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Category: cardiovascular health

Published on Leave a comment on Very Low Levels of Vitamin D and Heart Problems

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.

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Published on 1 Comment on To Drink Some Alcohol Or Not?

Lately the studies and articles about whether some alcohol consumption has health benefits (or not) have been mixed. But I am seeing patterns. Every one agrees that heavy alcohol consumption is unhealthy on many levels, but whether lower amounts are beneficial is disputed.  Some of the studies show a J-shaped curve: regular consumption of low to moderate levels of wine (e.g., up to one to 2 glasses of wine, esp. red wine) seems best for health and is associated with low prevalence of various diseases (cardiovascular disease, diabetes, stroke, heart failure) and death, while total abstainers have a higher rate of health problems and mortality, and high levels of consumption (heavy drinkers) is linked to even higher levels of serious disease (heart disease, cancer) and death. Studies world-wide also find an alcohol dose-related link to cancer (the more one drinks, the higher the rates of various cancers). Earlier posts on alcohol consumption health effects are here and also here.

Adding to the complexity of this issue, low to moderate levels of wine consumption, especially red wine (up to 1 to 2 glasses of wine per day or several times a week), are part of the Mediterranean diet (linked to many health benefits, including longevity, lower rates of cancer and heart disease), and part of the diet of communities with many healthy centenarians ("Blue Zones"), according to The Blue Zones author Dan Buettner.

Perhaps part of the problem with reviews of the studies is that what is "light to moderate drinking" varies from study to study - is it 1/2 glass or 1 glass daily or several times a week, or 2 or 3 glasses daily, or even more? People tend to underestimate what they drink when asked. There also is the issue of hard liquor/spirits (which recent studies find to have more negative health effects such as higher cancer mortality) vs wine or beer, and also if one drinks a little each day or engages in binge or episodic drinking  - all have different health effects. The CDC posts on its web-site: that moderate alcohol consumption is defined as having up to 1 drink per day for women and up to 2 drinks per day for men (this means no more than 7 drinks a week for a woman, and 14 for men). The Mayo Clinic defines a drink as one 12 oz. beer, 5 oz. of wine or  1.5 oz. of 80-proof spirits. I'm posting some of the studies and articles gathering recent headlines.

This was interesting in that 2 studies compared drinking low levels (1 daily wine glass) of white wine vs red wine. In the second study both wine groups also had significantly improved triglyceride levels, and the white wine group had significantly decreased fasting plasma glucose levels (better glucose control). From Washington Post: White wines may be just as good for you as red (in some ways, at least)

The short answer is that the evidence supporting white wine's health benefits, while still limited, is growing. While previous studies on the elixir have been mostly focused on testing in animals or on testing the components of the drink itself, scientists have recently reported on two randomized clinical trials that found good news for white wine enthusiasts.

The first study, called In Vino Veritas (In Wine, Truth) involved tracking 146 subjects half of whom drank pinot noir, and half of whom drank a white chardonnay-pinot over a year. The researchers reported at a European Society of Cardiology meeting last year that those who worked out twice per week and drank wine — either kind — saw a significant improvement in cholesterol levels.

The second, published Monday in the Annals of Internal Medicine, had a similar design. Researchers in Israel recruited 224 volunteers with diabetes 2 to drink 150 mL of either white wine, red wine or mineral water (the control) with dinner every day for two years. They were encouraged to eat a Mediterranean diet, which includes mostly plant-based foods and replaces butter with olive oil, but their caloric intake was not restricted.

The results were compelling: Drinking a glass of red wine (but not white wine) every day appeared to improve cardiac health and cholesterol management. But both red and white wine seemed to improve glucose control in some patients. Full of the same plant flavonoids in red wine that are thought to have a protective effect, white wine has been studied significantly less despite some promising initial findings. White wine has been shown by researchers at the University of Barcelona to be higher in antioxidants and has been associated with weight loss and anti-aging effects. Interestingly, researchers say no material differences were identified in blood pressure, adiposity, liver function, drug therapy, symptoms or quality of life among those who drank red wine, white wine or mineral water except for one thing. Sleep quality, it seems, improved in both wine groups.

A more detailed discussion of the above study (diabetics consuming either red wine, white wine, or mineral water). From Medscape:  Red Wine, White Wine Improve Cardiometabolic Risk Markers in Diabetics, Says 2-Year Trial

These results don't match up with all the other studies showing cardiovascular benefits from small to moderate levels of alcohol consumption. From Washington Post:  Surprising finding from heart study: Moderate drinking may have ‘cardiotoxic’ effects in elderly hearts

In a study of 4,466 people between the ages of 71 and 81, researchers found that even a limited alcohol intake of two or more servings a day for men and one or more for women was associated with subtle alterations in cardiac structure and function. Of those affected, the men experienced enlarged left ventricle walls while the women saw a small reduction in heart function.....elderly women appeared to be more susceptible to the cardiotoxic effects of alcohol.

