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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.

 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.]

 After writing about Lactobacillus sakei in the sinuses for several years (present in healthy sinuses, absent or less in those with chronic sinusitis, and also a treatment for chronic sinusitis), I wondered whether L. sakei is found anywhere else in the body. Today I read a study about gut microbes and strokes and there it was - the presence of L. sakei in the gut. Specifically, a study found that people who have ischemic strokes tend to have lower amounts ("depletion") of L. sakei in the gut than healthy people, even though it was detected in 80% of both groups.

The study found that in people with ischemic strokes there was evidence for the gut microbes being out of whack (dysbiosis), as well as more inflammation, and more of certain bacteria species (Atopobium cluster and Lactobacillus ruminis), and depletion of L. sakei bacteria. The researchers took samples of stool (fecal samples) from each person of both groups (ischemic stroke group and healthy group) and analyzed the stool with modern tests (genetic sequencing) to see whether 22 groups of bacteria were in it. (Note that there are normally hundreds of species of bacteria living in a healthy person's gut, as well as viruses, fungi, etc.).

So once again it looks like L. sakei may be beneficial bacteria, even in the gut. The researchers were careful to point out that they couldn't say that certain bacteria caused the strokes - just that there was an association. And what diet is associated with lower levels of inflammation in the body? Once again - a diet with lots of fruits, vegetables, whole grains, nuts, seeds, and legumes (think Mediterranean style diet). You want to feed the beneficial bacteria in the gut. Excerpts from PLoS One:

Gut dysbiosis is associated with metabolism and systemic inflammation in patients with ischemic stroke

The role of metabolic diseases in ischemic stroke has become a primary concern in both research and clinical practice. Increasing evidence suggests that dysbiosis is associated with metabolic diseases. The aim of this study was to investigate whether the gut microbiota, as well as concentrations of organic acids, the major products of dietary fiber fermentation by the gut microbiota, are altered in patients with ischemic stroke, and to examine the association between these changes and host metabolism and inflammation. We analyzed the composition of the fecal gut microbiota and the concentrations of fecal organic acids in 41 ischemic stroke patients and 40 control subjects via 16S and 23S rRNA-targeted quantitative reverse transcription (qRT)-PCR and high-performance liquid chromatography analyses..... Although only the bacterial counts of Lactobacillus ruminis were significantly higher in stroke patients compared to controls, multivariable analysis showed that ischemic stroke was independently associated with increased bacterial counts of Atopobium cluster and Lactobacillus ruminis, and decreased numbers of Lactobacillus sakei subgroup, independent of age, hypertension, and type 2 diabetes....Together, our findings suggest that gut dysbiosis in patients with ischemic stroke is associated with host metabolism and inflammation.    

Ischemic stroke is associated with metabolic diseases including obesity, type 2 diabetes (T2D), and dyslipidemia. Systemic low-grade inflammation is also closely linked to metabolic disorders and plays a substantial role in the pathogenesis of cardiovascular diseases, including ischemic stroke.....Increasing evidence suggests that dysbiosis of the gut microbiota is associated with the pathogenesis of both intestinal disorders, such as inflammatory bowel disease, and extra-intestinal disorders, including metabolic diseases.

In our study, the 22 bacterial groups/genera/species examined were comprised of (1) six anaerobes that predominate the human intestine (Clostridium coccoides group, Clostridium leptum subgroup, Bacteroides fragilis group, Bifidobacterium, Atopobium cluster, and Prevotella); (2) seven potential pathogens (Clostridium difficile, Clostridium perfringens, Enterobacteriaceae, Enterococcus spp., Streptococcus spp., Staphylococcus spp., and Pseudomonas spp.); and (3) nine lactobacilli (L. gasseri subgroup, L. brevis, L. casei subgroup, L. fermentum, L. fructivorans, L. plantarum subgroup, L. reuteri subgroup, L. ruminis subgroup, and L. sakei subgroup).

