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  A recent study looking at high dose supplementation of vitamin D found that it did not prevent cardiovascular disease. This study came about because of earlier studies observing that there is a higher incidence of cardiovascular disease in persons with low vitamin D levels (as measured in their blood). But such results from observational studies need rigorous testing in studies where people are randomly assigned to groups, and that are "double-blind" (no one knows who is getting the vitamin D until the end of the study) to eliminate bias. And this is what was done in this study, with the result that monthly high doses of vitamin D3 for 3 years did not prevent cardiovascular disease (including stroke, heart attacks, hypertension, etc) - as seen in that there were no group differences between the vitamin D and placebo groups. Finding no effects are "null findings".

But note that the subjects in the study got monthly high doses, and not daily or weekly vitamin D. It is unknown whether daily dosing would have made a difference in the results. However, the vitamin D levels in the blood soon reached levels (about 51.725 ng/mL) that many view as a desirable "protective" level. So we'll see what other studies find. But these results are definitely disappointing for those wanting an easy "magic bullet" for preventing cardiovascular disease. Bottom line: focus on lifestyle (diet, exercise, not smoking, etc) for heart health. From Science Daily:

Monthly high-dose vitamin D supplementation does not prevent cardiovascular disease

Results of a large randomized trial indicate that monthly high-dose vitamin D supplementation does not prevent cardiovascular disease, according to a study published by JAMA Cardiology. Studies have reported increased incidence of cardiovascular disease (CVD) among individuals with low vitamin D status. To date, randomized clinical trials of vitamin D supplementation have not found an effect, possibly because of using too low a dose of vitamin D. Robert Scragg, M.B.B.S., Ph.D., of the University of Auckland, New Zealand, and colleagues randomly assigned adults (age 50 to 84 years) to receive oral vitamin D3 (n = 2,558; an initial dose of 200,000 IU, followed a month later by monthly doses of 100,000 IU) or placebo (n = 2,552) for a median of 3.3 years.

Of the 5,108 participants included in the primary analysis, the average age was 66 years; 25 percent were vitamin D deficient. Cardiovascular disease occurred in 303 participants (11.8 percent) in the vitamin D group and 293 participants (11.5 percent) in the placebo group. Similar results were seen for participants with vitamin D deficiency at study entry and for other outcomes such as heart attack, angina, heart failure, hypertension, and stroke.

The authors write that the results of this study do not support the use of monthly high-dose vitamin D for the prevention of CVD. "The effects of daily or weekly dosing on CVD risk require further study." [Original study.]

Image result for calcium rich foods, wikipedia Once again, research shows that a supplement is not beneficial and may have some health harms, while eating foods rich in the mineral or vitamin being measured has health benefits. A ten year study found that calcium supplements are not beneficial and linked to health harm - they raised the risk of atherosclerosis, as measured by "coronary artery calcification" or plaque buildup in arteries, while a diet high in calcium rich foods was linked with health benefits (a protective effect). Other studies have found a higher risk for other health problems with calcium supplements (heart attacks, kidney stones, death),

Currently an estimated 43 percent of American adults take a supplement that includes calcium. Instead, for health benefits, focus on eating calcium rich foods. Some calcium rich foods are: dairy products (milk, cheese, yogurt, kefir), sardines, salmon, broccoli, collard greens, kale, edamame, figs, oranges, white beans, okra, tofu, and almonds. From Science Daily:

Calcium supplements may damage the heart

After analyzing 10 years of medical tests on more than 2,700 people in a federally funded heart disease study, researchers at Johns Hopkins Medicine and elsewhere conclude that taking calcium in the form of supplements may raise the risk of plaque buildup in arteries and heart damage, although a diet high in calcium-rich foods appears be protective.

In a report on the research....the researchers caution that their work only documents an association between calcium supplements and atherosclerosis, and does not prove cause and effect. But they say the results add to growing scientific concerns about the potential harms of supplements....But our study adds to the body of evidence that excess calcium in the form of supplements may harm the heart and vascular system.

