cardiovascular health

  The use of nanomaterials has been really increasing  in recent years without us really understanding if  nanoparticles have negative health effects, and if they travel to the brain or other organs in the human body. Nanoparticles are used in many  consumer products, including foods (e.g., nano-sized titanium dioxide) and medicines, but they are also found in air pollution  (e.g., tires breaking down, vehicle exhaust). Well..... evidence is starting to appear that YES - nanoparticles can travel  throughout the body, and they can accumulate in the body, including lungs and brain, and they can have negative health effects. For example, inhaled nanoparticles from air pollution are able to deposit deep in the lungs where they cause oxidative stress and inflammation.

Now new research in both humans and mice has shown that inhaled nanoparticles can travel from the lungs into the bloodstream. In this study both healthy males and heart disease patients inhaled gold nanoparticles of varying sizes. The gold was detected in the blood and urine within 15 minutes to 24 hours after exposure, and was still present 3 months after exposure. The levels were greater following inhalation of smaller 5 nanometer (nm) particles compared to the larger 30 nm particles (meaning the body had trouble clearing the smaller nanoparticles). The nanoparticles acculmulated more in inflamed vascular sites, including carotid plaques in patients at risk of a stroke. Showing this is important in explaining how tiny nanosized particles in air pollution are linked to cardiovascular disease and death - for example, why and how they can trigger heart attacks and other "cardiovascular events". Science Daily:

Nanoparticles can travel from lungs to blood, possibly explaining risks to heart

Tiny particles in air pollution have been associated with cardiovascular disease, which can lead to premature death. But how particles inhaled into the lungs can affect blood vessels and the heart has remained a mystery. Now, scientists have found evidence in human and animal studies that inhaled nanoparticles can travel from the lungs into the bloodstream, potentially explaining the link between air pollution and cardiovascular disease. Their results appear in the journal ACS Nano.

The World Health Organization estimates that in 2012, about 72 percent of premature deaths related to outdoor air pollution were due to ischemic heart disease and strokes. Pulmonary disease, respiratory infections and lung cancer were linked to the other 28 percent. Many scientists have suspected that fine particles travel from the lungs into the bloodstream, but evidence supporting this assumption in humans has been challenging to collect. So Mark Miller and colleagues at the University of Edinburgh in the United Kingdom and the National Institute for Public Health and the Environment in the Netherlands used a selection of specialized techniques to track the fate of inhaled gold nanoparticles.

In the new study, 14 healthy volunteers, 12 surgical patients and several mouse models inhaled gold nanoparticles, which have been safely used in medical imaging and drug delivery. Soon after exposure, the nanoparticles were detected in blood and urine. Importantly, the nanoparticles appeared to preferentially accumulate at inflamed vascular sites, including carotid plaques in patients at risk of a stroke. The findings suggest that nanoparticles can travel from the lungs into the bloodstream and reach susceptible areas of the cardiovascular system where they could possibly increase the likelihood of a heart attack or stroke, the researchers say. [Original study.]

  A recent study looking at high dose supplementation of vitamin D found that it did not prevent cardiovascular disease. This study came about because of earlier studies observing that there is a higher incidence of cardiovascular disease in persons with low vitamin D levels (as measured in their blood). But such results from observational studies need rigorous testing in studies where people are randomly assigned to groups, and that are "double-blind" (no one knows who is getting the vitamin D until the end of the study) to eliminate bias. And this is what was done in this study, with the result that monthly high doses of vitamin D3 for 3 years did not prevent cardiovascular disease (including stroke, heart attacks, hypertension, etc) - as seen in that there were no group differences between the vitamin D and placebo groups. Finding no effects are "null findings".