Although only the bacterial counts of L. ruminis were significantly higher in stroke patients compared to the controls.....Thus, increased L. ruminis subgroup counts might contribute to inflammation in stroke patients. Conversely, ischemic stroke was also associated with decreased counts of other Lactobacillus species such as the L. sakei subgroup. It was previously reported that L. sakei is associated with higher BMI in healthy adults and the elderly. Notably, a significant depletion of L. sakei was reported in the sinus mucosa of patients with chronic rhinosinusitis. These organisms were found to provide a protective effect against sinus mucosa infection through the competitive inhibition of pathogenic bacteria.... depletion of these bacteria might be deleterious to intestinal mucosal defense in patients with stroke

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

  Study after study finds negative health effects from air pollution, such as heart disease (here, here, and here). Now two more studies found that living in areas with high air pollution is linked to a higher stroke risk. One study (done in Japan) found an increase of ischemic stroke on the same day as exposure to high levels of air pollution, while the other (done in London, UK) found a higher risk of death after stroke (especially ischemic strokes) in patients who live in areas of high air pollution. This was especially pronounced with exposure to smaller or fine particulate matter (PM2.5)- which is found in high quantities in vehicle exhaust fumes.

It is thought that the fine particles in the air (PM2.5) contribute to the development of potentially fatal diseases various ways - by causing chronic inflammation, and also because they slip past the body's defenses and can be absorbed deep into the lungs and bloodstream. They are not sneezed or coughed out the way larger natural particles, like airborne soil and sand, are removed from the body's airways. What can be done? Other studies have found that when air pollution is reduced, than the risk of death is reduced. So yes, pollution controls on vehicles such as trucks and buses are good. And just think how much air pollution will be reduced when electric vehicles replace current gas powered cars and trucks. From Medscape:

Air Pollution Linked to Higher Stroke Mortality

More evidence showing that living in areas with high levels of air pollution is linked to a higher stroke risk has come from two new studies. Both studies are published online in the journal Stroke. The first, from the United Kingdom, shows a higher risk for death after a stroke in patients who live in areas of high air pollution, and the other, a Japanese study, suggests a higher risk for a new stroke the same day as exposure to high levels of air pollution.

"We have shown a significantly increased risk of death after stroke in patients who had long-term exposure to high levels air pollution before their stroke occurred," senior author of the UK study, Charles Wolfe, MD.... "This was particularly pronounced for high exposure to smaller particulate matter — particles below 2.5 μm in diameter (PM2.5) — which are found in high quantities in exhaust fumes." For the study, Professor Wolfe and colleagues analyzed data from the South London Stroke Register, a population-based register covering an urban, multiethnic population.....Results showed an increased risk for death up to 5 years after stroke in patients living in areas of high air pollution.

"While this study adds to the evidence linking air pollution to cardiovascular disease, it cannot prove causality as it has an observational design," Professor Wolfe commented...."So it is difficult to say for certain that it is the air pollution that is responsible but there are many studies now that have shown similar associations," he said. He noted that the smaller particles (PM2.5) were associated with a worse effect on mortality and this correlated with biological studies that have shown a greater inflammatory effect of small particulate matter vs larger particulate matter on the vessel wall. "Our study suggests that people who have previously had an ischemic stroke, but not a hemorrhagic stroke, may be more vulnerable and at a higher risk of death to chronic, long-term exposure of PM," they conclude.

The Japanese study, by lead author Ryu Matsuo, MD, PhD, Department of Health Care Administration and Management Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan, and colleagues, looked at acute exposure to air pollution and shows a small increase in the risk of having a stroke within a day of high exposure to pollution. For the study, the researchers analyzed data on 6885 ischemic stroke patients from a multicenter hospital-based stroke registry in Japan who were previously independent and hospitalized within 24 hours of stroke onset.

Professor Wolfe said his group have conducted a similar study looking at exposure of air pollution in the year before stroke, which showed a 23% increase in stroke risk in those exposed to higher levels of PM2.5. 

