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Another study has shown health benefits from eating a diet rich in whole grains, as compared to one with lots of refined grains (think bagels, muffins, white bread). Fifty overweight Danish adults were randomly assigned to either a group where all grains eaten were whole grains or a group where all grain products were of refined grains. They did this for 8 weeks, then ate their usual diet for a few weeks (the "washout period"), and then were assigned to the other dietary group for 8 weeks.

They found that eating the diet rich in whole grains resulted in: consuming fewer calories (the whole grains made them feel fuller), losing weight, and a decrease in chronic low-grade inflammation (by measuring blood inflammation markers). The whole grain rye seemed to be especially beneficial. But interestingly, the researchers found that the whole grain diet did not significantly change the gut microbe composition. But they did find that 4 strains of Faecalibacterium prausntzii and one of Prevotella copri increased in abundance after whole grain and decreased after refined grain consumption. F.prausnitzii is a desirable and beneficial keystone species in the gut (here and here).

Other studies show that eating a diet rich in whole grains (rather than refined grains) is associated with a decreased risk of several diseases, including type 2 diabetes and cardiovascular diseases. Bottom line: choose whole grains whenever possible. From Science Daily:

Several reasons why whole grains are healthy

When overweight adults exchange refined grain products -- such as white bread and pasta -- with whole grain varieties, they eat less, they lose weight and the amount of inflammation in their bodies decreases. These are some of the findings of a large Danish study headed by the National Food Institute, Technical University of Denmark. 

The study included 50 adults at risk of developing cardiovascular disease or type 2 diabetes. Blood tests showed that the participants had less inflammation in their bodies when eating whole grains. In particular, it appeared that rye had a beneficial effect on the blood's content of inflammatory markers. Inflammation is the natural response of the body to an infection, but some people have slightly elevated levels of inflammation (so-called low-grade inflammation) even though there is no infection. This is particularly the case in overweight people. In overweight people, an increased level of 'unnecessary' (subclinical) inflammation may lead to increased risk of developing type 2 diabetes.

The study also shows that participants eat less when whole grain products are on the menu -- presumably because whole grain consumption causes satiety. While eating the whole grain diet, participants have generally lost weight. The researchers used DNA sequencing to analyze stool samples from the participants in order to examine whether the different diet types affected the participants' gut bacteria composition. Overall, the analysis did not shown major effects of the dietary grain products on the composition of the gut bacteria. [Original study.]

So you finally lost weight by diligently dieting, but now the issue is how to keep the weight from creeping back up again. Keeping strict watch over what you eat (basically continuing to diet)? Or exercising? Or...? Another issue muddying the waters is that a big weight loss also lowers the metabolism rate - something that occurred to former participants of the reality TV show The Biggest Loser.

They lost enormous amounts of weight during the 30 week competition (over 100 pounds on average), but 6 years later much of the weight was regained, and they were burning hundreds fewer calories each day at rest. So they had become metabolically much slower over time.

A study looking at 14 former participants of The Biggest Loser 6 years after the show found that a large persistent increase in physical activity was essential for long-term maintenance of weight loss. Those who regained the least weight were the most active, and vice versa. On the other hand, food intake (keeping calorie intake low) wasn't the most important.

How much of an increase in physical activity was needed to maintain the weight loss? Researchers found that an increase of about 80 minutes of daily moderate activity (such as brisk walking) or 35 minutes of daily vigorous activity was needed. From Medscape:

The Biggest Loser: Physical Exertion Is Key to Keeping Weight Off

Persistent increased physical activity is likely essential for long-term maintenance of weight loss, new research from participants in the US TV reality show The Biggest Loser suggests.... Using objective measures for both energy intake and physical activity in 14 former Biggest Loser contestants 6 years after they participated in the competition, Dr Kerns and colleagues found that those who had regained the least weight were the most active, and vice versa. Food intake, on the other hand, had very little effect on long-term weight-loss maintenance.

Asked to comment, Eric Ravussin, PhD, Boyd Professor at Louisiana State University, Baton Rouge, and coeditor of Obesity, told Medscape Medical News that the data align with those of follow-ups to major trials — including the Diabetes Prevention Program and the Action for Health Diabetes (Look AHEAD) study as well as with the National Weight Control Registry — of thousands of people who have lost at least 30 pounds and kept them off for at least a year. "The successful losers…all report high levels of physical activity" for weight maintenance, in contrast to weight loss, for which caloric deficit plays a far greater role, Dr Ravussin noted.

