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Chronic venous insufficiency: What to know

Venous insufficiency occurs when the valves in a person's veins do not work properly. This means that the veins are less able to transport blood back to the heart.

Venous insufficiency is fairly common. According to the Society for Vascular Surgery, it affects up to 40 percent of people in the United States.

It is also usually chronic. This condition causes leg and foot swelling, varicose veins, and aching legs.

In this article, we cover the causes and risk factors for venous insufficiency, as well as how to diagnose and treat it.

What is venous insufficiency? Woman holding her leg due to venous insufficiency
Symptoms of venous insufficiency can include dull aching and swelling in the legs and blood clots.

The heart pumps oxygen-rich blood through the arteries to the rest of the body, while the veins bring deoxygenated blood back to the heart.

When a person has venous insufficiency, their veins have trouble moving deoxygenated blood from the arms and legs back to the heart. Faulty valves inside the veins usually cause venous insufficiency.

Veins have valves made up of two flaps, which prevent the backward flow of blood. These are called bicuspid valves. If the veins are damaged or become dilated, the valves may fail to close properly.

When the valves do not work properly, blood will flow back into the veins instead of forward to the heart. This causes blood to pool in the veins, often in the legs and feet.

This results in many of the symptoms associated with venous insufficiency, such as skin discoloration, swelling, and pain.

Symptoms Some of the symptoms of venous insufficiency include: heaviness, throbbing, or dull aching in the legs swelling of the legs and ankles cramping or itching in the legs patches of darker, brownish skin thicker or harder skin on the legs or ankles open sores blood clots varicose veins Thank you for supporting Medical News Today Causes and risk factors varicose veins on the leg
Varicose veins can cause venous insufficiency. The following factors are more likely to cause venous insufficiency: having a family history of the condition having blood clots having varicose veins being pregnant having obesity smoking having phlebitis, or swelling of superficial veins sitting or standing for long periods of time Treatments The best treatment for chronic venous insufficiency will vary from person to person. Doctors must consider several factors before deciding on the best treatment course. Some of these factors include the cause and symptoms of venous insufficiency and the age and health status of the person. Treatments for chronic venous insufficiency include the following: Medications Healthcare provides may prescribe medications that improve blood flow through the vessels. Some medications that can help treat venous insufficiency include: diuretics, which are medications that remove excess fluid from the body pentoxifylline, which reduces inflammation and improves blood flow blood thinners, or anticoagulants, which prevent blood clots Home remedies People can reduce the symptoms of venous insufficiency at home using the following methods: Wearing compression stockings. These are special elastic stockings that apply pressure to the lower leg and foot. Compression stockings help reduce swelling and improve blood flow. Elevating the legs above the heart. This helps pull blood from the legs toward the heart Practicing good skin hygiene. People with venous insufficiency can develop skin problem, such as dermatitis, cellulitis, or atrophie blanche (white atrophy). People with venous insufficiency can take care of their skin using the following methods: keeping it moisturized so that it does not become dry or flaky exfoliating regularly to remove dead skin cells applying topical ointments as their healthcare provider instructs Nonsurgical procedures The following nonsurgical methods can help treat venous insufficiency: Ablation In some cases, doctors will recommend destroying damaged veins in a process called ablation. They destroy the veins by applying either heat or chemicals. Sclerotherapy In sclerotherapy, a doctor will inject a liquid or foam solution into the damaged vein. The vein reacts to the solution and swells shut. Then, the body absorbs the vein and redirects blood to other healthy veins. Phlebectomy A phlebectomy is a minimally invasive procedure in which a medical professional removes varicose veins through small punctures in the skin. Laser therapy Laser therapy is a relatively new procedure in which a doctor uses lasers to close damaged veins. Surgical procedures People with serious cases of venous insufficiency may require surgery. Some surgical procedures that treat venous insufficiency include: repairing damaged veins or valves stripping or removing damaged veins implanting a small mesh tube, called a stent, to widen the vein ligation, in which a doctor ties off veins through a small incision in the skin Types of venous insufficiency Chronic venous insufficiency falls into three different categories depending on the severity of the symptoms. Stage 1. Swelling and changes in skin pigmentation characterize this stage. Stage 2. Swelling, changes in skin pigmentation, and dermatitis characterize this stage. Stage 3. Swelling, changes in skin pigmentation, varicose veins, and ulcers characterize this stage. Venous insufficiency can cause chronic venous hypertension, a condition characterized by high blood pressure in the veins of the legs. Blood clots or other blockages in the veins can also lead to this condition. If left untreated, chronic venous hypertension can cause abnormalities in the capillaries within the leg tissues, resulting in ulceration, swelling, and hyperpigmentation. This is a condition in which patches of skin become darker than usual. Thank you for supporting Medical News Today Diagnosis mri scanning procedure
A doctor may request an MRI scan to diagnose venous insufficiency. A physical examination is the first step toward diagnosing venous insufficiency. A doctor will also review a person's medical history and current health status before making a diagnosis. Diagnostic procedures that help determine whether or not a person has venous insufficiency include: Venogram. This examination uses X-ray technology to examine how blood flows through the veins. It requires injecting contrast material into a vein. Healthcare providers uses venograms to locate blood clots and evaluate varicose veins. Duplex ultrasound. This noninvasive test examines the speed and direction of blood flow through the veins and arteries. Additional medical tests for venous insufficiency can include: Prevention Many of the risk factors associated with venous insufficiency are related to a person's lifestyle. People can reduce their risk of developing venous insufficiency by making small lifestyle adjustments, such as: getting regular exercise avoiding wearing high heels avoiding standing or sitting for long periods of time maintaining a healthy body weight Summary Venous insufficiency is common condition in which the blood does not flow smoothly through the veins and back to the heart. This is due to faulty valves in the veins. Venous insufficiency is a common condition. It is not life-threatening, but it is usually chronic. Symptoms of venous insufficiency include varicose veins, swelling, and heavy, aching legs. Left untreated, venous insufficiency can lead to other health conditions, such as dermatitis, venous ulceration, and chronic venous hypertension. Treatment of venous insufficiency varies depending on the severity of the symptoms, the individual's medical history and current health status, and the cause of the condition. Treatments for venous insufficiency focus on managing symptoms and preventing further complications. Those who have had venous insufficiency require ongoing care even after successful treatment, as the condition often reappears.
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What to know about high blood pressure during pregnancy

A woman can develop high blood pressure, or hypertension, at any point during pregnancy.

High blood pressure is affecting more and more pregnant women. According to the Centers for Disease Control and Prevention (CDC), the number of pregnant women who developed high blood pressure in the United States almost doubled between 1993 and 2014.

High blood pressure affects an estimated 6–8 percent of pregnancies in women aged 20–44 in the U.S.

If left untreated, high blood pressure can lead to serious health complications for the mother, her infant, or both. In most cases, however, hypertension is preventable and treatable.

In this article, we will discuss the different types of high blood pressure that a woman can develop during pregnancy, the risk factors and complications of high blood pressure, and how to prevent and treat high blood pressure during pregnancy.

