Posts Tagged ‘health’

Exercising before breakfast may have more health benefits than waiting until after the meal to get moving, according to a study published in the Journal of Clinical Endocrinology & Metabolism in October.

Researchers led by Javier Gonzalez, a physiologist at the University of Bath in England, conducted the study on a group of 30 overweight, sedentary men. One group drank a carbohydrate-laden vanilla shake for breakfast two hours before moderate cycling, while another group drank it after the same exercise. Both groups exercised three times per week. A third group was given the carb-rich drink but did not work out.

While riders in both cycling groups burned about the same number of calories each time they exercised, those in the group that worked out before drinking the shake burned about twice as many calories from fat per ride as the ones who had the shake beforehand. After the six-week study, members of the exercise-before-meal group also had improved insulin sensitivity, which lowers the risk of diabetes. People in both exercise groups had improved cardiorespiratory fitness compared to those who did not cycle, according to the study.

Exercising before breakfast may have burned more fat because fatty acids can fuel cells if glucose isn’t available, such as after a time of fasting when blood sugar is low, according to Runner’s World. While exercising before breakfast takes advantage of overnight fasting, similar results might be possible by abstaining from food at another time. “We believe that the key is the fasting period, rather than the time of day,” Gonzalez tells The New York Times.

Emily Makowski is an intern at The Scientist. Email her at emakowski@the-scientist.com.

https://www.the-scientist.com/news-opinion/exercising-before-eating-burns-more-fat–study-66789?utm_campaign=TS_DAILY%20NEWSLETTER_2019&utm_source=hs_email&utm_medium=email&utm_content=80070748&_hsenc=p2ANqtz-_mk5jB1Vyqx3xPsKPzk1WcGdxEqSmuirpfpluu4Opm4tMO6n7rXROJrCvQp0yKBw2eCo4R4TZ422Hk6FcfJ7tDWkMpyg&_hsmi=80070748

There are no instant, miracle cures. But recent studies suggest we have more control over our cognitive health than we might think. It just takes some effort.

When it comes to battling dementia, the unfortunate news is this: Medications have proven ineffective at curing or stopping the disease and its most common form, Alzheimer’s disease. But that isn’t the end of the story. According to a recent wave of scientific studies, we have more control over our cognitive health than is commonly known. We just have to take certain steps—ideally, early and often—to live a healthier lifestyle.

In fact, according to a recent report commissioned by the Lancet, a medical journal, around 35% of dementia cases might be prevented if people do things including exercising and engaging in cognitively stimulating activities. “When people ask me how to prevent dementia, they often want a simple answer, such as vitamins, dietary supplements or the latest hyped idea,” says Eric Larson, a physician at Kaiser Permanente in Seattle and one of a group of scientists who helped prepare the report. “I tell them they can take many common-sense actions that promote health throughout life.”

The Lancet report, distilling the findings of hundreds of studies, identifies several factors that likely contribute to dementia risk, many of which can be within people’s power to control. These include midlife obesity, physical inactivity, high blood pressure, Type 2 diabetes, social isolation and low education levels.

Of course, there are no guarantees. Dementia is a complicated disease that has multiple causes and risk factors, some of which remain unknown. Nevertheless, there is increasing evidence that people—even those who inherit genes that put them at greater risk of developing Alzheimer’s in later life—can improve their chances by adopting lifestyle changes.

“It’s not just about running three times a week,” says Sarah Lenz Lock, executive director of AARP’s Global Council on Brain Health. “Instead, it’s about a package of behaviors, including aerobic exercise, strength training, a healthy diet, sleep and cognitive training.”

Because most neurodegenerative diseases take years, if not decades, to develop, researchers say the best time to focus on brain health is long before symptoms occur—ideally by midlife if not before. Still, they emphasize that it is never too late to start.

What follows is a look at what scientific studies tell us about possible ways to reduce dementia risk.

