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More risk factors linked with overweight

The link between obesity and cardiac disease is not merely anecdotal, there is proof for that. Now, there is further proof that even overweight causes a clustering of risk factors for cardio vascular abnormalities. A recent publication in Heart Asia, a British Medical Journal, has showed that there is not much difference between the cardio vascular risk factors in obese and overweight people. “The clutch of risk factors – glucose intolerance, hyper tension, high cholesterol – are all significantly higher among overweight and obese subjects than among normal subjects,” Vijay Viswanathan, MV Hospital for Diabetes and Prof. M.Viswanthan Diabetes Research Center said. He co-authored the article with Shabana Tharkar, also from the Indian hospital.

The study, conducted among two groups – 2021 subjects aged over 20 years, and 1289 subjects aged 8-19 years – indicated that even among overweight, 'non-obese' people, the presence of major cardiovascular risk factors was not significantly different. While the total diabetes prevalence among the obese population is 28.4 per cent, among the overweight population is 25 per cent. Again, with hypertension, the value for the obese group is 34.2 per cent, while for the overweight population it is 27.6 per cent. In contrast, the corresponding values are 16.2 per cent (diabetes) and 20.2 (hypertension).

Similarly, the study showed higher values for triglycerides and high HDL cholesterol for both these groups.

Overweight was defined as a Body Mass Index, equal to, or in excess of 25 kg/m2 and obesity, a BMI of 30 kg/m2 or above. Further worrisome is the increasing rate of overweight and obesity among both men and women from 1995 to 2008, across all age groups. Dr. Viswanathan added that this is the result of rapid urbanisation. “Obesity has already hit the Western world and it is time for Indians to wake up to the alarm bells,” according to the article. Results from previous studies show a lower risk of developing diabetes with just a five per cent initial reduction in weight, Dr. Viswanathan said.

The findings highlight the urgent need for framing direct and indirect strategies to control the rising levels of obesity in the population, in order to substantially reduce the country's non communicable diseases burden, he added. Regulating the diet, reducing intake of fast foods and high-calorie meals, and upping physical activity and exercise on a regular basis would go a long way in keeping weight under control, diabetologists advise.

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Low Level of “Good” Cholesterol Associated with Alzheimer’s

A low level of “good” cholesterol is a well-known risk factor for heart disease. A new study by investigators at Columbia University College of Physicians & Surgeons now suggests that a low level of good cholesterol may also raise the risk of developing Alzheimer's disease.

“Low levels of 'good' cholesterol (a.k.a. high-density lipoproteins or HDL) are very common in the United States,” says the study's lead author, Christiane Reitz, MD, PhD, assistant professor of neurology (in the Sergievsky Center and Taub Institute). “If raising HDL can lower a person's risk of developing Alzheimer's disease, that means we may be able to significantly reduce the rate of Alzheimer's disease in the population,” Reitz says, though she cautions that the finding still must be confirmed in other studies.

The study, which appears in the December issue of Archives of Neurology, is co-authored with Jose Luchsinger, MD, MPH, associate professor of medicine and epidemiology, and Richard Mayeux, MD, director of the Gertrude Sergievsky Center and Sergievsky Professor of Neurology, Psychiatry, and Epidemiology.

Previously, the relationship between HDL and Alzheimer's disease had been unclear. Some studies found an association, but others, including one of Reitz's own, found no connection. The new study, Reitz says, follows subjects for a longer period of time than previous studies, resulting in a more accurate account of the number of subjects who ultimately develop Alzheimer's.

After monitoring 1130 elderly residents of northern Manhattan for an average of four years, the researchers found a 40 percent higher incidence of Alzheimer's in residents with low HDL (less than 55 mg/dl). The reason that low HDL is associated with a higher rate of Alzheimer's isn't understood. One possibility is that it works through stroke. “We know low HDL raises the risk of stroke and that stroke is associated with Alzheimer's, so stroke may be the mediator,” Reitz says. “But there's also evidence that HDL works by itself to clear amyloid proteins [the proteins believed to cause Alzheimer's] from the brain.”

