All Posts tagged risk

Most Brits are “replete’ in iron

A UK report has found most Brits gain adequate levels of iron, but warned that the elderly, small children, girls, some women and the poor may be susceptible to deficiencies and should consider iron supplementation among other measures. “While most people in the UK are iron replete, health professionals need to be alert to increased risk of iron deficiency anaemia in toddlers, girls and women of reproductive age (particularly those from low income groups) and some adults aged over 65 years,” wrote the Scientific Advisory Committee on Nutrition’s Committee on Medical Aspects of Food and Nutrition Policy (COMA).

“Those with symptoms suggesting iron deficiency anaemia should receive appropriate clinical assessment and advice, including dietary advice on how to increase their iron intakes and to consider use of iron supplements if required.” The report updated COMA’s 1998 finding that high levels of red meat consumption were linked to colorectal cancer and also investigated the effects of reduced iron-rich red meat consumption. COMA concluded that a, “healthy balanced diet, which includes a variety of foods containing iron” is the best way to attain, “adequate iron status”.

“Such an approach is more important than consuming iron-rich foods at the same time as foods/drinks that enhance iron absorption (e.g., fruit juice, meat) or not consuming iron rich foods with those that inhibit iron absorption (e.g., tea, coffee, milk),” the committee said.

On the issue or red meat consumption COMA found that reduced red meat consumption levels would not cause widespread iron deficiencies. “Adults with relatively high intakes of red and processed meat (around 90 g/day or more) should consider reducing their intakes. A reduction to the UK population average for adult consumers (70 g/day cooked weight) would have little impact on the proportion of the adult population with low iron intakes.”

Current UK guidelines state that 3.2 oz (90g) is a healthy daily portion of red meat, and that only those who eat more than 5oz (140g) need to cut back. However some research has challenged these levels. A 2005 European study found those who regularly eat more than 5.6oz (160g) of red meat daily increase their risk of contracting bowel cancer by a third. In 2007, the World Cancer Research Fund report in 2007 concluded that there was a link between red meat consumption and an increased risk of bowel cancer.

The COMA report follows research from the British Nutrition Foundation (BNF) which contradicts these recommendations

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Increased B vitamins may ease PMS

Higher intakes of the B vitamins thiamine and riboflavin from the diet may reduce the incidence of premenstrual syndrome (PMS) by about 35 percent, suggest new findings. According to a new paper published in the American Journal of Clinical Nutrition, the link between B vitamins and PMS is biologically plausible since B vitamins such as thiamine and riboflavin are known to play important roles in the synthesis of various neurotransmitters involved in PMS.

While most women experience mild emotional or physical premenstrual symptoms, as many as 8-20 per cent of women experience symptoms severe enough to meet the definition of premenstrual syndrome, which can substantially interfere with daily activities and relationships. The new study, performed by researchers from the University of Massachusetts, Harvard, and the University of Iowa, indicates that increase intakes of certain B vitamins from food sources may help reduce the incidence of PMS.

Using data from 1,057 women with PMS and 1,968 women without PMS participating in the Nurses' Health Study II cohort, the researchers found that women with the highest average intakes of riboflavin two to four years prior to diagnosis were associated with a 35 percent lower incidence of PMS than women with the lowest average intakes. On the other hand, the researchers did not observe any benefits with other B vitamins, including niacin, folate, B6, and B12. In addition, supplemental intakes of these vitamins was not linked to PMS incidence, they added. “We observed a significantly lower risk of PMS in women with high intakes of thiamine and riboflavin from food sources only,” wrote the researchers. “Further research is needed to evaluate the effects of B vitamins in the development of premenstrual syndrome.”

Beyond the B vitamins, there is also some evidence for the potential of a diet rich in calcium and vitamin D to lower the risk of developing PMS, a condition that affects up to a fifth of all women. According to a study published in 2005 in the Archives of Internal Medicine (Vol. 165, pp1246-1252), researchers from the University of Massachusetts and GlaxoSmithKline reported for the first time that calcium and vitamin D may help prevent the initial development of PMS.