 Uh oh - once again a drug taken for a common problem (heartburn) is linked to an unexpected negative health effect (higher risk of strokes). Millions of Americans take proton pump inhibitors  (PPIs) to treat acid reflux and heartburn. They are among the most prescribed drugs in the United States, are frequently taken for long periods of time, and are available over the counter. But according to preliminary research presented at a 2016 American Heart Association conference, these medications may also increase the risk of ischemic stroke. Ischemic strokes, which are the most common type of stroke, occur when a blood clot cuts off blood flow to the brain.

Earlier research has linked proton pump inhibitors to increased risk of dementia in older patients, disruption of gut microbes, increased risk of C. difficile infections, and kidney disease. Stomach acid seems to play a role in the normal balance of microbes in the digestive system. When someone takes PPIs it lowers their amount of stomach acid, and so disrupts the gut microbial community (and these changes last for at least a month after discontinuing the drug).

The research was conducted in Denmark among a quarter-million patients who suffered from stomach pain and indigestion, and were taking one of four PPIs: Prilosec, Protonix, Prevacid or Nexium. Overall, they found that ischemic stroke risk increased by 21% among patients who were taking a PPI. The researchers found either no increased risk or minimal increased risk of stroke when taking low doses of PPIs. But at the highest doses of PPIs, they found that stroke risk increased from 30% (Prevaacid) to a high of 94% (Protonix). Another group of medications used to treat heartburn - called H2 blockers - were not linked to increased stroke risk.

Hey, what this research suggests is that not everything should be treated with pills. Medical professionals agree: the safest and best way to reduce heartburn is by making some lifestyle changes. Eat smaller meals (and not right before bedtime), lose weight if needed, don't eat very fatty meals, drink less alcohol, and don't smoke. From EurekAlert:

Popular heartburn medication may increase ischemic stroke risk

A popular group of antacids known as proton pump inhibitors, or PPIs, used to reduce stomach acid and treat heartburn may increase the risk of ischemic stroke, according to preliminary research presented at the American Heart Association's Scientific Sessions 2016.

"PPIs have been associated with unhealthy vascular function, including heart attacks, kidney disease and dementia," said Thomas Sehested, M.D., study lead author and a researcher at the Danish Heart Foundation in Copenhagen, Denmark. "We wanted to see if PPIs also posed a risk for ischemic stroke, especially given their increasing use in the general population." Ischemic stroke, the most common type of stroke, is caused by clots blocking blood flow to or in the brain.

Researchers analyzed the records of 244,679 Danish patients, average age 57, who had an endoscopy -- a procedure used to identify the causes of stomach pain and indigestion. During nearly six years of follow up, 9,489 patients had an ischemic stroke for the first time in their lives. Researchers determined if the stroke occurred while patients were using 1 of 4 PPIs: omeprazole (Prilosec), pantoprazole (Protonix), lansoprazole (Prevacid) and esomeprazole (Nexium).

For ischemic stroke, researchers found:Overall stroke risk increased by 21 percent when patients were taking a PPI. At the lowest doses of the PPIs, there was slight or no increased stroke risk. At the highest dose for these 4 PPI's, stroke risk increased from 30 percent for lansoprazole (Prevacid) to 94 percent for pantoprazole (Protonix). There was no increased risk of stroke associated with another group of acid-reducing medications known as H2 blockers, which include famotidine (Pepcid) and ranitidine (Zantac).

Authors believe that their findings, along with previous studies, should encourage more cautious use of PPIs. Sehested noted that most PPIs in the United States are now available over the counter. Doctors prescribing PPIs, should carefully consider whether their use is warranted and for how long: "We know that from prior studies that a lot of individuals are using PPIs for a much longer time than indicated, which is especially true for elderly patients."