Because the study included a large number of African Americans and Hispanics, unlike previous studies that focused on whites, the finding may indicate that low HDL is linked to a high risk of Alzheimer's in many different ethnicities.

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Chocolate reduces effect of Chronic Fatigue Syndrome

Chocolate reduces effect of Chronic Fatigue Syndrome

Researchers from the University of Hull and the Hull York Medical School have found dark chocolate has a significant effect on reducing the symptoms of Chronic Fatigue Syndrome (CFS). The research, published in Nutrition Journal, found that polyphenol rich chocolate eases the condition, with subjects noting significant improvements to their well-being. Chocolate is known to increase neurotransmitters like phenyl ethylamine, serotonin, and anandamide in the brain, but this is the first time that polyphenol rich chocolate in people with CFS has been studied.

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Above: Professor Steve Atkin.

Subjects with CFS having severe fatigue of at least 10 out of 11 on Chalder Fatigue Scale were enrolled on the pilot study. Participants were given one of two types of chocolate, one with a high cocoa content and the other without.

Over an eight week period the volunteers consumed one type of chocolate followed by a two week wash out period and then another eight weeks of eating the other variety. The dark chocolate contained 85% cocoa solids with the alternative containing none. Each individual bar weighed 15g with each volunteer expected to eat three per day, and also told not to consume more or make changes to their diet.

Researchers also noted the weight of subject did not significantly alter despite consuming an extra 245 calories per day for two months.

Professor Steve Atkin who led the study says: “The significance of the results is particularly surprising because of the small number of subjects in the study. A further study is needed to see what the effects would be on a larger group of people, but this is potentially very encouraging news for those who suffer from Chronic Fatigue Syndrome.”

This latest finding follows recent research also carried out at the University of Hull and the Hull York Medical School where dark chocolate was found to help reduce the risk of heart attacks in people with Type 2 diabetes by increasing the amount of good cholesterol in the blood stream.

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A Whey to Reduce High Blood Pressure

Supplementing diet with whey-based protein may help reduce high blood pressure, a U.S. researcher says.

Nutritional biochemist Susan Fluegel of Washington State University in Spokane says daily doses of commonly available whey brought a more than 6-point reduction in the average blood pressure of men and women with elevated systolic and diastolic blood pressures. Whey is a by-product of cheese-making. “One of the things I like about this is it is low-cost,” Fluegel says in a statement. “Not only that, whey protein has not been shown to be harmful in any way.”

The study, published in International Dairy Journal, finds not everyone drinking the whey-supplemented drink has changes in blood pressure.

The supplement did not lower the blood pressure of subjects who did not have elevated pressure to begin with. That's good, says Fluegel, since low blood pressure can also be a problem. However, blood-pressure reductions — as seen in those with elevated pressure in this study — can bring a 35 percent to 40 percent reduction in fatal strokes, says Fluegel.

Fluegel and colleagues looked at 71 student subjects ages 18-26, but Fluegel says older people with blood pressure issues would likely get similar results. The supplement was delivered in fruit-flavored drinks developed at the university's creamery.

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A healthy diet cuts Alzheimer’s risk

Dr. Gu and her colleagues studied a cohort of 2148 elderly subjects 65 years and older living in New York City. All subjects were healthy and free of dementia at study entry. Their dietary habits were obtained via questionnaire, and they were prospectively evaluated with the same standardized neurologic and neuropsychological measures approximately every 1.5 years for an average of 4 years.

The researchers used reduced rank regression to calculate dietary patterns according to their effect on 7 nutrients previously shown in the literature to be related to Alzheimer's disease: saturated fatty acids, monounsaturated fatty acids, ω-3 polyunsaturated fatty acids, ω-6 polyunsaturated fatty acids, vitamin E, vitamin B12, and folate.