The study appears to contradict or at least provide a new perspective on previous research. According to the Harvard School of Public Health, more than 100 prospective studies show that moderate drinking is associated with a lower risk of heart attack and other cardiovascular issues. "The effect is fairly consistent, corresponding to a 25 percent to 40 percent reduction in risk," according to a summary of literature its researchers put together.

More support for low levels/moderate alcohol intake, but not for smoking and heavy alcohol use, or even for totally abstaining from alcohol. from Science Daily:  Smoking, heavy alcohol use are associated with epigenetic signs of aging

Cigarette smoking and heavy alcohol use cause epigenetic changes to DNA that reflect accelerated biological aging in distinct, measurable ways, according to research....They found that all levels of exposure to smoke were associated with significantly premature aging. Interestingly, moderate alcohol use -- about one to two drinks per day -- was correlated with the healthiest aging, while very low and high consumption were linked to accelerated aging.

From Science Daily:  Women with moderate beer consumption run lower risk of heart attack

Women who drink beer at most once or twice per week run a 30 percent lower risk of heart attack, compared with both heavy drinkers and women who never drink beer. These are the findings of a Swedish study which has followed 1,500 women over a period of almost 40 years....High spirits consumption was associated with increased risk of cancer mortality. (NOTE: The original study is in the Scandinavian Journal of Health Care - In addition, they found that women who sometimes drank wine had a lower risk of developing diabetes compared with the other two groups. Also: a tendency for increased mortality was found in women who had never drunk alcohol.)

However, a September 2015 Medscape article said that the picture is complex (some alcohol linked to better cardiovascular health, but that alcohol consumption is linked to cancer). They found the greatest negative effects in low income countries where there are higher rates of heavy alcohol use. Alcohol Ups Mortality and Cancer Risk; No Net Benefit

Last year Medscape published an article pointing out the conclusions of the 2014 World Cancer Report (WCR), issued by the World Health Organization's International Agency for Research on Cancer (IARC). The main conclusion: the rate of cancer from alcohol consumption is dose dependent - the more alcohol a person drinks, the higher the risk of cancer. Back in 1988 , the IARC labeled alcohol a carcinogen. However, what is "light to moderate drinking" varies from study to study, and perhaps light and moderate levels need to be separated out. From Medscape: No Amount of Alcohol Is Safe

The more alcohol that a person drinks, the higher the risk. The alcohol/cancer link has been strengthened by the finding of a dose/response relationship between alcohol consumption and certain cancers. A causal relationship exists between alcohol consumption and cancers of the mouth, pharynx, larynx, esophagus, colon-rectum, liver, and female breast; a significant relationship also exists between alcohol consumption and pancreatic cancer.

But surely, light drinking doesn't cause or contribute to cancer? Apparently, it does. In a meta-analysis of 222 studies comprising 92,000 light drinkers and 60,000 nondrinkers with cancer, light drinking was associated with risk for oropharyngeal cancer, esophageal squamous cell carcinoma, and female breast cancer.From this meta-analysis, it was estimated that in 2004 worldwide, 5000 deaths from oropharyngeal cancer, 24,000 from esophageal squamous cell carcinoma, and 5000 from breast cancer were attributable to light drinking. Light drinking was not associated with cancer of the colon-rectum, liver, or larynx.

However, a caveat is in order here. When alcohol use is self-reported, respondents might underestimate, or underreport, their actual alcohol intake. This can result in finding associations between cancer and light to moderate drinking, when in reality, alcohol intake is much higher.

Published on Leave a comment on Confirm High Blood Pressure Readings

A new U.S. Preventive Services Task Force (USPSTF) recommendation says that while they recommend screening for high blood pressure in adults aged 18 years or older, they also recommend that high blood pressure levels should generally be confirmed with home or ambulatory blood pressure monitoring before starting treatment for hypertension. This is because many factors can influence readings in an office, including "white coat hypertension" - which is an elevated reading from the stress of being in the doctor's office. The USPSTF evaluates, reviews, and makes evidence-based recommendations about clinical preventive services such as screenings, counseling services, and preventive medications. From Medical Xpress:

Confirm high blood pressure outside doctor's office, US task force says

High blood pressure levels should generally be confirmed with home or ambulatory blood pressure monitoring before starting treatment for hypertension, a new U.S. Preventive Services Task Force (USPSTF) recommendation says.