But note that the subjects in the study got monthly high doses, and not daily or weekly vitamin D. It is unknown whether daily dosing would have made a difference in the results. However, the vitamin D levels in the blood soon reached levels (about 51.725 ng/mL) that many view as a desirable "protective" level. So we'll see what other studies find. But these results are definitely disappointing for those wanting an easy "magic bullet" for preventing cardiovascular disease. Bottom line: focus on lifestyle (diet, exercise, not smoking, etc) for heart health. From Science Daily:

Monthly high-dose vitamin D supplementation does not prevent cardiovascular disease

Results of a large randomized trial indicate that monthly high-dose vitamin D supplementation does not prevent cardiovascular disease, according to a study published by JAMA Cardiology. Studies have reported increased incidence of cardiovascular disease (CVD) among individuals with low vitamin D status. To date, randomized clinical trials of vitamin D supplementation have not found an effect, possibly because of using too low a dose of vitamin D. Robert Scragg, M.B.B.S., Ph.D., of the University of Auckland, New Zealand, and colleagues randomly assigned adults (age 50 to 84 years) to receive oral vitamin D3 (n = 2,558; an initial dose of 200,000 IU, followed a month later by monthly doses of 100,000 IU) or placebo (n = 2,552) for a median of 3.3 years.

Of the 5,108 participants included in the primary analysis, the average age was 66 years; 25 percent were vitamin D deficient. Cardiovascular disease occurred in 303 participants (11.8 percent) in the vitamin D group and 293 participants (11.5 percent) in the placebo group. Similar results were seen for participants with vitamin D deficiency at study entry and for other outcomes such as heart attack, angina, heart failure, hypertension, and stroke.

The authors write that the results of this study do not support the use of monthly high-dose vitamin D for the prevention of CVD. "The effects of daily or weekly dosing on CVD risk require further study." [Original study.]

Mediterranean Diet is Healthy Eating – A Good Option for Seniors Is this really a surprise to anyone at this point? According to a recent study: Almost half of all deaths in the United States in 2012 that were caused by cardiometabolic diseases such as heart disease, stroke and type 2 diabetes, have been linked to "suboptimal diets" - that is, to eating poorly and so not getting enough of certain foods and nutrients, and too much of other foods. Deaths due to heart disease, stroke, or type 2 diabete were linked to: high sodium (salt) intake, not eating enough nuts and seeds, a high intake of processed meats, and low intake of seafood omega-3 fats.

The study looked at consumption of 10 foods or nutrients that are associated with cardiometabolic diseases: fruits, vegetables, nuts/seeds, whole grains, unprocessed red meats, processed meats, sugar-sweetened beverages (SSBs), polyunsaturated fats, seafood omega-3 fats, and sodium. The researchers incorporated data from National Health and Nutrition Examination Surveys, from studies and clinical trials, and from the National Center for Health Statistics. So how should one eat for heath? Lots of fruits and vegetables, legumes (beans), nuts, seeds, whole grains, fish, and less processed food and fast food. (A plus of this is that it also feeds your beneficial gut microbes.) Read ingredient lists and try to avoid whatever foods have ingredients that you ordinarily wouldn't cook with or don't understand what they are (for example, colors, additives, titanium dioxide, artificial or natural flavors, etc.). From Science Daily:

High number of deaths from heart disease, stroke and diabetes linked to diet

Nearly half of all deaths in the United States in 2012 that were caused by cardiometabolic diseases, including heart disease, stroke and type 2 diabetes, have been linked to substandard eating habits, according to a study published in the March 7 issue of JAMA and funded by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health. Of the 702,308 adult deaths due to cardiometabolic diseases, 318,656, or about 45 percent, were associated with inadequate consumption of certain foods and nutrients widely considered vital for healthy living, and overconsumption of other foods that are not.

The list includes foods and nutrients long-associated with influencing cardiometabolic health. The highest percentage of deaths was linked to excess consumption of sodium. Processed meats, sugar-sweetened beverages and unprocessed red meats were also consumed in excess. Americans did not consume enough of some foods that have healthful effects such as fruits, vegetables, nuts and seeds, whole grains, polyunsaturated fats and seafood omega-3 fats.

The study also shows that the proportion of deaths associated with diet varied across population groups. For instance, death rates were higher among men when compared to women; among blacks and Hispanics compared to whites; and among those with lower education levels, compared with their higher-educated counterparts. The authors concluded that "these results should help identify priorities, guide public health planning, and inform strategies to alter dietary habits and improve health." The study findings were based on death certificate data collected by the National Center for Health Statistics, part of the Centers for Disease Control and Prevention.