During the follow-up, 253 individuals developed Alzheimer's disease. The study found that one dietary pattern — characterized by higher intakes of salad dressing, nuts, fish, tomatoes, poultry, cruciferous vegetables, fruits, and dark and green leafy vegetables and a lower intake of high-fat dairy products, red meat, organ meat, and butter — was significantly associated with a reduced risk for Alzheimer's disease.

Compared with subjects in the lowest tertile of adherence to this pattern, the Alzheimer's disease hazard ratio (95% confidence interval) for subjects in the highest tertile was 0.62 (0.43 – 0.89) after multivariable adjustment (P for trend = .01).

The study also found that subjects who were older, less educated, and current smokers tended to be less adherent to the protective diet. Hispanic individuals adhered less than white and black individuals (P = .02), and women tended to adhere more than men (P = .05).

“The dietary pattern that was most protective against Alzheimer's reflected a diet rich in ω-3 and ω-6 polyunsaturated fatty acids, vitamin E, and folate but poor in saturated fatty acids and vitamin B12,” commented Dr. Gu. “The combination of nutrients in this dietary pattern reflects multiple pathways in the development of Alzheimer's disease.

“For example, vitamin B12 and folate are homocysteine-related vitamins that may have an impact on the disease through their ability to lower circulating homocysteine levels,” she said. “Vitamin E is a strong antioxidant, and the fatty acids may be linked to dementia and cognitive function through atherosclerosis, thrombosis, or inflammation. Fatty acids may also affect brain development and membrane functioning.”

She added that the study has several limitations. “We used a single measurement of the diet, and this might not have captured the long-term dietary habits of the subjects. We also excluded subjects from the final analysis because they were lost to follow-up, and this might have introduced selection bias. We also can't completely rule out the possibility that the reduced risk associated with this protective diet was due to residual confounding.”

Further studies are planned, Dr. Gu said. “We cannot say based on this study alone that this type of dietary pattern prevents Alzheimer's disease, but many studies have consistently shown that fruits and vegetables and unsaturated fatty acids are associated with a lower risk. We want to repeat these findings in different populations and see if they can be confirmed in other studies.”

Commenting on this study for Medscape Neurology, David Knopman, MD, professor of neurology at the Mayo Clinic and a member of the Mayo Clinic Alzheimer's Disease Research Center in Rochester, Minnesota, said that, despite the study authors' best efforts, it is still not clear whether diet alone makes a difference.

“Dietary habits, which often are lifelong, are certainly part of the array of health behaviors that contribute to better cognitive health in late life. However, diet and other health behaviors are intertwined. Because a healthy diet contributes to better cardiac health, lower weight, lower blood pressure and a lower risk for diabetes, there are many reasons to view the dietary habits described by Dr. Gu and colleagues as beneficial.”

The study was supported by federal National Institute on Aging grants. Dr. Gu and Dr. Knopman have disclosed no relevant financial relationships.

Arch Neurol. Published online April 12, 2010.

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Vitamin B Benefits Celiac Patients

Patients who use vitamin supplements also showed lower levels of plasma homocysteine than in patients who did not (P = 0.001) or healthy controls (P = 0.003). Vitamin B6 and folate were both associated with homocysteine levels, whereas vitamin B12 was not. Twenty-four (48%) of 50 controls and 23 (50%) of 46 of the celiac disease patients carried the MTHFR thermolabile variant T-allele (P = 0.89).

The research team concludes that Homocysteine levels are dependent on Marsh classification and the regular use of B-vitamin supplements reduces of homocysteine levels in patients with celiac disease.The study confirms earlier studies suggesting that both the presence and severity of celiac disease determined homocysteine levels.

The regular use of supplemental B vitamins resulted in higher levels of serum vitamin B6, folate, vitamin B12 and lower levels of plasma homocysteine in patients with celiac disease. Moreover, supplemental B vitamins seem to offer protection against the effects of villous atrophy on homocysteine levels, independent of the genetic susceptibility status as determined by carriage of the C677T polymorphism of 5,10 methylenetetrahydrofolate reductase.

World J Gastroenterol. 2009;15:955–960

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