Many factors can affect blood pressure readings, such as stress, physical activity and caffeine or nicotine, the USPSTF said. And, some people experience "white-coat hypertension"—an increase in blood pressure at the doctor's office from stress—when having their blood pressure taken. All of these factors can make it hard to tell if someone really has high blood pressure, the researchers said.

That's why the Task Force recommends confirming a diagnosis of high blood pressure, or hypertension, before starting treatment, unless someone has very high blood pressure that needs to be treated right away."For most patients, elevated blood pressure readings in the doctor's office should be confirmed outside the doctor's office before starting treatment," said Task Force vice-chair Dr. Kirsten Bibbins-Domingo.

Blood pressure levels can be confirmed with ambulatory blood pressure monitoring. Your doctor will provide a small, portable device that automatically measures your blood pressure every 20 to 30 minutes over 12 to 48 hours. If this method isn't available, people can take their blood pressure at different times throughout the day using home blood pressure monitoring, the USPSTF said. Ambulatory blood pressure monitoring is the first choice for confirming a diagnosis of high blood pressure, the Task Force said. But, when not available, home monitors are an acceptable alternative.

Home blood pressure monitoring devices can cost from less than $20 to $100 or more, according to Consumers Union. Devices that use upper arm readings—rather than finger or wrist—are considered more accurate, the American Heart Association (AHA) says. But, it's important that the cuff that wraps around your arm fits properly, the AHA advises.

The dangers of sustained high blood pressure include an increased risk for heart attack, stroke, kidney disease and heart failure, the USPSTF said. High blood pressure is a leading cause of death in the United States, particularly among older Americans, Bibbins-Domingo said.

Published on Leave a comment on More Negative News About Hormone Disrupting Chemicals

More and more studies are finding negative health effects from hormone disrupting chemicals (which we are exposed to every single day, and subsequently which are in all of us), such as parabens, phthalates, Bisphenol-A (BPA), and chemical substitutes for BPA such as Bisphenol-S (BPS) and BPF. The following are a few recent studies and one article from my files. Also check out the other endocrine disrupting chemical studies I've posted (SEARCH: 'endocrine disruptors', and 'phthalates').

Bottom line: Read labels and try to minimize plastics in personal care products (e.g., lotion) and your food if possible (e.g., choose glass, stainless steel, wax paper, aluminum foil). This is especially important during pregnancy.  Even BPA alternatives (labeled BPA-free) should be viewed as the same as BPA - as endocrine disruptors. In other words, currently there are no good BPA substitutes. Don't microwave food in a plastic dish or container, or covered with plastic wrap. Eat fresh foods rather than packaged, processed foods. From Newsweek:

BPA Is Fine, If You Ignore Most Studies About It

Bisphenol-A (BPA) is either a harmless chemical that’s great for making plastic or one of modern society’s more dangerous problems. Depends whom you ask. BPA is in many types of plastics and the epoxy resins that line most aluminum cans, as well as thermal papers like receipts. It is an endocrine disruptor that mimics estrogen, a hormone especially important in sexual development, and the fact that it’s all over the place worries many people. Newsweek spoke with about 20 scientists, leaders in the field of BPA research, and the majority say it is likely (though not certain) that the chemical plays a role in a litany of health concerns: obesity, diabetes, problems with fertility and reproductive organs, susceptibility to various cancers and cognitive/behavioral deficits like ADHD.  ...continue reading "More Negative News About Hormone Disrupting Chemicals"

Published on Leave a comment on Meat is OK If You Also Eat Lots of Plant-Based Foods

 People have asked me if eating sweet desserts or hamburgers is bad for the health if the rest of their diet is good - with lots of fruits, vegetables, whole grains, legumes (beans), and nuts (much like the Mediterranean diet). My sense over the past few years of looking at the research is that one should look at the overall diet, and that a "perfect diet" all the time is pretty darn hard to achieve, if not impossible, for most of us. So this new research looking at gut bacteria and "chemical fingerprints of cellular processes" (by looking at stool and urine samples) of people eating different diets (vegan, vegetarian, omnivore) was reassuring.  The findings suggest: make sure to feed your beneficial bacteria with a healthy diet like the Mediterranean diet (lots of plant-based foods), and then some deviation (cookies! steak!) is OK.

