 25 print edition.

According to background information provided in the articles, previous research has suggested that physical activity is associated with reduced rates of cognitive impairment in older adults. However, much of this research has apparently been conducted among individuals who are generally in good health. Further, many of these studies rely on self-reports of physical activity, which are not always accurate; and focus on moderate or vigorous exercise, instead of low-intensity physical activity. The two articles being presented today seek to fill in these gaps in the research.

In one article, Marie-Noël Vercambre, Ph.D., from the Foundation of Public Health, Mutuelle Generale de l'Education Nationale, Paris, and colleagues examined data from the Women's Antioxidant Cardiovascular Study, which included women who had either prevalent vascular disease or three or more coronary risk factors. The researchers determined patients' physical activity levels at baseline (1995 to 1996) and every two years thereafter. Between 1998 and 2000, they conducted telephone interviews with 2,809 women; the calls included tests of cognition, memory and category fluency, and followed up the tests three more times over the succeeding 5.4 years.

The researchers analyzed data to correlate cognitive score changes with total physical activity and energy expenditure from walking. As participants' energy expenditure increased, the rate of cognitive decline decreased. The amount of exercise equivalent to a brisk, 30-minute walk every day was associated with lower risk of cognitive impairment.

In another report, Laura E. Middleton, Ph.D., from the Heart and Stroke Foundation Centre for Stroke Recovery, Sunnybrook Research Institute, Toronto, and colleagues utilized data from the Health, Aging, and Body Composition study, an ongoing prospective cohort study. The researchers measured participants' total energy expenditure by using doubly labeled water, a technique that provides evidence of how much water a person loses and thus serves as an objective measure of metabolic activity. The authors calculated participants' activity energy expenditure (AEE), defined as 90 percent of total energy expenditure minus resting metabolic rate. The 197 participants, with an average age of 74.8 years, had no mobility or cognitive problems when the research began in 1998 to 1999. At that time, researchers assessed participants' cognitive function, and followed up two to five years later with the Modified Mini-Mental State Examination (MMMSE).

The authors adjusted the data for baseline MMMSE scores, demographics, fat-free mass, sleep duration, self-reported health and diabetes mellitus. When these variables were accounted for, participants who had the highest AEE scores tended to have lower odds of incident cognitive impairment. The authors also noticed a significant dose response between AEE and incidence of cognitive impairment.

The authors of both articles suggest that there is more to be learned about the relationship between physical activity and cognitive function. "Various biologic mechanisms may explain the positive relation between physical activity and cognitive health," write Vercambre and colleagues. Middleton and co-authors state, "The mechanisms by which physical activity is related to late-life cognition are likely to be multifactorial." Both groups of researchers note that studies such as theirs point toward some possible answers. As Vercambre and co-authors comment, "If confirmed in future studies, physical activity recommendations could yield substantial public health benefits given the growing number of older persons with vascular conditions and their high risk of cognitive impairment." And Middleton and colleagues conclude, "We are optimistic that even low-intensity activity of daily living may be protective against incident cognitive impairment."

12:53 PM

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Over half of all Alzheimer's disease cases could potentially be prevented through lifestyle changes and treatment or prevention of chronic medical conditions, according to a study led by Deborah Barnes, PhD, a mental health researcher at the San Francisco VA Medical Center.

Analyzing data from studies around the world involving hundreds of thousands of participants, Barnes concluded that worldwide, the biggest modifiable risk factors for Alzheimer's disease are, in descending order of magnitude, low education, smoking, physical inactivity, depression, mid-life hypertension, diabetes and mid-life obesity.

In the United States, Barnes found that the biggest modifiable risk factors are physical inactivity, depression, smoking, mid-life hypertension, mid-life obesity, low education and diabetes.

Together, these risk factors are associated with up to 51 percent of Alzheimer's cases worldwide (17.2 million cases) and up to 54 percent of Alzheimer's cases in the United States (2.9 million cases), according to Barnes.

"What's exciting is that this suggests that some very simple lifestyle changes, such as increasing physical activity and quitting smoking, could have a tremendous impact on preventing Alzheimer's and other dementias in the United States and worldwide," said Barnes, who is also an associate professor of psychiatry at the University of California, San Francisco.

1:14 PM

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Researchers at Mount Sinai School of Medicine have found that grape seed polyphenols—a natural antioxidant—may help prevent the development or delay the progression of Alzheimer's disease. The research, led by Giulio Maria Pasinetti, MD, PhD, The Saunder Family Professor in Neurology, and Professor of Psychiatry and Geriatrics and Adult Development at Mount Sinai School of Medicine, was published online in the current issue of the Journal of Alzheimer's Disease.

This is the first study to evaluate the ability of grape-derived polyphenols to prevent the generation of a specific form of β-amyloid (Aβ) peptide, a substance in the brain long known to cause the neurotoxicity associated with Alzheimer disease. In partnership with a team at the University of Minnesota led by Karen Hsiao Ashe, MD, PhD, Dr. Pasinetti and his collaborators administered grape seed polyphenolic extracts to mice genetically determined to develop memory deficits and Aβ neurotoxins similar to those found in Alzheimer's disease. They found that the brain content of the Aβ*56, a specific form of Aβ previously implicated in the promotion of Alzheimer's disease memory loss, was substantially reduced after treatment.

Previous studies suggest that increased consumption of grape-derived polyphenols, whose content, for example, is very high in red wine, may protect against cognitive decline in Alzheimer's. This new finding, showing a selective decrease in the neurotoxin Aβ*56 following grape-derived polyphenols treatment, corroborates those theories.