Source: The American Journal of Clinical Nutrition. Published online ahead of print, doi: 10.3945/ajcn.110.009530 “Dietary B vitamin intake and incident premenstrual syndrome” Authors: P.O. Chocano-Bedoya, J.E. Manson, S.E. Hankinson, W.C. Willett, S.R. Johnson, L. Chasan-Taber, A.G. Ronnenberg, C. Bigelow, E.R. Bertone-Johnson

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High fibre diet helps you live longer

Eating a diet rich in fibre has long been known to help keep your digestive tract working properly. It’s also thought to lower the risk of heart disease, some cancers and diabetes. Now, a new study suggests it could reduce the risk of death from cardiovascular, infectious and respiratory diseases. People who ate a high-fibre diet decreased their risk of dying over a nine year period compared to those who ate less fibre, according to a new study in the Archives of Internal Medicine.

The findings are based on a diet study from the National Institutes of Health and AARP, which included 219,123 men and 168,999 women ages 50 to 71 when the study began. Researchers from the National Cancer Institute examined food surveys completed by the participants in 1995 or 1996. After nine years about 11,000 people died and researchers used national records to determine the cause.

People who ate at least 26 grams per day were 22 percent less likely to die than those who consumed the least amount of fibre — about 13 grams per day or less. Men and women who consumed diets higher in fibre also had a reduced risk of cardiovascular, infectious and respiratory diseases, the study found. Getting fibre from grains seemed to have the biggest impact, the authors write.

The study has some limitations — mainly, people who ate high-fibre diets might also have been more likely to eat healthier diets overall, attributing to their longevity. Still, the study offers more evidence that fibre is certainly good for you. Federal dietary guidelines recommend people consume at least 14 grams of fibre per 1,000 calories, so about 28 grams for an average 2,000 calorie-per-day diet. But many experts say many people don’t get enough.

 

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Craving for alcohol linked to obesity

Addiction researchers at Washington University School of Medicine in St. Louis have found that a risk for alcoholism also may put individuals at risk for obesity. The researchers noted that the association between a family history of alcoholism and obesity risk has become more pronounced in recent years. Both men and women with such a family history were more likely to be obese in 2002 than members of that same high-risk group had been in 1992. “In addiction research, we often look at what we call cross-heritability, which addresses the question of whether the predisposition to one condition also might contribute to other conditions,” says first author Richard A. Grucza, PhD. “For example, alcoholism and drug abuse are cross-heritable. This new study demonstrates a cross-heritability between alcoholism and obesity, but it also says — and this is very important — that some of the risks must be a function of the environment. The environment is what changed between the 1990s and the 2000s. It wasn’t people’s genes.”

Obesity in the United States has doubled in recent decades from 15 percent of the population in the late 1970s to 33 percent in 2004. Obese people – those with a body mass index (BMI) of 30 or more – have an elevated risk for high blood pressure, diabetes, heart disease, stroke and certain cancers.

Reporting in the Archives of General Psychiatry, Grucza and his team say individuals with a family history of alcoholism, particularly women, have an elevated obesity risk. In addition, that risk seems to be growing. He speculates that may result from changes in the food we eat and the availability of more foods that interact with the same brain areas as addictive drugs. “Much of what we eat nowadays contains more calories than the food we ate in the 1970s and 1980s, but it also contains the sorts of calories — particularly a combination of sugar, salt and fat — that appeal to what are commonly called the reward centers in the brain,” says Grucza, an assistant professor of psychiatry. “Alcohol and drugs affect those same parts of the brain, and our thinking was that because the same brain structures are being stimulated, overconsumption of those foods might be greater in people with a predisposition to addiction.”

Grucza hypothesized that as Americans consumed more high-calorie, hyper-palatable foods, those with a genetic risk for addiction would face an elevated risk from because of the effects of those foods on the reward centers in the brain. His team analyzed data from two large alcoholism surveys from the last two decades. The National Longitudinal Alcohol Epidemiologic Survey was conducted in 1991 and 1992. The National Epidemiologic Survey on Alcohol and Related Conditions was conducted in 2001 and 2002. Almost 80,000 people took part in the two surveys.

