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Many, many people wind up taking numerous courses of antibiotics at some points in life. Think of recurrent sinus infections or urinary tract infections or other infections. Or some conditions (e.g. dental or skin conditions) are treated with really long courses of antibiotics  New research (from 36,429 women participating in the long-running Nurses' Health Study)  found that women who take antibiotics over a long period of time during middle-age (40 to 59 years old), but even more so in late adulthood (60 years and over), are at increased risk of heart attack or stroke within the next 8 years.

How increased a risk for cardiovascular diseas? 28% or higher risk (compared to those who didn't take antibiotics)! But looking at the actual numbers it means: Among women who take antibiotics for two months or more in late adulthood, six women per 1,000 would develop a cardiovascular disease, compared to three per 1,000 among women who had not taken antibiotics.

Eight years was the length of the study, so it is unknown if the increased risk persists longer. The authors give a number of possible reasons for these results, but think it might be because antibiotic use results in gut microbial alterations. And the longer the antibiotic use, the more persistent the gut microbiome (microbial community) alterations. Other research studies supports this link (antibiotic use - gut microbe disruptions - increased cardiovascular disease). Another reason to eat in as healthy a manner as possible to feed beneficial gut microbes: a diet rich in fruits, vegetables, whole grains, seeds, and nuts.

From Medical Xpress: Antibiotic use linked to greater risk of heart attack and stroke in women

Women who take antibiotics over a long period of time are at increased risk of heart attack or stroke, according to research carried out in nearly 36,500 women. The study, published in the European Heart Journal today, found that women aged 60 or older who took antibiotics for two months or more had the greatest risk of cardiovascular disease, but long duration of antibiotic use was also associated with an increased risk if taken during middle age (aged 40-59). The researchers could find no increased risk from antibiotic use by younger adults aged between 20-39.  ...continue reading "Link Between Antibiotics, Heart Attacks, and Stroke Risk In Older Women"

How many times have you heard to eat lots of fruits, vegetables, whole grains, nuts, legumes (beans), and seeds? Study after study finds that eating a diet rich in these foods is linked to all sorts of health benefits. A big reason is that they have lots of fiber - which feeds beneficial microbes in our gut. A recently published review of studies in the prestigious journal Lancet examined studies done over the past 40 years and found numerous health benefits.

The researchers found that people consuming high levels of dietary fiber and whole grains have a lower risk of death from heart disease (cardiovascular mortality) and death from any cause. They also have a lower incidence of heart disease, stroke, type 2 diabetes, and colorectal cancer (as compared to those eating less fiber). There was a dose-response effect - in other words, the more fiber eaten daily, the lower the incidence of these diseases and deaths. They also found that a high fiber diet is also linked to lower cholesterol levels, lower weight, and lower blood pressure.

This study viewed 25 to 29 grams per day as a high fiber diet, but said the findings suggest that higher levels of fiber would be even more protective. Which means put down that delicious white bread and sugary cereal and start eating whole grain foods! Nowadays the average person eats less than 20 grams of fiber per day, but guidelines say to eat at least 30 grams per day. The researchers pointed out that getting fiber from real food is best.

From Science Daily: High intake of dietary fiber and whole grains associated with reduced risk of non-communicable diseases

People who eat higher levels of dietary fiber and whole grains have lower rates of non-communicable diseases compared with people who eat lesser amounts, while links for low glycaemic load and low glycaemic index diets are less clear. Observational studies and clinical trials conducted over nearly 40 years reveal the health benefits of eating at least 25g to 29g or more of dietary fiber a day, according to a series of systematic reviews and meta-analyses published in The Lancet.  ...continue reading "Eating Lots of Fiber Has Health Benefits"

Very interesting - that infections may be a trigger for a coronary heart disease event such as heart attack or ischemic stroke, within the next 3 months. [Ischemic strokes are strokes caused by a blood clot.] A recent study found that the association held for both inpatient (in hospital) and outpatient infections, but was stronger for inpatient infections . The most common infections before a heart attack or stroke were urinary tract infections (≈29%), pneumonia/respiratory infections (≈27%), skin and subcutaneous infections, and blood infections.

From Medical Xpress: Infections may be a trigger for heart attack, stroke

Diabetes, high blood pressure and elevated cholesterol are well-known risk factors for cardiovascular disease. But what about just getting sick? Could picking up some type of bug increase your chance of having a stroke or heart attack?  A new study suggests it could. 

...continue reading "Infections A Trigger For Heart Attack Or Stroke?"