"Since naturally occurring polyphenols are also generally commercially available as nutritional supplements and have negligible adverse events even after prolonged periods of treatment, this new finding holds significant promise as a preventive method or treatment, and is being tested in translational studies in Alzheimer's disease patients," said Dr. Pasinetti.

The study authors emphasize that in order for grape-derived polyphenols to be effective, scientists need to identify a biomarker of disease that would pinpoint who is at high risk to develop Alzheimer's disease.

"It will be critical to identify subjects who are at high risk of developing Alzheimer's disease, so that we can initiate treatments very early and possibly even in asymptomatic patients," said Dr. Pasinetti. "However, for Alzheimer's disease patients who have already progressed into the initial stages of the disease, early intervention with this treatment might be beneficial as well. Our study implicating that these neurotoxins such as Aβ*56 in the brain are targeted by grape-derived polyphenols holds significant promise."

This research was funded by a grant from the National Institutes of Health. Dr. Giulio Pasinetti is a named inventor of a pending patent application filed by Mount Sinai School of Medicine (MSSM) related to the study of Alzheimer's disease. In the event the pending or issued patent is licensed, Dr. Pasinetti would be entitled to a share of any proceeds MSSM receives from the licensee.

2:18 PM

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Whether we choose to accept or fight it, the fact is that we will all age, but will we do so successfully? Aging successfully has been linked with the "positivity effect", a biased tendency towards and preference for positive, emotionally gratifying experiences. New research published in Biological Psychiatry now explains how and when this effect works in the brain.

German neuroscientists studied this effect by using neuroimaging to evaluate brain engagement in young and old adults while they performed a specialized cognitive task that included supposedly irrelevant pictures of either neutral, happy, sad or fearful faces. During parts of the task when they didn't have to pay as much attention, the elderly subjects were significantly more distracted by the happy faces. When this occurred, they had increased engagement in the part of the brain that helps control emotions and this stronger signal in the brain was correlated with those who showed the greatest emotional stability.

"Integrating our findings with the assumptions of life span theories we suggest that motivational goal-shifting in healthy aging leads to a self-regulated engagement in positive emotions even when this is not required by the setting," explained author Dr. Stefanie Brassen. "In addition, our finding of a relationship between rostral anterior cingulate cortex activity and emotional stability further strengthens the hypothesis that this increased emotional control in aging enhances emotional well being."

"The lessons of healthy aging seem to be similar to those of resilience, throughout life. As recently summarized in other work by Drs. Dennis Charney and Steven Southwick, when coping with extremely stressful life challenges, it is critical to realistically appraise the situation but also to approach it with a positive attitude," noted Dr. John H. Krystal, the Editor of Biological Psychiatry.

Lifespan theories explain that positivity bias in later life reflects a greater emphasis on short-term rather than long-term priorities. The study by Dr. Brassen and colleagues now provides another clue to how the brain contributes to this age-related shift in priorities.

This makes aging successfully sound so simple – use your brain to focus on the positive.

1:35 PM

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Improving and maintaining health factors not traditionally associated with dementia, such as denture fit, vision and hearing, may lower a person's risk for developing dementia, according to a new study published in the July 13, 2011, online issue of Neurology®, the medical journal of the American Academy of Neurology.

"Our study suggests that rather than just paying attention to already known risk factors for dementia, such as diabetes or heart disease, keeping up with your general health may help reduce the risk for dementia," said study author Kenneth Rockwood, MD, of Dalhousie University in Halifax, Nova Scotia, Canada.

The study included 7,239 people free of dementia ages 65 and older from the Canadian Study of Health and Aging. After five years and again after 10 years, they were evaluated for Alzheimer's disease and all types of dementia. Participants were asked questions about 19 health problems not previously reported to predict dementia. Problems included arthritis, trouble hearing or seeing, denture fit, chest or skin problems, stomach or bladder troubles, sinus issues, broken bones and feet or ankle conditions, among others.

After 10 years, 2,915 of the participants had died, 883 were cognitively healthy, 416 had Alzheimer's disease, 191 had other types of dementia, 677 had cognitive problems but no dementia, and the cognitive status of 1,023 people was not clear.

The study found that each health problem increased a person's odds of developing dementia by 3.2 percent compared to people without such health problems. Older adults without health problems at baseline had an 18 percent chance to become demented in 10 years, while such risk increased to 30 percent and 40 percent in those who had 8 and 12 health problems, respectively.

"More research needs to be done to confirm that these non-traditional health problems may indeed be linked to an increased risk of dementia, but if confirmed, the consequences of these findings could be significant and could lead to the development of preventive or curative strategies for Alzheimer's disease," said Jean François Dartigues, MD, PhD, with the National Institute of Health and Medical Research (INSERM) in Paris, France, in an accompanying editorial.

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A new study gauging the impact of consuming more fish oil showed a marked reduction both in inflammation and, surprisingly, in anxiety among a cohort of healthy young people.

The findings suggest that if young participants can get such improvements from specific dietary supplements, then the elderly and people at high risk for certain diseases might benefit even more.

The findings by a team of researchers at Ohio State University were just published in the journal Brain, Behavior and Immunity. It is the latest from more than three decades of research into links between psychological stress and immunity.

Omega-3 polyunsaturated fatty acids, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have long been considered as positive additives to the diet. Earlier research suggested that the compounds might play a role in reducing the level of cytokines in the body, compounds that promote inflammation, and perhaps even reduce depression.

Psychological stress has repeatedly been shown to increase cytokine production so the researchers wondered if increasing omega-3 might mitigate that process, reducing inflammation.

