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Another study that links following the Mediterranean diet with a beneficial health effect - this time a lower risk of ischemic stroke. Unfortunately, it did not seem to lower the risk of hemorrhagic stroke.

The findings were presented at the American Stroke Association's annual meeting. From Medical Xpress:

Mediterranean diet may lower stroke risk, study finds

A Mediterranean diet may reduce your risk of one type of stroke, new research suggests. People who most closely followed the Mediterranean diet were less likely to suffer an ischemic stroke—caused by a blood clot—compared to people with the lowest adherence to the diet, the study found.

A Mediterranean diet includes plenty of fruits and vegetables, whole grains, legumes, nuts, fish, poultry and olive oil. There is limited consumption of red meat, sweets and saturated fats such as those in meat, butter and full-fat dairy products, according to the researchers.

Sherzai's team analyzed data from more than 104,000 teachers in California, averaging 52 years of age, who are taking part in a long-term study. The participants, 90 percent of who were white, were divided into five groups based on how well they followed a Mediterranean diet.

While closely following a Mediterranean diet was associated with a reduced risk of a stroke caused by a blood clot, the healthy eating plan had no effect on a person's odds for a bleeding (hemorrhagic) stroke, according to the study.

According to the researchers, prior research has shown that people who follow a Mediterranean diet have a lower risk of heart disease, mental decline and death, but there is little information about how the diet affects stroke risk.Wright noted that the study was especially rigorous, since the authors accounted for "other factors that would reduce stroke risks, such as exercise, total caloric intake,body mass index, smoking and menopausal/hormonal status."

Image result for dark chocolate Now this is shocking news for chocolate lovers - that it may be contaminated with lead and cadmium! Maybe it's not so bad for those who rarely eat chocolate, but it's not good for those who really love their chocolate and eat a lot. The group As You Sow did independent laboratory testing of 42 chocolate products for lead and cadmium and found that 26 of the chocolate products (~62%) contained lead and/or cadmium at levels in which one serving exceeds theCalifornia safe harbor level for reproductive harm.From The Washington Post:

How much lead is in your chocolate?

If you (like me) have been happily snarfing down chocolate in recent years, secure in the knowledge that those flavonols were at least doing good things for your heart, today is not your day. Just in time for Valentine's Day, a California consumer health watchdog group filed legal notices Wednesday demanding that many of the big chocolate companies post warnings on their packages that show their products contain high levels of lead and cadmium.

As You Sow, an Oakland nonprofit, says single servings of  26 products it tested (three times) contain more of the two harmful heavy metals than allowed under the Golden State's Proposition 65 toxic chemical warning law. Here is the list, which includes many of the big name producers of my favorite food. Try not to weep openly at work.

"We are getting [lead and cadmium] from multiple sources," Eleanne Van Vliet, director of toxic chemicals research for As You Sow, said in an interview. "The problem with those toxic heavy metals is they accumulate in the body. It’s terrible for adults, but especially for children." Overexposure to lead, of course, can cause all kinds of health problems,including lowering children's IQ. Cadmium is a carcinogen and can cause kidney and bone damage.

Now before you ask the boss to remove all the vending machines, let's be clear that the chocolate companies, and the association that represents them, are having none of this. They say there are, at worst, trace amounts of lead and cadmium in chocolate from natural sources and that regulators have rejected this argument before....Van Vliet insists that As You Sow is not talking about tiny amounts; rather, she says, if you think about the amount of chocolate the average person consumes each year, these concentrations are worrisome.If we could get them all in a room, both sides would probably agree on one thing: We do eat a lot of chocolate. 

.However, that prompted researchers at the University of California Santa Cruz to look into the amount of lead (but not cadmium) in chocolate, and the results were somewhat sobering. Their study, published in 2005 in the journal Environmental Health Perspectives, concluded that the lead in chocolate was not from naturally occurring sources, a stance that one of the researchers, Russ Flegal, reiterated when I called him.