“We looked particularly at family history of alcoholism as a marker of risk,” Grucza explains. “And we found that in 2001 and 2002, women with that history were 49 percent more likely to be obese than those without a family history of alcoholism. We also noticed a relationship in men, but it was not as striking in men as in women.” Grucza says a possible explanation for obesity in those with a family history of alcoholism is that some individuals may substitute one addiction for another. After seeing a close relative deal with alcohol problems, a person may shy away from drinking, but high-calorie, hyper-palatable foods also can stimulate the reward centers in their brains and give them effects similar to what they might experience from alcohol.

“Ironically, people with alcoholism tend not to be obese,” Grucza says. “They tend to be malnourished, or at least under-nourished because many replace their food intake with alcohol. One might think that the excess calories associated with alcohol consumption could, in theory, contribute to obesity, but that’s not what we saw in these individuals.” Grucza says other variables, from smoking, to alcohol intake, to demographic factors like age and education levels don’t seem to explain the association between alcoholism risk and obesity. “It really does appear to be a change in the environment,” he says. “I would speculate, although I can’t really prove this, that a change in the food environment brought this association about. There is a whole slew of literature out there suggesting these hyper-palatable foods appeal to people with addictive tendencies, and I would guess that’s what we’re seeing in our study.” The results, he says, suggest there should be more cross-talk between alcohol and addiction researchers and those who study obesity. He says there may be some people for whom treating one of those disorders also might aid the other.

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Olive oil and veggies help the heart

It's no secret that eating well is good for both body and mind, so it may not come as a surprise that a new study finds women who eat more olive oil and leafy vegetables such as salads and cooked spinach are significantly less likely to develop heart disease.A group of Italian researchers found that women who ate at least 1 serving of leafy vegetables per day were more than 40 percent less likely to develop heart disease over an average of eight years, relative to women who ate two or fewer portions of those vegetables each week. Women who downed at least 3 tablespoons of olive oil daily – such as in salad dressing – were also 40 percent less likely to be diagnosed with heart disease, compared to women who ate the least olive oil.

It's not exactly clear why specifically leafy vegetables and olive oil may protect the heart, said study author Dr. Domenico Palli of the Cancer Research and Prevention Institute in Florence. “Probably the mechanisms responsible for the protective effect of plant-origin foods on cardiovascular diseases involve micronutrients such as folate, antioxidant vitamins and potassium, all present in green leafy vegetables.” Folate reduces blood levels of homocysteine, Palli explained, which is thought to increase the risk of cardiovascular disease by damaging the inner lining of arteries. Other studies have shown people who eat more potassium have lower blood pressure, which can protect the cardiovascular system. Virgin olive oil may be particularly effective at lowering heart disease risk because of its high level of antioxidant plant compounds, he added.

This is not the first study to link olive oil or vegetables to good heart health. Most famously, the traditional Mediterranean diet — rich in vegetables and monounsaturated fats from olive oil and nuts, but low in saturated fat from meat and dairy — has been tied to a decreased risk of heart disease. Mediterranean-style eating has also been credited with lowering risk for some cancers, diabetes, and, more recently, with slowing brain aging. Cardiovascular disease is a major killer, responsible for 30 percent of all deaths worldwide and the leading cause of death for both men and women in the U.S.

To look more closely at the role of foods in protecting against heart disease, Palli and colleagues reviewed dietary information collected from nearly 30,000 Italian women participating in a large national health study. Researchers followed the women, whose mean age was 50 at the beginning of the study, for an average of 8 years, noting who developed heart disease. In that time, the women experienced 144 major heart disease-related events, such as heart attack or bypass surgery, the authors report in the American Journal of Clinical Nutrition. Women who ate at least one daily serving (about two ounces) of leafy vegetables – such as raw lettuce or endives, or cooked vegetables like spinach or chard — had a 46 percent lower risk of developing heart disease than women who ate at most two portions per week. Consuming at least an ounce of olive oil per day lowered their risk by 44 percent relative to women who consumed a half-ounce or less daily, the authors found.