The reason for the difference between what works for weight loss vs maintenance, he said, probably has a lot to do with metabolic adaptation. This was the subject of another Biggest Loser paper published in Obesity in 2016, in which a person's metabolism slows down in response to a large drop in weight, making weight-loss maintenance difficult without an extra "push" from exercise, he explained.

The subjects in the new study were 14 participants with class III obesity who participated in a single season of The Biggest Loser, during which they underwent an intensive 30-week diet and exercise program and lost an average of 60 kg. Most regained weight after the program ended, although the degree of regain was highly variable. The median weight loss after 6 years was 13%. Seven subjects above the median weighed 24.9% less than baseline (maintainers) while the seven below the line (regainers) weighed 1.1% above their baseline. The maintainers had significantly greater increases in physical activity from baseline compared with the regainers..... that 35 minutes a day of intensive exercise, or 80 minutes of moderate activity, would roughly approximate the calorie expenditures among the maintainers.

Interesting study finding - that both high and low levels of magnesium is associated with a higher risk of dementia. Magnesium is an essential mineral needed for more than 300 biochemical reactions in the body. According to a large study done in the Netherlands of people who were followed for about 8 years - there was a U-shaped incidence of dementia based on their levels of magnesium. The lowest incidence was in those with "in the middle" normal levels of magnesium in the blood. All the study participants were mentally healthy when the study started.

The researchers stated that magnesium levels are considered "relatively stable over time", but a limitation of the study is that they only looked at magnesium levels once - at the beginning of the study, so they could have changed over time. Of course further studies are needed. [Other posts on magnesium and health - here, here, and here.]

Magnesium is widely available in foods. Foods that are good sources of magnesium include: spinach and other dark green leafy vegetables, almonds, cashews, peanuts, bananas, soybeans, kidney and black beans (legumes), whole grains, lentils, seeds, yogurt, brown rice, potatoes, and avocados. It is recommended that magnesium is obtained from the diet, and not from supplements (due to health risks from high doses). From Science Daily:

Both high, low levels of magnesium in blood linked to risk of dementia

People with both high and low levels of magnesium in their blood may have a greater risk of developing dementia, according to a study published in the September 20, 2017, online issue of Neurology®, the medical journal of the American Academy of Neurology.

The study involved 9,569 people with an average age of 65 who did not have dementia whose blood was tested for magnesium levels. The participants were followed for an average of eight years. During that time, 823 people were diagnosed with dementia. Of those, 662 people had Alzheimer's disease. The participants were divided into five groups based on their magnesium levels. Both those with the highest and the lowest levels of magnesium had an increased risk of dementia, compared to those in the middle group.

Both the low and high groups were about 30 percent more likely to develop dementia than those in the middle group. Of the 1,771 people in the low magnesium group, 160 people developed dementia, which is a rate of 10.2 per 1,000 person-years. For the high magnesium group, 179 of the 1,748 people developed dementia, for a rate of 11.4 per 1,000 person-years. For the middle group, 102 of the 1,387 people developed dementia, for a rate of 7.8. Kieboom noted that almost all of the participants had magnesium levels in the normal range, with only 108 people with levels below normal and two people with levels above normal[Original study.]

Once again a study finds that pesticide exposure is linked to an adverse health effect - that pesticide exposure in the home during pregnancy and early childhood is linked to an elevated risk of brain tumor in the child. Other studies have also found that pesticides used in the home are associated with a higher risk of childhood cancers.

This is because pesticides do cross the placental barrier, as the study researchers point out: "There is evidence that pesticides cross the fetal-placental barrier since residues of some insecticides have been found in umbilical cord blood, neonatal hair, and meconium following maternal exposure during pregnancy." Also, the International Agency for Research on Cancer (IARC) has classified "more than twenty pesticide chemical compounds as potential human carcinogens".