1. Blood-pressure control

The potential role that cardiovascular health—including blood pressure—plays in dementia has been one of the tantalizing highlights of recent research based on the Framingham Heart Study, which has followed thousands of residents of Framingham, Mass., and their relatives since 1948.

The research found a 44% decline in the dementia rate among people age 60 or older for the period 2004 to 2008, compared with 1977 to 1983. Diagnoses fell to two for every 100 study participants from 3.6 in the earlier period. Over the same roughly 30 years, the average age at which dementia was diagnosed rose to 85 from 80.

Co-author Claudia Satizabal, an assistant professor at UT Health San Antonio, says the research suggests that improvements in cardiovascular health and education levels help explain the trend. Improvements in dementia rates have occurred only in participants “who had at least a high-school diploma,” the study says. And as dementia rates have fallen, the study also says, so have the rates of “stroke and other cardiovascular diseases,” thanks in part to a greater use of blood-pressure medication.

Unlike studies in which participants are randomly assigned to different treatment groups and then monitored for results, the Framingham study and others that analyze population data cannot definitively prove a cause-and-effect relationship. Dr. Satizabal says that while the significant decline in dementia rates since 1977 suggests that management of stroke and heart issues could have contributed, that “is something that needs more research.”

A recent study that randomly assigned participants to different treatment goals offers further evidence for the idea that high blood pressure is a treatable risk factor that leads to dementia.

In 2010, researchers at Wake Forest School of Medicine began enrolling almost 9,400 people age 50 and older with high blood pressure in one of two groups. With the aid of medication, one group reduced its systolic blood pressure—which measures pressure in the arteries when the heart contracts—to less than 120. The other group aimed for less than 140.

The group with lower blood pressures experienced such significantly lower rates of death, strokes and heart attacks that in 2015 the researchers stopped the trial ahead of schedule. The scientists concluded it would be unethical to continue because most people should be targeting the lower blood pressure, says the study’s co-author Jeff Williamson, a Wake Forest medical school professor.

In 2017 and 2018, the researchers performed a final round of cognitive tests on participants and discovered that the lower-blood-pressure group had 19% fewer diagnoses of mild cognitive impairment, often a precursor to dementia, and 15% fewer cases of any type of dementia, mild or otherwise.

Using MRIs, the researchers scanned 673 participants’ brains and, upon follow-up, found less damaging changes in the lower-blood-pressure group.

“This is the first trial that has demonstrated an effective strategy for prevention of cognitive impairment,” says Kristine Yaffe, professor of psychiatry, neurology and epidemiology at the University of California, San Francisco. “That’s pretty big news,” says Dr. Yaffe, who wasn’t involved in the study.

2. Exercise

Several studies that have followed large numbers of people for years suggest that physically active individuals are less likely than inactive peers are to develop dementia, according to a recent World Health Organization report.

Exercise increases the flow of blood to the brain, improves the health of blood vessels and raises the level of HDL cholesterol, which together help protect against cardiovascular disease and dementia, says Laura Baker, a professor at Wake Forest School of Medicine. Exercise can also lead to the formation of new brain synapses and protect brain cells from dying.

Prof. Baker’s studies suggest that aerobic exercise can help improve cognitive function in people with mild memory, organizational and attention deficits, which are often the first symptoms of cognitive impairment.

One recent study conducted by Prof. Baker and several co-authors enrolled 65 sedentary adults ages 55 to 89 with mild memory problems. For six months, half completed four 60-minute aerobic-exercise sessions at the gym each week. Under a trainer’s supervision, they exercised mainly on treadmills at 70% to 80% of maximum heart rate. The other half did stretching exercises at 35% of maximum heart rate.

At the beginning and end of the study, researchers collected participants’ blood and spinal fluid and obtained MRI scans of their brains. Over the six months, the aerobic-exercise group had a statistically significant reduction in the level in their spinal fluid of tau protein, which accumulates in the brains of people with Alzheimer’s. They also had increased blood flow to areas of the brain that are important for attention and concentration, and their scores on cognitive tests improved. The stretching group, in contrast, showed no improvement on cognitive tests or tau levels.