To test their theory, they turned to a familiar group of research subjects – medical students. Some of the earliest work these scientists did showed that stress from important medical school tests lowered students’ immune status.

“We hypothesized that giving some students omega-3 supplements would decrease their production of proinflammatory cytokines, compared to other students who only received a placebo,” explained Janice Kiecolt-Glaser, professor of psychology and psychiatry.

“We thought the omega-3 would reduce the stress-induced increase in cytokines that normally arose from nervousness over the tests.”

The team assembled a field of 68 first- and second-year medical students who volunteered for the clinical trial. The students were randomly divided into six groups, all of which were interviewed six times during the study. At each visit, blood samples were drawn from the students who also completed a battery of psychological surveys intended to gauge their levels of stress, anxiety or depression. The students also completed questionnaires about their diets during the previous weeks.

Half the students received omega-3 supplements while the other half were given placebo pills.

“The supplement was probably about four or five times the amount of fish oil you’d get from a daily serving of salmon, for example,” explained Martha Belury, professor of human nutrition and co-author in the study.

Part of the study, however, didn’t go according to plans.

Changes in the medical curriculum and the distribution of major tests throughout the year, rather than during a tense three-day period as was done in the past, removed much of the stress that medical students had shown in past studies.

“It may be too early to recommend a broad use of omega-3 supplements throughout the public, especially considering the cost and the limited supplies of fish needed to supply the oil,” Belury said. “People should just consider increasing their omega-3 through their diet.”

“These students were not anxious. They weren’t really stressed. They were actually sleeping well throughout this period, so we didn’t get the stress effect we had expected,” Kiecolt-Glaser said.

But the psychological surveys clearly showed an important change in anxiety among the students: Those receiving the omega-3 showed a 20 percent reduction in anxiety compared to the placebo group.

An analysis of the of the blood samples from the medical students showed similar important results.

“We took measurements of the cytokines in the blood serum, as well as measured the productivity of cells that produced two important cytokines, interleukin-6 (IL-6) and tumor necrosis factor alpha (TNFa),” said Ron Glaser, professor of molecular virology, immunology & medical genetics and director of the Institute for Behavioral Medicine Research.

“We saw a 14 percent reduction in the amounts of IL-6 among the students receiving the omega-3.” Since the cytokines foster inflammation, “anything we can do to reduce cytokines is a big plus in dealing with the overall health of people at risk for many diseases,” he said.

While inflammation is a natural immune response that helps the body heal, it also can play a harmful role in a host of diseases ranging from arthritis to heart disease to cancer.

While the study showed the positive impact omega-3 supplements can play in reducing both anxiety and inflammation, the researchers aren’t willing to recommend that the public start adding them to the daily diet.

"It may be too early to recommend a broad use of omega-3 supplements throughout the public, especially considering the cost and the limited supplies of fish needed to supply the oil,” Belury said. “People should just consider increasing their omega-3 through their diet.”

Some of the researchers, however, acknowledged that they take omega-3 supplements.

2:22 PM

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Source: Health Behavior News Service

The debate between good fat versus bad fat continues, as a new evidence review finds that a modified fat diet — and not a low fat diet — might be the real key to reducing one’s risk of heart disease.

A low fat diet replaces saturated fat — such as or animal or dairy fat — with starchy foods, fruits and vegetables, while a modified fat diet replaces saturated fat with monounsaturated and polyunsaturated fats, found in foods such as liquid vegetable oils, fish, nuts and seeds.

Lead review author Lee Hooper, M.D., said she and her colleagues were surprised there was such a clear difference between the effects of the diets.

Hooper, a senior lecturer in research synthesis and nutrition at Norwich Medical School at the University of East Anglia, in England, said the main theory has been that eating saturated fat raises LDL cholesterol, which raises our risk of cardiovascular disease and therefore should make the effects of a low fat diet and a modified fat diet very similar.

“However, the review shows clearly that modified fat diets appear to be more effective in reducing the risk of cardiovascular events than low fat diets,” she said. “This could be due to a low fat diet being harder to maintain, but this is not clear.”

The review appears in the July issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates research in all aspects of health care. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing trials on a topic.

The authors published an earlier version of this review in 2000, in which 27 randomized controlled studies were included. This current version analyzes 48 studies conducted between 1965 and 2009 and including 65,508 participants from around the globe. Participants were all adults who had heart disease, were at risk of heart disease or were from the general healthy population. All studies reduced or modified participants’ dietary fat or cholesterol for at least six months by at least 30 percent.

Hooper and her team found that reducing saturated fat in diets reduced the risk of having a cardiovascular event, such as heart attack, stroke and unplanned heart surgery, by 14 percent. Of the 65,508 participants, 7 percent had a cardiovascular event. Researchers noted benefits in individuals who followed a modified diet for at least two years.

Yet, is a 14 percent reduced risk enough to motivate people to change their diets?
“In my experience people are very individual as far as what motivates them to make dietary changes,” said Rachel Johnson, a professor of medicine at the University of Vermont. “Many counselors assess their clients’ stages of change to determine whether they are open to making lifestyle changes.”

Johnson said that among others, the stages of change include (1) pre-contemplation: not yet acknowledging there is a problem behavior that needs to be changed, (2) action/willpower: changing behavior and (3) maintenance: sustaining the behavior change.
“Information like this study provides may be helpful in motivating people who have moved past the pre-contemplation stage to make a change,” she added.

The Cochrane reviewers were unable to find proof that making long-term reductions to dietary fat intake had any effect on a person’s risk of death by cardiovascular causes, including heart attack, stroke and diabetes. The evidence also was not clear as to whether currently healthy people would benefit by reducing fat in their diets as much as those who are already at risk of heart disease.