The following are examples (but there are more) of other studies finding pesticide and childhood cancer links: A meta-analysis published in 2015 in Pediatrics by researchers at Harvard University found that children exposed to indoor insecticides (also herbicides) have a higher risk of certain childhood cancers, specifically leukemia, lymphomas, and brain tumors. A 2013 study published in Cancer Causes and Control found that professional pest control applications in the home within a year of conception and during pregnancy was associated with a higher risk of childhood brain tumors. A review of studies published in 2010 found that pesticide exposure during pregnancy and childhood increased the risk of childhood leukemia.

The good news is that there are alternatives to exposing fetuses and children to toxic pesticides at home - by using alternative ways of dealing with pests, such as least toxic Integrated Pest Management (IPM) or organic methods. That means doing other things (such as sealing or caulking holes, putting out traps and baits, vacuuming), a focus on least toxic methods and on prevention (here and here), rather than routinely applying toxic pesticides. If needed, least toxic pesticides include boric acid and vinegar. Other sources of pesticide exposure for pregnant women and children are foods and exposure in settings outside the home - perhaps even a friend's yard. By the way, pesticide exposure for everyone is linked to a higher risk of health problems, not just pregnant women and children.

From Science Daily: Pesticide use during pregnancy linked to increased risk of childhood brain tumors

Previous epidemiological studies have suggested that exposure to pesticides during pregnancy may have a possible role in the development of childhood brain tumors. In a new International Journal of Cancer analysis, researchers found a link between maternal residential pesticide use -- particularly insecticides -- and the risk of childhood brain tumorsThe analysis included 437 malignant childhood brain tumor cases and 3102 controls from two French studies. Pesticide use was associated with a 1.4-times increased risk of childhood brain tumors.

The investigators noted that many pesticide compounds are classified as probable carcinogens, and there is evidence that some insecticides can pass through the feto-placental barrier. "Although such retrospective studies cannot identify specific chemicals used or quantify the exposure, our findings add another reason to advise mothers to limit their exposure to pesticides around the time of pregnancy," said Nicolas Vidart d'Egurbide Bagazgoïtia, lead author of the study. [Original study.]

OK, this study was done in mice, but it's the kind of study results that everyone hopes (and thinks) is also true for humans. So drink a nice cuppa black tea and think about how you're increasing bacteria in the gut associated with weight loss.

Black tea (as well as green tea) has polyphenols that stimulate the growth of gut bacterium and the formation of short-chain fatty acids. By the way, the mice were given decaffeinated tea extracts, so theoretically both decaf and caffeinated tea should have benefits. The big question though is - will drinking black tea daily actually result in weight loss? From Medical Xpress:

Black tea may help with weight loss, too

UCLA researchers have demonstrated for the first time that black tea may promote weight loss and other health benefits by changing bacteria in the gut. In a study of mice, the scientists showed that black tea alters energy metabolism in the liver by changing gut metabolites. The research is published in the European Journal of Nutrition. The study found that both black and green tea changed the ratio of intestinal bacteria in the animals: The percentage of bacteria associated with obesity decreased, while bacteria associated with lean body mass increased.

Previous studies indicated that chemicals in green tea called polyphenols are absorbed and alter the energy metabolism in the liver. The new findings show that black tea polyphenols, which are too large to be absorbed in the small intestine, stimulate the growth of gut bacterium and the formation of short-chain fatty acids, a type of bacterial metabolites that has been shown to alter the energy metabolism in the liver.

The researchers also collected samples from the mice's large intestines (to measure bacteria content) and liver tissues (to measure fat deposits). In the mice that consumed either type of tea extract, there was less of the type of bacteria associated with obesity and more of the bacteria associated with lean body mass. However, only the mice that consumed black tea extract had an increase in a type of bacteria called Pseudobutyrivibrio, which could help explain the difference between how black tea and green tea change energy metabolism.

The new study also concluded that both green tea and black tea have different effects on liver metabolism. According to Henning, the molecules in green tea are smaller and can more readily be absorbed into the body and reach the liver directly, while black tea molecules are larger and stay in the intestine rather than being absorbed. When black tea molecules stay in the intestinal tract, they enhance the growth of beneficial bacteria and the formation of microbial metabolites involved in the regulation of energy metabolism. [Original study.]