"The average lead concentration of cocoa beans was ≤ 0.5 ng/g, which is one of the lowest reported values for a natural food," they wrote. "In contrast, lead concentrations of manufactured cocoa and chocolate products were as high as 230 and 70 ng/g, respectively, which are consistent with market-basket surveys that have repeatedly listed lead concentrations in chocolate products among the highest reported for all foods. One source of contamination of the finished products is tentatively attributed to atmospheric emissions of leaded gasoline, which is still being used in Nigeria."

Van Vliet says she doesn't know where the metals come from, only that they may enter the chocolate somewhere in the manufacturing process -- which Flegal said is also possible -- and are at unsafe levels in the chocolate we eat.

Well DUH, of course eating organic foods lowers pesticide exposures. And yes, it can be measured in your body. So, as previous studies have shown, replacing regular fruits and vegetables (conventionally grown) with organic fruits and vegetables will lower your exposure to pesticides and the levels in your body.

And why is this important? Research shows health effects from pesticides, so it is healthier for you to lower your pesticide exposures - whether from eating food, or from your house and your yard (breathing it in, getting it on skin).

From Science Daily: Organic food reduces pesticide exposure

While health-conscious individuals understand the benefits of eating fresh fruits and veggies, they may not be aware of the amount of pesticides they could be ingesting along with their vitamin C and fiber. A new study to be published in the Feb. 5 edition of Environmental Health Perspectives is among the first to predict a person's pesticide exposure based on information about their usual diet.

Curl and her colleagues analyzed the dietary exposure of nearly 4,500 people from six U.S. cities to organophosphates (OPs), the most common insecticides used on conventionally grown produce in the United States. OP pesticides are linked to a number of detrimental health effects, particularly among agricultural workers who are regularly exposed to the chemicals.

Results showed that among individuals eating similar amounts of fruits and vegetables, those who reported eating organic produce had significantly lower OP pesticide exposures than those consuming conventionally grown produce. In addition, consuming those conventionally grown foods typically treated with more of these pesticides during production, including apples, nectarines and peaches, was associated with significantly higher levels of exposure. "For most Americans, diet is the primary source of OP pesticide exposure," said Curl "The study suggests that by eating organically grown versions of those foods highest in pesticide residues, we can make a measurable difference in the levels of pesticides in our bodies."

The researchers were able to predict each participant's exposure to OP pesticides based on the amount and type of produce each participant typically ate and the U.S. Department of Agriculture's measurements of pesticide residue levels on those foods. The researchers then compared these predictions to pesticide metabolite levels measured in urine samples from a subset of 720 of these people.

"The next step is to use these exposure predictions to examine the relationship between dietary exposure to pesticides and health outcomes, including neurological and cognitive endpoints. We'll be able to do that in this same population of nearly 4,500 people," she said.

One way people can reduce their pesticide exposure, said Curl, is to eat organic versions of those foods that are listed on the Environmental Working Group's "Dirty Dozen" list, which ranks fruits and vegetables according to pesticide residue level.

This is very interesting, and raises all sorts of possibilities for microbial transplants. While it's looking at only one person, this seems to be evidence that microbes are involved with our weight and manipulating them may result in weight gain or loss. From Science Daily:

Rapid and unexpected weight gain after fecal transplant

A woman successfully treated for a recurrent Clostridium difficile infection with stool from an overweight donor rapidly gained weight herself afterwards, becoming obese, according to a case report published in the new journal Open Forum Infectious Diseases.

Fecal microbiota transplant (FMT) is a promising treatment for relapsing C. difficile infections, a common cause of antibiotic-related diarrhea that in severe cases may be life-threatening. The case suggests that clinicians should avoid selecting stool donors who are overweight. The report also raises questions about the role of gut bacteria in metabolism and health.