“There is no clear difference in effect in people at increased risk of cardiovascular disease and in the general population,” said Hooper. She added, though, that data suggest “we would all benefit to some extent.”

The American Heart Association (AHA) recommends watching both your intake of trans fat and saturated fat. The association suggests people eat less than 7 percent of total calories from saturated fat and less than 1 percent of total calories from trans fat.
And while, according to the AHA website, Americans should reduce “bad” fats in our diet and replace them with the “better” fats — monounsaturated and polyunsaturated fats — the Cochrane reviewers found it was not clear which of these fats are more beneficial.
T

2:11 PM

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Lack of physical exercise is often implicated in many disease processes. However, sedentary behavior, or too much sitting, as distinct from too little exercise, potentially could be a new risk factor for disease. The August issue of the American Journal of Preventive Medicine features a collection of articles that addresses many aspects of the problem of sedentary behavior, including the relevant behavioral science that will be needed to evaluate whether initiatives to reduce sitting time can be effective and beneficial.

"Epidemiologic and physiologic research on sedentary behavior suggests that there are novel health consequences of prolonged sitting time, which appear to be independent of those attributable to lack of leisure-time physical activity," commented Neville Owen, PhD, Head of Behavioural Epidemiology at the Baker IDI Heart and Diabetes Institute, Melbourne, Australia. "However, behavioral research that could lead to effective interventions for influencing sedentary behaviors is less developed, especially so for adults. The purpose of this theme issue of the American Journal of Preventive Medicine is to propose a set of perspectives on 'too much sitting' that can guide future research. As the theme papers demonstrate, recent epidemiologic evidence (supported by physiologic studies) is consistent in identifying sedentary behavior as a distinct health risk. However, to build evidence-based approaches for addressing sedentary behavior and health, there is the need for research to develop new measurement methods, to understand the personal, social, and environmental factors that influence sedentary behaviors, and to develop and test the relevant interventions."

Contributed by an international, multidisciplinary group of experts, papers include a compelling cross-national comparison of sedentary behavior, several reports on trends in sedentary behavior among children and a discussion of the multiple determinants of sedentary behavior and potential interventions. The collection is particularly noteworthy because it:

- Represents a major advance in collecting and analyzing current research on sedentary behavior, especially the relevant behavioral science that must be better understood if such behaviors are to change over time to improve health outcomes.
- Adds "momentum" to the discussion about sedentary behavior potentially being an independent risk factor for disease, ie, when examined specifically and distinctly from the effects of physical activity or exercise in large prospective studies, those who sit more often are found to have a greater risk of premature death, particularly from heart disease.
- Indicates that, despite the need for additional research on potential cause-and-effect relationships, and particularly the underlying physiological mechanisms that might be at play, there is now a growing momentum to address the issue of sedentary behavior more proactively in health promotion and disease prevention.
- Shows that children's current and future health is particularly at risk given that they spend substantial amounts of their day sitting at school, at home and through transport, and that new technologies and entertainment formats may exacerbate this problem. Thus, it is critical to understand what influences children to sit so much, so we can develop effective interventions.

Has particularly important implications for workplace environments and the potential health benefits of re-engineering workplace design and processes, especially in developed countries where most adults spend most of their workday sitting. These concerns have an important economic, population health and social equity context, even though the studies did not include economic or sociocultural research on this topic specifically.

The authors highlight the fact that broad-reach approaches and environmental and policy initiatives are becoming part of the sedentary behavior and health research agenda. In this context, mass media health promotion campaigns are already beginning to incorporate messages about reducing sitting time in the home environment, together with now-familiar messages about increasing physical activity. In the workplace, there is already active marketing of innovative technologies that will act to reduce sitting time (such as height-adjustable desks). Community entertainment venues or events may also consider providing non-sitting alternatives. Community infrastructure to increase active transport (through walking or biking) is also likely to reduce time spent sitting in cars. If such innovations are more broadly implemented, systematic evaluations of these "natural experiments" could be highly informative, especially through assessing whether changes in sedentary time actually do result.

6:58 AM

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A new study demonstrates that higher-protein meals improve perceived appetite and satiety in overweight and obese men during weight loss. According to the research, published in Obesity, higher-protein intake led to greater satiety throughout the day as well as reductions in both late-night and morning appetite compared to a normal protein diet.

"Research has shown that higher-protein diets, those containing 18 to 35 percent of daily calorie intake from dietary protein, are associated with reductions in hunger and increased fullness throughout the day and into the evening hours," said Heather Leidy, Ph.D., study author and professor in the Department of Nutrition and Exercise Physiology at the University of Missouri. "In our study, the two groups ate either 25 or 14 percent of calories from protein, while the total calories and percent of calories from fat stayed the same between the higher-protein and normal-protein diet patterns. "

During the study, Dr. Leidy and associates also conducted an eating frequency substudy in which the 27 participants on both normal- and higher-protein diets consumed either three meals or six meals per day. The researchers found that eating frequency had no effect on appetite and satiety on the normal-protein diet. However, subjects on the higher-protein diet who ate three meals per day experienced greater evening and late-night fullness than those who ate six meals per day.

11:34 AM

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The author of this paper set out to determine the extent to which potential "errors" in many early epidemiologic studies led to erroneous conclusions about an inverse association between moderate drinking and coronary heart disease (CHD). His analysis is based on prospective data for more than 124,000 persons interviewed in the U.S. National Health Interview Surveys of 1997 through 2000 and avoids the pitfalls of some earlier studies. He concludes that the so-called "errors" have not led to erroneous results, and that there is a strong protective effect of moderate drinking on CHD and all-cause mortality.