The researchers found that while the kind of gut bacteria dominating were different among the groups (vegan, vegetarian, omnivores), they also found that eating a lot of fiber-rich foods, such as fruit, vegetables, and legumes (typical of a Mediterranean diet) is linked to a rise in health promoting short chain fatty acids (SCFA). Yes, levels of trimethylamine oxide (TMAO) (which is linked to cardiovascular disease) were significantly lower in vegetarians and vegans than they were in those of the omnivores. But the more omnivores closely followed a Mediterranean diet, the lower were their TMAO levels.(Which is great!). As the researchers said: "Western omnivore diets are not necessarily detrimental when a certain consumption level of plant foods is included. From Science Daily:

High dietary fiber intake linked to health promoting short chain fatty acids

Eating a lot of fibre-rich foods, such as fruit, vegetables, and legumes--typical of a Mediterranean diet--is linked to a rise in health promoting short chain fatty acids, finds research published online in the journal Gut. And you don't have to be a vegetarian or a vegan to reap the benefits, the findings suggest.

Short chain fatty acids (SCFAs), which include acetate, propionate, and butyrate, are produced by bacteria in the gut during fermentation of insoluble fibre from dietary plant matter. SCFAs have been linked to health promoting effects, including a reduced risk of inflammatory diseases, diabetes, and cardiovascular disease.

The researchers gathered a week's information on the typical daily diet of 153 adults who either ate everything (omnivores, 51), or were vegetarians (51), or vegans (51), and living in four geographically distant cities in Italy....The Mediterranean diet is characterised by high intake of fruit, vegetables, legumes, nuts and cereals; moderately high intake of fish; regular but moderate alcohol consumption; and low intake of saturated fat, red meat, and dairy products. Most (88%) of the vegans, almost two thirds of the vegetarians (65%), and around a third (30%) of the omnivores consistently ate a predominantly Mediterranean diet.

The investigation showed distinct patterns of microbial colonisation according to usual dietary intake. Bacteroidetes were more abundant in the stool samples of those who ate a predominantly plant based diet, while Firmicutes were more abundant in those who ate a predominantly animal products diet. Both these categories of organisms (phyla) contain microbial species that can break down complex carbohydrates, resulting in the production of SCFAs.

Specifically, Prevotella and Lachnospira were more common among the vegetarians and vegans while Streptococcus was more common among the omnivores. And higher levels of SCFA were found in vegans, vegetarians, and those who consistently followed a Mediterranean diet. Levels of SCFAs were also strongly associated with the quantity of fruit, vegetables, legumes, and fibre habitually consumed, irrespective of the type of diet normally eaten.

On the other hand, levels of trimethylamine oxide (TMAO)--a compound that has been linked to cardiovascular disease--were significantly lower in the urine samples of vegetarians and vegans than they were in those of the omnivores. But the more omnivores closely followed a Mediterranean diet, the lower were their TMAO levels, the analysis showed.

TMAO levels were linked to the prevalence of microbes associated with the intake of animal proteins and fat, including L-Ruminococcus (from the Lachnospiraceae family). Eggs, beef, pork and fish are the primary sources of carnitine and choline--compounds that are converted by gut microbes into trimethylamine, which is then processed by the liver and released into the circulation as TMAO.

The researchers point out that SCFA levels can naturally vary as a result of age and gender, and their study did not set out to establish any causal links. But they nevertheless suggest that the Mediterranean diet does seem to be associated with the production of health promoting SCFAs. They conclude: "We provide here tangible evidence of the impact of a healthy diet and a Mediterranean dietary pattern on gut microbiota and on the beneficial regulation of microbial metabolism towards health maintenance in the host." And they add: "Western omnivore diets are not necessarily detrimental when a certain consumption level of [plant] foods is included."

Published on Leave a comment on New Report About Harms of Endocrine Disruptors

A report released this week by the Endocrine Society states that the list of health problems that scientists can confidently link to exposure to hormone-disrupting chemicals has grown to include: diabetes, cardiovascular disease, obesity, reproductive and developmental problems, thyroid impairment, certain reproductive cancers, and neurodevelopmental problems such as decreased IQ. This statement (report) is based on the summaries of 1300 studies on endocrine disrupting chemicals (EDCs), and it also adds support to the idea that even minute doses of these chemicals can interfere with the activity of natural hormones, which play a major role in regulating physiology and behavior. The statement also stated that most industrial chemicals released into the environment—numbering in the tens of thousands—have never been tested for endocrine-disrupting potential. EDCs include such common chemicals as bisphenol A (BPA), phthalates, parabens, some pesticides (e.g., atrazine), flame retardants, some persistent organic pollutants, and dioxins.