A newly published study suggests that exercising an hour or more per week could lower the incidence of depression. The study followed 33,000 adults in Norway  for 11 years, and found that an hour or more of weekly exercise was associated with 12% fewer cases of developing depression. But note that it didn't prevent anxiety.

Interestingly, the researchers found that "regular leisure-time exercise of any intensity" had these positive effects - it doesn't have to be aerobic or incredibly strenuous exercise. Exercise is associated with a number of biological changes that could have an impact on mental health. From Science Daily:

One hour of exercise a week can prevent depression

A landmark study led by the Black Dog Institute has revealed that regular exercise of any intensity can prevent future depression -- and just one hour can help. Published in the American Journal of Psychiatry, the results show even small amounts of exercise can protect against depression, with mental health benefits seen regardless of age or gender.

In the largest and most extensive study of its kind, the analysis involved 33,908 Norwegian adults who had their levels of exercise and symptoms of depression and anxiety monitored over 11 years. The international research team found that 12 percent of cases of depression could have been prevented if participants undertook just one hour of physical activity each week.

A healthy cohort of participants was asked at baseline to report the frequency of exercise they participated in and at what intensity: without becoming breathless or sweating, becoming breathless and sweating, or exhausting themselves. At follow-up stage, they completed a self-report questionnaire (the Hospital Anxiety and Depression Scale) to indicate any emerging anxiety or depression.

Results showed that people who reported doing no exercise at all at baseline had a 44% increased chance of developing depression compared to those who were exercising one to two hours a week. However, these benefits did not carry through to protecting against anxiety, with no association identified between level and intensity of exercise and the chances of developing the disorder. [Original article.]

Is frequent sauna bathing beneficial? That's what one study suggests. When the study started all 1621 men (aged 42 to 60) had normal blood pressure and none had been diagnosed with hypertension, and the follow-up was about 22 years later. The study took place in Finland, where sauna bathing is an important part of the culture - for all men, from all walks of life. The study found that frequent sauna bathing lowered the risk of developing hypertension - 46% when comparing men who sauna bathed once a week vs those who sauna bathed 4 to 7 times a week.

How could sauna bathing have these effects? There are several possibilities, but one is that sauna bathing produces "acute vasodilation" of the blood vessels, which leads to a significant drop in blood pressure. The temperature in the sauna is usually from 80 °C to 100 °C (176 to 212 degrees Fahrenheit), and the average sauna session (in this study) lasted an average of 14.4 minutes. From Science Daily:

Frequent sauna bathing keeps blood pressure in check

Frequent sauna bathing reduces the risk of elevated blood pressure, according to an extensive follow-up population-based study carried out at the University of Eastern Finland. The risk of developing elevated blood pressure was nearly 50% lower among men who had a sauna 4-7 times a week compared to men who had a sauna only once a weekThe same researchers have previously shown that frequent sauna bathing reduces the risk of sudden cardiac death, and cardiovascular and all-cause mortality. Elevated blood pressure is documented to be one of the most important risk factors of cardiovascular diseases.

The Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD) involved 1,621 middle-aged men living in the eastern part of Finland. Study participants without elevated blood pressure of over 140/90 mmHg or with diagnosed hypertension at the study baseline were included in this long-term follow-up study. Based on their sauna bathing habits, men were divided into three sauna frequency groups: those taking a sauna once a week, 2-3 times a week, or 4-7 times a week. During an average follow-up of 22 years, 15.5% of the men developed clinically defined hypertension. The risk of hypertension was 24% decreased among men with a sauna frequency of 2-3 times a week, and 46% lowered among men who had a sauna 4-7 times a week.

Sauna bathing may decrease systemic blood pressure through different biological mechanisms. During sauna bathing, the body temperature may rise up to 2 °C degrees, causing vessels vasodilation. Regular sauna bathing improves endothelial function, i.e. the function of the inside layer of blood vessels, which has beneficial effects on systemic blood pressure. Sweating, in turn, removes fluid from the body, which is a contributing factor to decreased blood pressure levels. Additionally, sauna bathing may also lower systemic blood pressure due to overall relaxation of the body and mind.