3. Cognitive training

Many population studies suggest that education increases cognitive reserve, a term for the brain’s ability to compensate for neurological damage. The Framingham study, for example, found that participants with at least a high-school diploma benefited the most from declining dementia rates, compared with participants with less education.

In another population study, researchers at Columbia University analyzed data from 593 people age 60 or older, 106 of whom developed dementia. People with clerical, unskilled or semiskilled jobs had greater risk of getting the disease than managers and professionals.

In a separate study, some of the same researchers followed 1,772 people age 65 or older, 207 of whom developed dementia. After adjusting the results for age, ethnic group, education and occupation, the authors found that people who engaged in more than six activities a month—including hobbies, reading, visiting friends, walking, volunteering and attending religious services—had a 38% lower rate of developing dementia than people who did fewer activities.

In yet another study, researchers at institutions including Rush University Medical Center’s Rush Institute for Healthy Aging examined the brains of 130 deceased people who had undergone cognitive evaluations when alive. Among individuals in whom similar levels of Alzheimer’s-related brain changes were seen in the postmortem examinations, the researchers found that those who had more education generally had shown higher cognitive function.

Yaakov Stern, a professor at Columbia University College of Physicians and Surgeons who has written about these studies and the impact of education on dementia, recommends maintaining “educational and mentally stimulating activities throughout life.” This fosters growth of new neurons and may slow the rate at which certain regions of the brain shrink with age. It also promotes cognitive reserve, he says.

4. Diet

Efforts to study the impact of diet on dementia are relatively new, but there are some indications that certain diets may be beneficial in lowering the risk of dementia.

Several population studies, for instance, suggest that people with a Mediterranean diet, which is high in fish, fruits, nuts and vegetables, have lower rates of dementia, according to the World Health Organization.

But a variation on that diet may offer even more protection against the development of Alzheimer’s disease, according to a study released in 2015.

In this study, researchers including Dr. Martha Clare Morris, director of the Rush Institute for Healthy Aging, analyzed data from 923 people ages 58 to 98 who kept detailed food diaries about what they ate from 2004 to 2013.

In total, 158 subjects developed dementia. But among individuals who remained cognitively healthy, a high proportion had consumed a diet heavy in leafy green and other vegetables, nuts, berries, beans, whole grains, fish, poultry, olive oil and wine (in moderation). Their diets were limited in red meat, butter, cheese, sweets and fried and fast foods.

This diet, which researchers named the Mind diet, shares many elements of a Mediterranean diet. But the Mind diet prescribes more foods—including berries and leafy green vegetables—that are associated with lower rates of neurological diseases.

The researchers scored each of the 923 participants on how closely their detailed eating habits followed three diets: Mind, Mediterranean, and Dash diet, designed to reduce high blood pressure. For each diet, researchers ranked the participants based on their scores, subdividing them by the degree to which they followed each diet—closely, partly or little.

This led to several discoveries: First, there were about 50% fewer Alzheimer’s diagnoses among participants who most closely followed either the Mind diet or the Mediterranean diet, compared with those who followed either diet only a little. For the Dash diet, there was a 39% reduction for those who were most faithful to its rules.

Meanwhile, even those who only partly followed the Mind diet saw a 35% reduction in Alzheimer’s diagnoses, while no reduction was seen for those who only partly followed either the Mediterranean or Dash diet.

In contrast to the Mediterranean and Dash diets, “even modest adherence to the Mind diet may have substantial benefits for prevention of Alzheimer’s disease,” says Kristin Gustashaw, a dietitian at Rush.

5. Sleep

No one knows for sure why we sleep. One theory is that sleep helps us remember important information by performing a critical housekeeping function on brain synapses, including eliminating some connections and strengthening others.