At the time of the woman's fecal transplant in 2011, her weight was stable at 136 pounds, and her Body Mass Index (BMI) was 26. Then 32 years old, she had always been of normal weight. The transplant used donor stool from the woman's overweight but otherwise healthy teenage daughter, administered via colonoscopy, to restore a healthy balance of bacteria in the woman's gut, curing her C. difficile infection.

Sixteen months later, the woman weighed 170 pounds, and her BMI was 33, meeting medical criteria for obesity. The weight gain persisted despite a medically supervised liquid protein diet and exercise program. Continuing efforts to diet and exercise did not lower her weight: Three years after the transplant, she weighed 177 pounds with a BMI of 34.5, and she remains obese today.

"We're questioning whether there was something in the fecal transplant, whether some of those 'good' bacteria we transferred may have had an impact on her metabolism in a negative way," said Colleen R. Kelly, MD, of the Warren Alpert Medical School of Brown University, who wrote the case report with Neha Alang, MD, of Newport Hospital in Rhode Island. Such a link between bacteria in the gastrointestinal tract and weight is supported by previously published animal studies, where transfer of gut bacteria from obese to normal-weight mice can lead to a marked increase in fat. In light of the case and the animal data, the authors recommend selecting stool donors who are not overweight for fecal transplants.

Importantly, the FMT was not the only possible cause of the woman's weight gain. In addition to treatment for C. difficile, she had also been treated with several antibiotics for Helicobacter pylori infection. Other possible contributing factors in the woman's weight gain include the resolution of her C. difficile infection, genetic factors, aging, and stress related to illness. However, as noted above, she had never been overweight before.

The possibility of lowering the risk of ischemic stroke (and poor recovery from it) is a good reason to try to increase vitamin D levels - by supplements and/or sunlight. Note that an ischemic stroke occurs when a blood vessel that supplies blood to the brain is blocked by a blood clot. From Medical Xpress:

Low vitamin D predicts more severe strokes, poor health post-stroke

Stroke patients with low vitamin D levels were found to be more likely than those with normal vitamin D levels to suffer severe strokes and have poor health months after stroke, according to research presented at the American Stroke Association's International Stroke Conference 2015. Low vitamin D has been associated in past studies with neurovascular injury (damage to the major blood vessels supplying the brain, brainstem, and upper spinal cord).

"Many of the people we consider at high risk for developing stroke have low vitamin D levels. Understanding the link between stroke severity and vitamin D status will help us determine if we should treat vitamin D deficiency in these high-risk patients," said Nils Henninger, M.D., senior study author and assistant professor of neurology and psychiatry at University of Massachusetts Medical School in Worchester.

Henninger and colleagues studied whether low blood levels of 25-hydroxyvitamin D, a marker of vitamin D status, is predictive of ischemic stroke severity and poor health after stroke in 96 stroke patients treated between January 2013 and January 2014 at a U.S. hospital. They found:

  • Overall, patients who had low vitamin D levels –defined as less than 30 nanograms per milliliter (ng/mL) – had about two-times larger areas of dead tissue resulting from obstruction of the blood supply compared to patients with normal vitamin D levels.
  • This association was similar among patients who suffered lacunar strokes (in which the small, intricate arteries of the brain are affected) and patients with non-lacunar strokes (such as those caused by carotid disease or by a clot that originated elsewhere in the body).
  • For each 10 ng/mL reduction in vitamin D level, the chance for healthy recovery in the three months following stroke decreased by almost half, regardless of the patient's age or initial stroke severity.

Bottom line: try not to eat processed sweetened foods or drink sodas because high intake is linked to type 2 diabetes. Several studies point the finger in particular to high fructose corn syrup, which is the most frequently used sweetener in processed foods, particularly fruit-flavored drinks and soda. An earlier 2013 study from Europe found that drinking one 12-ounce sugar-sweetened soft drink a day can increase the risk of type 2 diabetes by 22%. Instead eat real whole foods like fruits and vegetables. From Medscape:

Added Sweeteners in Processed Foods Tied to Diabetes

A large body of evidence from animal studies and observational and clinical trials in humans suggests that eating processed foods with added sweeteners is contributing to the growing incidence of type 2 diabetes, a new review, published online January 29 in the Mayo Clinic Proceedings, concludes. Thus, "by limiting sugar to 5% to 10% of total caloric intake, the harmful effects of sugar, particularly fructose, on insulin resistance could be minimized," he and his colleagues conclude. This in turn "may protect against diabetes and its complications, including early mortality from cardiovascular causes."