Image result for pills wikipedia A new study has been released that reminds us that all drugs (whether prescription or non-prescription) have side-effects.  This time a nation wide study from Denmark found that short-term use of the non-steroidal anti-inflammatory drugs (NSAIDs) ibuprofen (e.g. Advil and Motrin) and diclofenac is linked to a higher risk of cardiac arrest (the heart suddenly stops beating). It was an observational study so can't definitely say that ibuprofen and diclofenac caused the cardiac arrests, but the findings match a growing body of evidence.

Since Ibuprofen and other NSAIDs are popular non-prescription medicines used worldwide, people assume they are safe to use. In Denmark, ibuprofen is the only NSAID sold as an over-the-counter drug, and only in small amounts. In the U.S., both ibuprofen and diclofenac are sold in both non-prescription and prescription forms.

In the study, they found an increased risk of cardiac arrest in ibuprofen and diclofenac users. However, they did not find a risk of cardiac arrest with the use of COX-2 selective inhibitors, rofecoxib and celecoxib, nor with the NSAID naproxen. One of the researchers (Dr. Gislason) therefore advises consumers to try to avoid diclofenac, to limit the use of ibuprofen to no more than 1200 mg per day, and that perhaps the safest is naproxen (up to 500 mg per day). From Medical Xpress:

'Harmless' painkillers associated with increased risk of cardiac arrest

Painkillers considered harmless by the general public are associated with increased risk of cardiac arrest, according to research published today in the March issue of European Heart Journal - Cardiovascular Pharmacotherapy.....The current study investigated the link between NSAID use and cardiac arrest. All patients who had an out-of-hospital cardiac arrest in Denmark between 2001 and 2010 were identified from the nationwide Danish Cardiac Arrest Registry. Data was collected on all redeemed prescriptions for NSAIDs from Danish pharmacies since 1995. These included the non-selective NSAIDs (diclofenac, naproxen, ibuprofen), and COX-2 selective inhibitors (rofecoxib, celecoxib).

A total of 28 947 patients had an out-of-hospital cardiac arrest in Denmark during the ten year period. Of these, 3 376 were treated with an NSAID up to 30 days before the event. Ibuprofen and diclofenac were the most commonly used NSAIDs, making up 51% and 22% of total NSAID use, respectively. Use of any NSAID was associated with a 31% increased risk of cardiac arrest. Diclofenac and ibuprofen were associated with a 50% and 31% increased risk, respectively. Naproxen, celecoxib and rofecoxib were not associated with the occurrence of cardiac arrest, probably due to a low number of events.

"The findings are a stark reminder that NSAIDs are not harmless," said Professor Gislason. "Diclofenac and ibuprofen, both commonly used drugs, were associated with significantly increased risk of cardiac arrest. NSAIDs should be used with caution and for a valid indication. They should probably be avoided in patients with cardiovascular disease or many cardiovascular risk factors." NSAIDs exert numerous effects on the cardiovascular system which could explain the link with cardiac arrest. These include influencing platelet aggregation and causing blood clots, causing the arteries to constrict, increasing fluid retention, and raising blood pressure. [Original study.]

 This past week a study was published linking 8 to 10 portions of fruits and vegetables per day with a lower risk of early death, cancer, heart disease, and stroke. This confirms other research linking many daily servings of fruits and vegetables with various health benefits. For example, the study findings discussed in the Nov. 2, 2016 post: "Eating lots of fruits and vegetables (more than 10 servings a day!)  is linked to better cognitive functioning in both normal weight and overweight adults (both young and older adults), and may delay the onset of cognitive decline that occurs with aging and also dementia."

This new study led by researchers from the Imperial College London reviewed 95 previous studies of the relationship between diet and health. They found that people who ate 10 portions of fruits and vegetables a day had nearly a third lower risk of premature death and stroke than those who ate very little or no fruits and vegetables. The researchers pointed out that as the amount of fruits and vegetables eaten daily went up, the health benefits also increased (lower risk of heart disease, stroke, cardiovascular disease, cancer), and the risk of premature death decreased - thus a dose related relationship. So better to eat some fruits and vegetables than none! A portion is about 80 grams, equivalent to a medium apple, 1 banana, or generally about 1/2 cup of vegetables or fruits.