Another theory is that sleep washes “toxic substances out of our brains that shouldn’t be there,” including beta amyloid and tau proteins that are implicated in Alzheimer’s, says Ruth Benca, a professor of medicine at the University of California, Irvine.

In a 2015 study, Prof. Benca and others examined 98 participants without dementia ages 50 to 73. Many were at genetic risk for the disease. Brain scans revealed that those reporting more sleep problems had higher levels of amyloid deposits in areas of the brain typically affected by Alzheimer’s.

“Poor sleep may be a risk factor for Alzheimer’s,” says Prof. Benca, who is conducting a study to see whether treating sleep problems may help prevent dementia.

She says sleep—or a lack of it—may help explain why about two-thirds of Alzheimer’s patients are women. Some researchers theorize that during menopause women can become vulnerable to the disease, in part due to increased prevalence of insomnia.

6. Combination

There is a growing consensus that when it comes to preserving brain health, the more healthy habits you adopt, the better.

According to a forthcoming study of 2,765 older adults by researchers at Rush, nonsmokers who stuck to the Mind diet, got regular exercise, engaged in cognitively stimulating activities and drank alcohol in moderation had 60% fewer cases of dementia over six years than people with just one such habit.

A study published in July found that people at greater genetic risk for Alzheimer’s appear to benefit just as much from eating well, exercising and drinking moderately as those who followed the same habits but weren’t at elevated genetic risk for the disease.

The study, by researchers including Kenneth Langa, associate director of the Institute of Gerontology at the University of Michigan, examined data from 196,383 Britons age 60 and older. Over about a decade, there were 38% fewer dementia diagnoses among individuals who had healthy habits and a gene, APOE4, that puts people at higher risk for Alzheimer’s, than there were among people who had the gene and poor habits. The gene increases the risk for Alzheimer’s by two to 12 times, depending on how many copies a person has.

Among participants with low genetic risk for Alzheimer’s, healthy habits were associated with a 40% reduction in the incidence of the disease. The results suggest a correlation between lifestyle, genetic risk and dementia, the study says.

Many point to a recent clinical trial in Finland of 1,260 adults ages 60 to 77 as proof that a multipronged approach can work.

The researchers, from institutions including the Karolinska Institute in Sweden and the National Institute for Health and Welfare in Helsinki, randomly assigned half of the participants, all deemed at high risk for dementia, to regular sessions with nutritionists, exercise trainers and instructors in computerized brain-training programs. The participants attended social events and were closely monitored for conditions including high blood pressure, excess abdominal weight and high blood sugar.

“They got support from each other to make lifestyle changes,” says co-author Miia Kivipelto, a professor at the Karolinska Institute in Sweden.

The other half received only general health advice.

After two years, both groups showed improvements in cognitive performance. But the overall scores of the intensive-treatment group improved by 25% more than the scores for the other group. The intensive-treatment group scored between 40% and 150% better on tests of executive function, mental speed and complex memory tasks, suggesting that a multifaceted approach can “improve or maintain cognitive functioning in at-risk elderly people,” the study says.

“We are studying whether exercise and lifestyle can be medicine to protect brain health as we get older,” says Prof. Baker, who is overseeing a U.S. study modeled on the Finnish trial.

https://apple.news/AzlC5CLNvQJWJrsP-qrJFIw

By Steven Reinberg

Loneliness can take a heavy toll on heart patients — including a higher risk of death in the year after hospitalization, researchers found.

“This study confirms what has also been indicated in previous research regarding the serious health consequences of loneliness,” said lead researcher Anne Vinggaard Christensen, of Copenhagen University Hospital in Denmark.

“Loneliness should be considered a serious risk factor in patients with cardiac disease and should be included in risk evaluation of patients,” added Christensen, who is with the hospital’s heart center.

The Danish researchers cautioned, however, that their findings can’t prove that loneliness caused people to die, only that loneliness and the risk of death appear to be connected. But the differences in mortality between those who felt lonely and those who didn’t can’t be explained by their medical condition alone, they said.