"The researchers were motivated to look at the effects of calcium on the heart and vascular system because studies already showed that "ingested calcium supplements -- particularly in older people -- don't make it to the skeleton or get completely excreted in the urine, so they must be accumulating in the body's soft tissues," says nutritionist John Anderson, Ph.D., professor emeritus of nutrition at the University of North Carolina at Chapel Hill's Gillings School of Global Public Health and a co-author of the report. Scientists also knew that as a person ages, calcium-based plaque builds up in the body's main blood vessel, the aorta and other arteries, impeding blood flow and increasing the risk of heart attack.

Their study focused on 2,742 of these participants who completed dietary questionnaires and two CT scans spanning 10 years apart. The participants chosen for this study ranged in age from 45 to 84, and 51 percent were female. Forty-one percent were white, 26 percent were African-American, 22 percent were Hispanic and 12 percent were Chinese. At the study's onset in 2000, all participants answered a 120-part questionnaire about their dietary habits to determine how much calcium they took in by eating dairy products; leafy greens; calcium-enriched foods, like cereals; and other calcium-rich foods....The coronary artery calcium tests were repeated 10 years later to assess newly developing or worsening coronary heart disease.

Next, the investigators focused on the differences among those taking in only dietary calcium and those using calcium supplements. Forty-six percent of their study population used calcium supplements. The researchers.....found that supplement users showed a 22 percent increased likelihood of having their coronary artery calcium scores rise higher than zero over the decade, indicating development of heart disease....Among participants with highest dietary intake of calcium -- over 1,022 milligrams per day -- there was no increase in relative risk of developing heart disease over the 10-year study period.

Excerpts from the original study (Please note:  CVD = cardiovascular disease, CAC = coronary artery calcification) in the  Journal of the American Heart Association:  Calcium Intake From Diet and Supplements and the Risk of Coronary Artery Calcification and its Progression Among Older Adults: 10‐Year Follow‐up of the Multi‐Ethnic Study of Atherosclerosis (MESA)

Recent evidence derived from randomized, controlled trials, including the Women's Health Initiative, have raised a concern for an association between calcium supplement use and increased risk for CVD events.12, 13, 14 Among calcium supplement users, a high intake of calcium greater than 1400 mg/day has been reported to be associated with higher death rates from all causes, including from CVD.15

The purported CVD risk associated with total calcium intake may depend on the source of calcium intake.3 Intake of calcium from food sources has not been shown to increase CVD risk, whereas a signal for increased risk of myocardial infarction (MI) among calcium supplement users has been reported.7 In a similar fashion, dietary calcium intake may decrease risk of kidney stones, whereas calcium supplementation may increase risk.16 One explanation for this apparent paradox may be that large boluses of calcium intake through supplements may transiently elevate serum calcium concentrations,17, 18 which, in turn, may lead to vascular calcification and other adverse health effects.

In summary, results from this long‐term study of 10 years showed a protective relationship between total calcium intake and incident coronary atherosclerosis, particularly among nonsupplement users. Even though mean total calcium intake in quintile 5 was greater than the upper limits of current recommendations, no increased risk of CAC progression was found, and the highest quintile of calcium intake actually had decreased risk of incident CAC among those without prevalent CAC at baseline. However, we found evidence that calcium supplement use was independently associated with incident CAC, whether or not we adjusted for total calcium intake.

    Artificial trans fats in foods are bad for health in so many ways: linked to increased risk of coronary heart disease, atherosclerosis, inflammation, and risk of early death. And even though the FDA is finally phasing out partially hydrogenated oils (because they have high levels of artificial trans fats) within the next 3 years, trans fats will still be found in foods (processed foods). How can this be? Well, trans fats are still allowed to be in foods that are labeled as 0 trans fats if it is less than .5 grams trans fats per serving (a loophole allows them to round downward to zero ). And according to research by Environmental Working Group (EWG), trans fats are being used by the food industry in undisclosed ways in amounts low enough to exploit the trans fat loophole. Besides partially hydrogenated oils, they are found in other types of refined oils, monoglycerides, diglycerides and other emulsifiers, and even in flavors and colors. So when you see ZERO trans fats on the label, it doesn't actually mean that it is zero trans fats. The problem is that over the course of a day, eating a number of foods and servings that have under .5 grams of trans fats adds up to levels that research now says has negative health effects!