Where are endocrine disruptors found? People are exposed to chemicals with estrogenic effects in their everyday life, because endocrine disrupting chemicals are found in low doses in thousands of products. Many plastic products, including those advertised as "BPA free", have been found to leach endocrine-disrupting chemicals (the substitute chemicals are no better than BPA, and may be worse). Examples: plastic food containers which then leach into foods, linings of metal beverage, formula, and food cans, soft plastic toys, dental sealants, consumer goods, receipts, personal care products that contain parabens or phthalates (e.g., found in lotions,sunscreens, fragrances), household products (such as cleaning products, vinyl shower curtains) , cars (that new car smell in car interiors), etc. Americans love plastics, but there is a serious human health cost.

NOTE: To minimize EDC exposure - try to avoid plastic food and beverage containers. Instead try to use glass, stainless steel, or ceramics. Eat as many unprocessed and fresh foods as possible. Use cloth shower curtains. Read labels and avoid BPA, phthalates, parabens. Avoid fragrances. Don't use or buy non-stick pans, stain and water-resistant coatings on clothing, furniture and carpets. When buying new furniture, check that it doesn't have added fire retardants.

Of course any public discussion of the harms from endocrine disrupting chemicals, as well as the newly released Endocrine Society report, is drawing sharp criticisms from the chemical industry (especially the American Chemistry Council, the largest trade group for the chemicals industry). Of course. We all know that the lobbying efforts by the chemical industry to suppress and deny the evidence of harm to humans from EDCs has been and will continue to be massive. Sadly, but at this point EDCs are found in almost everyone on earth. More about the report, from Science Daily:

Chemical exposure linked to rising diabetes, obesity risk

Emerging evidence ties endocrine-disrupting chemical (EDC) exposure to two of the biggest public health threats facing society -- diabetes and obesity. EDCs contribute to health problems by mimicking, blocking or otherwise interfering with the body's natural hormones. By hijacking the body's chemical messengers, EDCs can alter the way cells develop and grow. Known EDCs include bisphenol A (BPA) found in food can linings and cash register receipts, phthalates found in plastics and cosmetics, flame retardants and pesticides. The chemicals are so common that nearly every person on Earth has been exposed to one or more.  ...continue reading "New Report About Harms of Endocrine Disruptors"

Published on Leave a comment on Millions of Deaths Annually Due to Air Pollution?

A recent post (Air Pollution Can Kill You) discussed recent research that found that air pollution is linked to an overall increase in death rates, especially cardiovascular disease. But how many deaths each year are linked to air pollution? Recent research suggests that outdoor air pollution, mostly by fine particulate matter with a diameter smaller than 2.5 micrometers (PM2.5), leads to 3.3 million premature deaths per year worldwide, predominantly in Asia. The number one cause  worldwide is residential energy use such as heating and cooking, (India ,China, and the developing world).

But surprisingly agriculture or farming is number 2 worldwide. How can that be? Well, farms produce ammonia from fertilizer and animal waste. That ammonia then combines with sulfates from coal-fired power plants and nitrates from vehicle exhaust to form the soot particles that are the big air pollution killers. The United States had about 54,905 deaths in 2010 from soot and smog. Power plants and traffic (vehicle emissions) are big sources of the air pollution linked to deaths in the USA. From Medical Xpress:

Millions of premature deaths tied to air pollution

Outdoor air pollution leads to more than 3 million premature deaths per year, primarily in Asia, according to a letter published online Sept. 16 in Nature.

Johannes Lelieveld, Ph.D., from the Max Planck Institute for Chemistry in Germany, and colleagues used a global atmospheric chemistry model to investigate the link between premature mortality and seven emission source categories in urban and rural environments. The researchers found that outdoor air pollution, mostly by fine particulate matter with a diameter smaller than 2.5 micrometers (PM2.5), leads to 3.3 million premature deaths per year worldwide, predominantly in Asia. The largest impact on premature mortality globally comes from residential energy use such as heating and cooking, prevalent in India and China. In the United States, emissions from traffic and power generation are important. Agricultural emissions make the largest relative contribution to PM2.5 in the eastern United States, Europe, Russia, and East Asia, with the estimate of overall health impact depending on assumptions regarding particle toxicity. 

...continue reading "Millions of Deaths Annually Due to Air Pollution?"