Types of hypertension in pregnancy Pregnant woman having her blood pressure taken
A woman may experience chronic hypertension, gestational hypertension, or preeclampsia during pregnancy.

According to the CDC, blood pressure measurements that are greater than or equal to 140/90 millimeters of mercury indicate high blood pressure.

Women can experience one of three types of high blood pressure during pregnancy: chronic hypertension, gestational hypertension, or preeclampsia.

A person may have chronic hypertension before pregnancy, whereas gestational hypertension only occurs during pregnancy.

However, gestational hypertension may sometimes persist after the pregnancy to become chronic hypertension.

Chronic hypertension

Women who have chronic hypertension either had high blood pressure before becoming pregnant or developed it within the first half, or 20 weeks, of their pregnancy.

It is possible for a woman to develop a subtype called chronic hypertension with superimposed preeclampsia.

Women with this condition have high blood pressure and can possibly develop an abnormal amount of protein in their urine, or proteinuria. The presence of protein in the urine can indicate problems with the kidneys. Women may also have changes in liver function.

Gestational hypertension

Gestational hypertension only occurs during pregnancy and without the presence of protein in the urine or changes in liver function. Women usually develop this condition in the second half, or after the first 20 weeks, of their pregnancy.

This form of high blood pressure is typically temporary and tends to go away after childbirth. However, it can increase a woman's risk of developing high blood pressure later in life.

In some cases, the blood pressure will remain elevated after the pregnancy, resulting in chronic hypertension.

Preeclampsia

Preeclampsia is a high blood pressure condition that women can develop during pregnancy or after giving birth. It is a serious condition that can have severe consequences. It usually occurs in the third trimester. It rarely occurs after delivery, but it is possible.

Doctors often diagnose preeclampsia after taking blood pressure measurements and testing blood and urine samples. Women who develop a mild form of preeclampsia may not experience any symptoms.

If symptoms of preeclampsia do develop, they can include:

high blood pressure proteinuria excessive swelling of the face and hands weight gain due to fluid retention headaches dizziness irritability shortness of breath abdominal pain nausea vomiting blurred vision sensitivity to light

Preeclampsia with seizures, or eclampsia, is a different condition. It can be fatal.

Complications of hypertension for the mother If hypertension is severe or uncontrolled, it can cause complications for the mother and baby. High blood pressure during pregnancy puts women at an increased risk of more serious health conditions later in life. One 2013 study revealed that gestational hypertension was associated with a higher risk of ischemic heart disease, myocardial infarction (heart attack), heart failure, and ischemic stroke. Poorly controlled high blood pressure puts a woman at risk of developing preeclampsia and gestational diabetes. One complication of hypertension is HELLP syndrome. This is a rare life-threatening liver and blood disorder. Doctors consider it to be a severe variant of preeclampsia. HELLP stands for: Hemolysis, or the breaking down of red blood cells Elevated Liver enzymes, which is a sign of liver damage Low Platelet count; platelets are a material that forms blood clots Other complications associated with high blood pressure during pregnancy include: stroke placental abruption, a serious medical condition in which the placenta separates from the wall of the uterus too early preterm delivery, or giving birth before the due date, which healthcare providers may advise if the placenta is not providing a enough nutrients and oxygen to the baby or if the mother's life is in danger Thank you for supporting Medical News Today Risks of hypertension for the baby High blood pressure can increase the risk of poor birth outcomes, such as preterm delivery, smaller-than-average size, and infant death. High blood pressure affects the mother's blood vessels. This can decrease the flow of nutrients through the placenta to the baby, resulting in a low birth weight. Hypertension-related preterm delivery can result in health complications for the baby. These may include difficulty breathing if the lungs are not fully developed, for example. Signs and symptoms Pregnant woman at the doctors
A pregnant woman should attend regular prenatal checkups. The American Heart Association (AHA) call high blood pressure the "silent killer" because most people who have it do not develop symptoms. This means that a person may have high blood pressure without knowing it. Monitoring blood pressure is an essential part of prenatal care. It is important to remember that women can develop high blood pressure before, during, and after their pregnancy. It is important that women attend regular prenatal checkups to ensure that their blood pressure and other vital signs are within normal ranges and receive treatment if not. Also, blood pressure fluctuates in response to small changes in a person's life, such as stress, diet, exercise, and the quality of their sleep. This is why it is so important that people check their blood pressure regularly. Risk factors for hypertension Risk factors for gestational hypertension and preeclampsia include: a history of preeclampsia preexisting hypertension pregestational diabetes having twins or triplets preexisting kidney disease some autoimmune diseases The following are risk factors for a person to develop hypertension: having a family history of high blood pressure being overweight race age having high cholesterol stress smoking cigarettes drinking alcohol not exercising often becoming pregnant at an older age having had high blood pressure during a previous pregnancy Thank you for supporting Medical News Today Treatment Women with chronic hypertension should continue taking antihypertensive medication during their pregnancy. However, some common antihypertensive medications are not suitable for pregnant women to take, so healthcare providers may recommend a different medication. If gestational hypertension is severe or a woman develops preeclampsia or eclampsia, a doctor may prescribe medications to lower her blood pressure and help the baby mature if the pregnancy is not full-term. Women may be hospitalized for monitoring. Healthcare providers may recommend anticonvulsive medications, such as magnesium sulfate, to prevent seizures in people with eclampsia or preeclampsia. In some cases, a doctor may advise delivery of the baby for treatment. The timing of delivery depends on how severe the mother's condition has become, as well as how far along the pregnancy is. Women who are pregnant should speak with their healthcare provider about ways to control their blood pressure. Prevention Pregnant woman performing yoga
Doctors recommend regular exercise to prevent high blood pressure. Making simple lifestyle changes, such as getting more exercise and eating a more balanced diet, can help prevent high blood pressure. It is important to note that some risk factors, such as family history, race, and past pregnancy history, are not within a person's control. For this reason, not all cases of hypertension in pregnancy are preventable. Some ways to lower the risk of high blood pressure during pregnancy include: limiting salt intake staying hydrated eating a balanced diet that is rich in plant-based foods and low in processed foods getting regular exercise getting regular prenatal checkups avoiding smoking cigarettes and drinking alcohol Medical professionals tend to recommend that people have regular blood pressure screening, especially when they have risk factors, so that they can begin to treat it early. Summary High blood pressure, or hypertension, during pregnancy can be life-threatening to a woman in some cases. If left untreated, high blood pressure can cause harm to both the mother and her infant. It does not always lead to serious health complication, and sometimes, it will go away following childbirth. Hypertension during pregnancy is typically preventable and treatable. A doctor must closely monitor hypertension in pregnancy to prevent potentially life-threatening health complications. It is important that women attend regular prenatal evaluations and report any abnormal symptoms to ensure their own health and that of their infant.
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Statins: Risk of side effects is low, say experts

For most people who take statins to lower cholesterol, the risk of side effects is low compared to the benefits, according to a recent scientific statement.
pills and stethoscope against a pink and blue background
New research suggests that the benefits of statins outweigh the risks.