Artificial trans fats are found in a lot of processed foods. A EWG analysis found that harmful artificial trans fatty acids lurk in more than 27 percent of more than 84,000 processed foods common in American supermarkets.  Another 10 percent contain ingredients likely to contain trans fat. Foods most likely to have hidden trans fats are: breakfast bars, granola and trail mix bars, pretzels, peanut butter, crackers, breads, kids fruit snacks, kids cereal, graham crackers, whipped topping, non-dairy creamers, pudding mixes, cupcakes, and ice cream cones.

So what can you do? Read ingredient lists on labels and try to avoid foods with the above mentioned ingredients: partially hydrogenated oils, emulsifiers, monoglycerides, diglycerides and other emulsifiers, artificial flavors, artificial flavors, and colors. Try to cut back or avoid foods that have ingredients that are not real foods - tough to do, but it can be done.

And the amazing part, saturated fats (such as butter) are NOT linked to early death and heart disease, but trans fat in foods is. Latest research, from Science Daily:

Trans fats, but not saturated fats like butter, linked to greater risk of early death and heart disease

A study led by researchers at McMaster University has found that that trans fats are associated with greater risk of death and coronary heart disease, but saturated fats are not associated with an increased risk of death, heart disease, stroke, or Type 2 diabetes. The findings were published today by the British Medical Journal (BMJ)...."For years everyone has been advised to cut out fats. Trans fats have no health benefits and pose a significant risk for heart disease, but the case for saturated fat is less clear," said de Souza.

Saturated fats come mainly from animal products, such as butter, cows' milk, meat, salmon and egg yolks, and some plant products such as chocolate and palm oils. Trans unsaturated fats (trans fats) are mainly produced industrially from plant oils (a process known as hydrogenation) for use in margarine, snack foods and packaged baked goods.

Contrary to prevailing dietary advice, a recent evidence review found no excess cardiovascular risk associated with intake of saturated fat. In contrast, research suggests that industrial trans fats may increase the risk of coronary heart disease.

To help clarify these controversies, de Souza and colleagues analysed the results of 50 observational studies assessing the association between saturated and/or trans fats and health outcomes in adults....The team found no clear association between higher intake of saturated fats and death for any reason, coronary heart disease (CHD), cardiovascular disease (CVD), ischemic stroke or type 2 diabetes. However, consumption of industrial trans fats was associated with a 34 per cent increase in death for any reason, a 28 per cent increased risk of CHD mortality, and a 21 per cent increase in the risk of CHD.

Inconsistencies in the studies analysed meant that the researchers could not confirm an association between trans fats and type 2 diabetes. And, they found no clear association between trans fats and ischemic stroke. The researchers stress that their results are based on observational studies, so no definitive conclusions can be drawn about cause and effect. 

 

Air pollution is harmful on so many levels for all of us, (See recent Dec.post on harmful air pollution effects on pregnancy.) From Reuters Health:

Heart experts warn of air pollution dangers

Air pollution should be one of the avoidable heart risk factors - just like smoking and excess fat - that doctors warn patients to steer clear of, according to a new statement from 20 heart experts.

Citing pollution’s heavy toll on cardiovascular health, the panel urges people to take steps to protect themselves from breathing heavy traffic fumes or industrial air pollution whenever possible, and public officials to pass laws to reduce air pollution.Air pollution causes more than 3 million deaths worldwide each year and causes 3.1 percent of all cases of disability, Storey and his coauthors write in the European Heart Journal.

Air pollution is also ninth most important on a list of modifiable heart-disease risk factors - ranking above low physical activity, high-salt diet, high cholesterol and drug use, the authors point out.

Although gaseous air pollutants can be dangerous too, Storey said, airborne particles are the biggest contributor to cardiovascular disease because they cause inflammation of the lungs and enter the circulation, inflaming blood vessels, provoking clots and causing heart rhythm disturbances.

Particulate matter includes coarse particles from road dust, construction work and industrial emissions and fine particles from traffic, power plants and industrial and residential burning of oil, coal or wood for heating. The bulk of particulate air pollution is made up of these fine particles, known as PM2.5, that are less than 2.5 micrometers - about one fifth the size of visible dust. In 2013, the U.S. Environmental Protection Agency lowered the 24-hour exposure limit to an average of 12 micrograms.