About three-quarters of all packaged foods and beverages in the US contain added sugar, and it is estimated that Americans eat up to 22 to 47 teaspoons of sugar a day, including hidden sugar in processed foods, Dr DiNicolantonio said.

"High intakes of added sugars, especially in the form of sugar-sweetened beverages, are associated with an increased risk of type 2 diabetes." However, at the same time, "people should not be concerned about limiting fructose found in whole foods such as fruits and vegetables," she noted.

The AHA recommends limiting added sugars to no more than 6 tsp (24 g), or 100 calories, per day for women, and 9 tsp (36 g), or 150 calories, per day, for men and cutting sugar-sweetened beverage consumption to no more than 36 ounces, or 450 calories, per week.

From Science Daily:

Added fructose is a principal driver of type 2 diabetes, experts argue

Recent studies have shown that added sugars, particularly those containing fructose, are a principal driver of diabetes and pre-diabetes, even more so than other carbohydrates. Clinical experts challenge current dietary guidelines that allow up to 25 percent of total daily calories as added sugars, and propose drastic reductions in the amount of added sugar, and especially added fructose, people consume.

The totality of the evidence is compelling to suggest that added sugar, and especially added fructose (usually in the form of high-fructose corn syrup and table sugar), are a serious and growing public health problem, according to the authors.

While fructose is found naturally in some whole foods like fruits and vegetables, consuming these foods poses no problem for human health. Indeed, consuming fruits and vegetables is likely protective against diabetes and broader cardiometabolic dysfunction, explained DiNicolantonio and colleagues. The authors propose that dietary guidelines should be modified to encourage individuals to replace processed foods, laden with added sugars and fructose, with whole foods like fruits and vegetables

It's interesting how drinking alcohol seems to have a J-curve for health effects. Light drinkers seem to do the best, but heavy drinkers do the worst of all groups (also see earlier posts). This research (published this week in the journal Stroke) shows that drinking more than 2 drinks a day in middle age is a bigger risk factor (double the risk) for a stroke between the ages of 60 to 75 years than high blood pressure, diabetes, or genetics. And once again, looking at the study one can see that nondrinkers had a small increased risk for stroke vs very light drinkers. From Science Daily:

Heavy drinking in middle-age may increase stroke risk more than traditional factors

Drinking more than two alcoholic beverages a day in middle-age raised stroke risks more than traditional factors such as high blood pressure and diabetes. Heavy drinking in mid-life was linked to having a stroke about five years earlier in life irrespective of genetic and early-life factors.

In a study of 11,644 middle-aged Swedish twins who were followed for 43 years, researchers compared the effects of an average of more than two drinks daily ("heavy drinking") to less than half a drink daily ("light drinking").

The study showed that: - Heavy drinkers had about a 34 percent higher risk of stroke compared to light drinkers. - Mid-life heavy drinkers (in their 50s and 60s) were likely to have a stroke five years earlier in life irrespective of genetic and early-life factors. - Heavy drinkers had increased stroke risk in their mid-life compared to well-known risk factors like high blood pressure and diabetes.At around age 75, blood pressure and diabetes appeared to take over as one of the main influences on having a stroke.

Researchers analyzed results from the Swedish Twin Registry of same-sex twins who answered questionnaires in 1967-70. All twins were under age 60 at the start. By 2010, the registry yielded 43 years of follow-up, including hospital discharge and cause of death data. ... Almost 30 percent of participants had a stroke. They were categorized as light, moderate, heavy or non-drinkers based on the questionnaires. 