Published on Leave a comment on Air Pollution Can Kill You

Another study finding negative health effects from air pollution. This year I've posted several studies that found negative effects on the brain (and even cognition) from air pollution for people of all ages. Now this latest study found that in areas with air pollution, long-term exposure to outdoor fine particulate matter (PM2.5),which are fine particles in the air, are linked to an overall increase in risk of death, especially due to cardiovascular disease. The fine particles in the air contribute to the development of potentially fatal heart and lung diseases 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. From Science Daily:

Link between air pollution, increased deaths and increased deaths from heart disease affirmed

In what is believed to be the largest, most detailed study of its kind in the United States, scientists at NYU Langone Medical Center and elsewhere have confirmed that tiny chemical particles in the air we breathe are linked to an overall increase in risk of death. The researchers say this kind of air pollution involves particles so small they are invisible to the human eye (at less than one ten-thousandth of an inch in diameter, or no more than 2.5 micrometers across).

In a report on the findings, published in the journal Environmental Health Perspectives online Sept. 15, the scientists conclude that even minuscule increases in the amount of these particles (by 10 micrograms per cubic meter of air, for example) lead to an overall increased risk of death from all causes by 3 percent -- and roughly a 10 percent increase in risk of death due to heart disease. For nonsmokers, the risk increase rises to 27 percent in cases of death due to respiratory disease.

"Our data add to a growing body of evidence that particulate matter is really harmful to health, increasing overall mortality, mostly deaths from cardiovascular disease, as well as deaths from respiratory disease in nonsmokers," says lead study investigator and health epidemiologist George Thurston, ScD, a professor of population health and environmental medicine at NYU Langone. "Our study is particularly notable because all the data used in our analysis comes from government- and independently held sources."

According to Thurston, fine particles can contribute to the development of potentially fatal heart and lung diseases 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. Moreover, Thurston says, fine particles are usually made of harmful chemicals such as arsenic, selenium, and mercury, and can also transport gaseous pollutants, including sulfur and nitrogen oxides, with them into the lungs.

For their research, Thurston and his colleagues evaluated data from a detailed health and diet survey conducted by the National Institutes of Health (NIH) and the American Association of Retired Persons (AARP). The NIH-AARP study involved 566,000 male and female volunteers, ages 50 to 71, from California, Florida, Louisiana, New Jersey, North Carolina, Pennsylvania, and the metropolitan areas of Atlanta and Detroit. Analyzing information gathered about the participants between 2000 and 2009,....

Indeed, the team did not find any significant difference in the effect of particulate matter exposure between different sexes or age groups or by level of education. The researchers also noted that limiting the analysis to only the state of California, which has the most rigorous controls on air pollution, did not produce a different overall level of risk; instead, they found the same association between particulate matter exposure and increase in risk of death from all nonaccidental causes and from cardiovascular disease.

Published on Leave a comment on Health Benefits From the Flavanols in Chocolate

Image result for dark chocolate So far all the studies I've seen in the past 2 years about cocoa and chocolate have found various beneficial health effects from regularly eating small amounts of cocoa and chocolate. Now 2 new studies found benefits from the flavanols found in cocoa beans and chocolate. The studies found that consuming cocoa flavanols lowers blood pressure, increases flow-mediated vasodilation,improves blood cholesterol profile, and that regular dietary intake may reduce the risk of cardiovascular disease (CVD). However, note that chocolate and cocoa contain other compounds besides flavanols and these may also be exerting positive effects.

So now the question becomes, which chocolates have high levels of flavanols? Modern processing removes some of the flavanols - in fact, the more it undergoes processing, the more flavanols are lost. But it appears that dark chocolate and cocoa that has not undergone Dutch processing is best. According to a Medscape article on cocoa flavanols: "Traditional processing methods that yield "modern chocolate," especially alkalinization (dutching or Dutch processing, to mellow flavor), strips flavanols from cocoa. The bitterness from cacao mostly comes from flavanols. With the emerging recognition of the beneficial effects of flavanols there has been a shift in commercial production towards chocolate forms with high flavanol content." A recent study by Consumer Lab, which compared flavanol levels across many cocoa and chocolate products, also found that some chocolate brands were contaminated with cadmium (a toxic heavy metal), but that cocoa nibs had significantly lower levels. At any rate, the medical evidence does not support gorging on chocolate, but instead consuming chocolate or cocoa in moderation. From Science Daily:

Cocoa flavanols lower blood pressure and increase blood vessel function in healthy people

Two recently published studies in the journals Age and the British Journal of Nutrition (BJN) demonstrate that consuming cocoa flavanols improves cardiovascular function and lessens the burden on the heart that comes with the aging and stiffening of arteries. The studies also provide novel data to indicate that intake of cocoa flavanols reduces the risk of developing cardiovascular disease (CVD).