Once again, recent studies found that eating real food (fish) is associated with health benefits, but taking a supplement (omega-3) isn't. Similar findings about fish versus omega-3 fatty acid supplements have also been found in other studies. Fish contains omega-3 fatty acids and many other nutrients - more than are found in supplements.

The first study is a Cochrane review of studies already done. The review provides good evidence that taking long-chain omega 3 (fish oil, EPA or DHA) supplements does not benefit heart health or reduce risk of stroke or death from any cause. In other words, people take the supplements believing it helps heart (cardiovascular) health - but the evidence isn't there.

On the other hand, a large study of people living throughout the US and followed for 16 years found an association with higher fish consumption and lower risk of early death, and death from cardiovascular disease. Additionally, in men - those eating the most fish (as compared to those eating the least) had a lower risk of death from cancer, respiratory disease, and liver disease, and in women - lower risk of death from Alzheimer's disease. However, eating fried fish didn't have those health benefits. The group eating the most fish had 8 oz or more fish per week, while the group having the least had less than 2 oz. per week.

From Science Daily:  Omega 3 supplements have little or no heart or vascular health benefit

New evidence published today shows there is little or no effect of omega 3 supplements on our risk of experiencing heart disease, stroke or death.  ...continue reading "Health Benefits Linked to Eating Fish, Not Supplements"

Is this really a surprise to anyone at this point? According to a recent study: Almost half of all deaths in the United States in 2012 that were caused by cardiometabolic diseases such as heart disease, stroke and type 2 diabetes, have been linked to "suboptimal diets" - that is, to eating poorly and so not getting enough of certain foods and nutrients, and too much of other foods. Deaths due to heart disease, stroke, or type 2 diabete were linked to: high sodium (salt) intake, not eating enough nuts and seeds, a high intake of processed meats, and low intake of seafood omega-3 fats.

The study looked at consumption of 10 foods or nutrients that are associated with cardiometabolic diseases: fruits, vegetables, nuts/seeds, whole grains, unprocessed red meats, processed meats, sugar-sweetened beverages (SSBs), polyunsaturated fats, seafood omega-3 fats, and sodium. The researchers incorporated data from National Health and Nutrition Examination Surveys, from studies and clinical trials, and from the National Center for Health Statistics. So how should one eat for heath? Lots of fruits and vegetables, legumes (beans), nuts, seeds, whole grains, fish, and less processed food and fast food. (A plus of this is that it also feeds your beneficial gut microbes.) Read ingredient lists and try to avoid whatever foods have ingredients that you ordinarily wouldn't cook with or don't understand what they are (for example, colors, additives, titanium dioxide, artificial or natural flavors, etc.). From Science Daily:

High number of deaths from heart disease, stroke and diabetes linked to diet

Nearly half of all deaths in the United States in 2012 that were caused by cardiometabolic diseases, including heart disease, stroke and type 2 diabetes, have been linked to substandard eating habits, according to a study published in the March 7 issue of JAMA and funded by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health. Of the 702,308 adult deaths due to cardiometabolic diseases, 318,656, or about 45 percent, were associated with inadequate consumption of certain foods and nutrients widely considered vital for healthy living, and overconsumption of other foods that are not.

The list includes foods and nutrients long-associated with influencing cardiometabolic health. The highest percentage of deaths was linked to excess consumption of sodium. Processed meats, sugar-sweetened beverages and unprocessed red meats were also consumed in excess. Americans did not consume enough of some foods that have healthful effects such as fruits, vegetables, nuts and seeds, whole grains, polyunsaturated fats and seafood omega-3 fats.

The study also shows that the proportion of deaths associated with diet varied across population groups. For instance, death rates were higher among men when compared to women; among blacks and Hispanics compared to whites; and among those with lower education levels, compared with their higher-educated counterparts. The authors concluded that "these results should help identify priorities, guide public health planning, and inform strategies to alter dietary habits and improve health." The study findings were based on death certificate data collected by the National Center for Health Statistics, part of the Centers for Disease Control and Prevention.

 This past week a study was published linking 8 to 10 portions of fruits and vegetables per day with a lower risk of early death, cancer, heart disease, and stroke. This confirms other research linking many daily servings of fruits and vegetables with various health benefits. For example, the study findings discussed in the Nov. 2, 2016 post: "Eating lots of fruits and vegetables (more than 10 servings a day!)  is linked to better cognitive functioning in both normal weight and overweight adults (both young and older adults), and may delay the onset of cognitive decline that occurs with aging and also dementia."