[NOTE: Above photo is of interior of a modern Finnish sauna. Credit: Wikipedia]

Two studies looked at manganese and found that high levels are associated with problems. Manganese is an essential trace mineral necessary for development, metabolism, the antioxidant system, and for normal brain and nerve function. Getting manganese through foods (e.g. nuts, seeds, whole grains) is beneficial, but ingesting large amounts through supplements or being exposed to high levels in some other way (such as polluted air) is associated with various health problems. 

The first study found that high manganese in the diet (in mice) was associated with an increased risk of staph (Staphylococcus aureus) heart infection. The second study (done in East Liverpool, Ohio) found that exposure to consistently high levels of manganese in the air is associated with lower IQ scores in children. And why did the air the children were breathing have high levels of manganese? Because there was a nearby hazardous waste incinerator and a facility that handles manganese.

From Medical Xpress: Excess dietary manganese promotes staph heart infection

Too much dietary manganese—an essential trace mineral found in leafy green vegetables, fruits and nuts—promotes infection of the heart by the bacterium Staphylococcus aureus ("staph"). The findings, reported this week in the journal Cell Host & Microbe, add to the evidence that diet modifies risk for infection. The discovery also suggests that people who have excess levels of tissue manganese, including those who consume dietary supplements with high concentrations of the metal, may be at increased risk for staph infection of the heart.

Skaar and his colleagues studied the impact of dietary manganese on staph infection in a mouse model. Most of the mice that consumed a high manganese diet—about three times more manganese than normal—died after infection with staph. The investigators discovered that the animals on the high manganese diet were particularly susceptible to staph infection of the heart, which was a surprise, said Skaar, who is also professor of Pathology, Microbiology and Immunology.... The researchers found that excess manganese inactivates a key line of defense against pathogens: the innate immune system's reactive oxygen burst. 

Staph is the leading cause of bacterial endocarditis (infection of the inner lining of the heart chamber and heart valves) and the second most frequent cause of bloodstream infections. Interestingly, some populations of people have both increased risk for staph infections, particularly endocarditis, and higher than normal levels of tissue manganese, Skaar noted. These populations include intravenous drug users, patients with chronic liver disease and patients on long-term intravenous diets.

From Medical Xpress: Higher manganese levels in children correlate with lower IQ scores, study finds

A study led by environmental health researchers at the University of Cincinnati (UC) College of Medicine finds that children in East Liverpool, Ohio with higher levels of Manganese (Mn) had lower IQ scoresThe study analyzed blood and hair samples of 106 children 7 to 9 years of age from East Liverpool and surrounding communities, who enrolled in the study from March 2013 to June 2014.... The study found that increased Mn in hair samples was significantly associated with declines in full-scale IQ, processing speed and working memory.

Manganese is an element generally found in combination with iron and many minerals. It plays a vital role in brain growth and development, but excessive exposure can result in neurotoxicity. Manganese is used widely in the production of steel, alloys, batteries and fertilizers and is added to unleaded gasolineLocated in northeast Ohio along the Ohio River, East Liverpool has a demonstrated history of environmental exposures, with EPA records showing elevated levels of manganese concentrations since 2000.... all  [air] monitors in East Liverpool had "consistently exceeded" health-based guidelines set by the agency.

 Manganese (Mn). Credit: Wikipedia

Image result for chlamydia wikipediaThe annual Sexually Transmitted Disease Surveillance Report was released today by the US Centers for Disease Control and Prevention (CDC) and the news wasn't good. More than two million cases of chlamydia, gonorrhea and syphilis were reported in the United States in 2016 - the highest number ever. But the CDC acknowledges that the actual numbers are far higher - that most cases of STDs are not reported to the CDC. The CDC estimates that there are actually 20 million new STDs in the U.S. each year, including other sexually transmitted diseases such as genital herpes and human papillomavirus, and half of these are among young people ages 15 to 24 years.