As we age, our blood vessels become less flexible and less able to expand to let blood flow and circulate normally, and the risk of hypertension also increases. Arterial stiffness and blood vessel dysfunction are linked with cardiovascular disease -- the number one cause of deaths worldwide....Cocoa flavanols are plant-derived bioactives from the cacao bean. Dietary intake of flavanols has been shown to have a beneficial effect on cardiovascular health but the compounds are often destroyed during normal food processing. Earlier studies have demonstrated that cocoa flavanol intake improves the elasticity of blood vessels and lowers blood pressure....These two studies in Age and BJN are the first to look at the different effects dietary cocoa flavanols can have on the blood vessels of healthy, low-risk individuals with no signs or symptoms of cardiovascular disease.

Cocoa flavanols increase blood vessel flexibility and lower blood pressure - In the study published in Age, two groups of 22 young (<35 years of age) and 20 older (50-80 years of age) healthy men consumed either a flavanol-containing drink, or a flavanol-free control drink, twice a day for two weeks. The researchers then measured the effect of flavanols on hallmarks of cardiovascular aging, such as arterial stiffness (as measured by pulse wave velocity), blood pressure and flow-mediated vasodilation (the extent to which blood vessels dilate in response to nitric oxide). They found that vasodilation was significantly improved in both age groups that consumed flavanols over the course of the study (by 33% in the younger age group and 32% in the older age group over the control intervention). In the older age group, a statistically and clinically significant decrease in systolic blood pressure of 4 mm Hg over control was also seen.

Improving cardiovascular health and lowering the risk of CVD - In the second study, published in BJN, the researchers extended their investigations to a larger group (100) of healthy middle-aged men and women (35-60 years) with low risk of CVD. The participants were randomly and blindly assigned into groups that consumed either a flavanol-containing drink or a flavanol-free control drink, twice a day for four weeks.

"We found that intake of flavanols significantly improves several of the hallmarks of cardiovascular health," says Professor Kelm. In particular, the researchers found that consuming flavanols for four weeks significantly increased flow-mediated vasodilation by 21%. Increased flow-mediated vasodilation is a sign of improved endothelial function and has been shown by some studies to be associated with decreased risk of developing CVD. In addition, taking flavanols decreased blood pressure (systolic by 4.4 mmHg, diastolic by 3.9 mmHg), and improved the blood cholesterol profile by decreasing total cholesterol (by 0.2 mmol/L), decreasing LDL cholesterol (by 0.17 mmol/L), and increasing HDL cholesterol (by 0.1 mmol/L).

The researchers also calculated the Framingham Risk Score -- a widely used model to estimate the 10-year cardiovascular risk of an individual -- and found that flavanol intake reduced the risk of CVD. "Our results indicate that dietary flavanol intake reduces the 10-year risk of being diagnosed with CVD by 22% and the 10-year risk of suffering a heart attack by 31%," says Professor Kelm.

The combined results of these studies demonstrate that flavanols are effective at mitigating age-related changes in blood vessels, and could thereby reduce the risk of CVD in healthy individuals. The application of 10-year Framingham Risk Scores should be interpreted with caution as the duration of the BJN study was weeks not years and the number of participants was around 100, not reaching the scale of the Framingham studies. That being said, Professor Kelm comments that "the reduction seen in risk scores suggests that flavanols may have primary preventive potential for CVD."

Published on Leave a comment on Coffee Appears To Have Lots of Health Benefits

A nice summary article about the benefits and risks of coffee consumption. Summary of effects of drinking coffee: 1) May potentially increase blood pressure, but also may lower the risk for coronary disease, and protect against heart disease. 2) May cut stroke risk by as much as 25%, 3) Linked to  improved glucose metabolism, reduced risk for type 2 diabetes, and promotion of weight loss in overweight patients. 4) May reduce the risk for several cancers. 5) Appears to slow the progression of dementia and Parkinson's disease. 6) A significantly decreased risk of developing depression. 7) Slows progression in alcoholic cirrhosis, hepatitis C, and NAFLD (non-alcoholic fatty liver disease). 8) May be beneficial in dry-eye syndrome, gout, and in preventing MRSA infection. 9) May increase blood pressure, anxiety, insomnia, tremor, withdrawal symptoms, and potential increased risk of glaucoma. From Medscape:

How Healthy Is Coffee? The Latest Evidence

Earlier this year, the Dietary Guidelines Advisory Committee (DGAC) released a report[1] stating that up to five cups of coffee per day, or up to 400 mg of caffeine, is not associated with long-term health risks. Not only that, they highlighted observational evidence that coffee consumption is associated with reduced risk for several diseases, including type 2 diabetes, cardiovascular disease (CVD), and neurodegenerative disorders. The body of data suggesting that moderate coffee—and, in all likelihood, tea—consumption is not only safe but beneficial in a variety of mental and medical conditions is growing fast.