The results of this analysis support the vast majority of recent well-done prospective studies. In the present paper, non-drinkers had much higher risk of death than did almost all categories of subjects consuming alcohol. The author contends that these results lend credence to the argument that the relationship between alcohol and mortality is causal.

While some Forum reviewers felt that this analysis only replicates what has been shown in many other papers, it appears that erroneous information continues to be used by some policy groups in setting drinking guidelines. Thus, most reviewers believe that this new analysis provides important information on potential health effects of moderate drinking.

10:30 AM

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A combination of calcium and vitamin D may cut the chance of melanoma in half for some women at high risk of developing this life-threatening skin cancer, according to a new study by Stanford University School of Medicine researchers.

Using existing data from a large clinical trial, the study zeroed in on women with a history of non-melanoma skin cancer, as people with this generally non-fatal disease are more likely to develop the more lethal illness -- melanoma. The researchers found that women who once had non-melanoma and took the calcium-vitamin D combination developed 57 percent fewer melanomas than women with similar histories who were not given the supplements. Non-melanoma skin cancers, such as basal cell or squamous cell cancers, are the most common forms of skin cancer.

"In preventive medicine, we want to target people most at risk for the disease," said dermatologist Jean Tang, MD, PhD, lead author of the study. "If you previously had a non-melanoma skin cancer, calcium plus vitamin D might reduce your risk of the more deadly melanoma."

Tang added a note of caution. The study found that a daily dose of 1,000 mg calcium plus 400 IU of vitamin D doesn't provide skin cancer protection for everybody. Women without a history of non-melanoma skin cancer who took the supplements did not see any reduction of risk compared with their placebo-group counterparts, according to the research.

The study will be published online on June 27 in the Journal of Clinical Oncology.

Vitamin D is well-known for its role in bone growth, but it also affects non-skeletal cells. In many parts of the body, including the skin, vitamin D controls how quickly cells replicate, a process that often goes awry in cancer. Reports from various institutions have suggested that vitamin D is associated with lower risks of colon, breast, prostate and other cancers. Nonetheless, the Institute of Medicine published a report last November saying that more research was needed on vitamin D and calcium, as the evidence was insufficient to prove their having a benefit for conditions other than bone health.

This study is the second to look at the effect of vitamin D supplementation on cancer risk with a randomized, controlled trial.

Tang and colleagues analyzed data from the Women's Health Initiative, a study that followed 36,000 women ages 50 to 79 for an average of seven years. Half of the women took the daily dose of calcium and vitamin D as part of the experiment; the other half took a placebo pill. The WHI calcium plus vitamin D trial was designed to look at the effects of the supplement on hip fractures and colorectal cancers, but its researchers collected data on many other health issues, including other cancers.

Tang and colleagues took advantage of the large and long-term data set provided by the WHI trial to explore whether vitamin D has a protective effect against skin cancer. "Our results include the first positive cancer-reducing effect seen from the calcium plus vitamin D trial," said Teresa Fu, MD, a co-author of the study and a recent graduate of the School of Medicine.

The lack of protective effect in women without a history of non-melanoma skin cancer may be due to the amount of vitamin D given to the patients in the WHI trial. "The patients in the Women's Health Initiative were given vitamin D at a very low dose, based on today's knowledge -- only 400 IU per day," said David Feldman, MD, professor emeritus of endocrinology and a co-author of the study. Furthermore, patients in the placebo group were allowed to take as much vitamin D as patients that were provided the calcium and vitamin D supplements, so the experimental difference between the two groups was small. In light of that small difference, "it's somewhat surprising that there was an effect on melanoma risk, and I think many potential benefits of vitamin D may not have been detected," said Feldman.

Because men were not included in the trial, the researchers cannot be certain whether the protective effect of the supplements would also apply to men with a history of non-melanoma skin cancer. Nonetheless, a 2010 study by Tang demonstrated that elderly men with higher blood levels of vitamin D have fewer non-melanoma skin cancers.

Even in a large study like the WHI, the low frequency of melanomas means that the absolute number of cancers was small. Out of the 36,000 participants, only 176 cases of melanoma were reported. "That just highlights how large a trial needs to be to capture cancer as relatively rare as melanoma," said Marcia Stefanick, PhD, the Stanford WHI principal investigator and senior author of this study.

"These results spur us to do more studies," said Tang. She is planning multiple lines of research to examine the potential relationship between vitamin D and cancer prevention, including a study that will compare blood levels of vitamin D with melanoma outcomes. Another line of research will examine the effect of larger doses of vitamin D on the behavior of skin cells in patients with high skin-cancer risk.

9:43 AM

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Women who sit for long periods of time everyday are two to three times more likely to develop a life-threatening blood clot in their lungs than more active women, finds a study published on bmj.com today.

The new study is the first to prove that a sedentary lifestyle increases your risk of developing a pulmonary embolism – a common cause of heart disease.

An editorial published alongside the study says that, although the risk is small – equivalent to seven extra cases per 10,000 person years, and only slightly higher than seen in users of oral contraceptives or long haul airplane travel - the findings could have major health ramifications.

Pulmonary embolism develops when part, or all, of the blood clot travels through the bloodstream from the deep veins in the leg and up into the lungs. Symptoms include difficulty breathing, chest pain and coughing.

While other studies have explored the relationship between physical activity and pulmonary embolism, few data are available linking the condition with physical inactivity.

Dr Christopher Kabrhel and colleagues studied 69,950 female nurses over an 18-year period providing detailed information about their lifestyle habits by completing biennial questionnaires.