 Get active, really active, to reduce your risk for 5 diseases: breast cancer, colon cancer, heart disease, and ischemic stroke. Instead of the 150 minutes of brisk walking or 75 minutes per week of running (which is equal to the 600 metabolic equivalent (MET) minutes now recommended by the World Health Organization), this study found that much more exercise is needed for best health results.

This study (which was a review and analysis of 174 studies) found that there is a dose-response effect, with the most reduction in the risk of the 5 conditions by getting 3000 to 4000 MET minutes per week. This sounds like a lot, but the researchers  point out that this can be achieved by incorporating exercise into your daily routines. The researchers write: "A person can achieve 3000 MET minutes/week by incorporating different types of physical activity into the daily routine—for example, climbing stairs 10 minutes, vacuuming 15 minutes, gardening 20 minutes, running 20 minutes, and walking or cycling for transportation 25 minutes on a daily basis would together achieve about 3000 MET minutes a week."

So start thinking creatively about how to increase exercise or activity into your daily life, especially moderate or vigorous intensity activity. For example, park your car far from the store door, or better yet, bicycle or walk to the store from home. From Medscape:

Get Moving: High Physical-Activity Level Reduces Risk of 5 Diseases

High levels of physical activity can reduce the risk for five major diseases, including type 2 diabetes, new research shows. Findings from the systematic review and meta-analysis were published online ....The data, from a total 174 studies comprising 149,184,285 total person-years of follow-up, suggest that the more total regular daily physical activity one engages in — including recreation, transportation, occupational activity, and/or daily chores — the lower the risks for breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke.

However, significant reductions in those conditions were seen only with total activity levels considerably higher than the minimum 600 metabolic equivalent (MET) minutes per week recommended by the World Health Organization for health benefits. That 600 METs equates to about 150 minutes/week of brisk walking or 75 minutes/week of running. (A MET is defined as the ratio of the metabolic rate during that activity to the metabolic rate when resting.) Risks of the five conditions dropped significantly with an increase in MET minutes per week from 600 to 3000 to 4000, with less additive benefit seen above that level.

For reference, the authors say, "a person can achieve 3000 MET minutes/week by incorporating different types of physical activity into the daily routine — for example, climbing stairs 10 minutes, vacuuming 15 minutes, gardening 20 minutes, running 20 minutes, and walking or cycling for transportation 25 minutes on a daily basis would together achieve about 3000 MET minutes a week." "This amount might seem a bit large, but this is about total activity across all domains of life.…For people who currently don't exercise, clinicians could encourage them to incorporate physical activity into their daily routines, [such as] turning household chores into exercise. 

Another recent meta-analysis of trials involving more than one million individuals indicated that an hour of moderate-intensity activity, such as brisk walking or cycling, offsets the health risks of 8 hours of sitting. The message that physical inactivity is a killer — leading to 5.3 million premature deaths annually worldwide, which is as many as caused by smoking and twice as many as associated with obesity, has been emerging over the past few years, with warnings that "sitting is the new smoking."

This new research is the first meta-analysis to quantify the dose-response association between total physical activity across all domains and the risk of five chronic diseases. The 174 prospective cohort studies included 35 for breast cancer, 19 for colon cancer, 55 for diabetes, 43 for ischemic heart disease, and 26 for ischemic stroke. (Some included more than one end point.)....Higher levels of total physical activity were associated with lower risks of all five outcomes.

With the development of diabetes, for example, compared with no physical activity, those with 600 MET minutes per week (the minimum recommended level of activity) had a 2% lower risk. That risk reduction jumped by an additional 19% with an increase from 600 to 3600 METs/week. Gains were smaller above that, with the increase of total activity from 9000 to 12,000 MET minutes/week yielding only an additional 0.6% diabetes reduction.

