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Of course! The results of this study made perfect sense to me - that losing your wealth or savings in late middle-age is such a mental shock ("negative wealth shock") that it increases the risk of death for any reason ("all cause mortality") tremendously over the next 20 years. About 50% increased risk of death. For example, if you have to live off your savings after you get laid off or can't work due to illness, and perhaps even lose your house to foreclosure, is STRESSFUL beyond belief. Almost incomprehensible to anyone who has not personally gone through it.

On top of that, a person may then not be able to afford to go to the doctor, even if there is a problem, once they're financially stressed. And of course they may never financially recover because the "negative wealth shock" happened at an older age (the people were 51 to 61 at the start of the study).

Other research conducted at time of the Great Recession showed significant associations between negative wealth shocks and short-term health changes - including increased risk of depression, anxiety, suicide, impaired cardiovascular function, and substance abuse. And now we know that long-term there is an increased risk of death. From Science Daily:

Losing your nest egg can kill you

A sudden loss of net worth in middle or older age is associated with a significantly higher risk of death, reports a new Northwestern Medicine and University of Michigan studyWhen people lose 75 percent or more of their total wealth during a two-year period, they are 50 percent more likely to die in the next 20 years, the study found.  ...continue reading "Losing Your Wealth In Late Middle-Age and Increased Risk of Death"

The last post dealt with the link between highly processed food and increased risk of cancer. Now an interesting article written by Dr. Lisa Mosconi (Associate Director of the Alzheimer’s Prevention Clinic at Weill Cornell Medical College/New York -Presbyterian Hospital) refers to that study when discussing research about lifestyles (and especially diet) and later Alzheimer's disease.

It'll be interesting to see how this research plays out - is her approach stressing diet (and avoiding ultra-processed food and trans fats) and lifestyle correct or not? Much of what she says definitely makes sense and is supported by research, such as the negative health effects of chronic inflammation, and how eating actual, real foods has beneficial health effects. On the other hand, vitamin, mineral, and fish oil supplements generally don't show those health benefits (as she discusses here).

Currently there are a number of theories about causes of Alzheimer's disease (including the role of microbes), as well as a number of drug treatments that so far have gone nowhere. If Dr. Mosconi's research interests you, then read the interview she did in 2017. [In the interview she talks about the importance of exercise, intellectual stimulation, social networks, and the benefits of eating real foods rather than supplements. She recommends: drink water, eat fish, eat vegetables and fruit, eat glucose rich foods, and don't eat highly processed and fast foods.]  From Quartz:

The road to Alzheimer’s disease is lined with processed foods

Dementia haunts the United States. There’s no one without a personal story about how dementia has touched someone they care for. But beyond personal stories, the broader narrative is staggering: By 2050, we are on track to have almost 15 million Alzheimer’s patients in the US alone. ... It’s an epidemic that’s already underway—but we don’t recognize it as such. The popular conception of Alzheimer’s is as an inevitable outcome of aging, bad genes, or both.  ...continue reading "Ultra-Processed Foods and Alzheimer’s?"

A recent study published in BMJ (British Medical Journal) found a link between high consumption of ultra-processed food and higher rates overall of cancer, but also a higher risk of breast cancer. Specifically, a 10% increase in the proportion of ultra-processed foods in the diet was associated with a greater than 10% increase of overall cancer and 11% increase of breast cancer during the 6+ years of the study.

Alarmingly (because of the health implications), several surveys (in Europe, the US, Canada, New Zealand, and Brazil) have suggested that ultra-processed food products are now between 25 to 50% of calories eaten every day.

Ultra-processed food is food that is highly processed. It is food that is mass produced and packaged, as well as foods that have manufactured substances in them - such as hydrogenated oils (also contains trans fats), protein isolates, additives, preservatives, artificial or natural flavors, colors, nitrites (in processed meat), titanium dioxide (nanoparticles), etc. The food packaging can leach chemicals such as pthalates (endocrine disruptors). The list goes on and on and on. All of these things in ultra-processed foods may be involved in causing health problems, including cancer. They are typically also poorer nutritionally and higher in salt than unprocessed or minimally processed foods. These ultra-processed foods that are so popular are all around us - in fast food, in mass produced desserts and breads, packaged snacks, soups, cold cuts, margarine, frozen or shelf stable ready to eat meals, instant foods, sodas and drinks, etc.