This new study led by researchers from the Imperial College London reviewed 95 previous studies of the relationship between diet and health. They found that people who ate 10 portions of fruits and vegetables a day had nearly a third lower risk of premature death and stroke than those who ate very little or no fruits and vegetables. The researchers pointed out that as the amount of fruits and vegetables eaten daily went up, the health benefits also increased (lower risk of heart disease, stroke, cardiovascular disease, cancer), and the risk of premature death decreased - thus a dose related relationship. So better to eat some fruits and vegetables than none! A portion is about 80 grams, equivalent to a medium apple, 1 banana, or generally about 1/2 cup of vegetables or fruits.

From Science Daily: Eating up to ten portions of fruit and vegetables a day may prevent 7.8 million premature deaths worldwide

A fruit and vegetable intake above five-a-day shows major benefit in reducing the chance of heart attack, stroke, cancer and early death. This is the finding of new research, led by scientists from Imperial College London, which analysed 95 studies on fruit and vegetable intake....the greatest benefit came from eating 800 g a day (roughly equivalent to ten portions -- one portion of fruit or vegetables if defined as 80 g).

The results revealed that even a daily intake of 200 g was associated with a 16 per cent reduced risk of heart disease, an 18 per cent reduced risk of stroke, and a 13 per cent reduced risk of cardiovascular disease. This amount, which is equivalent to two and a half portions, was also associated with 4 per cent reduced risk in cancer risk, and 15 per cent reduction in the risk of premature death. Further benefits were observed with higher intakes. Eating up to 800 g fruit and vegetables a day -- or 10 portions -- was associated with a 24 per cent reduced risk of heart disease, a 33 per cent reduced risk of stroke, a 28 per cent reduced risk of cardiovascular disease, a 13 per cent reduced risk of total cancer, and a 31 per cent reduction in dying prematurely. This risk was calculated in comparison to not eating any fruit and vegetables. [Original study.]

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

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

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

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

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

Remember all the dietary advice that for years told us to avoid or limit consumption of eggs - that since they were high in cholesterol, they were bad for us and would increase our risk for heart disease? And the nonsense that we should only eat the egg whites while throwing out the yolks? Hah...That advice was wrong, which another recent study confirms.

Eggs are an amazingly nutritious food. They’re loaded with high quality protein, healthy fats, vitamins, minerals, high in choline (a brain nutrient), biotin, antioxidants, lutein, and zeaxanthin. One review of studies (involving millions of people) looked at whole egg consumption  and found that high egg consumption (up to one egg per day) is not associated with increased risk of coronary heart disease or stroke, and in fact there was a reduced risk of hemorrhagic stroke. Only among diabetics was there an elevated risk of coronary heart disease with high egg consumption (up to 1 egg per day). Another study found a lower risk of type 2 diabetes in middle-aged men (see post).

A recent study from Finland found that neither cholesterol nor egg intake (eating one egg per day) was associated with an increased risk of dementia or Alzheimer's disease in Finnish men who were followed for 22 years. Instead, eating eggs was associated with better cognitive performance in certain areas such as executive function, which includes memory, problem solving, and planning (they were given neuropsychological tests). From Science Daily:

High cholesterol intake and eggs do not increase risk of memory disorders

A new study from the University of Eastern Finland shows that a relatively high intake of dietary cholesterol, or eating one egg every day, are not associated with an elevated risk of dementia or Alzheimer's disease. Furthermore, no association was found in persons carrying the APOE4 gene variant that affects cholesterol metabolism and increases the risk of memory disorders. APOE4 is common in Finland.

The dietary habits of 2,497 men aged between 42 and 60 years and with no baseline diagnosis of a memory disorder were assessed at the onset the Kuopio Ischaemic Heart Disease Risk Factor Study, KIHD, in 1984-1989 at the University of Eastern Finland. During a follow-up of 22 years, 337 men were diagnosed with a memory disorder, 266 of them with Alzheimer's disease. 32.5 per cent of the study participants were carriers of APOE4.

The study found that a high intake of dietary cholesterol was not associated with the risk of dementia or Alzheimer's disease -- not in the entire study population nor in the carriers of APOE4. Moreover, the consumption of eggs, which are a significant source of dietary cholesterol, was not associated with the risk of dementia or Alzheimer's disease. On the contrary, the consumption of eggs was associated with better results in certain tests measuring cognitive performance

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

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

Air Pollution Linked to Higher Stroke Mortality

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

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

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

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

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

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

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

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

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

Popular heartburn medication may increase ischemic stroke risk

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

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

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

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

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