European studies have found that PM2.5 levels are often markedly higher near heavy traffic zones compared to elsewhere in the same city, and that the levels can more than double during rush hours, according to the position statement.

Some of the authors’ advice for people to protect themselves is as simple as walking, cycling and using public transportation instead of driving cars, and exercising in parks or gardens, rather than near busy roads. And everyone should avoid being outside when pollution is highest, though this is especially important for infants, elderly and people with heart problems, the authors say.People who live in heavily polluted areas should also consider ventilation systems with filtration in their homes, since a large portion of outdoor pollution can penetrate buildings.

The use of fossil fuels for heating and energy should also be decreased, according to the statement.

Studies have shown even short-term exposure to high PM2.5 levels increases deaths from heart disease and respiratory disease, and that people living in places with high PM2.5 have an 11 percent greater risk of dying from heart attacks, strokes and heart failure than those who live in cleaner areas.

Two studies that talk about a healthy diet and health benefits.From Science Daily:

Home cooking a main ingredient in healthier diet, study shows

People who frequently cook meals at home eat healthier and consume fewer calories than those who cook less, according to new Johns Hopkins Bloomberg School of Public Health research."When people cook most of their meals at home, they consume fewer carbohydrates, less sugar and less fat than those who cook less or not at all -- even if they are not trying to lose weight," says Julia A. Wolfson, MPP, a CLF-Lerner Fellow at the Johns Hopkins Center for a Livable Future and lead author of the study.The findings also suggest that those who frequently cooked at home -- six-to-seven nights a week -- also consumed fewer calories on the occasions when they ate out.

Wolfson and co-author Sara N. Bleich, PhD, an associate professor in the Department of Health Policy and Management at the Bloomberg School, analyzed data from the 2007-2010 National Health and Nutrition Examination Survey from more than 9,000 participants aged 20 and older... The researchers found that 8 percent of adults cooked dinner once or less a week and this group consumed, on an average day, 2,301 total calories, 84 grams of fat and 135 grams of sugar. Forty-eight percent of participants cooked dinner six to seven times a week and they consumed 2,164 calories, 81 grams of fat and 119 grams of sugar on an average day.

The research found blacks are more likely to live in households where cooking occurs less frequently than whites; and individuals who work more than 35 hours a week outside the home also cook less often.

From Medical Xpress:

Healthy diets are good for the kidneys

A healthy diet may help protect the kidneys, according to two studies that will be presented at ASN Kidney Week 2014 November 11¬-16 at the Pennsylvania Convention Center in Philadelphia, PA. Dietary modifications may be a low-cost, simple intervention to reduce the burden of chronic kidney disease (CKD). 

A higher-quality diet, as measured using 3 different scoring systems for dietary qualities known to reduce the risk of cardiovascular disease, was associated with a 16% to 23% reduced risk of needing dialysis or dying from kidney problems. Higher-quality diets included those high in fruits, vegetables, and unsaturated fats. The researchers also found that high sodium intake (average of 4.7g g/day) was linked with an increased risk of needing dialysis or dying from kidney problems, but no benefit was seen for low sodium intake (average 2.0 g/day) compared with moderate intake. In contrast, high potassium intake was associated with a reduced future risk.

Think lifestyle changes, not medications. From Medical Daily:

Mild Hypertension Should Be Treated With Advice On Lifestyle Changes, Not Medication

In 2013, Dr. Iona Heath, a retired general practitioner published an article in the Journal of  the American Medical Association, in which she spoke about the side effects of overtreatment and overdiagnosis of mild hypertension. Now, in a new study, researchers revisit this idea, saying that unnecessary treatment of mild hypertension in low-risk patients is harming them and putting a burden on health care resources. They also argue that there's a need to reexamine criteria for diagnosing hypertension and treating blood pressure. 

About 40 percent of the world’s population, including 67 million American adults, have hypertension. Over half are classified as having mild hypertension. 