On the other hand, unprocessed or minimally processed foods are fresh, dried, ground, chilled, frozen, pasteurised, or fermented foods such as fruits, vegetables, legumes (beans), rice, pasta, eggs, meat, fish, or milk. There are also “processed culinary ingredients”  which are salt, vegetable oils, butter, sugar, and other substances extracted from foods and used in kitchens to transform unprocessed or minimally processed foods into "culinary preparations" (meals). The study did NOT find any association with unprocessed, minimally processed, or processed culinary ingredients with cancer. Only with the ultra-processed food. Instead, the study found that higher consumption of “minimally/unprocessed foods” (and lower ultra-processed food) was associated with lower risks of overall cancer and breast cancer.

So an apple is unprocessed, and plain apple sauce made with just apples is minimally processed, while a packaged apple dessert with additives added is ultra-processed. Think of it as "transformed food". Also keep in mind that your beneficial gut microbes like unprocessed or minimally processed food - especially those high in fiber. You know - a diet rich in fruits, vegetables, whole grains, seeds, nuts, legumes (beans).  ...continue reading "Ultra-Processed Food and Risk of Cancer"

A number of recent studies and articles have discussed the effectiveness of diet in treating or preventing depression with the main conclusion that yes, it helps. Now an observational study (that will be presented in April) found that elderly people following the DASH diet most closely were 11% less likely to become depressed over time than those that did not.

Researchers studying 964 elderly participants over six and a half years found that those who followed the DASH diet, which emphasizes whole grains, fruits, and vegetables, had lower rates of depression, while those who ate a traditional Western diet were more prone to depression. The DASH (Dietary Approaches to Stop Hypertension) diet also emphasizes low sodium (salt) to lower blood pressure, as well as foods rich in nutrients (such as potassium, calcium, and magnesium) that are thought to lower blood pressure.

The study's lead author L. J. Cherian (at Rush Medical Center in Chicago) said that "we need to view food as medicine”. Yes. Eating more fruits and vegetables, whole grains, legumes, seeds, nuts have many health benefits (such as cardiovascular benefits, improving the gut microbes) -  a win-win. From Science Daily:

Diet shown to reduce stroke risk may also reduce risk of depression

People who eat vegetables, fruit and whole grains may have lower rates of depression over time, according to a preliminary study that will be presented at the American Academy of Neurology's 70th Annual Meeting in Los Angeles, April 21 to 27, 2018. The study found that people whose diets adhered more closely to the Dietary Approaches to Stop Hypertension (DASH) diet were less likely to develop depression than people who did not closely follow the diet. In addition to fruit and vegetables, the DASH diet recommends fat-free or low-fat dairy products and limits foods that are high in saturated fats and sugar. Studies have shown health benefits such as lowering high blood pressure and bad cholesterol (LDL), along with lowering body weight ...continue reading "DASH Diet Linked To Lower Rate of Depression"

Study after study has found negative health effects from frequent heavy drinking of alcohol, including a number of cancers. On the other hand, light to moderate drinking seems to have some health benefits (here and here). Recently a large study conducted in France found that chronic heavy drinking, which has resulted in alcohol use disorders (alcohol abuse, alcohol dependence, or alcoholism), is the biggest risk factor for developing dementia, especially early onset dementia. Only people with alcohol use disorders which resulted in them being hospitalized were included in the study.

But the surprising thing was that lower levels of "chronic heavy drinking" doesn't seem so much - it's daily consumption of more than 60 grams of pure alcohol  for men, and more than 40 grams of pure alcohol for women. In the United States, a standard drink contains about 14 grams of alcohol - which is a 12 ounce (350 ml) glass of beer, a 5 ounce (150 ml) glass of 12% wine, or a 1.5 ounce (44 ml) glass of spirits. In other words, drinking 3 glasses of wine daily (or more) is heavy drinking for a woman. (Note: The Centers for Disease Control (CDC) views moderate drinking as 1 glass of wine daily for women, and 2 glasses of wine daily for men).  ...continue reading "Heavy Drinking And Risk of Dementia"

A new observational study from Taiwan found that having one of eight chronic diseases, such as heart disease or diabetes, or their markers (e.g. high cholesterol levels as a marker for heart disease), also significantly raises the person's odds of developing cancer or dying from cancer. The study estimated that these diseases or markers accounted for about 20% of all new cancers and 39% of all cancer deaths. That's about the risk of 5 lifestyle factors combined (smoking, alcohol consumption, obesity, unhealthy diet, and lack of exercise) contributing to cancer development and death.