The report discusses the four STDs (sexually transmitted diseases) that are reported to the CDC. The 4th one is chancroid, but there were only 7 cases reported last year. Most of the new cases of STDs involved chlamydia, a bacterial infection that affects both men and women - about 1.6 million cases were reported to the CDC. Gonorrhea also increased among men and women last year, but the steepest rise was among men, especially among men who have sex with men (MSM). The CDC is especially concerned about the threat of gonorrhea becoming resistant to all treatments. Untreated STDs have serious health consequences (e.g. infertility, still-birth in infants)

This report stresses the need for STD screening and treatment, especially among pregnant women (make it part of prenatal care). There is also a need for STD education, and greater use of condoms to reduce risk of STDs. The CDC has a page on STD prevention (practice abstinence, use condoms, have fewer sexual partners and exclusive relationships, get the HPV vaccine, and talk with your partner about safe sex).  Excerpts from CDC:

STDs at record high, indicating urgent need for prevention

More than two million cases of chlamydia, gonorrhea and syphilis were reported in the United States in 2016, the highest number ever, according to the annual Sexually Transmitted Disease Surveillance Report released today by the Centers for Disease Control and Prevention (CDC).

The majority of these new diagnoses (1.6 million) were cases of chlamydia. There were also 470,000 gonorrhea cases and almost 28,000 cases of primary and secondary syphilis – the most infectious stages of the disease. While all three of these STDs can be cured with antibiotics, if left undiagnosed and untreated, they can have serious health consequences, including infertility, life-threatening ectopic pregnancy, stillbirth in infants, and increased risk for HIV transmission.

While young women continue to bear the greatest burden of chlamydia (nearly half of all diagnosed infections), surges in syphilis and gonorrhea are increasingly affecting new populations.

Syphilis rates increased by nearly 18 percent overall from 2015 to 2016. The majority of these cases occur among men – especially gay, bisexual and other men who have sex with men (MSM) – however, there was a 36 percent increase in rates of syphilis among women, and a 28 percent increase in syphilis among newborns (congenital syphilis) during this period. More than 600 cases of congenital syphilis were reported in 2016, which has resulted in more than 40 deaths and severe health complications among newborns. The disease is preventable through routine screening and timely treatment for syphilis among pregnant women.

While gonorrhea increased among men and women in 2016, the steepest increases were seen among men (22 percent). Research suggests that a large share of new gonorrhea cases are occurring among MSM. These trends are particularly alarming in light of the growing threat of drug resistance to the last remaining recommended gonorrhea treatment.

Image result for chlamydia wikipedia Chlamydia trachomatis (chlamydia) - in brown. Credit: Wikipedia

Another problem for overweight or obese men: an increased risk of poor sperm quality. Researchers in India found that compared to normal weight men, obesity was associated with lower sperm count, lower volume of semen, lower sperm concentration, poor sperm motility (the movement of sperm), as well as sperm defects. There is some evidence (from other studies and the researchers own work) that there is improvement in sperm quality with weight loss.

The researchers pointed out that other studies have shown that "paternal obesity at conception had deleterious effects on embryo health, implantation, pregnancy, and live birth rates." And that poor sperm quality is a cause of infertility. So.... what do the researchers recommend? Weight loss and exercise, and perhaps bariatric surgery, for obese men having fertility problems due to poor sperm quality. From Medical Xpress: 

As men's weight rises, sperm health may fall

A widening waistline may make for shrinking numbers of sperm, new research suggests. Indian scientists studied more than 1,200 men and found that too much extra weight was linked to a lower volume of semen, a lower sperm count and lower sperm concentration. In addition, sperm motility (the ability to move quickly through the female reproductive tract) was poor. The sperm had other defects as well, the researchers added. Poor sperm quality can lower fertility and the chances of conception.

"It's known that obese women take longer to conceive," said lead researcher Dr. Gottumukkala Achyuta Rama Raju, from the Center for Assisted Reproduction at the Krishna IVF Clinic, in Visakhapatnam. "This study proves that obese men are also a cause for delay in conception," he added.

But in continuing research, the study team is looking to see if losing weight will improve the quality of sperm. Although that study is still in progress, early signs look good that sperm quality improves as men lose weight, Rama Raju said. Recent reports have found that extreme weight loss after bariatric surgery reversed some of the sperm decline, he said.

For the study, Rama Raju and his colleagues used computer-aided sperm analysis to assess the sperm of 1,285 men. Obese men, they found, had fewer sperm, a lower concentration of sperm and inability of the sperm to move at a normal speed, compared with the sperm of men of normal weight. Moreover, the sperm of obese men had more defects than other sperm. These defects included defects in the head of the sperm, such as thin heads and pear-shaped heads.  [Original study.]

 Human sperm. Credit: Wikipedia