cardiovascular health

 Another study was just published with worrisome findings about phthalates. Phthalates are a group of chemicals used widely in common consumer products such as food packaging, toys, medical devices, medications, and personal care products. They are endocrine disruptors (can interfere with normal hormonal function) and are linked to a number of health problems (here, here, and here).

The study looked at urban Australian men and found that the higher the level of phthalates, the higher the rate of cardiovascular disease, type-2 diabetes, and hypertension. The researchers also found that higher levels of chronic low-grade inflammatory biomarkers (meaning higher levels of low-grade inflammation) was associated with higher levels of phthalates. All these findings confirm what other studies, done in other countries, have found.

Phthalates, which are measured in the urine,  were detected in 99.96% of the 1504 men. Eating a western dietary pattern (fast food, highly processed, low fiber) was also associated with higher phthalate levels.  However, they did not find an association of phthalate levels with asthma and depression. From Science Daily:

Everyday chemicals linked to chronic disease in men

Chemicals found in everyday plastics materials are linked to cardiovascular disease, type-2 diabetes and high blood pressure in men, according to Australian researchers. Researchers from the University of Adelaide and the South Australian Health and Medical Research Institute (SAHMRI) investigated the independent association between chronic diseases among men and concentrations of potentially harmful chemicals known as phthalates.

Phthalates are a group of chemicals widely used in common consumer products, such as food packaging and wrappings, toys, medications, and even medical devices. Researchers found that of the 1500 Australian men tested, phthalates were detected in urine samples of 99.6% of those aged 35 and over. "We found that the prevalence of cardiovascular disease, type-2 diabetes and high blood pressure increased among those men with higher total phthalate levels," says senior author Associate Professor Zumin Shi, from the University of Adelaide's Adelaide Medical School and the Freemasons Foundation Centre for Men's Health, and a member of SAHMRI's Nutrition & Metabolism theme.

"While we still don't understand the exact reasons why phthalates are independently linked to disease, we do know the chemicals impact on the human endocrine system, which controls hormone release that regulate the body's growth, metabolism, and sexual development and function. "In addition to chronic diseases, higher phthalate levels were associated with increased levels of a range of inflammatory biomarkers in the body," he says.

Age and western diets are directly associated with higher concentrations of phthalates. Previous studies have shown that men who ate less fresh fruit and vegetables and more processed and packaged foods, and drank carbonated soft drinks, have higher levels of phthalates in their urine.... Associate Professor Shi says that although the studies were conducted in men, the findings are also likely to be relevant to women. "While further research is required, reducing environmental phthalates exposure where possible, along with the adoption of healthier lifestyles, may help to reduce the risk of chronic disease," he says. [Original study.]

 Once again several studies found health benefits associated with drinking coffee daily - this time "reduced risk of death" in 2 studies, and in one study a reduced risk of gallbladder cancer.

Just keep in mind that the studies found associations, but did not establish that drinking coffee caused X (reduced risk of death) - so perhaps coffee drinkers differ in some still unknown way from non-coffee drinkers. But...so many studies are piling up showing an association with health benefits that it looks likely that it is actually the coffee causing the benefits. Both decaffeinated and regular coffee seem beneficial, and it doesn't matter how it is prepared (e.g., espresso, drip, cappuccino). (Earlier posts about coffee - here, here, here)

In the one study higher consumption of coffee was associated with a lower risk of death from heart disease, cancer, stroke, diabetes, and kidney disease in African Americans, Japanese Americans, Latinos, and whites. People who consumed a cup of coffee a day (decaffeinated or regular) were 12 percent less likely to die compared to those who didn't drink coffee, and those who drank two to three cups a day had an 18 percent reduced chance of death.

The conclusion of the other study of over half million adults in 10 European countries was similar: coffee drinking was associated with lower risk for death from "all causes", especially from circulatory diseases and diseases related to the digestive tract. This association held up among all the countries. The highest levels of consumption  group (3 cups or more of coffee per day)  had the lowest risk of death - as compared to those drinking none or less than 1 cup of coffee per day. However, the one negative result from drinking more than 3 cups of coffee daily was an increase in risk for ovarian cancer mortality in women (but only when compared to coffee non-drinkers).

From STAT News: Drink coffee? It won’t hurt you, and may reduce your risk of an early death

Good news, coffee drinkers: A couple of massive new studies that looked at hundreds of thousands of people for about 16 years finds that a few cups of coffee a day won’t hurt you and could lower your risk of dying prematurely. The studies reinforce previous findings that drinking an 8-ounce cup of joe (or three) won’t hurt you, but the authors of the new works and other experts say caveats abound.