They found that the risk of pulmonary embolism is more than two times higher in women who spend most time sitting (more than 41 hours a week outside of work) compared with those who spend least time sitting (less than 10 hours a week outside of work).

The results remained conclusive after taking account of factors such as age, body mass index and smoking, adding to the evidence that physical inactivity is a major cause of this condition.

The study also shows that physical inactivity correlated with heart disease and hypertension and could be one of the hidden mechanisms that link arterial disease and venous disease.

The authors conclude that physical inactivity is associated with incident pulmonary embolism in women, and suggest that public health campaigns that discourage physical inactivity among the general population could reduce the incidence of pulmonary embolism.

In the accompanying editorial, researchers in Canada say the study "reinforces the notion that prolonged inactivity increases the risk of venous thromboembolism, and it shows how this occurs in everyday life." The findings also indirectly support the use of preventive interventions for at risk people with prolonged immobility, they conclude.

9:42 AM

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While depression and anxiety have long been recognised as risk factors for heart disease, there is less certainty over the beneficial effects of a 'positive' psychological state, Now, following a study of almost 8000 British civil servants, researchers say that a satisfying life is indeed good for the heart.

The results of the study are published online today by the European Heart Journal.(1)

The civil servants - who were all members of the Whitehall II study cohort in the UK with an average age of 49 years (2) - were questioned about seven specific areas of their everyday lives: love relationships, leisure activities, standard of living, job, family, sex, and one's self. They were asked to rate their satisfaction in each domain on a scale of 1 ('very dissatisfied') to 7 ('very satisfied'). Ratings for each domain were also combined to provide an average satisfaction score for their overall lives.

The participants' health records were then examined for coronary related deaths, non-fatal heart attack, and clinically verified angina over a follow-up period of around six years.

Results of the investigation showed that higher levels of average life satisfaction were associated with a reduced (and statistically significant) risk of total coronary heart disease of 13% (HR 0.87; 95% CI: 0.78 – 0.98), after controlling for demographic and other health characteristics. An approximate 13% reduced risk of heart disease was also associated with satisfaction in four of the specific life domains - job, family, sex, and self (but not with love relationships, leisure activities, or standard of living). The reduced risk of total coronary heart disease was found in both men and women.

There was a 'dose response' in these associations such that those reporting the greatest average life satisfaction appeared to enjoy the greatest risk reduction in total coronary disease. However, when examining the association between average life satisfaction and fatal or non-fatal heart attack separately from angina, reduced risk was only evident with angina, which appeared to be driving the association between life satisfaction and total coronary heart disease. Such findings may be accounted for by the relatively young age of the study participants or by the possibility that life satisfaction may relate to a general risk of atherosclerosis but not to factors predisposing individuals to heart attack. Nevertheless, the authors propose that understanding the psychological profile of patients with angina may add predictive value to an assessment of their subsequent heart disease risk.

'Taken together,' say the investigators, 'this research indicates that being satisfied with specific life domains - in particular, one's job, family, sex life, and self - is a positive health asset associated with a reduction in incident coronary heart disease independently of traditional risk factors.'

Commenting on the results, investigator Dr Julia Boehm from the Department of Society, Human Development, and Health, at the Harvard School of Public Health, Boston, USA, said: 'Although conventional risk factors such as health behaviors, blood pressure, lipids and body mass index did not explain the relationship between life satisfaction and total coronary heart disease, other behavioural or biological mechanisms that promote resilience cannot be ruled out. Moreover, these findings suggest that interventions to bolster positive psychological states - not just alleviate negative psychological states - may be relevant among high-risk individuals.'

9:29 AM

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Adhering to a healthy lifestyle, including not smoking, exercising regularly, having a low body weight and eating a healthy diet, appears to lower the risk of sudden cardiac death in women, according to a study in the July 6 issue of JAMA.

"Sudden cardiac death (SCD) [defined as death occurring within one hour after symptom onset without evidence of circulatory collapse] accounts for more than half of all cardiac deaths, with an incidence of approximately 250,000 to 310,000 cases annually in the United States," the authors write as background information in the study. The authors also note that no prior studies have examined the combination of multiple lifestyle factors and risk of SCD.

Using data collected as part of the Nurses' Health Study, Stephanie E. Chiuve, Sc.D., of Brigham and Women's Hospital and Harvard Medical School, Boston, and colleagues examined the association between a healthy lifestyle and risk of SCD. A total of 81,722 women who participated in the Nurses' Health Study from June 1984 to June 2010 were included in the study, and lifestyle factors were assessed via questionnaires every two to four years. A low-risk lifestyle was defined as not smoking, having a body mass index (BMI) of less than 25, exercise duration of 30 minutes/day or longer, and consuming a diet closely related to a Mediterranean-style diet (emphasizes high intake of vegetables, fruits, nuts, legumes, whole grains and fish, with moderate alcohol intake).

During the 26 years of follow-up, there were 321 cases of SCD among women (average age 72 years at the time of the SCD event) in the study. All four low-risk factors were significantly and independently associated with a lower risk of SCD. Not smoking, exercising and eating a healthy diet each were inversely associated with risk of SCD. BMI also was associated with the risk of SCD, with women having a BMI between 21 and 24.9 at lowest risk.

Women at low risk for all four lifestyle factors had a 92 percent lower risk of SCD when compared with women at low risk for none of the four lifestyle factors.

"The primary prevention of SCD remains a major public health challenge because most SCD occurs among individuals not identified as high risk," the authors write. "In this cohort of female nurses, adherence to an overall healthy lifestyle was associated with a lower risk of SCD and may be an effective strategy for the prevention of SCD."