The eight chronic diseases and markers were: cardiovascular disease (markers for which include blood pressure, total cholesterol, and heart rate), diabetes, chronic kidney disease (markers for which include proteinuria and glomerular filtration rate), pulmonary disease, and gouty arthritis (for which uric acid is a marker). The higher the chronic disease and marker score, the higher the risk of developing cancer and cancer death (a dose-response). Chronic diseases and markers were associated with a shortened lifespan -  about 13.3 years in men and 15.9 years in women.

But the good news is that regular physical exercise lowers the risk of developing cancer by about 48% and the risk of cancer death by 27%. That's huge!  So physical exercise and activity could be viewed as "cancer prevention" strategies. The researchers pointed out that additional cancer prevention strategies are avoiding smoking (very important), avoiding excessive alcohol consumption, maintaining healthy weight, and a healthy diet. From Science Daily:

Substantial impact of chronic diseases on cancer risk

Several common chronic diseases together account for more than a fifth of new cancer cases and more than a third of cancer deaths, finds a study published by The BMJ today. The findings show that the cancer risks from common chronic diseases, such as heart disease and diabetes, are as important as those from five major lifestyle factors combined.

A team of researchers based in the US and Taiwan therefore set out to investigate the combined effect of eight common chronic diseases or disease markers (for example, high blood pressure as a marker of heart disease) on cancer risk compared with lifestyle factorsThey also explored whether physical activity could reduce the cancer risk associated with chronic diseases and disease markers. The study involved 405,878 men and women in Taiwan with no history of cancer .... underwent a series of medical tests between 1996 and 2007. .... Participants were followed for an average of 8.7 years.

The researchers found that cardiovascular disease markers, diabetes, chronic kidney disease markers, pulmonary disease, and gouty arthritis marker were individually associated with risk of developing cancer or cancer death. Higher chronic disease risk scores based on these diseases or markers were linked with an increased risk of developing cancer and cancer death, with the highest level associated with a more than twofold increase in risk of developing cancer and a fourfold increase in risk of cancer death.

High chronic disease risk scores were also associated with substantial reduction in life span. The highest scores were associated with 13.3 years of life lost in men and 15.9 years of life lost in women. Together, these chronic diseases and markers accounted for more than one fifth of all new cancers and more than one third of all cancer deaths in this study population, which was similar to the contribution of five major lifestyle risk factors combined -- smoking, insufficient physical activity, insufficient fruit and vegetable intake, alcohol consumption, and obesity.

The researchers also found that physical activity was associated with a nearly 40% reduction in the excess risks of cancer and cancer death associated with chronic diseases and markers. [Original study.]

Interesting new research found health benefits to the brain from daily low intake of alcohol (equivalent to about 2 1/2 drinks per day). The University of Rochester (in New York) researchers found that while low daily (chronic) levels of alcohol were beneficial to the brain's glymphatic system, higher daily levels or binge drinking was not. And the low daily levels of alcohol intake was also better for the glymphatic system than no alcohol at all (the control group). In 2015 this same research team described the glymphatic system as not just the brain’s “waste-clearance system,” but as potentially helping fuel the brain by transporting glucose, lipids, amino acids, and neurotransmitters.

I'm sure this study will be greeted by many as great news, but remember it was done with MICE, and not humans, so one should be cautious in generalizing the results. But the researchers think that it does apply to humans, and may explain why some studies find some health benefits to low levels of daily alcohol intake, even better than no alcohol, and many negative effects to higher levels of alcohol intake - thus the J-shaped curve of effects seen in studies. [NOTE: Studies also find that alcohol consumption can cause cancer, and this is dose related. Studies find the Mediterranean diet (which includes low to moderate levels of alcohol) beneficial for brain health.]