Murphy told STAT his is the largest study on coffee and mortality to date. In the study, researchers with the WHO’s International Agency for Research on Cancer and Imperial College London tracked 521,000 adults from 10 European countries who self-reported their coffee consumption over an average of 16 years.... In investigating more than 40,000 deaths from this group, the team found that participants who fell into the highest 25 percent of coffee consumers had a lower risk of death due to any cause compared to non-coffee drinkers. They saw a reduced risk of early death by diseases related to the digestive and circulatory systems. The researchers also discovered a link between higher coffee consumption and lower risk of early death by lung cancer in men. And they also looked at suicide — completed suicides were lower for coffee drinkers, but only in men. [Original study.]

In a second study of 180,000 people tracked for an average of 16 years, University of Southern California investigators found drinking one to six cups of coffee per week led to a decreased risk of early death. The study was focused on non-white populations, andtheir findings proved consistent for coffee drinkers across racial and ethnic groups. One of the USC study’s senior authors, V. Wendy Setiawan... said coffee consumption may be linked a lower risk of early death for people with heart disease, cancer, chronic lower respiratory disease, stroke, and kidney disease.Drink one cup per day, and the risk of dying early from those diseases decreases by 12 percent, she said. [Original study.]

This 2016 study is from Medscape: Coffee Consumption and Risk of Gallbladder Cancer in a Prospective Study

Evidence indicates that coffee consumption may reduce the risk of gallstone diseasewhich is strongly associated with increased risk of gallbladder cancer. The association between coffee consumption and gallbladder cancer incidence was examined in a prospective cohort study of 72,680 Swedish adults (aged 45 − 83 years) who were free of cancer and reported their coffee consumption at baseline.....  In conclusion, coffee consumption was observed to be associated with a reduced risk of gallbladder cancer. A potential protective association between coffee consumption and risk of gallbladder cancer may be mediated via reduced gallstone formation or through other mechanisms such as reduction of oxidative damage and inflammation and regulation of DNA repair, phase II enzymatic activity, apoptosis, angiogenesis, and metastasis.

Image result for dark chocolate Chocolate lovers can rejoice - because another study, which was actually a review of other studies - found that frequent consumption of chocolate, cocoa, and cocoa flavanols (an ingredient of cocoa) is linked with beneficial health effects. These included cardiovascular benefits, and dose-dependent improvements in cognition, attention, and memory. In other words - the more frequently one eats chocolate and cocoa (especially dark chocolate), the more beneficial health effects. So eat and enjoy! From Medical Xpress:

Cocoa and chocolate are not just treats—they are good for your cognition

A balanced diet is chocolate in both hands - a phrase commonly used to justify one's chocolate snacking behavior. A phrase now shown to actually harbor some truth, as the cocoa bean is a rich source of flavanols: a class of natural compounds that has neuroprotective effects. In their recent review published in Frontiers in Nutrition, Italian researchers examined the available literature for the effects of acute and chronic administration of cocoa flavanols on different cognitive domains. In other words: what happens to your brain up to a few hours after you eat cocoa flavanols, and what happens when you sustain such a cocoa flavanol enriched diet for a prolonged period of time?

Although randomized controlled trials investigating the acute effect of cocoa flavanols are sparse, most of them point towards a beneficial effect on cognitive performance. Participants showed, among others, enhancements in working memory performance and improved visual information processing after having had cocoa flavanols. And for women, eating cocoa after a night of total sleep deprivation actually counteracted the cognitive impairment (i.e. less accuracy in performing tasks) that such a night brings about. Promising results for people that suffer from chronic sleep deprivation or work shifts.

The effects of relatively long-term ingestion of cocoa flavanols (ranging from 5 days up to 3 months) has generally been investigated in elderly individuals. It turns out that for them cognitive performance was improved by a daily intake of cocoa flavanols. Factors such as attention, processing speed, working memory, and verbal fluency were greatly affected. These effects were, however, most pronounced in older adults with a starting memory decline or other mild cognitive impairments.

And this was exactly the most unexpected and promising result according to authors Valentina Socci and Michele Ferrara from the University of L'Aquila in Italy. "This result suggests the potential of cocoa flavanols to protect cognition in vulnerable populations over time by improving cognitive performance. If you look at the underlying mechanism, the cocoa flavanols have beneficial effects for cardiovascular health and can increase cerebral blood volume in the dentate gyrus of the hippocampus. This structure is particularly affected by aging and therefore the potential source of age-related memory decline in humans."