The women's intake of other types of vegetables, such as roots and cabbages, and their consumption of tomatoes or fruit did not seem to be linked to their risk for major heart events. Both fruits and vegetables have been associated with heart benefits in past studies conducted elsewhere in Europe and in North America. The authors caution that the apparent lack of positive effect from high fruit consumption in their results may have something to do with a different attitude toward fruit in Italy. It is cheap, varied and easily available, so eating a lot of fruit is a widespread habit but it does not necessarily signal that the rest of someone's diet is as healthy, the authors wrote. Another issue with the study, Palli noted, is that women had to report how much they ate of various items, and some may not have remembered their diets accurately, or may have changed their eating habits during the study period. In addition, people sometimes over-estimate their healthy behaviors, believing they eat healthier than they really do.

SOURCE: American Journal of Clinical Nutrition, published online December 22, 2010.

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Antioxidants lower stroke risk

Eating a diet high in antioxidants may protect against ischemic stroke, an Italian cohort study showed.

People who had a diet high in total antioxidant capacity — an index that takes into account several different antioxidants and their interactions — had a 59% reduced relative risk of ischemic stroke (HR 0.41, 95% CI 0.23 to 0.74), according to Nicoletta Pellegrini, PhD, of the University of Parma in Italy, and colleagues. But there was no such relationship with hemorrhagic stroke, they reported in the January issue of the Journal of Nutrition. In fact, the highest intake of the antioxidant vitamin E was associated with a greater risk of hemorrhagic stroke (HR 2.94, 95% CI 1.13 to 7.62).
Considering evidence suggesting that oxidative stress and systemic inflammation are involved in the pathogenesis of ischemic stroke, the researchers noted that “a high-total antioxidant capacity diet could be protective as a consequence of its ability to deliver compounds with antioxidant activity and with a demonstrated anti-inflammatory effect.” But, they acknowledged that the mechanism for such activity was unclear may “go beyond the antioxidant activity of the numerous total antioxidant capacity contributors present in foods and beverages.”

Pellegrini and her colleagues set out to explore the relationship between dietary total antioxidant capacity and the risk of stroke among 41,620 people participating in EPICOR, the Italian segment of the European Prospective Investigation into Cancer and Nutrition (EPIC). None had a history of stroke or MI at baseline. Dietary intake was assessed with a food frequency questionnaire. In the study population, more than half of the total antioxidants consumed came from coffee, wine, and fruit. Through a mean follow-up of 7.9 years, there were 112 ischemic strokes, 48 hemorrhagic strokes, and 34 other types of strokes. After adjustment for energy intake, hypertension, smoking status, education, nonalcoholic energy intake at recruitment, alcohol intake, waist circumference, body mass index, and total physical activity, individuals eating a diet in the highest tertile of total antioxidant capacity had a reduced risk of ischemic — but not hemorrhagic — stroke.

Looking at individual antioxidants, the researchers found that participants consuming the highest amounts of vitamin C had a reduced risk of ischemic stroke (HR 0.58, 95% CI 0.34 to 0.99). Controlling for vitamin C intake did not negate the overall association between antioxidants and ischemic stroke, which ruled out the nutrient as the sole driver of the relationship. High intake of vitamin E, on the other hand, was associated with nearly triple the relative risk of hemorrhagic stroke. However, “it must be stressed that the small number of cases observed in this population strongly limits the validity of statistical observations on hemorrhagic stroke,” noted the researchers, who called for further studies.

Aside from anti-inflammatory effects, it is possible that the association between antioxidants and ischemic stroke risk can be explained by the interaction between polyphenols — the major contributors to total antioxidant capacity — and the generation of nitric oxide from the vascular endothelium. That interaction leads to the vasodilation and expression of genes that may be protective for the vascular system, according to the researchers. In addition, coffee — the main source of antioxidants in the study population — reduces blood pressure, which is a recognized risk factor for ischemic stroke, the researchers wrote.