The American Heart Association (AHA) statement applies to those who — according to current guidelines — are at risk of heart attack and ischemic strokes, which are strokes arising from blood clots.

Statins are drugs that reduce low-density lipoprotein (LDL) cholesterol by blocking an enzyme in the liver.

Around a quarter of adults over the age of 40 years old in the United States use statins to reduce their risk of heart attack, ischemic stroke, and other conditions that can develop when plaque builds up in arteries.

However, up to 1 in 10 of individuals taking statins stop using them because they assume that the drug is responsible for symptoms that they experience, although that may not be the case.

"Stopping a statin," says Dr. Mark Creager, who is director of the Heart and Vascular Center at Dartmouth-Hitchcock Medical Center in Lebanon, NH, and former president of the AHA, "can significantly increase the risk of a heart attack or stroke caused by a blocked artery."

The journal Arteriosclerosis, Thrombosis, and Vascular Biology carries a full report on the research that went into the statement.

Within guidelines, 'benefits outweigh risks'

The statement's authors say that trials have proved that statins have had a major effect on reducing heart attacks, strokes, other cardiovascular diseases, and associated deaths.

Further to this, they reviewed a large number of studies and clinical trials that have evaluated the safety and potential adverse effects of statins.

"Over 30 years of clinical investigation," the authors write, "have shown that statins exhibit few serious adverse effects."

They point out that, apart from a few exceptions, it is possible to reverse the adverse effects of statin use. This should be compared, they argue, with the fact that heart attacks and stroke damage the heart or brain permanently, and they can kill.

They list the exceptions as "hemorrhagic stroke and the possible exception of newly diagnosed diabetes mellitus and some cases of autoimmune necrotizing myositis."

"Thus," they conclude, "in the patient population in whom statins are recommended by current guidelines, the benefit of reducing cardiovascular risk with statin therapy far outweighs any safety concerns."

According to the AHA, the current guidelines recommend the use of statins for the following groups:

Those who have experienced heart attack, stroke, transient ischemic attacks, or who have a history of cardiovascular conditions such as angina and peripheral artery disease. Adults aged 40–75 years old whose LDL cholesterol is in the 70–189 milligrams per deciliter (mg/dl) range and whose risk of having a heart attack or stroke in the next 10 years is 7.5 percent or above. Adults aged 40–75 years of age who have diabetes and whose LDL cholesterol is in the range 70–89 mg/dl. Anyone aged 21 years and older with a very high LDL cholesterol level of 190 mg/dl and above.
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'Muscle aches and pains'

People using statins who report side effects most often mention "muscle aches and pains."

However, the research that the statement's authors reviewed reveals that fewer than 1 percent of people who use statins "develop muscle symptoms that are likely caused by statin drugs."

Uncertainty about the causes of any aches and pains, coupled with the fact that they are taking statins, may prompt people to make a link where none exists.

The AHA say that if individuals stop taking their statins for this reason, they may be doing more harm than good by raising their risk of a cardiovascular event.

They urge healthcare providers to "pay close attention to their patients' concerns and help them assess likely causes." They could, for instance, check for blood markers of muscle damage. If they are normal, this could reassure their patients.

Another option is to check vitamin D levels, as insufficiency amounts can also cause muscle aches and pains.

Risk of diabetes and hemorrhagic stroke

There is a slight chance that statins might raise the risk of diabetes, especially in those at higher risk. These include individuals with obesity or whose lifestyle is largely sedentary.

The statement suggests that the absolute risk of being diagnosed with diabetes as a result of using statins is around 0.2 percent per year.

For those who already have diabetes, there could be a slight increase in the amount of glucose in the blood, as their HbA1c measure may reflect.

However, the increase is very small and should not prevent the use of statins, note the AHA.

The research that the statement reviewed did not find that statins increase the risk of a first hemorrhagic stroke, which is a type of stroke that occurs when a blood vessel ruptures.

People with a history of hemorrhagic stroke, on the other hand, may have a slightly higher risk of a further one if they use statins. However, this risk is very small and the overall benefits of statin use in reducing strokes and "other vascular events" outweighs it.

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Risk of other side effects

The statement's authors also looked at evidence that statin use might increase the risk of other conditions. These included damage to peripheral nerves, other neurological effects, damage to the liver, cataracts, and ruptures to a tendon.

They found, however, "little evidence" to support the idea that using statins raised the risk of these conditions.

In rare instances, there could be a side effect called rhabdomyolysis, which is a type of muscle injury that can lead to acute kidney failure. A sign of this can be passing dark urine, so if this happens people should stop taking their statins and see their doctor, say the AHA.

From the reviewed evidence, the statement suggests that rhabdomyolysis is a side effect in less than 0.1 percent of people taking statins.

"In most cases, you should not stop taking your statin medication if you think you are having side effects from the drug — instead, talk to your healthcare provider about your concerns."

Dr. Mark Creager

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What are the best foods to eat for energy?

All food provides the body with energy, but this energy can vary greatly. Some foods, such as sugars and refined carbs, give the body a quick jolt of energy. However, more often, the body needs more sustainable energy from ingredients such as fruits, grains, and legumes.

The list we give here focuses on foods and drinks that provide more stable energy throughout the day.

Drinks The following drinks can help boost energy: 1. Water Energy boosting foods water
Drinking water throughout the day boosts energy levels.

Water is the most crucial energizing ingredient on this list. Water is vital for every cell in the body to work correctly.

While most people think of dehydration as an extreme scenario, the body may become partially dehydrated if a person goes all morning without water.

Maintaining energy can be as simple as carrying a water bottle around and sipping it throughout the day to stay properly hydrated.

2. Coffee

Coffee is a recognizable energy booster. The caffeine in coffee makes the body and mind feel alert and may make people more productive.

Coffee also contains antioxidants called polyphenols, which may reduce oxidative stress in the cells and help the body function better.

Coffee is a stimulant, however, so people should consume it in moderation. Too much coffee may lead to energy loss as the body withdraws from the caffeine.

3. Green tea

Green tea still contains small amounts of caffeine, but it also has compounds that may help reduce oxidative stress and inflammation in the body. The result may be a smoother transition than coffee to a more awake and energetic state.

4. Yerba maté

Yerba maté is a drink native to South America. Drinking the herb as a tea provides the body with similar stimulating effects as tea or coffee.

Yerba maté contains many active nutrients, antioxidants, and amino acids. People who drink yerba maté say it provides a much smoother form of energy by comparison to the jolt of energy from coffee.

As a study in the journal Nutrients notes, yerba maté may also improve mood and help people feel full, even after exercise, which may be helpful for those looking to lose weight while maintaining their energy levels.