From Science Daily: Eating up to ten portions of fruit and vegetables a day may prevent 7.8 million premature deaths worldwide

A fruit and vegetable intake above five-a-day shows major benefit in reducing the chance of heart attack, stroke, cancer and early death. This is the finding of new research, led by scientists from Imperial College London, which analysed 95 studies on fruit and vegetable intake....the greatest benefit came from eating 800 g a day (roughly equivalent to ten portions -- one portion of fruit or vegetables if defined as 80 g).

The results revealed that even a daily intake of 200 g was associated with a 16 per cent reduced risk of heart disease, an 18 per cent reduced risk of stroke, and a 13 per cent reduced risk of cardiovascular disease. This amount, which is equivalent to two and a half portions, was also associated with 4 per cent reduced risk in cancer risk, and 15 per cent reduction in the risk of premature death. Further benefits were observed with higher intakes. Eating up to 800 g fruit and vegetables a day -- or 10 portions -- was associated with a 24 per cent reduced risk of heart disease, a 33 per cent reduced risk of stroke, a 28 per cent reduced risk of cardiovascular disease, a 13 per cent reduced risk of total cancer, and a 31 per cent reduction in dying prematurely. This risk was calculated in comparison to not eating any fruit and vegetables. [Original study.]

  Do you want to live longer and be healthy at the same time? Some possible ways may be to restrict the calories in the diet (every day) or to practice intermittent calorie restriction (a fasting mimicking diet a few days a month or even each week, such as the 5:2 diet). Previous studies in animals and humans have suggested that periodic fasting can reduce body fat, cut insulin levels, and provide other benefits. Studies in animals found that sharply restricting calories (calorie restriction or CR) daily resulted in longer, healthier lives, but it is unknown if the benefits of chronic calorie restriction also holds true for humans, and even if it might be dangerous. And really - how many people would actually want to reduce their calorie intake by 25% or more day in and day out for years? Intermittent calorie restriction seems much, much easier.

Two recently published studies suggest health benefits of calorie restriction diets - chronic calorie restriction in adult rhesus monkeys, and intermittent calorie restriction (a fasting mimicking diet a few days a month) in humans.

Researchers at the Univ. of Wisconsin–Madison and National Institute of Aging reanalyzed two studies they had originally done with conflicting results, and now they reported in Nature Communications that chronic calorie restriction produced health benefits (such as lower incidence of cancer, cardiovascular problems) and longer life in rhesus monkeys. Since these primates have human-like aging patterns, they thought that CR would also have similar benefits in humans - a longer, healthier life.  The researchers describe one monkey they started on a 30 percent calorie restriction diet when he was 16 years old (late middle age for rhesus monkeys), and that he is now 43 (a longevity record for the species). They found that in nonhuman primates calorie restriction is beneficial when started in adulthood (especially late middle age in males), but does not improve survival when started in juveniles (young animals) - and in fact they tended to die at an earlier age than the normal diet group of primates.

In the other study (in Science Translational Medicine), research suggests it is possible to gain anti-aging benefits with a “fasting-mimicking diet,” practiced just five days a month. 100 healthy adults (aged 20 to 70) were randomly assigned to either a group following a low-calorie "fasting-mimicking" diet (FMD) five days a month, for 3 months, or a normal diet control group. After 3 months, the control group also went on the fasting mimicking diet. Test subjects followed a 50 percent calorie restricted diet (totaling about 1,100 calories on the first day) and 70 percent diet (about 700 calories) on the next four days, then ate whatever they wanted for the rest of the month. The calorie-restricted diet was low in calories, sugars, and protein, was 100 percent plant-based, and featured vegetable soups, energy bars, energy drinks, and a chip snack, as well as mineral and vitamin supplements. (Note that Longo and Univ. of Southern California are both owners of L-Nutra, the company that manufactures the diet. But Longo says he takes no salary or consulting fees from the company.)

But it still wasn't easy for the test subjects to follow the 5 days of restricted calories per month because there was a 25% drop out rateHealth benefits (about a 6 pound weight loss, smaller waistlines, lower blood pressure, lower levels of inflammation, and better levels of glucose, triglycerides and cholesterol, etc.), showed up after the third month and persisted for at least three months—even after subjects had returned full-time to a normal diet. They lost body fat, but lean muscle mass remained unchanged. They found that the benefits were greater for people who were obese or otherwise unhealthy. In summary, the researchers said that 3 cycles of the 5 days per month of fasting-mimicking diet improved the levels of a variety of "markers/risk factors associated with poor health and aging and with multiple age-related diseases" (such as cancer, diabetes, heart disease, etc).