By the way - no, the mice didn't receive wine as the press release from the Univ. of Rochester says. The mice actually received "intraperitoneal injections of low, intermediate, and high doses of ethanol" or just plain saline (the control group). From Science Daily:

In wine, there's health: Low levels of alcohol good for the brain

While a couple of glasses of wine can help clear the mind after a busy day, new research shows that it may actually help clean the mind as well. The new study, which appears in the journal Scientific Reports, shows that low levels of alcohol consumption tamp down inflammation and helps the brain clear away toxins, including those associated with Alzheimer's disease.

"Prolonged intake of excessive amounts of ethanol is known to have adverse effects on the central nervous system," said Maiken Nedergaard, M.D., D.M.Sc., co-director of the Center for Translational Neuromedicine at the University of Rochester Medical Center (URMC) and lead author of the study. "However, in this study we have shown for the first time that low doses of alcohol are potentially beneficial to brain health, namely it improves the brain's ability to remove waste." The finding adds to a growing body of research that point to the health benefits of low doses of alcohol. While excessive consumption of alcohol is a well-documented health hazard, many studies have linked lower levels of drinking with a reduced risk of cardiovascular diseases as well as a number of cancers.

Nedergaard's research focuses on the glymphatic system, the brain's unique cleaning process that was first described by Nedergaard and her colleagues in 2012. They showed how cerebral spinal fluid (CSF) is pumped into brain tissue and flushes away waste, including the proteins beta amyloid and tau that are associated with Alzheimer's disease and other forms of dementia. Subsequent research has shown that the glymphatic system is more active while we sleep, can be damaged by stroke and trauma, and improves with exercise.

The new study, which was conducted in mice, looked at the impact of both acute and chronic alcohol exposure. When they studied the brains of animals exposed to high levels of alcohol over a long period of time, the researchers observed high levels of a molecular marker for inflammation, particularly in cells called astrocytes which are key regulators of the glymphatic system. They also noted impairment of the animal's cognitive abilities and motor skills.

Animals that were exposed to low levels of alcohol consumption, analogous to approximately 2 ½ drinks per day, actually showed less inflammation in the brain and their glymphatic system was more efficient in moving CSF through the brain and removing waste, compared to control mice who were not exposed to alcohol. The low dose animals' performance in the cognitive and motor tests was identical to the controls.

"The data on the effects of alcohol on the glymphatic system seemingly matches the J-shaped model relating to the dose effects of alcohol on general health and mortality, whereby low doses of alcohol are beneficial, while excessive consumption is detrimental to overall health" said Nedergaard. "Studies have shown that low-to-moderate alcohol intake is associated with a lesser risk of dementia, while heavy drinking for many years confers an increased risk of cognitive decline. This study may help explain why this occurs. Specifically, low doses of alcohol appear to improve overall brain health." [Original study. Especially interesting is the Introduction & Discussion sections.]

The spice turmeric is a very popular supplement nowadays, believed to have all sorts of health benefits due to the curcumin in it (e.g. that it is anticancer, anti-Alzheimer's, anti inflammatory). And yes, studies in the lab (in vitro and in vivo) look very promising. However, a large 2017 review of existing studies also found evidence that "curcumin is unstable under physiological conditions and not readily absorbed by the body, properties that make it a poor therapeutic candidate". In other words, the hype for curcumin supplements is not matching the reality, especially or probably because it is so poorly absorbed by humans. But researchers keep trying. And keep in mind that turmeric has other compounds in it also - it is not just curcumin and nothing else.

A "double-blind, placebo-controlled clinical trial" is the best evidence for something being effective. That means a study where people are randomly assigned to groups, no one actually knows who is getting what, and there is a placebo group that is getting a "sham" treatment. A recent study did exactly that in testing a new formulation of curcumin (Theracurmin) that was easily absorbed (bioavailable) by the persons participating in the study.

And yes - they found health benefits, specifically improvements in memory and attention in those persons taking the curcumin supplements over a 18 month period (as compared to those taking a placebo and whose memory and attention deteriorated over that time). The subjects (who were between 50 and 90 years of age) did not have dementia at the start of the study, but were showing signs of "normal aging" or had mild neurocognitive disorder. Brain scans (before and after treatment) suggested that the behavioral and cognitive benefits from curcumin were associated with "decreases in plaque and tangle accumulation in brain regions moduating mood and memory" - so it had anti-inflammatory and/or anti-amyloid brain effects.