Fruits The following fruits may help boost energy: 5. Bananas Bananas may be the best quick snack for sustained energy. While bananas are a good natural source of sugar, they are also rich in fibers that help slow the digestion of that sugar. Bananas contain helpful nutrients that make the body feel full of energy. A study in the journal PLoS One notes that eating a banana before a long bicycle ride helps performance and endurance just as much as a carbohydrate drink. While most people are not cycling each day, bananas may still provide energy. 6. Avocados Avocados are a well-rounded fruit in terms of health values and nutrients. As a study in Critical Reviews in Food Science and Nutrition notes, they contain nutrients, protein, and fiber that may help sustain energy levels throughout the day. They also contain good fats that may increase energy levels, and make fat-soluble nutrients more available in the body. 7. Goji Berries Goji berries are small, reddish berries containing many nutrients and important anti-aging and antioxidant properties, as a review in Drug Design, Development and Therapy notes. The specific antioxidants have many possible benefits, including giving the body more energy. Dried goji berries make a great addition to a trail mix, and many people add a few to a water bottle to drink throughout the day. 8. Apples Apples may be another simple snack to give the body lasting energy. Along with fiber and nutrients, a study in the journal Horticulture Research notes that apples are high in antioxidants called flavonoids, which may help fight against oxidative stress and inflammation in the body. 9. Strawberries As a study in the Journal of Agricultural and Food Chemistry notes, strawberries are a good source of minerals, vitamin C, and folates. They also contain phenols, which are essential antioxidants that may help the body create energy at the cellular level. People can add strawberries to many dishes, and a handful may also be an easy snack to add to a diet. 10. Oranges Most people enjoy oranges for their taste, which comes from the antioxidant vitamin C. Vitamin C may help reduce oxidative stress in the body and prevent fatigue. A study in the journal Antioxidants notes that young adult male students who have higher levels of vitamin C may also have better mood and may be less likely to experience confusion, anger, or depression. 11. Dark berries Berries, including blueberries, raspberries, and blackberries, may be a good energy boosting food when the body is craving something sweet. Dark berries tend to be higher in natural antioxidants than lighter-colored ones, which may reduce inflammation and fatigue in the body. They also tend to have less sugar than sweeter fruits, while still satisfying a craving for a sweet taste. Thank you for supporting Medical News Today Animal products The following animal products may help boost energy: 12. Fatty fish Energy boosting foods salmon
Salmon contains omega-3 fatty acids, which may improve brain function and reduce fatigue. Fish, in general, is an excellent and light source of protein and B vitamins that may give the body sustained energy throughout the day. Fatty cold-water fish, such as salmon, sardines, and tuna, tend to be higher in omega-3 fatty acids. As a study in the journal Nutrients notes, omega-3 fatty acids may improve brain function and reduce inflammation in the body, which may be a cause of fatigue in some people. 13. Beef liver Beef liver may be one of the best meat sources for vitamin B-12, which keeps the body feeling full of energy. While many cuts of meat contain vitamin B-12, the difference is that beef liver has a large amount. According to the United States Department of Agriculture (USDA), a 3-ounce cut of beef flank steak contains about 1.5 micrograms (mcg) of vitamin B-12. The same cut of beef liver contains 60 mcg of vitamin B-12, according to the USDA. 14. Yogurt Yogurt may also be a source of energy. As the USDA show, natural yogurt is rich in protein, fats, and simple carbohydrates, which provide energy to the body. Yogurt is also very easy to eat on the go, which makes it a great alternative to vending machine food. 15. Eggs Eggs provide the body with plenty of protein and nutrients for sustainable energy. As the USDA note, one large hard-boiled egg contains about 6 grams (g) of protein and 5 g of fat, as well as vitamins and minerals to help keep the body energized and feeling full for longer than other snacks. Vegetables The following vegetables are good options for energy: 16. Yams and sweet potatoes Yams and sweet potatoes are beneficial sources of carbohydrates, which provide energy. Yet sweet potatoes are also high in fiber, which may help slow the body's absorption of these carbohydrates. This may make them a good option for sustained energy throughout the day. 17. Beets As a study in the journal Food Science and Biotechnology notes, beets may provide the body with a great source of antioxidants and nutrients that help improve blood flow and energy. People can consume beets as dried beetroot chips, cooked beets or as a bottle of beetroot juice. 18. Dark leafy greens Dark, leafy greens such as kale, spinach, and collard greens are nutrient dense and contain filling proteins, as well as nutrients and antioxidants. Greens may be difficult to digest raw for some people, so breaking them down by cooking them with a bit of vinegar or lemon juice may help. 19. Dark chocolate Dark chocolate may be an easy way to increase energy. Rich, dark chocolate usually has much less sugar than milk chocolate. Less sugar means less immediate energy, but more cocoa content means more of the benefits of cocoa, including helpful antioxidants such as flavonoids. A study in the journal Archives of the Turkish Society of Cardiology notes that dark chocolate may benefit the cardiovascular system by helping more blood pump around the body. This blood carries fresh oxygen, which may also make a person feel more awake and alert. Grains The following grains may help with energy: 20. Oatmeal A bowl of whole-grain oatmeal may be a great way to provide the body with energy. Oats are rich in fiber, and they may enable the body to feel fuller for longer than other breakfast choices. As a study in The Journal of Nutrition notes, whole-grain oats are also a source of essential minerals, vitamins, and phenolic compounds, all of which may help energize the body. 21. Popcorn Popcorn is rich in carbohydrates. However, it also contains fiber to help slow the digestion. Popcorn may make a person feel full for longer than other carbohydrates. As a study in Nutrition Journal notes, people who ate popcorn rather than potato chips felt fuller from the snack. This may be helpful for dieters, as popcorn usually contains fewer calories than potato chips. 22. Quinoa Quinoa is a seed, but most people treat it as a grain. Quinoa is high in protein, carbohydrates, and fiber. The combination of amino acids and slow-release carbohydrates may make for sustainable energy rather than a short burst of glucose from other grains. 23. Brown rice One of the benefits of brown rice may be that it retains much of the fiber from the husk. The husk is not there in white rice, which may cause the body to absorb the carbohydrate content quickly. This may lead to a spike and then a crash in energy levels. By having the husk, brown rice may help slow the digestion of these carbohydrates, therefore, releasing energy more slowly. Thank you for supporting Medical News Today Beans and legumes The following beans and legumes may help with energy: 24. Soybeans Whether roasted soybeans or young edamame beans in the pod, soybeans contain protein with a wide variety of amino acids, as well as magnesium and potassium, according to the USDA. 25. Lentils Energy boosting foods lentils
Lentils are an excellent source of protein and fiber. Lentils are a relatively cheap form of protein and fiber, which may make them a great option for people on a budget. The USDA note that 1 cup of lentils contains about 18 g of protein, 40 g of carbs, 15 g of fiber, and less than 4 g of sugar. The fiber may help to manage the digestion of the carbs, keeping the body full and providing a source of sustained energy. 26. Nuts Many nuts contain a blend of protein, fats, and some carbohydrates to provide energy throughout the day. Nuts are typically also rich sources of vitamins and minerals such as magnesium, calcium, or phosphorous. Nuts are usually high in essential fatty acids. As a study in the Journal of Parenteral and Enteral Nutrition notes, these fatty acids may help reduce inflammation, which may also reduce fatigue. Nuts are high in calories, as well, so people should be careful not to eat too many 27. Peanut butter Peanut butter is typically rich in protein, fats, and fiber, and may help a person feel full for longer after eating it. This may cut the need for constant snacking, which may also leave a person feeling drained as their body has to digest continuously. 28. Seeds Many seeds, such as pumpkin seeds, chia seeds, and flax seeds, are rich sources of fatty acids and fiber, which may translate to more energy. Seeds are also easy to carry and make a great addition to a quick trail mix. Foods to avoid While most foods provide energy, the ones above focus on sustained energy. Foods to try to avoid may include: fast foods or fried foods added sugars packaged snacks and candy bars baked sweets such as cakes and cupcakes Takeaway While this list is not exhaustive, the idea behind finding energy boosting foods is to consume a varied, balanced diet. Vitamins, fiber, fats, and proteins are all essential for energy, but it is crucial to find a balance between them. People should try to choose a varied diet containing many different, nutritious foods that give the body sustained energy.
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Excess belly fat common in those with high heart risk