Among identical twin pairs, siblings who had a stroke drank more than their siblings who hadn't had a stroke, suggesting that mid-life drinking raises stroke risks regardless of genetics and early lifestyle.

The study is consistent with the American Heart Association's recommended limit of two drinks a day for men and one for women. That's about 8 ounces of wine (two drinks) for a man and 4 ounces (one drink) for a woman. Regular heavy drinking of any kind of alcohol can raise blood pressure and cause heart failure or irregular heartbeats over time with repeated drinking, in addition to stroke and other risks.

Evidence is growing that "mini-fasts" (when food is not eaten) for as little as a 12 hour time period every day is good for the body and may help with weight control. For example, eat supper and then nothing more (but water is OK) till the next day's breakfast - instant 12 hour fast! The second study posted liked a 16 hour mini-fast. From the NY Times:

A 12-Hour Window for a Healthy Weight

Scientists, like mothers, have long suspected that midnight snacking is inadvisable. But until a few years ago, there was little in the way of science behind those suspicions. Now, a new study shows that mice prevented from eating at all hours avoided obesity and metabolic problems — even if their diet was sometimes unhealthful.

Researchers at the Salk Institute for Biological Studies in San Diego and elsewhere began experimenting with the eating patterns of laboratory mice in a previous study. On that occasion, some mice consumed high-fat food whenever they wanted; others had the same diet but could eat only during an eight-hour window. None exercised. The mice that ate at all hours soon grew chubby and unwell, with symptoms of diabetes. But the mice on the eight-hour schedule gained little weight and developed no metabolic problems. Those results were published in 2012.

For the new study, which appeared in the journal Cell Metabolism in December, Salk scientists fed groups of adult males one of four diets: high-fat, high-fructose, high-fat and high-sucrose, and regular mouse kibble. Some of the mice in each dietary group were allowed to eat whenever they wanted throughout their waking hours; others were restricted to feeding periods of nine, 12 or 15 hours. The caloric intake for all the mice was the same.

By the end, the mice eating at all hours were generally obese and metabolically ill, reproducing the results of the earlier study. But those mice that ate within a nine- or 12-hour window remained sleek and healthy, even if they cheated occasionally on weekends. What’s more, mice that were switched out of an eat-anytime schedule lost some of the weight they had gained.

“Time-restricted eating didn’t just prevent but also reversed obesity,” says Satchidananda Panda, an associate professor at the Salk Institute who oversaw the studies. “That was exciting to see.” Mice that consumed regular kibble in fixed time periods also had less body fat than those that ate the same food whenever they chose.

Precisely how a time-based eating pattern staved off weight gain and illness is not fully understood, but Dr. Panda and his colleagues believe that the time at which food is eaten influences a body’s internal clock. “Meal times have more effect on circadian rhythm than dark and light cycles,” Dr. Panda says. And circadian rhythm in turn affects the function of many genes in the body that are known to involve metabolism.

To date, Dr. Panda’s studies have been conducted with only mice, but he says the results seem likely to apply to humans. The upshot: Contain your eating to 12 hours a day or less. And pay attention to when you begin. The clock starts, Dr. Panda says, with “that first cup of coffee with cream and sugar in the morning.”

Another article also liked an "energy restriction period" (mini-fast), but they liked a 16 hour non-eating period.Here is the complete abstract (summary) of the article in Proceedings of the National Academy of Sciences USA,Nov. 25, 2014:

Meal frequency and timing in health and disease.

Although major research efforts have focused on how specific components of foodstuffs affect health, relatively little is known about a more fundamental aspect of diet, the frequency and circadian timing of meals, and potential benefits of intermittent periods with no or very low energy intakes. The most common eating pattern in modern societies, three meals plus snacks every day, is abnormal from an evolutionary perspective. Emerging findings from studies of animal models and human subjects suggest that intermittent energy restriction periods of as little as 16 h can improve health indicators and counteract disease processes. The mechanisms involve a metabolic shift to fat metabolism and ketone production, and stimulation of adaptive cellular stress responses that prevent and repair molecular damage. As data on the optimal frequency and timing of meals crystalizes, it will be critical to develop strategies to incorporate those eating patterns into health care policy and practice, and the lifestyles of the population.