Other researchers say there is no need to suffer through such extreme diets, but to instead follow a healthy lifestyle, which includes a healthy diet (with lots of vegetables, fruits, legumes, seeds, whole grains, and nuts), and to exercise. And remember - nowhere does following restricted calorie diets mean you'll live longer - just that you should be healthier as you age (hopefully). There are no guarantees in life...

From Science Translational Medicine: Fasting-mimicking diet and markers/risk factors for aging, diabetes, cancer, and cardiovascular disease

Mice that fast periodically are healthier, metabolically speaking. To explore whether fasting can help people as well, Wei et al. studied 71 people who either consumed a fasting-mimicking diet for 5 days each month for 3 months or maintained their normal diet for 3 months and then switched to the fasting schedule. The fasting-like diet reduced body weight and body fat, lowered blood pressure, and decreased the hormone IGF-1, which has been implicated in aging and disease. A post hoc analysis replicated these results and also showed that fasting decreased BMI, glucose, triglycerides, cholesterol, and C-reactive protein (a marker for inflammation). These effects were generally larger in the subjects who were at greater risk of disease at the start of the study. A larger study is needed to replicate these results, but they raise the possibility that fasting may be a practical road to a healthy metabolic system.

From Nature Communications:  Caloric restriction improves health and survival of rhesus monkeys

 Interesting idea - that perhaps our community of gut microbes being out of whack (dysbiosis) leads to hypertension. This study was done in both humans and mice - with an analysis of bacteria in both hypertensive individuals and pre-hypertensives, and also healthy individuals (the controls). Then the microbes from 2 hypertensive individuals were transplanted into mice (fecal microbiota transplants). And lo and behold - the mice became hypertensive with an alteration of their gut microbes. This is amazing!

The study showed that transplanting microbes from hypertensives to non-hypertensives caused an elevation in blood pressure in the formerly healthy group. This shows the direct influence of gut microbes on blood pressure. The bacteria found in both the pre-hypertensives and hypertensives (especially an overgrowth of Prevotella and Klebsiella bacteria) are those linked to inflammation. And what kind of diet is linked to that bacteria? A high fat diet. Yes, the Western diet with lots of fat and highly processed foods.

The researchers talked about other research also showing Prevotella being associated not only with hypertension, but also other diseases (e.g., periodontal diseases and rheumatoid arthritis). On the other hand, Faecalibacterium, Oscillibacter, Roseburia, Bifidobacterium, Coprococcus, and Butyrivibrio, which were "enriched" in healthy controls, were lower in pre-hypertensive and hypertensive persons. In the past I have posted about a "special" bacteria that is even called  a "keystone" gut bacteria - Faecalibacterium prausnitziithat is linked to health and is low or absent in the gut in a number of diseases ((here and here). It is not available in a supplement at this time (because it dies within a few minutes upon exposure to oxygen), but diet influences it. A high animal meat, high animal fat, high sugar, highly processed foods, and low fiber diet (the typical Western diet) lowers F. prausnitzii numbers, while a high-fiber, low meat diet increases F. prausnitzii numbers.

What you can do: Feed the beneficial gut microbes by increasing the amount of fruits, vegetables, whole grains, seeds, nuts that you eat. And cut back on the greasy, high fat processed and fast foods.

The following excerpt is misleading - for example, it ignores the first part of the actual study which looked at the gut bacteria of pre-hypertensives, hypertensive, and healthy people. Then gut bacteria from hypertensive people were transplanted into healthy mice, and gut bacteria from healthy people were transplanted into hypertensive mice. Also, it wasn't rats, but mice used in the study. It goes to show why it's important to look at original studies - not just believe articles out there blindly. [See original study.] From Science Daily: Unhealthy gut microbes a cause of hypertension, researchers find

Researchers have found that the microorganisms residing in the intestines (microbiota) play a role in the development of high blood pressure in rats mice....Scientists studied two sets of rats mice, one group with high blood pressure ("hypertensive") and one with normal blood pressure ("normal").... All animals were then given antibiotics for 10 days to reduce their natural microbiota. After the course of antibiotics, the researchers transplanted hypertensive microbiota to normal blood pressure rats mice and normal microbiota to the hypertensive group. 