More than half of people with mild hypertension are treated with drugs, but there has been no evidence to suggest that blood pressure-lowering drugs prevent heart attacks. Instead of prescribing drugs to control mild hypertension, the authors urge clinicians to recommend healthier lifestyles to patients, which include exercising, quitting smoking, and decreased alcohol consumption. They also urge clinics to improve the accuracy of blood pressure-measuring instruments and to inform patients about measuring blood pressure at home. 

From Medical Xpress:

Experts raise concern over unnecessary treatment of mild hypertension in low risk people

Lowering the drug threshold for high blood pressure has exposed millions of low-risk people around the world to drug treatment of uncertain benefit at huge cost to health systems, warn US experts in BMJ today. Dr Stephen Martin and colleagues argue that this strategy is failing patients and wasting healthcare resources.

Over half of people with mild hypertension are treated with medication. Yet treating low risk mildly hypertensive patients with drugs has not been proven to reduce cardiovascular disease or death. The authors argue that overemphasis on drug treatment "risks adverse effects, such as increased risk of falls, and misses opportunities to modify individual lifestyle choices and tackle lifestyle factors at a public health level."

And for those over 65 the levels can be even higher. From Science News:

'Mild' control of systolic blood pressure in older adults is adequate: 150 is good enough

A broad review of the use of medications to reduce blood pressure has confirmed that "mild" control of systolic pressure is adequate for adults age 65 or older -- in the elderly, there's no clear benefit to more aggressive use of medications to achieve a lower pressure. Historically, most medical practitioners tried to achieve control of systolic pressure -- the higher of the two blood pressure readings -- to 140 or less. Recently changed guidelines now suggest that for adults over 60, keeping the systolic pressure at 150 or less is adequate, and this extensive analysis confirms that.

Another reason to improve your lifestyle.From Medical Daily:

Erectile dysfunction can be reversed without medication

Men suffering from sexual dysfunction can be successful at reversing their problem by focusing on lifestyle factors and not just relying on medication, according to research. Researchers have highlighted the incidence of erectile dysfunction and lack of sexual desire among Australian men aged 35-80 years. Over a five-year period, 31% of the 810 men involved in the study developed some form of erectile dysfunction. The major risk factors for this are typically physical conditions rather than psychological ones, such as being overweight or obese, a higher level of alcohol intake, having sleeping difficulties or obstructive sleep apnoea, and age.

"The good news is, our study also found that a large proportion of men were naturally overcoming erectile dysfunction issues. The remission rate of those with erectile dysfunction was 29%, which is very high. This shows that many of these factors affecting men are modifiable, offering them an opportunity to do something about their condition," Professor Wittert says.

"Erectile dysfunction can be a very serious issue because it's a marker of underlying cardiovascular disease, and it often occurs before heart conditions become apparent. Therefore, men should consider improving their weight and overall nutrition, exercise more, drink less alcohol and have a better night's sleep, as well as address risk factors such as diabetes, high blood pressure and cholesterol.

A question that some may have about the persistence of the virus on surfaces . From Medical Daily:

Sex Toys Can Show Traces Of HPV 24 Hours After Use, Have Increased Chance Of Spreading Virus, Despite Cleaning

Shared sex toys between two women and between women and men could have traces of the human papillomavirus even after they’ve been cleaned. According to a study published in the journal Sexually Transmitted Infections,researchers from the Division of Infectious Diseases at the Indiana University School of Medicine found that women could be potentially putting their partners at risk...HPV is one of the most commonly sexually transmitted diseases, approximately 79 million Americans are currently infected with the disease, and that number increases by 14 million each year.

The study focused on women between the ages of 18 and 29 who had been in sexual relationships with both a man and a women in the prior year. They gave each woman a cleaning product, one vibrator made of thermoplastic elastomer, and another made out of soft silicone. The participants were asked to swab the vibrations after vaginal use, immediately after cleaning, and 24 hours later.

The authors found that in 75 percent of vagina samples (9 out of 12), HPV was detected. In the nine vibrators from the HPV-positive women, 85 percent (8) of showed signs of the virus; after cleaning, 56 percent (5 of the 9) had traces of HPV. Twenty-four hours after cleaning the contaminated vibrators, 40 percent (2 out of the 5) of the swabs were still positive. They also found that silicone vibrators had a lower detection rate 24 hours after cleaning.