Excess waist fat is common in many people with a high risk of heart disease and stroke, according to a recent European study.
middle aged man doing squats
New research finds that two-thirds of people at high risk of developing cardiovascular disease have excess belly fat.

The study, called EUROASPIRE V, is a survey of cardiovascular disease prevention and diabetes. It forms part of a European Society of Cardiology research program.

The findings featured recently at the World Congress of Cardiology & Cardiovascular Health in Dubai in the United Arab Emirates.

They revealed that nearly two-thirds of individuals at high risk of cardiovascular disease had excess abdominal fat.

The results also showed that:

Only 47 percent of those taking drugs to reduce high blood pressure were achieving a target of under 140/90 millimeters of mercury, or under 140/85 for those who reported having diabetes. Among individuals using lipid-lowering medication, only 43 percent had reached the low-density lipoprotein (LDL) cholesterol target of under 2.5 millimoles per liter. Many who were not in receipt of treatment for high blood pressure and high LDL cholesterol had those conditions. Only 65 percent of individuals receiving treatment for type 2 diabetes had attained the target blood sugar of under 7.0 percent glycated hemoglobin (HbA1c).

"The survey," says Kornelia Kotseva, chair of the EUROASPIRE Steering Committee and a professor at Imperial College London in the United Kingdom, "shows that large proportions of individuals at high risk of cardiovascular disease have unhealthy lifestyle habits and uncontrolled blood pressure, lipids, and diabetes."

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Individuals with high heart risk

The recent study focuses on "apparently healthy individuals in primary care at high risk of developing cardiovascular disease, including those with diabetes."

Altogether, 78 primary care practices from 16, mainly European, countries took part in the research, which took place during 2017–2018.

They recruited individuals who were under 80 years of age and had no history of coronary artery disease or other conditions arising from atherosclerosis.

However, assessments had shown that they were at high risk of developing cardiovascular disease due to one or more of the following: high blood pressure, high cholesterol, or diabetes.

The researchers used medical records to identify those eligible for the study and invited them for an interview and clinical exam.

The interviewers asked questions about diet, exercise, smoking, and other lifestyle factors.

The analysis included a total of 2,759 people. Of these:

64 percent had central obesity, which is a measure of excess abdominal fat. 37 percent were in the overweight category for body mass index (25.0–29.9 kilograms per square meter). 18 percent were current smokers. 36 percent were achieving the typical guideline physical activity level of at least 30 minutes on 5 days of the week.

The researchers defined central obesity as having a waist size of at least 88 centimeters (34.7 inches) for women and at least 102 centimeters (40.2 inches) for men.

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'GPs need to be more proactive'

Prof. Kotseva urges primary care practitioners to be proactive about looking for cardiovascular risk factors.

They need to probe beyond the risk factors that they are already aware of and "always investigate smoking, obesity, unhealthy diet, physical inactivity, blood pressure, cholesterol, and diabetes," she argues.

Individuals often don't realize that they should be receiving treatment. They may visit their doctor for diabetes care and not know that they also have high blood pressure.

"In our study, many participants with high blood pressure and cholesterol were not being treated," notes Prof. Kotseva.

She suggests that the findings highlight a need for more investment and policy that focuses on prevention.

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The recent news follows that of earlier research that featured at the European Society of Cardiology Congress in April 2018 in Ljubljana, Slovenia.

In that study, researchers from the Mayo Clinic in Rochester, MN concluded that excess belly fat is "bad for the heart," even in individuals whose BMI is in the normal range.

They advised doctors not to assume that having normal BMI means that there is no heart-related issue in an otherwise healthy individual.

A BMI in the normal range does not necessarily indicate normal fat distribution. It is important to measure central obesity as well, to get a better picture of heart risk.

"These data make it clear that more efforts must be made to improve cardiovascular prevention in people at high risk of cardiovascular disease."

Prof: Kornelia Kotseva

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What too much sleep can do to your health

New research finds that both insufficient and excessive sleep may raise the risk of cardiovascular problems and premature death.
person in bed waking up with their hand on their face
New research finds that sleeping too much can raise the risk of early death and cardiovascular problems.

The Centers for Disease Control and Prevention (CDC) report that a third of the United States population does not get enough sleep.

The CDC also warn that sleep deprivation raises the risk of various chronic conditions such as diabetes, cardiovascular disease, obesity, and depression.

But, according to new research appearing in the European Heart Journal, sleeping too much may affect health just as negatively as sleeping too little.

Chuangshi Wang, a doctoral candidate at McMaster University in Ontario in Canada, and Peking Union Medical College at the Chinese Academy of Medical Sciences in China, is the lead author of the new paper.

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Wang and colleagues examined the sleeping habits of more than 116,000 people aged between 35 and 70 years who had enrolled in the Prospective Urban Rural Epidemiology (PURE) study.

In their analysis, the researchers also included information about the participants' socioeconomic status, lifestyle habits, physical activity, diet, use of various medications, and family history of chronic conditions.

Overall, 4,381 people died and 4,365 people had a heart attack or stroke during the 8-year follow-up period of the PURE study.

The analysis by Wang and her team revealed that people who regularly slept more than the recommended 6–8 hours a night were more likely to die prematurely or develop cardiovascular disease.

More specifically, the risk of premature death or cardiovascular conditions was 5 percent higher for people who slept 8–9 hours than for people who slept the recommended amount.

Those who slept 9–10 hours were 17 percent more likely to die or develop heart and blood vessel conditions. Similarly, people who regularly slept more than 10 hours were 41 percent more likely to die prematurely or develop cardiovascular problems.

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Also, the study found a 9 percent higher risk of the outcomes mentioned above among those who slept 6 hours or less. However, the authors caution that this increase was not statistically significant.

Wang comments on the findings, saying, "Our study shows that the optimal duration of estimated sleep is six to eight hours per day for adults."

"Given that this is an observational study that can only show an association rather than proving a causal relationship, we cannot say that too much sleep per se causes cardiovascular diseases," she cautions.

