Women suffering from diabetes plus depression have a greater risk of dying, especially from heart disease, a new study suggests.In fact, women with both conditions have a twofold increased risk of death, researchers say. “People with both conditions are at very high risk of death,” said lead researcher Dr. Frank B. Hu, a professor of medicine at Harvard Medical School. “Those are double whammies.” When people are afflicted by both diseases, these conditions can lead to a “vicious cycle,” Hu said. “People with diabetes are more likely to be depressed, because they are under long-term psychosocial stress, which is associated with diabetes complications.”
People with diabetes plus depression are less likely to take care of themselves and effectively manage their diabetes, he added. “That can lead to complications, which increase the risk of mortality.” Hu stressed that it is important to manage both the diabetes and the depression to lower the mortality risk. “It is possible that these two conditions not only influence each other biologically, but also behaviorally,” he said.
Type 2 diabetes plus depression are often related to unhealthy lifestyles, including smoking, poor diet and lack of exercise, according to the researchers. In addition, depression may trigger changes in the nervous system that adversely affect the heart, they said.
The report is published in the January issue of the Archives of General Psychiatry.
Commenting on the study, Dr. Luigi Meneghini, an associate professor of clinical medicine and director of the Eleanor and Joseph Kosow Diabetes Treatment Center at the Diabetes Research Institute of the University of Miami Miller School of Medicine, said the findings were not surprising.
“The study highlights that there is a clear increase in risk to your health and to your life when you have a combination of diabetes and depression,” he said. Meneghini noted there are many diabetics with undiagnosed depression. “I am willing to bet that there are quite a number of patients with diabetes and depression walking around without a clear diagnosis.” Patients and doctors need to be more aware that depression is an issue, Meneghini added.
For the study, Hu’s team collected data on 78,282 women who were aged 54 to 79 in 2000 and who were participants in the Nurses’ Health Study. Over six years of follow-up, 4,654 women died, including 979 who died of cardiovascular disease, the investigators found. Women who had diabetes had about a 35 percent increased risk of dying, and those with depression had about a 44 percent increased risk, compared with women with neither condition, the researchers calculated. Those with both conditions had about twice the risk of dying, the study authors found.
When Hu’s team looked only at deaths from heart disease, they found that women with diabetes had a 67 percent increased risk of dying and those with depression had a 37 percent increased risk of death. But women who had both diabetes and depression had a 2.7-fold increased risk of dying from heart disease, the researchers noted.
In the United States, some 15 million people suffer from depression and 23.5 million have diabetes, the researchers say. Up to one-fourth of people with diabetes also experience depression, which is nearly twice as many as among people who don’t have diabetes, they added. “The combination of diabetes and depression needs to be addressed,” Meneghini concluded. He added that patients need to tell their doctors if they are feeling depressed, and doctors also need to be on the lookout for signs of depression in their diabetic patients.
SOURCES: HealthDay News; Frank B. Hu, M.D., Ph.D., professor, medicine, Harvard Medical School, Boston; Luigi Meneghini, M.D., associate professor, clinical medicine and director, Eleanor and Joseph Kosow Diabetes Treatment Center, Diabetes Research Institute, University of Miami Miller School of Medicine; January 2011, Archives of General Psychiatry
Older adults who eat a healthy diet tend to live longer than those who indulge in desserts and high-fat dairy products, according to a new study in the Journal of the American Dietetic Association. With the projected doubling of our older population by 2030, what people put on their plates may be even more important.
For 10 years, researchers followed the eating habits of 2,500 healthy seniors aged 70 to 79. They found people who ate ice cream, whole milk and other high fat-dairy items had a 40% higher risk of dying during the decade of study than those who ate a healthful diet. People who ate sweets such as doughnuts, cakes, and cookies had a 37% higher risk of dying in that same 10 year study period.
The seniors were placed into one of the following 6 dietary categories depending upon what they ate: 1) Healthy foods 2) High-fat dairy products 3) Meat, fried foods and alcohol 4) Breakfast cereal 5) Refined grains and 6) Sweets and desserts. The people with the more healthful diets not only lived longer they also reported having a better quality of life, for a longer period of time than others.
“Our study and several previous studies suggest that it may be important what people eat at any age and that people can perhaps increase their quality of life and survival by following a healthy diet,” explains lead author Amy Anderson, Postdoctoral Researcher with the University of Maryland's Department of Nutrition and Food Science.