9:25 AM

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Giving vitamin D3 (cholecalciferol) to predominantly elderly women, mainly in institutional care, seems to increase survival. These women are likely to be vitamin D deficient with a significant risk of falls and fractures. This is the key conclusion in a systematic review published in the latest edition of The Cochrane Library.

Up until now there has been no clear view on whether there is a real benefit of taking vitamin D. "A Cochrane meta-analysis published only a couple of years ago found that there was some evidence for benefit, but it could not find an effect on mortality. We were, however, aware that more trials had been published and wanted to assess the effects of vitamin D when you added all the data together," said Dr Goran Bjelakovic, who works at Department of Internal Medicine - Gastroenterology and Hepatology, at the University of Nis, in Serbia and at The Cochrane Hepato-Biliary Group at The Copenhagen Trial Unit in Copenhagen, Denmark.

The eight-strong international team of researchers identified 50 randomised trials that together had 94,148 participants. They had a mean age of 74 years, and 79% were women. "Our analyses suggest that vitamin D3 reduces mortality by about 6%. This means that you need to give about 200 people vitamin D3 for around two years to save one additional life," says Bjelakovic.

There were no significant benefits of taking other forms of vitamin D such as vitamin D2, and the active forms of the vitamin, alfacalcidol or calcitriol. However, the researchers point out that they could only find much less data relating to these types of vitamin D and so these conclusions should be taken with caution. "We need to have more randomised trials that look specifically to see whether these forms of vitamin D do or don't have benefits," says Bjelakovic. His team did conclude that alfacalcidol and calcitriol significantly increased the risk of hypercalcaemia, and vitamin D3 combined with calcium significantly increased the risk of kidney stones.

There have been reports and comments that taking vitamin D can reduce the risk of getting cancer, but this work showed no evidence that vitamin D reduced cancer-related mortality.

"Previous reviews of preventive trials of vitamin D have not included as much information and have not examined the separate influence of different forms of vitamin D on mortality. By taking data from a larger number of trials we have been able to shed much more light on this important issue," says Bjelakovic.

9:24 AM

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Moderate reductions in the amount of salt people eat doesn't reduce their likelihood of dying or experiencing cardiovascular disease. This is the main conclusion from a systematic review published in the latest edition of The Cochrane Library.

There is lots of evidence that reducing dietary salt intake reduces blood pressure and the researchers did see some indication of this occurring. "Intensive support and encouragement to reduce salt intake did lead to a reduction in salt eaten and a small reduction in blood pressure after more than six months," says lead author Professor Rod Taylor who works at the Peninsula College of Medicine and Dentistry at the University of Exeter.

"What we wanted to see was whether this dietary change also reduced a person's risk of dying or suffering from cardiovascular events," says Taylor.

An earlier Cochrane review of dietary advice published in 2004 could not find enough evidence to allow the researchers to draw any conclusions about the effects of reducing salt intake on mortality or cardiovascular events. In Taylor's newly published research, however, the team managed to locate seven studies that together included 6,489 participants. This gave a sufficiently large set of data to be able to start drawing conclusions. Even so, Taylor believes he would need to have data from at least 18,000 individuals before he could expect to reveal any clear health benefits.

Most experts are agreed that consuming too much salt is not good for you and that salt reduction is beneficial in people with normal and high blood pressure. "We believe that we didn't see big benefits in this study because the people in the trials we analyzed only reduced their salt intake by a moderate amount, so the effect on blood pressure and heart disease was not large," says Taylor. He believes that health practitioners need to find more effective ways of reducing salt intake that are both practicable and inexpensive.

Many countries have government-sanctioned recommendations that call for reduced dietary sodium. In the UK, the National Institute of Health and Clinical Guidance (NICE) has recently called for an acceleration of the reduction in salt in the general population from a maximum intake of 6g per day per adult by 2015 to 3g by 2025.

"With governments setting ever lower targets for salt intake, and food manufacturers working to remove it from their products, it's really important that we do some large research trials to get a full understanding of the benefits and risks of reducing salt intake," says Taylor.

9:16 AM

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Doses up to 325 milligrams daily associated with a 23 percent lower risk of death for people with diabetes

In some cases, an apple a day may keep the doctor away, but for people with diabetes, regular, over-the-counter Aspirin may also do the job.

A new study by University of Alberta researcher Scot Simpson has shed light on the use of Aspirin as a preventative measure for cardiovascular disease and reoccurrence in patients with diabetes.

The study collected data from clinical trials that looked at whether taking Aspirin as a course of treatment would prevent a first or recurrent heart attack or stroke.

Using information from diabetic patients in these studies, Simpson discovered that patients with previous cardiac episodes who were taking a low dose of Aspirin daily had very little benefit in terms of prevention of a second heart attack or a decreased risk of mortality. However, in patients taking higher doses of Aspirin, the risk of a repeat heart attack and/or death was significantly lower.

"We took all of the data from 21 studies and focused specifically on diabetic patients who had suffered a previous heart attack or stroke to measure the ability of Aspirin to prevent a second event. We found that, if those patients took up to 325 milligrams of Aspirin per day, they had a 23 percent lower risk of death," said Simpson.

Simpson, an associate professor in the Faculty of Pharmacy and Pharmaceutical Sciences, says that people with diabetes are at an increased risk of cardiovascular disease, adding there is evidence that suggests as much as 60 per cent of deaths in diabetics are attributable to heart disease. Simpson says he always suspected the Aspirin dosage could play a role in treating cardiovascular disease in diabetics and felt because Aspirin was an over-the-counter medication, it's something that pharmacists could have an active role in administering.