The researchers found that the group treated with hypertensive microbiota developed elevated blood pressure. A more surprising result is that the rats mice treated with normal microbiota did not have a significant drop in blood pressure, although readings did decrease slightly. This finding is "further evidence for the continued study of the microbiota in the development of hypertension in humans and supports a potential role for probiotics as treatment for hypertension," wrote the researchers. "Studies showing that supplementing the diet with probiotics (beneficial microorganisms found in the gut) can have modest effects on blood pressure, especially in hypertensive models."

NOTE that the actual study said in its CONCLUSIONS:  "Taken together, we have described clearly the disordered profiles of gut microbiota and microbial products in human patients with pre-hypertension and hypertension, established the relationship between gut dysbiosis and hypertension, and provided important evidence for the novel role of gut microbiota dysbiosis as a key factor for blood pressure changes. Our findings point towards a new strategy aimed at preventing the development of hypertension and reducing cardiovascular risks through restoring the homeostasis of gut microbiota, by improving diet and lifestyle or early intervening with drugs or probiotics."

Image result for eggs Remember all the dietary advice that for years told us to avoid or limit consumption of eggs - that since they were high in cholesterol, they were bad for us and would increase our risk for heart disease? And the nonsense that we should only eat the egg whites while throwing out the yolks? Hah...That advice was wrong, which another recent study confirms.

Eggs are an amazingly nutritious food. They’re loaded with high quality protein, healthy fats, vitamins, minerals, high in choline (a brain nutrient), biotin, antioxidants, lutein, and zeaxanthin. One review of studies (involving millions of people) looked at whole egg consumption  and found that high egg consumption (up to one egg per day) is not associated with increased risk of coronary heart disease or stroke, and in fact there was a reduced risk of hemorrhagic stroke. Only among diabetics was there an elevated risk of coronary heart disease with high egg consumption (up to 1 egg per day). Another study found a lower risk of type 2 diabetes in middle-aged men (see post).

A recent study from Finland found that neither cholesterol nor egg intake (eating one egg per day) is associated with an increased risk of dementia or Alzheimer's disease in Finnish men who were followed for 22 years. Instead, eating eggs was associated with better cognitive performance in certain areas such as executive function, which includes memory, problem solving, and planning (they were given neuropsychological tests). From Science Daily:

High cholesterol intake and eggs do not increase risk of memory disorders

A new study from the University of Eastern Finland shows that a relatively high intake of dietary cholesterol, or eating one egg every day, are not associated with an elevated risk of dementia or Alzheimer's disease. Furthermore, no association was found in persons carrying the APOE4 gene variant that affects cholesterol metabolism and increases the risk of memory disorders. APOE4 is common in Finland.

The dietary habits of 2,497 men aged between 42 and 60 years and with no baseline diagnosis of a memory disorder were assessed at the onset the Kuopio Ischaemic Heart Disease Risk Factor Study, KIHD, in 1984-1989 at the University of Eastern Finland. During a follow-up of 22 years, 337 men were diagnosed with a memory disorder, 266 of them with Alzheimer's disease. 32.5 per cent of the study participants were carriers of APOE4.

The study found that a high intake of dietary cholesterol was not associated with the risk of dementia or Alzheimer's disease -- not in the entire study population nor in the carriers of APOE4. Moreover, the consumption of eggs, which are a significant source of dietary cholesterol, was not associated with the risk of dementia or Alzheimer's disease. On the contrary, the consumption of eggs was associated with better results in certain tests measuring cognitive performance

 Worried about whether being physically active just on weekends can make a difference in health if the rest of the week is spent sitting all day? Well, there is good news! Being a "weekend warrior" (one who exercises or is active only one or two days a week) may also offer health benefits according to a new study (associated with lower death rates from all causes, cancer, and cardiovascular disease).