Eating healthy meant including more low-fat dairy products, fruits and vegetables, whole grains, poultry and fish in the diet as opposed to meat, fried foods, sweets, highly sugared drinks and other fatty foods. The healthy group got only 3% of their calories from high-fat dairy products such as cheese and ice cream, for example, while the high-fat dairy group got 17% of their calories from these foods. The healthier group also ate fewer sweets with only 6% of their calories coming from these treats compared to 25% by those in the desserts group.
The study noted that in the past century, the leading causes of death were from infectious diseases. Now people are dying from chronic illnesses such as heart disease and cancer, which are often tied to what we eat.
“I think this research is important, especially now with the baby boomers entering these older age groups. So if people have a higher quality of life and survival , if they're healthier, this can reduce the cost of health care and improve people's daily lives in general,” says Anderson.
All had reported on their diet at the beginning of the study. During follow-up, about 2,358 died.
The top calcium consumers had a 25 percent lower risk of dying from any cause and a 23 percent lower risk of dying from heart disease during follow-up relative to men that had the least amount of calcium in their diet. Calcium intake didn't significantly influence the risk of dying from cancer.
Men in the top third based on their calcium intake were getting nearly 2,000 milligrams a day, on average, compared to about 1,000 milligrams for men in the bottom third. The US Recommended Dietary Allowance (RDA) for calcium intake is 1,000 milligrams for men 19 to 50 years old and 1,200 milligrams for men 50 and over. “Intake of calcium above that recommended daily may reduce all-cause mortality,” Kaluza and her colleagues conclude.
Calcium could influence mortality risk in many ways, they note, for example by reducing blood pressure, cholesterol, or blood sugar levels. For the men in the study, the main sources of calcium in the diet were milk and milk products and cereal products. In contrast to calcium, there was no relationship between magnesium consumption and overall mortality or deaths from cancer or heart disease. Study participants' intakes ranged from around 400 milligrams per day to around 525 milligrams; the RDA for magnesium is 420 milligrams for men 31 and older.
This analysis, the researchers say, may have found no effect for magnesium because all of the men in the study seemed to be getting enough of the mineral in their diet. “Further studies are needed in other populations with lower dietary magnesium intakes to address this issue,” they say. Future research should also look into calcium and magnesium intake from drinking water, they add, which can be a significant source of these minerals.
SOURCE: American Journal of Epidemiology
In the current study, vitamin K2 — which study participants most frequently got through cheese — was linked to the odds of developing or dying from cancer, whereas vitamin K1 was not.
The findings are based on data from 24,340 German adults who were between the ages of 35 and 64, and cancer-free at the outset. The researchers estimated the participants' usual vitamin K intake based on a detailed dietary questionnaire. Over the next decade, 1,755 participants were diagnosed with colon, breast, prostate or lung cancers, of whom 458 died during the study period.
In general, the researchers found, the one quarter with the highest intakes of vitamin K2 were 28 percent less likely to have died of any one of the cancers than the one-quarter of men and women with the lowest intakes of the vitamin. That was with factors like age, weight, exercise habits, smoking and consumption of certain other nutrients, like fiber and calcium, taken into account.
Of the one-quarter of study participants who got the least vitamin K2, 156 — or 2.6 percent — died of one of the four cancers. That was true of 1.6 percent of participants with the highest intakes of the vitamin from food.
When Linseisin's team looked at the cancer types individually, there was no clear link between either form of vitamin K and breast cancer or colon cancer. However, greater consumption of vitamin K2 was linked to lower risks of developing or dying from lung cancer — a disease for which smoking is the major risk factor — or of developing prostate cancer.
Of the one-quarter of study participants with the lowest vitamin K2 intakes, 47 — or 0.8 percent — developed lung cancer, versus 0.4 percent of the one-quarter who got the most vitamin K2 in their diets. When it came to prostate cancer, there were 111 cases among the one-quarter of men with the lowest vitamin K2 intakes, and 65 cases in the group with the highest consumption.
In theory, vitamin K itself could offer some protection against cancer. It's often used to counteract too-high doses of blood thinners, although this does not have an obvious link to cancer. In lab research, however, Linseisin and his colleagues point out, the vitamin has been shown to inhibit cancer cell growth and promote apoptosis — a process by which abnormal cells kill themselves off.
But whether vitamin K intake itself is responsible for the lower cancer risks in this study is unclear, according to the researchers. One limitation is that they estimated vitamin K intake based on participants' reported eating habits; most of their vitamin K came from eating cheese, and it's possible, Linseisin and his colleagues note, that some other components of that food are related to cancer risk.
Future studies, the researchers say, should measure people's blood levels of vitamin K and look at the relationship of those levels with cancer risks.
SOURCE: American Journal of Clinical Nutrition