"The pharmacists' best role for chronic disease management is working proactively with physicians and patients," said Simpson. "Whether that means working directly with the physician, and consulting about prescribed medications, or when the patient is deciding about whether or not to take Aspirin as part of a treatment plan, pharmacists can have a significant, positive impact."

9:12 AM

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Ten weeks of preventive supplementation with a natural form of vitamin E called tocotrienol in dogs that later had strokes reduced overall brain tissue damage, prevented loss of neural connections and helped sustain blood flow in the animals’ brains, a new study shows.

Researchers say the findings suggest that preventive, or prophylactic, use of this natural form of vitamin E could be particularly helpful to people considered at highest risk for a major stroke: those who have previously suffered a ministroke, or a temporary stoppage of blood flow in the brain.

Of the almost 800,000 strokes in the United States each year, an estimated 25 percent are repeat events, according to the American Heart Association.

Vitamin E occurs naturally in eight different forms, and this work led by Ohio State University scientists is focused on the tocotrienol form, also known as TCT. The commonly known form of vitamin E belongs to a variety called tocopherols. TCT is not abundant in the American diet but is available as a nutritional supplement. It is a common component of a typical Southeast Asian diet.

In the study, 24 hours after a stroke, lesions indicating brain tissue damage were about 80 percent smaller in dogs that received supplementation than were the lesions in dogs that received no intervention. Imaging tests showed that the treated animals’ brains had better blood flow at the stroke site as compared to untreated dogs’ brains, a difference attributed to tiny collateral blood vessels’ ability to improve circulation in the brain when blood flow stopped in more substantial vessels.

“For the first time, in this pre-clinical large-animal model, we were able to see something that we were never able to see in the mouse or the rat: that if you had a stroke and you had prophylactically taken tocotrienol, the area of the brain affected by the stroke received blood flow from the collaterals,” said Chandan Sen, professor and vice chair for research in Ohio State’s Department of Surgery and senior author of the study. “These collaterals, which are an emergency response system, wake up when the blood circulation in the brain is challenged.”

Sen and colleagues have spent the past 10 years documenting in cell cultures and rodents how this form of vitamin E protects brain cells from dying after the insult of a stroke. They say that the results of this large-animal study offer the last piece of evidence needed to validate testing the nutritional supplement’s protection against stroke in humans. A phase II trial of its effectiveness in humans is in the planning stages.

“For the first time, in this pre-clinical large-animal model, we were able to see something that we were never able to see in the mouse or the rat: that if you had a stroke and you had prophylactically taken tocotrienol, the area of the brain affected by the stroke received blood flow from the collaterals.”

The research is published online and is scheduled for future print publication in the Journal of Cerebral Blood Flow & Metabolism.

In the study, 20 dogs were randomly assigned to one of two groups: those receiving a placebo pill, and those receiving 200 milligrams of mixed tocotrienols. Though alpha-tocotrienol is the form of the vitamin known for its protection of brain cells, the supplement for this study contained a mix of tocotrienols to make it more accessible and affordable.

The dogs ate regular food and received two supplement pills per day for 10 weeks. At this point, scientists induced stroke by blocking the middle cerebral artery in the animals’ brains for one hour while the animals were under anesthesia.

The researchers used a variety of imaging techniques to examine the effects of the stroke on the two groups. Magnetic resonance imaging (MRI) showed the differences in the volume of tissue damaged by the stroke. One hour after the stroke, the lesions in the treated dogs’ brains were about 60 percent smaller than the size of the lesions in the untreated brains. Twenty-four hours after the stroke, the lesions were 80 percent smaller in treated animals compared to untreated animals.

In collaboration with the Ohio Supercomputer Center, the scientists mapped the brain’s communication network, represented by white matter fiber pathways. The sophisticated video images of the stroke-affected brain showed major gaps in this fiber network in the brains of animals that received no supplementation. The fiber connections were protected in the brains of dogs that received TCT.

Images of the blood vessels in the animals’ brains showed different responses in the brain blood circulation based on whether or not they had received preventive treatment. The researchers used a scoring system to determine how much of the collateral circulatory system was activated in response to the blocked blood flow associated with the stroke. The score in treated dogs was almost twice as high as that in untreated animals.

“This function in the brain is similar in humans and large mammals, which underscores the significance of these findings,” said Cameron Rink, first author of the study and an assistant professor of vascular surgery at Ohio State.

Additional examination of the affected brain tissue showed that the TCT supplementation appeared to support arteriogenesis, a process by which collateral arteries remodel themselves into larger vessels so they can bypass the site of blockage. Genes associated with this process were more active in the affected brain tissue from treated animals than were those from untreated dogs.

Preventive use of TCT, a natural vitamin, is safe and should be embraced as a preventive therapy along with aspirin, a commonly prescribed medicine to prevent a stroke, said Sen, who is also a deputy director of Ohio State’s Davis Heart and Lung Research Institute.

“Though most of us have no idea if we are at risk for stroke, a sizable population has had a ministroke and is therefore at high risk for a large stroke. If I had a ministroke, why would I not take something that would minimize my damage during a stroke?” Sen said. “And this is not a drug; it is a nutritional countermeasure. So there are no worries about side effects. Therefore I see it as having prophylactic value.”

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Vitamin D can help elderly women survive

Cutting down on salt doesn't reduce your chance of dying

Higher daily dose of aspirin prevents heart attacks

ONE FORM OF NATURAL VITAMIN E MAY REDUCE STROKE DAMAGE

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