They noted some limitations of the study, including the low numbers of cases when different types of stroke were analyzed, the measurement of total antioxidant capacity at baseline only, and the inability to rule out confounding effects of other dietary components, like sodium and potassium.

Source: Del Rio D, et al “Total antioxidant capacity of the diet is associated with lower risk of ischemic stroke in a large Italian cohort” J Nutr 2011; 141: 118-123.

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Infant obesity widespread in the USA

A study led by Brian Moss of Wayne State University’s School of Social Work reveals that one third of infants in the U.S. are obese or at risk of obesity. In addition, of the 8,000 infants studied, those found to be obese at 9 months had a higher risk of being obese at 2 years. Other studies have revealed that Infant obesity increases the risk for later childhood obesity and could lead to other obesity-related health problems like heart disease, asthma, high blood pressure and cancer. According to the U.S. Centers for Disease Control and Prevention, childhood and infant obesity has more than tripled in the past 30 years.

Moss, in collaboration with William H. Yeaton from the Institute for Social Research at the University of Michigan in Ann Arbor, published their analysis, “Young Children’s Weight Trajectories and Associated Risk Factors: Results from the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B),” in the January/February 2011 issue of the American Journal of Health Promotion. The ECLS-B draws from a representative sample of American children born in 2001 with diverse socioeconomic and racial/ethnic backgrounds. It is one of the first studies to monitor weight status changes of a nationally representative sample of very young children.

For their study, Moss and Yeaton used results from ECLS-B to follow the trajectory of the infants’ weight status at 9 months and 2 years, then performed statistical analyses to examine whether weight persistence, loss or gain was linked to demographic characteristics such as sex, race/ethnicity, geographic region or socioeconomic status. Children above the 95th percentile on standard growth charts were considered to have infant obesity, children in the 85th to 95th percentile were considered at risk for obesity.

Some of their results show that:
• 31.9 percent of 9-month-olds were at risk or obese;
• 34.3 percent of 2-year-olds were obese or at risk for obesity;
• 17 percent of the infants were obese at 9 months, rising to 20 percent at 2 years;
• 44 percent of the infants who were obese at 9 months remained obese at 2 years;
• Hispanic and low-income children were at greater risk for weight status gain;
• Females and Asian/Pacific Islanders were at lower risk for undesirable weight changes;
• 40 percent of 2-year-olds from the lowest income homes were at risk or obese compared to 27 percent of those from the highest income homes.

“This study shows that a significant proportion of very young children in the United States is at risk or is obese,” said Moss. The team notes a consistent pattern of obesity starting early in life. “As obesity becomes an increasing public health concern, these findings will help guide health practitioners by targeting high risk populations and foster culturally sensitive interventions aimed at prevention and treatment of obesity,” Moss said.

“We are not saying that overweight babies are doomed to be obese adults. However, we have found evidence that being overweight at 9 months puts you on track for being overweight or obese later in childhood.”

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Omega-3 foods prevent eye disease

Eating a diet rich in omega-3 fatty acids appears to protect seniors against the onset of a serious eye disease known as age-related macular degeneration (AMD).  Researchers did a fresh analysis of a one-year dietary survey conducted in the early 1990s. The poll involved nearly 2,400 seniors between the ages of 65 and 84 living in Maryland’s Eastern Shore region, where fish and shellfish are eaten routinely.

While participants in all groups, including controls, averaged at least one serving of fish or shellfish per week, those who had advanced AMD had consumed less fish and seafood containing omega-3 fatty acids. After their food intake was assessed, participants underwent eye examinations. About 450 had AMD, including 68 who had an advanced stage of the disease, which can lead to severe vision impairment or blindness. Prior evidence suggested that dietary zinc is similarly protective against AMD, so the researchers looked to see if zinc consumption from a diet of oysters and crabs reduced risk of AMD, but no such association was seen.