So should cocoa become a dietary supplement to improve our cognition? "Regular intake of cocoa and chocolate could indeed provide beneficial effects on cognitive functioning over time. There are, however, potential side effects of eating cocoa and chocolate. Those are generally linked to the caloric value of chocolate, some inherent chemical compounds of the cocoa plant such as caffeine and theobromine, and a variety of additives we add to chocolate such as sugar or milk." Nonetheless, the scientists are the first to put their results into practice: "Dark chocolate is a rich source of flavanols. So we always eat some dark chocolate. Every day." [Original study.]

 Should the results of this study determine what kind of coffee one drinks? Does it really make a difference? Eh...Not for me (because all coffee seems to be beneficial), but it might for you.

Studies show that daily drinking of coffee appears to have health benefits. Studies have linked coffee consumption with lower rates of cancer (here and here), cardiovascular disease, and diabetes. Coffee contains beneficial chemicals (such as caffeine and chlorogenic acid) that are antioxidant and anti-inflammatory, and could help fight chronic inflammatory diseases. It turns out that how much coffee beans are roasted changes how much chlorogenic acid they contain, but the amount of caffeine basically stays the same among the different roasting levels.

Researchers in Korea compared the caffeine and chlorogenic acid components of Arabica coffee beans at different roasting levels: Light, Medium, City, and French roast. They then tested various protective antioxidant and anti-inflammatory properties of the different coffee extracts in various "cell models" (meaning in the lab, not on real people). They found that chlorogenic acid levels were higher in light roasted coffee extract than the other roasted groups, and also light roasted coffee extract had the highest antioxidant activity. The results found that increasing degrees of roasting reduced antioxidant and anti-inflammatory activities.

From the Journal of Medicinal Food: Cellular Antioxidant and Anti-Inflammatory Effects of Coffee Extracts with Different Roasting Levels

During roasting, major changes occur in the composition and physiological effects of coffee beans. In this study, in vitro antioxidant effects and anti-inflammatory effects of Coffea arabica green coffee extracts were investigated at different roasting levels corresponding to Light, Medium, City, and French roast. Total caffeine did not show huge difference according to roasting level, but total chlorogenic acid contents were higher in light roasted coffee extract than other roasted groups. In addition, light roasted coffee extract had the highest antioxidant activity.... The expression of mRNA for tumor necrosis factor-alpha and interleukin-6 was decreased in cells treated with the coffee extracts and the expression decreased with increasing roasting levels. These data suggest that coffee has physiological antioxidant and anti-inflammatory activities and these effects are negatively correlated with roasting levels in the cell models.

Coffee is one of the most popular beverages worldwide. Increasing consumption of coffee is related to the pleasing taste and aroma, as well as its physiological effects. Coffee is proposed to exert beneficial effects against cancer, cardiovascular disease, obesity, and diabetes. Coffee contains phenolic compounds such as caffeic acid, chlorogenic acid, ferulic acid, vanillic acid, and other phytochemicals. The quality of coffee is significantly related to the roasting process.... During roasting, there are numerous changes in coffee bean compound profiles and the aroma is increased. Major changes in coffee bean composition occur during roasting as a result of the Maillard reaction..... Roasting markedly affects chlorogenic acid, leading to hydrolysis of chlorogenic acid. New compounds are formed during the roasting process; one of these is melanoidin. Its formation might alter the overall antioxidant capacity of coffee beans after roasting.

Coffee is a rich source of antioxidants that may contribute to prevention of oxidative stress-related diseases. The antioxidant properties of coffee may reflect the presence of both phenolic and nonphenolic bioactive compounds, such as caffeine and chlorogenic acids. Previous studies have shown that coffee has protective effects against oxidation and DNA damage in human cell models and has been shown to possess an in vitro antioxidant activity that lessens lipid peroxidation and neoplastic activity. 

Caffeine is the major component in coffee extract and has antioxidant property. Chlorogenic acid is another well-known efficient antioxidant in coffee extract; it was highest in Light roast coffee extract and highest with low roasting temperature and lowest in Dark roasted extract. Carbohydrates, protein, and chlorogenic acid are all decreased in coffee during the roasting process.... Caffeine contents showed no differences among roasting levels, but chlorogenic acid content decreased as roasting degree increased..... The effect of coffee roasting on the antioxidant properties of coffee extracts was investigated in several earlier studies; antioxidant capacity decreased in Dark roast coffee. The antioxidant property of coffee extracts prepared with different roasting levels was also determined in this study. The best antioxidant activity was evident in Light roast coffee extract and the lowest in French roast coffee.

  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