Loneliness is a subjective experience, one that is distressing and unpleasant, the researchers noted.

The connection between loneliness and health is complex, Christensen said.

People who are lonely or socially isolated tend to have more unhealthy lifestyles. They smoke more, are less likely to be physically active and don’t take their medication, she said.

“Having a social network helps motivate people to make healthier choices,” Christensen said. “A social network can act as a buffer for stress.”

Also, lonely people have been found to have higher levels of stress hormones and lower immune function, she added.

“These different pathways are interconnected and help us understand why people feeling lonely or socially isolated experience worse health,” Christensen said.

James Maddux is a professor emeritus in the department of psychology at George Mason University in Fairfax, Va. Reviewing the findings, he took issue with the study’s methodology.

“My major concern about the methodology is that their measure of loneliness is rather weak and is not consistent with most studies about loneliness that I am familiar with,” Maddux said. He explained that the question used to measure loneliness failed to capture loneliness “as a profound sense of isolation and disconnected from others, accompanied by sadness and a longing to be with others. In other words, loneliness is painful.”

Still, even in its flawed state, the new study “adds to the growing research on the perils of social isolation among people in general and among older adults over 60 in particular,” said Maddux. “These results help reaffirm what we’ve learned so far about how unhealthy social isolation can be.”

For the study, Christensen and her colleagues collected data on more than 13,400 heart patients after they left the hospital from 2013 to 2014. Their average age was in the mid-60s.

Participants completed questionnaires on their health, psychological well-being, quality of life and levels of anxiety and depression.

Compared to people who didn’t feel lonely, those who said they were lonely were nearly three times more likely to be anxious and depressed and have a lower quality of life, the researchers found.

A year later, Christensen’s team found that feeling lonely had a significant impact on participants’ health.

Regardless of other factors, lonely women were nearly three times more likely to die than women who weren’t lonely, and lonely men were more than twice as likely to die, the researchers found.

Living alone, however, is not necessarily equal to feeling lonely, and it was linked to a lower risk of depression and anxiety than living with others.

But among men, living alone was tied with a 39% greater risk for poor heart health. This may be because men tend not to have an extensive support network after divorce or death of a spouse, compared with women, the researchers noted.

“Loneliness can have many causes and can occur even if you have people around you,” Christensen said.

For some, it would help to have a family member who remembers to ask how they are doing and is ready to listen, she said.

“For others, help with practical things might be what they need, and for some, the opportunity to talk to other patients who have gone through the same thing is helpful,” Christensen said.

She also stressed that the effects of loneliness are not confined to heart disease. “It’s also [detrimental] for individuals who do not suffer from an illness. Loneliness seems to be damaging to your health no matter what,” Christensen said.

The report was published online Nov. 4 in the journal Heart.

https://consumer.healthday.com/cardiovascular-health-information-20/misc-stroke-related-heart-news-360/risks-mount-for-lonely-hearts-after-cardiac-surgery-751879.html

By Jonathan Lambert

If you’re looking for motivation to take up running, perhaps this will help. A new study finds that people who run as little as once a week have a lower risk of early death compared with people who don’t run at all.

In fact, any amount of running was associated with a 27 percent lower risk of premature death. And researchers found no evidence that running more alters that number significantly, according to a new meta-analysis published November 4 in the British Journal of Sports Medicine.

“This is good news for the many adults who find it hard to find time for exercise,” says Elaine Murtagh, an exercise physiologist at Mary Immaculate College in Limerick, Ireland, who was not involved in the study. “Any amount of running is better than none.”

While this conclusion might seem obvious to runners, the science has been fairly mixed, says public health researcher Željko Pedišić of Victoria University in Melbourne, Australia. “Some studies found a significant benefit of running, but others did not,” he says.

Also unclear was whether the duration or intensity of running mattered. Researchers who study the effects of running think about the activity in terms of doses, as though it were itself a medicine. Pedišić says that while it might make sense that more running would yield greater health benefits, some studies have sparked debate by suggesting that higher levels of running — more than 250 minutes a week — could actually negate any benefits in terms of mortality.