Overall, compared with insufficiently active individuals (total activity < 600 MET minutes/week), the risk reduction for those in the highly active category (≥ 8000 MET minutes/week) was 14% for breast cancer; 21% for colon cancer; 28% for diabetes; 25% for ischemic heart disease; and 26% for ischemic stroke

 Credit: Medscape

 Another study that found benefits to dog ownership. The study authors concluded that: "Our study provides evidence that dog owners are at a lower risk for ischemic stroke, hemorrhagic stroke and heart failure." This could be to daily exercise, or that dog ownership results in less stress or better psychosocial health, or even some other reason (perhaps dog owners are healthier to start with).   Note: myocardial infarction (MI) is commonly known as a heart attack. From Medscape:

Canine Companions Appear to Help Heart Health: Swedish Study

Middle-aged and older dog owners were less likely to die from cardiovascular heart disease (CVD) or all causes, and those who lived alone were less likely to have an MI (myocardial infarction) or stroke, during a decade of follow-up in a large study based on Swedish national registry data[1]. The findings suggest that "especially for those who live alone, dog ownership makes a significant difference . . . in health status," Dr Mwenya Mubanga (Uppsala University, Sweden) told Heartwire from Medscape.....

Dog owners get daily exercise from walking their dogs, and canine companions can reduce stress, which might explain these findings, the researchers speculate....Similarly, Dr Gang Hu (Pennington Biomedical Research, Baton Rouge, LA).....pointed out that the dog owners do more exercise (by walking their dogs), which may contribute to having a lower body weight, lower blood pressure, and possibly good lipid levels and a lower risk of diabetes—which may all act to lower mortality. Having a dog may also reduce the chances of having depression, which might partly explain the more striking findings in the people who lived alone, he added.

Since 2001, dog owners in Sweden have been required by law to register their dogs, and an estimated 83% of dogs were registered that year with the Swedish Board of Agriculture and/or the Swedish Kennel Club dog registries, Mubanga and colleagues explain. They examined the Swedish national registry data to see how dog ownership was related to new CVD events or mortality.....This included 162,091 dog owners (4.8% of the population) and 3,195,153 people who were not dog owners.

Dog owners who lived alone or with at least one child or adult were less likely to die of CVD or all causes during follow-up compared with those who did not own a dog, but the relationships were stronger for solitary dwellers. Among dog owners, solitary dwellers (but not others) were also significantly less likely to have an MI or stroke than people who did not have a dog.

 The finding that the oral bacteria Streptococcus mutans, which is found in 10% of the population, is linked with hemorrhagic strokes is big. S. mutans is found in tooth decay or cavities (dental caries). The researchers found a link with cnm-positive S. mutans with both intracerebral hemorrhage (ICH) and also with cerebral microbleeds. Some risk factors for strokes have long since been known, such as high blood pressure and advanced age, but then there are those hemorrhagic strikes that don't seem to fit the norm, with no apparent risk factors. Well, apparently the presence of cnm-positive S. mutans is one. My understanding of what cnm-positive S. mutans means is S. mutans bacteria that carries the collagen-binding Cnm gene. This bacteria can be found in a person's saliva and in dental plaque, and swabs of both were taken for this study.

This study builds on other studies that find a link between the bacteria Streptococcus mutans and a number of systemic diseases, including bacteremia, infective endocarditis and hemorrhagic stroke. The researchers of this latest study suggest that infection with cnm-positive S. mutans causes constant inflammation (as shown by 2 inflammatory markers: CRP and fibrinogen), which then causes damage to blood vessels (endothelial damage) in the brain. Bottom line: take care of your teeth and gums. From Science Daily:

Oral bacteria linked to risk of stroke

In a study of patients entering the hospital for acute stroke, researchers have increased their understanding of an association between certain types of stroke and the presence of the oral bacteria (cnm-positive Streptococcus mutans).

In the single hospital study, researchers at the National Cerebral and Cardiovascular Center in Osaka, Japan, observed stroke patients to gain a better understanding of the relationship between hemorrhagic stroke and oral bacteria. Among the patients who experienced intracerebral hemorrhage (ICH), 26 percent were found to have a specific bacterium in their saliva, cnm-positive S. mutans. Among patients with other types of stroke, only 6 percent tested positive for the bacterium.