Current government guidelines recommend at least 150 minutes per week of moderate-intensity activity (such as brisk walking or tennis), or at least 75 minutes per week of vigorous activity (such as jogging or swimming laps), or equivalent combinations of moderate and vigorous physical activity. From Science Daily:

'Weekend warriors' have lower risk of death from cancer, cardiovascular disease

Physical activity patterns characterized by just one or two sessions a week may be enough to reduce deaths in men and women from all causes, cardiovascular disease (CVD) and cancer, regardless of adherence to physical activity guidelines, a new study of over 63,000 adults reports. The finding suggests that less frequent bouts of activity, which might fit more easily into a busy lifestyle, offer significant health benefits, even in the obese and those with medical risk factors.

Regular physical activity is associated with lower risks of death from all causes, cardiovascular disease and cancer, and has long been recommended to control weight, cholesterol, and blood pressure. The World Health Organization recommends that adults do at least 150 minutes per week of moderate-intensity activity, or at least 75 minutes per week of vigorous-intensity activity, or equivalent combinations.

But research is yet to establish how the frequency and total weekly dose of activity might best be combined to achieve health benefits. For example, individuals could meet current guidelines by doing 30 minutes of moderate-intensity physical activity five days of the week or 75 minutes of vigorous-intensity physical activity on just one day of the week. Those who do all their exercise on one or two days of the week are known as 'weekend warriors'. 

 Image result for human heart in human body wikipedia Heart attacks run in the family? Does this mean you are doomed to also have a heart attack? Well, the good news from a large study is that a healthy lifestyle (with at least 3 of these 4 behaviors: not currently smoking, not being obese, regular physical activity at least once per week, and eating a good diet)  lowers the risk of a heart attack by nearly 50% even in those with a high genetic risk for heart attacks. (This is compared to those with an unhealthy lifestyle, which is none or only one healthy behavior.)  In this study a healthy diet was one with lots of fruits, nuts, vegetables, whole grains, fish, and dairy products, and a reduced amount of refined grains, processed meats, red meat, sugar-sweetened beverages, and trans fats.

The researchers also reversed the question and asked: "If you happen to inherit good genes, can a bad lifestyle offset that? We actually found yes." The risk of heart attack is also reduced nearly 50% in those people with good genes and a good lifestyle. BOTTOM LINE: Healthy lifestyle counts, no matter whether heart disease and heart attacks run in the family or not. There is an interaction between the two, From Science Daily:

Following a healthy lifestyle can greatly reduce genetic heart attack risk

It is well known that following a healthy lifestyle -- not smoking, avoiding excess weight and getting regular exercise -- can reduce the risk of heart disease. But what about people who have inherited gene variants known to increase risk? A study led by Massachusetts General Hospital (MGH) investigators has found that, even among those at high genetic risk, following a healthy lifestyle can cut in half the probability of a heart attack or similar event

"The basic message of our study is that DNA is not destiny," says Sekar Kathiresan, MD...."Many individuals -- both physicians and members of the general public -- have looked on genetic risk as unavoidable, but for heart attack that does not appear to be the case."  

In order to investigate whether a healthy lifestyle can mitigate genetic risk, the multi-institutional research team analyzed genetic and clinical data from more than 55,000 participants in four large-scale studies. Three of these studies....followed participants for up to 20 years. Each participant in the current analysis was assigned a genetic risk score....The investigators used four AHA-defined lifestyle factors -- no current smoking; lack of obesity (defined as a body mass index less than 30); physical exercise at least once a week; and a healthy dietary pattern -- to determine a lifestyle score, whether participants had a favorable (three or four healthy factors), intermediate (two factors) or unfavorable (one or no healthy factors) lifestyle.

Across all three prospective studies, a higher genetic risk score significantly increased the incidence of coronary events -- as much as 90 percent in those at highest risk. While known risk factors such as a family history and elevated LDL cholesterol were also associated with an elevated genetic risk score, genetic risk was the most powerful contributor to cardiac risk. Similarly, each healthy lifestyle factor reduced risk, and the unfavorable lifestyle group also had higher levels of hypertension, diabetes and other known risk factors upon entering the studies.

Within each genetic risk category, the presence of lifestyle factors significantly altered the risk of coronary events to such an extent that following a favorable lifestyle could reduce the incidence of coronary events by 50 percent in those with the highest genetic risk scores. Among participants in the BioImage study, both genetic and lifestyle factors were independently associated with levels of calcium-containing plaque in the coronary arteries, and healthy lifestyle factors were associated with less extensive plaque within each genetic risk group. [Original study]