A 2012 study of over 400,000 people, published in the New England Journal of Medicine, reported that coffee consumption is associated with a 10% reduction in all-cause mortality at 13-year follow-up.... It's important to note that much of the evidence on the potential health effects of coffee, caffeine, and other foods and nutrients is associational and doesn't prove causality—observational investigations come with limitations and often rely on error-prone methods such as patient questionnaires. However, the sheer volume of existing observational data linking coffee and/or caffeine with various health benefits—as well as, in many cases, evidence of a dose response—suggests that the most widely consumed stimulant in the world has positive influences on our health. 

Cardiovascular Disease:...However, when caffeine is ingested via coffee, enduring blood pressure elevations are small and cardiovascular risks may be balanced by protective properties. Coffee beans contain antioxidant compounds that reduce oxidation of low-density lipoprotein (LDL) cholesterol, and coffee consumption has been associated with reduced concentrations of inflammatory markers. Moderate coffee intake is associated with a lower risk for coronary heart disease as far out as 10 years, and data suggest that an average of two cups per day protects against heart failure.

Cerebrovascular Disease and Stroke: The vascular benefits of coffee are not lost on the brain. According to a 2011 meta-analysis, consuming between one and six cups per day reportedly cut stroke risk by 17%. A 22%-25% risk reduction was seen in a large sample of Swedish women followed for an average of 10 years.

Diabetes:...Numerous studies have linked regular coffee drinking with improved glucose metabolism, insulin secretion, and a significantly reduced risk for diabetes. Most recently, findings from a long-term study published this year suggest that coffee drinkers are roughly half as likely to develop type 2 diabetes as are nonconsumers, even after accounting for smoking, high blood pressure, and family history of diabetes.

Cancer: ...Evidence suggests that moderate to heavy coffee consumption can reduce the risk for numerous cancers, including endometrial (> 4 cups/day), prostate (6 cups/day), head and neck (4 cups/day), basal cell carcinoma (> 3 cups/day), melanoma,and breast cancer (> 5 cups/day). The benefits are thought to be at least partially due to coffee's antioxidant and antimutagenic properties.

Neurodegeneration: Beyond the short-term mental boost it provides, coffee also appears to benefit longer-term cognitive well-being. A 2012 study reported that patients with mild cognitive impairment and plasma caffeine levels of > 1200 ng/mL—courtesy of approximately three to five cups of coffee per day—avoided progression to dementia over the following 2-4 years. On a related note, a study from last year reported that caffeine consumption appears to enhance memory consolidation....Caffeinated coffee has long been thought to be neuroprotective in Parkinson disease (PD)....—as well as in multiple sclerosis. 

Depression: A 2011 study suggests that a boost in coffee consumption might also benefit our mental health: Women who drank two to three cups of coffee per day had a 15% decreased risk for depression compared with those who drank less than one cup per week. A 20% decreased risk was seen in those who drank four cups or more per day. Newer work also suggests that regular coffee drinking may be protective against depression.

Liver Disease: The liver might help break down coffee, but coffee might protect the liver (in some cases). Evidence suggests that coffee consumption slows disease progression in patients with alcoholic cirrhosis and hepatitis C, and reduces the risk of developing hepatocellular carcinoma. A 2012 study reported that coffee intake is associated with a lower risk for nonalcoholic fatty liver disease (NAFLD), while work published in 2014 found that coffee protects against liver fibrosis in those with already established NAFLD.

And That's Not All…: An assortment of other research suggests that coffee intake might also relieve dry-eye syndrome by increasing tear production, reduce the risk for gout, and potentially fight infection. Coffee and hot tea consumption were found to be protective against one of the medical community's most concerning bugs, methicillin-resistant Staphylococcus aureus (MRSA). While it remains unclear whether the beverages have systemic antimicrobial activity, study participants who reported any consumption of either were approximately half as likely to have MRSA in their nasal passages.

And Finally, the Risks: As is often the case, with benefits come risks, and coffee consumption certainly has negative medical and psychiatric effects to consider. Besides the aforementioned potential increase in blood pressure, coffee can incite or worsen anxiety, insomnia, and tremor and potentially elevate glaucoma risk. Also, given the potential severity of symptoms, caffeine withdrawal syndrome is included as a diagnosis in the DSM-5.