So...  Stay tuned. Meanwhile, perhaps frequent eating of foods containing turmeric may also have beneficial effects, as some studies suggest. From Science Daily:

Curcumin improves memory and mood

Lovers of Indian food, give yourselves a second helping: Daily consumption of a certain form of curcumin -- the substance that gives Indian curry its bright color -- improved memory and mood in people with mild, age-related memory loss, according to the results of a study conducted by UCLA researchers. .... Found in turmeric, curcumin has previously been shown to have anti-inflammatory and antioxidant properties in lab studies. It also has been suggested as a possible reason that senior citizens in India, where curcumin is a dietary staple, have a lower prevalence of Alzheimer's disease and better cognitive performance.

The double-blind, placebo-controlled study involved 40 adults between the ages of 50 and 90 years who had mild memory complaints. Participants were randomly assigned to receive either a placebo or 90 milligrams of curcumin twice daily for 18 months. All 40 subjects received standardized cognitive assessments at the start of the study and at six-month intervals, and monitoring of curcumin levels in their blood at the start of the study and after 18 months. Thirty of the volunteers underwent positron emission tomography, or PET scans, to determine the levels of amyloid and tau in their brains at the start of the study and after 18 months.

The people who took curcumin experienced significant improvements in their memory and attention abilities, while the subjects who received placebo did not, Small said. In memory tests, the people taking curcumin improved by 28 percent over the 18 months. Those taking curcumin also had mild improvements in mood, and their brain PET scans showed significantly less amyloid and tau signals in the amygdala and hypothalamus than those who took placebos. The amygdala and hypothalamus are regions of the brain that control several memory and emotional functions. [Original study.]

Many people look forward to retirement, thinking of all the wonderful things they will finally be able to do.  However, what no one expects is that retirement can have a negative effect on their cognitive functioning. This is what a long-term study carried out by the University of London in the United Kingdom found. The study tracked 3,433 civil servants for the 14 years before retirement, and then another 14 years afterward. The participants were given periodic examinations to assess their cognitive functioning (verbal memory, abstract reasoning, etc.).

The researchers found that when people did eventually retire, they experienced decline in their verbal memory 38 percent faster than before they stopped working. They concluded that the act of retirement significantly accelerates verbal memory decline. They also found that a higher employment grade was protective against verbal memory decline while people were still working, but this ‘protective effect’ was lost when individuals retired, resulting in a similar rate of decline after retirement across the different employment grades.

The researchers pointed out that the adverse effect of retirement on verbal memory is consistent with the results of other studies. That's why they stress how important it is to continue undertaking mentally stimulating activities after retirement in order to prevent this decline. The researchers felt that the study results supported the ‘use it or lose it’ hypothesis regarding verbal memory function. But the good news was that retirement seemed to have little impact on other domains of cognitive functions, such as abstract reasoning and verbal fluency. They just showed normal age-related declines over time.

From European Journal of Epidemiology: Effect of retirement on cognitive function: the Whitehall II cohort study

According to the ‘use it or lose it’ hypothesis, a lack of mentally challenging activities might exacerbate the loss of cognitive function. On this basis, retirement has been suggested to increase the risk of cognitive decline, but evidence from studies with long follow-up is lacking. We tested this hypothesis in a cohort of 3433 civil servants who participated in the Whitehall II Study, including repeated measurements of cognitive functioning up to 14 years before and 14 years after retirement. Piecewise models, centred at the year of retirement, were used to compare trajectories of verbal memory, abstract reasoning, phonemic verbal fluency, and semantic verbal fluency before and after retirement.

We found that all domains of cognition declined over time. Declines in verbal memory were 38% faster after retirement compared to before, after taking account of age-related decline. In analyses stratified by employment grade, higher employment grade was protective against verbal memory decline while people were still working, but this ‘protective effect’ was lost when individuals retired, resulting in a similar rate of decline post-retirement across employment grades. We did not find a significant impact of retirement on the other cognitive domains. In conclusion, these findings are consistent with the hypothesis that retirement accelerates the decline in verbal memory function. This study points to the benefits of cognitively stimulating activities associated with employment that could benefit older people’s memory.