Good news for those people who enjoy drinking a glass of orange juice each day. From NPR News:

What's More Nutritious, Orange Juice Or An Orange? It's Complicated

We all could probably eat more fruits and vegetables. But if forced to choose between whole fruit or a glass of juice, which one seems more healthful? The general advice is to opt for the fruit, since juices are stripped of the fiber – which most us don't get enough of — in whole fruit. And let's face it: Most juice contains a lot of sugar, which most of us consume too much of.

So our interest was piqued when we spotted a study suggesting that, when it comes to oranges, juice might actually unlock more carotenoids and flavonoids – both beneficial phytonutrients — than an equivalent amount of fruit.

To figure that out, German and Saudi researchers started with a big batch of fresh navel oranges. They analyzed the fruit in three forms: peeled segments, a mashed-up puree and as juice, both fresh-squeezed and pasteurized. They found that levels of vitamin C and carotenoids were basically the same in the juice and the unprocessed fruit, while levels of flavonoids were significantly lower.

But then the scientists threw their orange test foods into in a test tube model designed to mimic digestion, and that's when things got interesting: Much more of the carotenoids and flavonoids were released from the orange juice than from the fruit slices or mush. The differences were striking: Carotenoid release went up from nearly 11 percent in the fruit to 28 percent in the fresh juice, and up to 39.5 percent in the pasteurized juice. Meanwhile, flavonoids were boosted nearly five-fold in juice compared to fruit.

The findings, which appear in the Journal of Agricultural and Food Chemistry, are scientifically intriguing. For example, the researchers suspect heat may have something to do with the extra carotenoids released in pasteurized juice....That said, the new study "is in line with other studies that have found that nutrients in some fruits and vegetables are more bioavailable when the produce is chopped, mashed, juiced or prepared with oils," Blumberg notes in an email to The Salt.

Indeed, there's a whole avenue of research that is challenging our understanding of how to unleash the nutrition fixed inside fruits and veggies. For instance, as we've reported, we get more beta-carotene from tomatoes when we add a little fat like olive oil, and gently cooking carrots can coax them to release more nutrients. And while cooking broccoli for too long can destroy its antioxidants, chopping it is ideal.

Even though the researchers said this was a "preliminary study"(looking only at non-Hispanic whites), what was good was that results are based on a very large sample size. Coffee drinkers can definitely feel that they are doing something beneficial for their health. From Medical Xpress:

Coffee may be associated with a lower risk of malignant melanoma

Both epidemiological and pre-clinical studies have suggested that coffee consumption has a protective effect against non-melanoma skin cancers. However the protective effect for cutaneous melanoma (malignant and in situ) is less clear, according to a study published January 20 in the Journal of the National Cancer Institute.

To determine if there is an association between coffee consumption and risk of cutaneous melanoma, Erikka Loftfield, M.P.H., of the Division of Cancer Epidemiology and Genetics, National Cancer Institute, and colleagues used data from the NIH-AARP Diet and Health Study. Information on coffee consumption was obtained from 447,357 non-Hispanic white subjects with a self-administered food-frequency questionnaire in 1995/1996, with a median follow-up of 10 years. 

Overall, the highest coffee intake was inversely associated with a risk of malignant melanoma, with a 20% lower risk for those who consumed 4 cups per day or more. There was also a trend toward more protection with higher intake, with the protective effect increasing from 1 or fewer cups to 4 or more. However, the effect was statistically significant for caffeinated but not decaffeinated coffee and only for protection against malignant melanoma but not melanoma in-situ, which may have a different etiology.

The researchers point out that the results are preliminary and may not be applicable to other populations, and therefore additional investigations of coffee intake are needed.