Strokes are characterized as either ischemic strokes, which involve a blockage of one or more blood vessels supplying the brain, or hemorrhagic strokes, in which blood vessels in the brain rupture, causing bleeding.

The researchers also evaluated MRIs of study subjects for the presence of cerebral microbleeds (CMB), small brain hemorrhages which may cause dementia and also often underlie ICH. They found that the number of CMBs was significantly higher in subjects with cnm-positive S. mutans than in those without. The authors hypothesize that the S. mutans bacteria may bind to blood vessels weakened by age and high blood pressure, causing arterial ruptures in the brain, leading to small or large hemorrhages.

"This study shows that oral health is important for brain health. People need to take care of their teeth because it is good for their brain and their heart as well as their teeth," Friedland said. "The study and related work in our labs have shown that oral bacteria are involved in several kinds of stroke, including brain hemorrhages and strokes that lead to dementia."

Multiple research studies have shown a close association between the presence of gum disease and heart disease, and a 2013 publication by Jan Potempa, Ph.D., D.Sc., of the UofL School of Dentistry, revealed how the bacterium responsible for gum disease worsens rheumatoid arthritisThe cnm-negative S. mutans bacteria is found in approximately 10 percent of the general population, Friedland says, and is known to cause dental cavities (tooth decay). Friedland also is researching the role of oral bacteria in other diseases affecting the brain. http://www.nature.com/articles/srep20074

  New research found that negative health effects - 35% increased risk of cardiovascular problems (coronary heart disease, heart attacks, strokes) are when the vitamin D levels are really low (under 15 nanograms per milliliter). Currently many doctors recommend optimal levels for health as somewhere between 35 to 40 ng/ml. One article in Medscape recommended 1,000 IU of vitamin D (preferably D3) daily to achieve this level. Or you can go outside in the sun for 15 to 20 minutes. From Science Daily:

Specific vitamin D levels linked to heart problems

A lack of vitamin D can result in weak bones. Recent studies also show that vitamin D deficiency is linked to more serious health risks such as coronary artery disease, heart attacks, and strokes. And now, a new study shows what level of deficiency puts someone at risk of developing these heart problems.Researchers at the Intermountain Medical Center Heart Institute in Salt Lake City have found that patients are fine from a heart standpoint, and may need no further treatment, if their vitamin D level is anywhere above 15 nanograms per milliliter.

"Although vitamin D levels above 30 were traditionally considered to be normal, more recently, some researchers have proposed that anything above 15 was a safe level. But the numbers hadn't been backed up with research until now," said J. Brent Muhlestein, MD, co-director of cardiovascular research at the Intermountain Medical Center Heart Institute, and lead researcher of the study.

The body naturally produces vitamin D as a result of exposure to the sun, and it's also found in a few foods -- including fish, fish liver oils, and egg yolks as well as some dairy and grain products. Those who don't have enough exposure to sunlight or vitamin D producing foods often have low vitamin D levels. Low levels are also attributed to race because people with dark skin have a natural protectant against ultraviolet light.

Dr. Muhlestein and his team have studied the effects of vitamin D on the heart for several years, looking at smaller numbers of patients. In this study, thanks to Intermountain Healthcare's vast clinical database, they were able to evaluate the impact of vitamin D levels on more than 230,000 patients. The 230,000 patients were split up into four groups (<15 ng/ml, 15-29, 30-44, ≥45) and were followed for the next three years by researchers who looked for major adverse cardiac events, including death, coronary artery disease, heart attacks, stroke, and incidents of heart or kidney failure.

Dr. Muhlestein found that for the nine percent of patients in the lower than 15 group, their risk of cardiovascular events increased by 35 percent compared to the other three groups, and the risks faced by the other three groups weren't very different from each other.