Pedišić and his colleagues tried to make sense of these conflicting findings by pooling and reanalyzing data from previous studies, an approach known as a meta-analysis. They settled on 14 previously published studies, which collectively asked 232,149 participants about their running habits and then tracked their health over a period of time from 5 ½ to 35 years.

Over the course of each study a total of 25,951 participants died, allowing the researchers to look for statistical associations between running and risk of death.

The researchers found that runners, even those who reported running as infrequently as once a month, had a 27 percent reduced risk of death from any cause compared with non-runners. Each study differed slightly in how they defined a runner, making it difficult to say exactly how little running is necessary for a benefit, though Pedišić says taking just a few strides a week is almost certainly not enough.

Still, the lower risk of early death was more or less the same across all running doses, from running no more than once a week for less than 50 minutes to running every day for a weekly total of 250 minutes. “All these doses of running are significantly associated with lower risk of death,” Pedišić says. “There was no significant difference between frequency, duration or pace,”

“Not finding a trend does not mean that the trend does not exist,” Pedišić cautions. A trend could be too small to be detected within the sample size. Studying the health effects of heavy running can be difficult because there aren’t many people who run that much, he says.

While more evidence is needed to determine if there is an upper limit to how much running is beneficial, this study fits with other research finding health benefits for any level of activity, says Angelique Brellenthin, a kinesiologist at Iowa State University in Ames who was not involved in the study, “Any amount of physical activity that you can fit into your schedule is good for you,” she says.

Running just once a week may help you outpace an early death

Laura Lewis and her team of researchers have been putting in late nights in their Boston University lab. Lewis ran tests until around 3:00 in the morning, then ended up sleeping in the next day. It was like she had jet lag, she says, without changing time zones. It’s not that Lewis doesn’t appreciate the merits of a good night’s sleep. She does. But when you’re trying to map what’s happening in a slumbering human’s brain, you end up making some sacrifices. “It’s this great irony of sleep research,” she says. “You’re constrained by when people sleep.”

Her results, published last week in the journal Science, show how our bodies clear toxins out of our brains while we sleep and could open new avenues for treating and preventing neurodegenerative diseases like Alzheimer’s.

When we sleep our brains travel through several phases, from a light slumber to a deep sleep that feels like we’ve fallen unconscious, to rapid eye movement (REM) sleep, when we’re more likely to have dreams. Lewis’ work looks at non-REM sleep, that deep phase which generally happens earlier in the night and which has already been associated with memory retention. One important 2013 study on mice showed that while the rodents slept, toxins like beta amyloid, which can contribute to Alzheimer’s disease, got swept away.

Lewis was curious how those toxins were cleared out and why that process only happened during sleep. She suspected that cerebrospinal fluid, a clear, water-like liquid that flows around the brain, might be involved. But she wasn’t sure what was unique about sleep. So her lab designed a study that measured several different variables at the same time.

Study participants had to lie down and fall asleep inside an MRI machine. To get realistic sleep cycles, the researchers had to run the tests at midnight, and they even asked subjects to stay up late the night before so people would be primed to drift off once the test began.

Lewis outfitted the participants with an EEG cap so she could look at the electrical currents flowing through their brains. Those currents showed her which stage of sleep the person was in. Meanwhile, the MRI measured the blood oxygen levels in their brains and showed how much cerebrospinal fluid was flowing in and out of the brain. “We had a sense each of these metrics was important, but how they change during sleep and how they relate to each other during sleep was uncharted territory for us,” she says.

What she discovered was that during non-REM sleep, large, slow waves of cerebrospinal fluid were washing over the brain. The EEG readings helped show why. During non-REM sleep, neurons start to synchronize, turning on and off at the same time. “First you would see this electrical wave where all the neurons would go quiet,” says Lewis. Because the neurons had all momentarily stopped firing, they didn’t need as much oxygen. That meant less blood would flow to the brain. But Lewis’s team also observed that cerebrospinal fluid would then rush in, filling in the space left behind.