"However, too little sleep could be an underlying contributor to death and cases of cardiovascular disease, and too much sleep may indicate underlying conditions that increase risk."

Corresponding author Dr. Salim Yusuf, who is the principal investigator of the PURE study, and a professor of medicine at McMaster, also comments on the findings.

"The general public should ensure that they get about six to eight hours of sleep a day. On the other hand, if you sleep too much regularly, say more than nine hours a day, then you may want to visit a doctor to check your overall health."

Dr. Salim Yusuf

"For doctors," continues Dr. Yusuf, "including questions about the duration of sleep and daytime naps in the clinical histories of your patients may be helpful in identifying people at high risk of heart and blood vessel problems or death."

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What foods protect the liver?

The liver is responsible for breaking down carbohydrates, making glucose, and detoxing the body. It also stores nutrients and creates bile, which is necessary to digest and absorb the nutrients in food properly. There are many foods and drinks that a person can consume to help protect the liver.

Liver health is vital for overall health. Liver dysfunction can lead to liver disease, metabolic disorder, and even type 2 diabetes.

While it may be impossible to manage all risk factors, consuming certain foods and drinks may help promote liver health.

In this article, we will cover the best foods for liver health, their beneficial effects for the organ, and some foods to avoid.

Top foods and drinks for liver health Some of the best foods and drinks that are good for the liver include: 1. Coffee Foods good for liver coffee
Drinking coffee offers protection against fatty liver disease.

A 2013 review that appears in the journal Liver International suggests that over 50 percent of people in the United States consume coffee daily.

Coffee appears to be good for the liver, especially because it protects against issues such as fatty liver disease.

The review also notes that daily coffee intake may help reduce the risk of chronic liver disease. It may also protect the liver from damaging conditions, such as liver cancer.

A 2014 study that appears in the Journal of Clinical Gastroenterology suggests that the protective effects of coffee are due to how it influences liver enzymes.

Coffee, it reports, seems to reduce fat buildup in the liver. It also increases protective antioxidants in the liver. Compounds in coffee also help liver enzymes rid the body of cancer-causing substances.

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2. Oatmeal

Consuming oatmeal is an easy way to add fiber to the diet. Fiber is an important tool for digestion, and the specific fibers in oats may be especially helpful for the liver. Oats and oatmeal are high in compounds called beta-glucans.

As a 2017 study in the International Journal of Molecular Sciences reports, beta-glucans are very biologically active in the body. They help modulate the immune system and fight against inflammation, and they may be especially helpful in the fight against diabetes and obesity.

The review also notes that beta-glucans from oats appear to help reduce the amount of fat stored in the liver in mice, which could also help protect the liver. More clinical studies are necessary to confirm this, however.

People looking to add oats or oatmeal to their diet should look for whole oats or steel-cut oats, rather than prepackaged oatmeal. Prepackaged oatmeal may contain fillers such as flour or sugars, which will not be as beneficial for the body.

3. Green tea

Foods good for liver green tea
Consuming green tea may help reduce overall fat content.

A 2015 study in the World Journal of Gastroenterology notes that green tea may help reduce overall fat content, fight against oxidative stress, and reduce other signs of nonalcoholic fatty liver disease (NAFLD).

It is important to note that tea may be better than extracts, as some extracts may damage the liver rather than heal it.

The study notes that there are still no specific recommendations for people with this condition to consume tea or tea extracts, but the link to liver health is promising.

4. Garlic

Adding garlic to the diet may also help stimulate the liver. A 2016 study that appears in the journal Advanced Biomedical Research notes that garlic consumption reduces body weight and fat content in people with NAFLD, with no changes to lean body mass. This is beneficial, as being overweight or obese is a contributing factor to NAFLD.

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5. Berries

Many dark berries, such as blueberries, raspberries, and cranberries, contain antioxidants called polyphenols, which may help protect the liver from damage.

As a study in the World Journal of Gastroenterology suggests, regularly eating berries may also help stimulate the immune system.

6. Grapes

The study that features in the World Journal of Gastroenterology reports that grapes, grape juice, and grape seeds are rich in antioxidants that may help the liver by reducing inflammation and preventing liver damage.

Eating whole, seeded grapes is a simple way to add these compounds to the diet. A grape seed extract supplement may also provide antioxidants.

7. Grapefruit

The World Journal of Gastroenterology study also mentions grapefruit as a helpful food. Grapefruit contains two primary antioxidants: naringin and naringenin. These may help protect the liver from injury by reducing inflammation and protecting the liver cells.

The compounds may also reduce fat buildup in the liver and increase the enzymes that burn fat. This may make grapefruit a helpful tool in the fight against NAFLD.

8. Prickly pear

The fruit and juice of the prickly pear may also be beneficial to liver health. The World Journal of Gastroenterology study suggests that compounds in the fruit may help protect the organ.

Most research focuses on extracts from the fruit, however, so studies that focus on the fruit or juice itself are necessary.

9. Plant foods in general

Foods good for liver avacado
Avocados and other plant foods contain compounds linked closely to liver health.

A 2015 study that appears in the journal Evidence-based Complementary and Alternative Medicine reports that a large number of plant foods may be helpful for the liver.

These include:

avocado banana barley beets and beet juice broccoli brown rice carrots fig greens such as kale and collards lemon papaya watermelon

People should eat these foods as part of a whole and balanced diet.

10. Fatty fish

As a study in the World Journal of Gastroenterology points out, consuming fatty fish and fish oil supplements may help reduce the impact of conditions such as NAFLD.

Fatty fish is rich in omega-3 fatty acids, which are the good fats that help reduce inflammation. These fats may be especially helpful in the liver, as they appear to prevent the buildup of excess fats and maintain enzyme levels in the liver.

The study recommends eating oily fish two or more times each week. If it is not easy to incorporate fatty fish such as herring or salmon into the diet, try taking a daily fish oil supplement.

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11. Nuts

The same study says that eating nuts may be another simple way to keep the liver healthy and protect against NAFLD. Nuts generally contain unsaturated fatty acids, vitamin E, and antioxidants. These compounds may help prevent NAFLD, as well as reduce inflammation and oxidative stress.

Eating a handful of nuts, such as walnuts or almonds, each day may help maintain liver health. People should be sure not to eat too many, however, as nuts are high in calories.

12. Olive oil

Eating too much fat is not good for the liver, but some fats may help it. According to the World Journal of Gastroenterology study, adding olive oil to the diet may help reduce oxidative stress and improve liver function. This is due to the high content of unsaturated fatty acids in the oil.

Foods to avoid In general, finding balance in the diet will keep the liver healthy. However, there are also some foods and food groups that the liver finds harder to process. These include: Fatty foods: These include fried foods, fast food, and takeout from many restaurants. Packaged snacks, chips, and nuts may also be surprisingly high in fats. Starchy foods: These include breads, pasta, and cakes or baked goods. Sugar: Cutting back on sugar and sugary foods such as cereals, baked goods, and candies may help reduce the stress on the liver. Salt: Simple ways to reduce salt intake include eating out less, avoiding canned meats or vegetables, and reducing or avoiding salted deli meats and bacon. Alcohol: Anyone looking to give their liver a break should consider reducing their intake of alcohol or eliminating it from the diet completely. Summary The liver plays an important role in the body. While it largely takes care of itself, a person can help maintain liver health by consuming some certain foods and drinks. There are also many types of food that may harm the liver. Choosing foods that are good for the liver can help a person avoid potential health issues in the future.
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What is a pescatarian diet?