A recent study's results give hope to those who haven't really exercised or been physically active as they've gone through middle-age (it's viewed as "sedentary aging") and wonder if this dooms them in some way. Is it too late to get benefits from starting to exercise now? Studies show that being sedentary (that is, not being physically active or exercising weekly) and in "poor physical fitness" in middle-age is a risk factor for later heart failure. This is because a consequence of "sedentary aging" is stiffness of the heart, specifically the left ventricle (thus a loss of "cardiac plasticity").

But the study found that after 2 years of an exercise program in (formerly) sedentary middle-aged adults, they improved their maximal oxygen uptake, decreased the heart's stiffness, and improved overall fitness. All good, even though it was a small study (only 53 people completed the study). So the bottom line is: No, it's not too late to start exercising. The heart has elasticity and can remodel itself if the exercise is started before age 65 and is done 4 to 5 times a week. The adults studied were both male and female, between the ages of 45 and 64,  and exercised or were physically active for a total of 150 to 180 minutes a week, which meant at least 30 minutes 4 or 5 times a week.

Looking at the study's exercise regimen, it's clear that a variety of exercises or physical activities (low, moderate, and high intensity) is necessary. Some of the time one should be active or exercise to a point of breaking a sweat and feeling the heart pump. This meant that over time the participants increased their exercise frequency, duration, and intensity. Think about it - as you get more fit, it takes more to get your heart pumping and to break a sweat, and you can handle more exercise. 

Unfortunately the "control group", who did a combination of yoga, balance, and strength training 3 times a week for 2 years did not show improvements in heart plasticity, maximal oxygen uptake, or in overall fitness.Yikes. Sooo...the study clearly shows it is worth getting off your butt and making the effort to exercise. Perhaps view it as brushing your teeth - a daily nuisance, but necessary for health. The researchers themselves stated "Exercise is medicine." From Science Daily:

Proper exercise can reverse damage from heart aging

Exercise can reverse damage to sedentary, aging hearts and help prevent risk of future heart failure -- if it's enough exercise, and if it's begun in time, according to a new study by cardiologists at UT Southwestern and Texas Health Resources. To reap the most benefit, the exercise regimen should begin by late middle age (before age 65), when the heart apparently retains some plasticity and ability to remodel itself, according to the findings by researchers at the Institute for Exercise and Environmental Medicine (IEEM), which is a collaboration between UT Southwestern Medical Center and Texas Health Presbyterian Hospital Dallas.

And the exercise needs to be performed four to five times a week. Two to three times a week was not enough, the researchers found in an earlier study..... The regimen included exercising four to five times a week, generally in 30-minute sessions, plus warmup and cool-down: One of the weekly sessions included a high-intensity 30-minute workout, such as aerobic interval sessions in which heart rate tops 95 percent of peak rate for 4 minutes, with 3 minutes of recovery, repeated four times (a so-called "4 x 4"). Each interval session was followed by a recovery session performed at relatively low intensity. One day's session lasted an hour and was of moderate intensity. (As a "prescription for life," Levine said this longer session could be a fun activity such as tennis, aerobic dancing, walking, or biking.) One or two other sessions were performed each week at a moderate intensity, meaning the participant would break a sweat, be a little short of breath, but still be able to carry on a conversation -- the "talk test.".... One or two weekly strength training sessions using weights or exercise machines were included on a separate day, or after an endurance session.

The more than 50 participants in the study were divided into two groups, one of which received two years of supervised exercise training and the other group, a control group, which participated in yoga and balance training.A t the end of the two-year study, those who had exercised showed an 18 percent improvement in their maximum oxygen intake during exercise and a more than 25 percent improvement in compliance, or elasticity, of the left ventricular muscle of the heart, Dr. Levine noted. He compared the change in the heart to a stretchy, new rubber band versus one that has gotten stiff sitting in a drawer. Sedentary aging can lead to a stiffening of the muscle in the heart's left ventricle, the chamber that pumps oxygen-rich blood back out to the body, he explained.

"When the muscle stiffens, you get high pressure and the heart chamber doesn't fill as well with blood. In its most severe form, blood can back up into the lungs. That's when heart failure develops," said Dr. Levine, who holds the S. Finley Ewing Chair for Wellness at Texas Health Dallas and the Harry S. Moss Heart Chair for Cardiovascular Research. Earlier research by UT Southwestern cardiologists showed that left ventricular stiffening often shows up in middle age in people who don't exercise and aren't fit, leaving them with small, stiff chambers that can't pump blood as well[Original study.]