“It’s a fantastic paper,” says Maiken Nedergaard, a neuroscientist at the University of Rochester who led the 2013 study that first described how sleep can clear out toxins in mice. “I don’t think anybody in their wildest fantasy has really shown that the brain’s electrical activity is moving fluid. So that’s really exciting.”

One big contribution of the paper is it helps show that the systems Nedergaard has been studying in mice are present and hugely important for humans too. “It’s telling you sleep is not just to relax,” says Nedergaard. “Sleep is actually a very distinct function.” Neurons don’t all turn off at the same time when we’re awake. So brain blood levels don’t drop enough to allow substantial waves of cerebrospinal fluid to circulate around the brain and clear out all the metabolic byproducts that accumulate, like beta amyloid.

The study also could have clinical applications for treating Alzheimer’s. Recent attempts at developing medications have targeted beta amyloid. But drugs that looked promising at first all failed once they got into clinical trials. “This opens a new avenue,” says Nedergaard. Instead of trying to act on one particular molecule, new interventions might instead focus on increasing the amount of cerebrospinal fluid that washes over the brain.

That would help clear out beta amyloid but also could help with other molecules like tau, a protein that gets tangled in Alzheimer’s patients’ brains and harms the connections between neurons. Finding a way to clear out all of that garbage could be much more powerful than just focusing on one piece of the problem. “Aging is not just about one molecule,” says Nedergaard. “Everything fails.”

These discoveries bring along their own set of questions. Lewis didn’t study what happens during other stages of sleep, and she only looked at healthy young adults. But the methods she used were entirely noninvasive—or as noninvasive as having people sleep in an MRI while hooked up to lots of machines can be. She didn’t even inject any dye. That will make it easier to start studying older participants who may be developing neurodegenerative diseases.

https://www.wired.com/story/scientists-now-know-how-sleep-cleans-toxins-from-the-brain/?bxid=5c48e315fc942d0477abe04c&cndid=50678559&esrc=sign-up-page&source=EDT_WIR_NEWSLETTER_0_DAILY_ZZ&utm_brand=wired&utm_campaign=aud-dev&utm_mailing=WIR_Daily_110119&utm_medium=email&utm_source=nl&utm_term=list1_p4

By Nicholas Bakalar

Trans fatty acids, known to increase the risk for heart disease, stroke and diabetes, have now been linked to an increased risk for dementia.

Researchers measured blood levels of elaidic acid, the most common trans fats, in 1,628 men and women 60 and older and free of dementia. Over the following 10 years, 377 developed some type of dementia.

Trans fats, which are added to processed food in the form of partially hydrogenated vegetable oils, increase levels of LDL, or “bad” cholesterol. Meat and dairy products naturally contain small amounts of trans fats, but whether these fats raise bad cholesterol is unknown.

After controlling for other factors, the scientists found that compared with those in the lowest one-quarter in blood levels of elaidic acid, those in the highest were 50 percent more likely to develop any form of dementia and 39 percent more likely to develop Alzheimer’s disease in particular. Elaidic acid levels were not associated with vascular dementia considered alone. The study is in Neurology.

The senior author, Dr. Toshiharu Ninomiya, a professor of public health at Kyushu University in Japan, said the study is observational so cannot prove cause and effect. “It is difficult to avoid trans fats completely, and the risk of a small amount of trans fats is unclear,” he said. “But it would be better to try to avoid them as much as possible.”

Dog ownership was linked to improved outcomes after a major CV event and with a lower risk for death in the long term, according to two studies published in Circulation: Cardiovascular Quality and Outcomes.