In the pescatarian diet, a person's main source of animal protein comes from fish and other seafood, such as shrimp.

Eating a diet consisting mainly of plant-based foods has a variety of health benefits, which the addition of fish and fish products may enhance.

However, some types of fish may absorb mercury from their environment, so certain people may need to limit their intake.

In this article, we look at the potential health benefits of a pescatarian diet and what people can eat on this kind of diet.

Health benefits of the pescatarian diet The pescatarian diet has many health benefits. Below, we cover some of these benefits. Heart health Pescatarian diet salmon
Eating fish provides omega-3 fatty acids, some of which are integral for healthy living.

Eating fish, especially fatty fish, provides increased long-chain omega-3 fatty acid intake. An omega-3 fatty acid is an unsaturated fat that can be beneficial to people, and some omega-3s are integral for healthy living.

People who eat fish have lower blood pressure, a lower risk of abnormal heart rhythms, and fewer fatal heart attacks than those who do not include fish in their diet.

Apart from fish, the pescatarian diet consists mainly of plant foods. According to one 2017 analysis, people who have a diet high in vegetables and other plant foods have a reduced risk of coronary heart disease.

The study authors say that the heart health benefits of a plant-based diet include improved blood lipids and lower blood pressure.

The same research concludes that a vegetarian diet could reverse atherosclerotic plaques when combined with exercise and stress management.

Atherosclerosis occurs when plaque builds up in the arteries. This causes the arteries to harden, narrow, and restrict the blood flow.

Cancer

A pescatarian diet may also protect people against colorectal cancers, or cancers that affect the colon and rectum.

According to a 2015 study, colorectal cancers are the second leading cause of cancer deaths in the United States.

The study used data from a cohort of over 77,650 people and found that the pescatarian diet had a strong protective effect against colorectal cancers.

Diabetes and inflammation

Following a plant-based diet can reduce the risk of type 2 diabetes and metabolic syndrome.

Metabolic syndrome includes conditions such as insulin resistance, high blood pressure, and obesity.

There is also evidence that omega-3s present in fatty fish may reduce inflammation, though this evidence comes from trials of supplements.

Plant-based diets are high in anti-inflammatory and antioxidant agents, such as flavonoids. These are natural compounds present in plants. Flavonoids have a range of anti-inflammatory and antidiabetic properties.

A 2016 study, again looking at different dietary patterns among more than 77,000 people in the U.S., found that people following a pescatarian diet had the highest flavonoid intake of all those taking part.

Thank you for supporting Medical News Today Environmental and animal welfare benefits Some people choose vegetarian diets because they disagree with factory farming practices or killing animals for food. For people concerned about animal welfare, the pescatarian diet may be a little more suitable. This is because some scientists argue that fish cannot feel pain. A 2015 study concluded that although fish can experience psychological stress, they lack the neural network necessary to experience pain. The pescatarian diet may also appeal to those who want to eat foods from what they perceive to be sustainable farming practices. Is a pescatarian diet sustainable? Pescatarian diet fish farming
While some see farming fish as a solution to over-fishing, it can still damage water ecosystems. The pescatarian diet is more sustainable than factory farming of mammals or birds, but it does have some environmental issues. Some people believe that the farming of pigs and ruminants, such as cattle, sheep, and goats, can harm the environment. Both groups emit greenhouse gases, with ruminants producing methane gas and pigs producing ammonia. On a global scale, these gases contribute to global warming. Also, large-scale deforestation for grazing and agriculture makes the greenhouse gas issue worse. Although fish do not produce greenhouse gases, fishing and fisheries represent a challenge to water ecosystems. For example, eating wild line-caught fish is not necessarily better for the environment than eating farmed fish, and the trawlers used to catch trawler-caught fish can affect ocean ecosystems in many ways. Some people see farming fish as a solution to over-fishing and depleted fish stocks, and the practice has grown rapidly over the past few years. However, in certain circumstances, fish farming can: damage water ecosystems introduce invasive species use wild fish for feed cause overcrowding cause disease The pescatarian diet may also be expensive or difficult to maintain when people live some distance from coastlines or fresh waterways. Some people may also find it hard to access sustainably sourced tinned fish. What can someone following the pescatarian diet eat? Listed below are some suggestions for sources of fish that a person on a pescatarian diet can eat: canned sardines canned salmon canned tuna fish sticks frozen salmon, trout, and herring frozen shrimp fresh fish, such as salmon, pollock, catfish, and sardines fresh shellfish, such as shrimp, clams, and scallops Other foods to include are: fruit vegetables cereals and whole grains, including oats, bulgar wheat, amaranth, corn, and rice food containing grain products pseudo grains, such as quinoa and buckwheat, which are gluten-free legumes, including kidney beans, pinto beans, and peas legume products, including tofu and hummus nuts and nut butters seeds, such as flaxseeds, hemp seeds, and chia eggs and dairy, if lacto-ovo-vegetarian If a person follows a strict pescatarian diet and avoids consuming eggs and dairy, they might need to check their calcium intake and consider taking supplements. Thank you for supporting Medical News Today 1-day meal plan Here, we give examples of recipes for meals that a person might consider when choosing a pescatarian diet: Breakfast Pescatarian diet sardines on crosti
Sardines are an excellent source of protein and omega-3s. Sardines on crostini Sardines are an excellent source of omega-3s. Using spinach to make a pesto spread on the crostini provides a source of vitamin C and vitamin A. The vitamin C helps increase the amount of iron a person absorbs. This recipe uses canned sardines, but it is also possible to use fresh sardines or anchovies. Starting the day with protein increases the feeling of fullness, and the pesto adds healthful greens that are a source of iron. Lunch Classic baked falafel Tahini is good source of plant protein and omega-3s. Chickpeas are also a good source of plant protein and fiber. Add a healthful Mediterranean salad to this recipe to create a filling lunch. Dinner Roasted salmon with shallot grapefruit sauce Salmon provides omega-3s essential fatty acids. Strong-flavored fish go very well with citrus fruits such as grapefruit. The addition of grapefruit to this recipe also adds vitamin C and fiber, and it counts toward the 2 servings of fruit that a person should eat per day. Disadvantages of a pescatarian diet Heavy metal and pollutants in marine fish is a global issue. With 92 percent of fish consumed by humans being marine fish, mostly from coastal fisheries, there is a risk of contamination. Mercury is present in the atmosphere and bodies of water and, because of this, nearly all fish may be a source of mercury. For most people, the mercury present in fish is not a risk, explain the U.S. Food and Drug Administration (FDA). However, they advise women considering becoming pregnant, women who are pregnant, nursing mothers, and young children not to eat specific fish. Fish to avoid include: shark sword fish king mackerel tilefish Fish low in mercury include: canned light tuna salmon pollock shrimp catfish Thank you for supporting Medical News Today Summary A pescatarian diet may be healthful and carries health benefits, as long as people avoid fish with high levels of mercury. However, this diet may not be as sustainable as some people think. Plant-based diets can help a person maintain a healthy weight, and they also may help with weight loss when necessary. A pescatarian diet may also be more healthful than some diets that rely on calorie deficits to reduce weight. People may find that canned tuna and sardines, as well as smoked fish, are the easiest foods to obtain and eat. These are full-flavored options, but frozen white fish and fish sticks are more delicately flavored options. Where possible, people may wish to try to buy fresh fish from sustainable sources. A useful website that can help is Seafood Watch.
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Iron-rich foods for vegetarians and vegans

Iron is an essential mineral for health. Although red meat and seafood are good sources of iron, many plant-based foods also contain plenty of this mineral.