The researchers believe that the low dietary zinc levels relative to zinc supplements could account for the absence of such a link. However, they cautioned against people to start taking omega-3 supplements to protect against AMD based on this study because they are not sure that the above results have sufficient power to draw any conclusions. The correlation is important but larger studies with longer term follow-up are needed before being able to properly assess the impact.

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Mediterranean diet cuts Alzheimer’s

Alzheimer’s disease, a major form of dementia, has no cure. Luckily, diet and lifestyle can be modified to reduce the risk. For instance, Mediterranean diet and physical activity may each independently reduce the risk of the condition, according to a study in the Aug 2009 issue of Journal of American Medical Association. Dr. N. Scarmeas and colleagues of Taub Institute for Research in Alzheimer’s Disease and the Aging Brain and Department of Neurology at Columbia University Medical Center found men and women those who adhered most closely to Mediterranean diet were 40 percent less likely to be diagnosed with Alzheimer’s disease during a average of 5.4-year follow-up, compared to those who adhered to the diet least closely.

The researchers also found those who most actively engaged in physical activity were up to 33 percent less likely to be diagnosed with Alzheimer’s compared with those who were least active. For the study, Scarneas et al. followed 1880 community-dwelling elderly people who lived without dementia at baseline in New York for their dietary habits and physical activity.

Adherence to a Mediterranean-style diet was assessed on a scale of 0-9, or trichotomized into low, middle, or high and dichotomized into low and high. Physical activity was trichotomized into no physical activity, some, and much and dichotomized into low and high. Neurological and neuropsychological measures were conducted about every 1.5 years from 1992 to 2006. During the 5.4-year follow-up, 282 incident cases of Alzheimer’s were identified.

Those who adhered to the Mediterranean diet with a high score were at 40 percent reduced risk of Alzheimer, compared to those on the diet with a low score. A Mediterranean diet with a middle score did not seem to help compared to a diet with a low score. Those who engaged in some physical activity or much physical activity were at a 25 percent or 33 percent reduced risk of Alzheimer’s disease, respectively, compared with those who did no physical activity. Men and women who had neither followed Mediterranean diet nor much physical activity had an absolute Alzheimer’s risk of 19 percent. This is compared to 12 percent for those who followed both high scored Mediterranean diet and engaged in much physical activity – a difference of 45 percent.

The researchers concluded “both higher Mediterranean-type diet adherence and higher physical activity were independently associated with reduced risk for AD (Alzheimer’s disease).”

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Red meat increases women stroke risk

Women consuming too much red meat may have a higher risk of stroke than women eating less, says a new study. Red meat is high in saturated fat and cholesterol; both are risk factors for cardiovascular disease, heart attack, and stroke. The United States Centers for Disease Control and Prevention suggests lowering saturated fat intake and eating more fresh fruits and vegetables to help reduce your risk of stroke. Writing in the journal Stroke, researchers examined nearly 35,000 Swedish women, ages 39 to 73. None of the women had heart disease prior to the start of the study in 1997.

After ten years, results showed 4% of the study participants, 1,680 women, had a stroke. Those consuming the most red meat had the highest risk of stroke. Women in the top tenth of red meat intake, consuming at least 3.6 ounces each day, were 42% more likely to have a stroke, compared to women who ate just under one ounce of red meat daily.

Eating processed meat also increased stroke risk. Women eating 1.5 ounces of processed meat each day were 24% more likely to suffer a cerebral infarction, compared to woman consuming less than half an ounce of processed meat each day. Processed meat was not linked to any other form of stroke. Cerebral infarction is a type of stroke caused by a disturbance in the blood vessels supplying blood to the brain. Other types of stroke involve a rupturing of a blood vessel, called hemorrhagic strokes.

The scientists blame red meat and processed meat’s effect on raising blood pressure for the increased stroke risk. According to the World Health Organization (WHO), every year an estimated 17 million people die due to cardiovascular diseases, most notably stroke and heart attack. The WHO lists physical inactivity and unhealthy diet as the main risk factors for heart disease and major cardiac events.

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