“The findings in these two well-done studies and analyses build upon prior studies and the conclusions of the 2013 American Heart Association Scientific Statement ‘Pet Ownership and Cardiovascular Risk’ that dog ownership is associated with reductions in factors that contribute to cardiac risk and to cardiovascular events,” Glenn N. Levine, MD, professor of medicine at Baylor College of Medicine in Houston, director of the cardiac care unit at Michael E. DeBakey Medical Center in Houston and chair of the writing group of the AHA’s scientific statement on pet ownership, said in a press release. “Further, these two studies provide good, quality data indicating dog ownership is associated with reduced cardiac and all-cause mortality.”

Study on Swedish patients

Mwenya Mubanga, MD, PhD, assistant undergoing research training in the department of medical sciences, molecular epidemiology at Uppsala University in Sweden, and colleagues analyzed data from 181,696 patients with MI (mean age, 71 years; 64% men) and 154,617 patients with stroke (mean age, 73 years; 55% men) between 2001 and 2012 from the Swedish National Patient Register. Patients were aged 40 to 85 years and did not have an event between 1997 and 2001. Information on dog ownership was collected from two dog registers, as dogs are required to be registered in Sweden since 2001.

Death was the main outcome that was assessed in this study. A secondary outcome included rehospitalization for the same event after 30 days.

Dog ownership accounted for 5.7% of patients with MI and 4.8% of those with stroke.

During 804,137 person-years of follow-up for patients with MI, dog owners had a reduced risk for death after hospitalization, which was seen in those who lived alone (adjusted HR = 0.67; 95% CI, 0.61-0.75) and those who lived with a partner or child (aHR = 0.85; 95% CI, 0.8-0.9).

Similar results were seen for patients with ischemic stroke during 638,219 person-years of follow-up. The adjusted HR for patients who owned a dog and lived alone was 0.73 (95% CI, 0.66-0.8) and 0.88 for those who owned a dog and lived with a partner or child (95% CI, 0.83-0.93).

Dog ownership was also associated with a reduced risk for hospitalization for recurrent MI (HR = 0.93; 95% CI, 0.87-0.99).

“One mechanism may be an increased motivation for engagement in consistent physical activity in dog owners, a factor regarded important in post-event recovery of cognition, arm function, balance and gait,” Mubanga and colleagues wrote. “Another explanation is reduced risk of depression, an important risk factor for death after myocardial infarction.”

Systematic review, meta-analysis

In another study from the same publication, Caroline K. Kramer, MD, PhD, assistant professor in the division of endocrinology and metabolism at University of Toronto, and colleagues performed a systematic review and meta-analysis of data from 3,837,005 participants from 10 studies published between 1950 and May 24, 2019.

Studies were included if they included original data of prospective observational studies, included patients older than 18 years, reported CV mortality or all-cause mortality and evaluated dog ownership at baseline.

During a mean follow-up of 10.1 years, there were 530,515 deaths.

There was a 24% risk reduction for all-cause mortality in participants who owned a dog compared with those who did not (RR = 0.76; 95% CI, 0.67-0.86). Six studies showed a significant reduction in the risk for death in participants who owned a dog.

Participants with prior coronary events who lived in a home with a dog had an even more pronounced reduction in the risk for all-cause mortality (RR = 0.35; 95% CI, 0.17-0.69; I2 = 0%). When the analyses were restricted to studies that evaluated CV mortality, there was a 31% risk reduction for CV death in participants who owned a dog (RR = 0.69; 95% CI, 0.67-0.71; I2 = 5.1%).

“Taken together, our meta-analysis suggests the need for further investigation of the potential for dog ownership as a lifestyle intervention that may offer significant health benefits, particularly in populations at high risk for cardiovascular death,” Kramer and colleagues wrote.

https://www.healio.com/cardiology/vascular-medicine/news/online/%7B32f1f7e0-a796-4e8b-8a0d-75c32fa1de7d%7D/dog-ownership-may-improve-outcomes-reduce-mortality-risk-after-cv-events?utm_source=selligent&utm_medium=email&utm_campaign=cardiology+news&m_bt=1162769038120