Numerous vegetables, legumes, and other foods contain a form of iron called nonheme iron, which accounts for the majority of people's iron intake in the United States. The type of iron in animal products is called heme iron.

Although the body can absorb it more easily, heme iron is not essential to the human diet.

By selecting the right foods, people eating a vegetarian or vegan diet can meet their daily iron requirements without needing to take supplements.

In this article, we list the best iron-rich vegetarian foods. We also provide some tips to help people maximize their iron absorption from nonheme sources.

The following are some of the best iron-rich foods for vegetarians and vegans:

Lentils Different lentils on spoons which are iron-rich foods for vegetarians
Lentils are rich in iron and protein.

Lentils are rich in iron, protein, and fiber, making them a great addition to a healthful diet. Each cup of cooked lentils contains 6.59 milligrams (mg) of iron and 17.86 grams (g) of protein.

Lentils also contain many other nutrients, including B vitamins, magnesium, potassium, and zinc.

Research suggests that eating lentils on a regular basis reduces the risk of diabetes, obesity, cancer, and heart disease.

People can include brown, red, or green lentils in soups, stews, curries, salads, and other meals.

Cannellini beans Cannellini beans, or white kidney beans, provide 5.2 mg of iron per cup. As with lentils, the protein and fiber content of beans makes them a healthful option. They also contain many other essential minerals and plant compounds. Several studies support the consumption of beans to reduce the risk of heart disease and related conditions. Other types of bean, including those below, also contain high amounts of iron per cup: Beans are a very versatile food, and they work well as an ingredient in many dishes, including tacos, chili, soups, salads, and bean dips. Tofu Tofu is a bean curd that manufacturers make by coagulating the milk from soybeans. It is popular among vegans and vegetarians as it contains significant amounts of protein, iron, and calcium. A half-cup serving of tofu contains 6.65 mg of iron and about 10 g of protein. Some research suggests that soy products reduce the risk of heart disease, breast cancer, and prostate cancer. Tempeh and natto are other soy products that contain iron and may provide additional health benefits. Tofu is available in several different forms, including firm, soft, and silken. People can grill or fry firm tofu to use as a meat substitute, add soft tofu to casseroles, and blend silken tofu with cocoa powder and a sweetener to make a delicious chocolate dessert. Amaranth This ancient grain is gluten-free and provides 5.17 mg of iron per cooked cup along with over 9 g of protein. It also contains many other nutrients that are essential for health, including fiber, manganese, and magnesium. A 2012 review of research on the amaranth grain suggests that it has antioxidant and antitumor effects, reduces cholesterol and blood sugar levels, boosts immune function, and improves high blood pressure and anemia. Other grains that provide plenty of iron include quinoa and steel-cut oats. Thank you for supporting Medical News Today Fortified cereals Oats in a bowl which are an iron-rich food
Fortified cereals are a good source of iron for vegetarians and vegans. Many types of breakfast cereal, including oats, contain iron that manufacturers add during processing. Fortified grains are a vital source of this mineral, providing approximately half of all dietary iron in the U.S. People should look for fortified breakfast cereals that contain 100 percent of the daily value of iron per serving. While these cereals are generally suitable for vegetarians, vegans should check if the product also has added vitamin D. Not all vitamin D sources are vegan-friendly. Dark chocolate Although chocolate is traditionally a dessert food, a 3-ounce serving of dark chocolate provides 7 mg of iron. Cocoa is also one of the best sources of flavonoid antioxidants, which may provide heart benefits, protect nerves, boost immunity, and improve cognitive function and mood. While dark chocolate is an iron-rich food, it is high in calories, so people should enjoy it as an occasional treat. Baked potatoes Potatoes, especially their skins, are a good source of iron. A medium potato in its skin provides 2 mg of iron. Potatoes are a staple food in many cultures and can benefit health in numerous ways. They are a source of carbohydrates, dietary fiber, resistant starch, vitamin C, and potassium. For a complete meal, people can top baked potatoes with cottage cheese, hummus, beans, or lentils and serve them with vegetables or salad. It is best to avoid adding a lot of butter, oil, or cheese to the potatoes as this increases the fat and calorie content of the meal. Spinach Spinach is low in calories but high in fiber, vitamins, minerals, and antioxidants. One cup of cooked spinach provides 6.43 mg of iron. Most people find it easy to incorporate more spinach into their diets by sautéing or steaming the vegetable and adding it to soups and stir-fries. Raw spinach can also be an ingredient in smoothies and salads. Dried apricots A cup of dried apricot halves contains 4.1 mg of iron. Dried fruits are also rich in fiber, vitamins, minerals, and antioxidants. They make ideal snacks as they are easy to eat on the go. However, dried fruit is also high in sugar and calories. To avoid weight gain or the effects of too much sugar, people should enjoy dried apricots in moderation. Thank you for supporting Medical News Today Hulled hemp seeds Hulled hemp seeds
Hulled hemp seeds are a plant-based source of omega-3 fats. A 3-tablespoon serving of hulled hemp seeds contains 2.38 mg of iron and over 9 grams of protein. These seeds are one of the few plant-based sources of omega-3 fats, which are essential for heart and brain health. A 2018 study reported that hemp seed extract demonstrated antioxidant effects in laboratory tests. These antioxidant benefits, coupled with the omega-3 content of the seeds, may help protect against heart problems and neurodegenerative diseases. People can sprinkle hemp seeds on oatmeal, yogurt, or desserts, or blend them into smoothies for a snack that is rich in iron and protein. Blackstrap molasses Blackstrap molasses is a byproduct of sugar production. Unlike sugar, the molasses retains the nutrients from sugar cane, which include calcium, magnesium, and vitamin B-6. This thick syrup is also a good source of iron, providing 3.6 mg per tablespoon. However, it is best to limit the intake of blackstrap molasses to avoid consuming too much sugar. People typically use blackstrap molasses in baked goods and raw desserts, as a glaze for vegetables, or to sweeten oatmeal. How much iron do you need? The National Institutes of Health recommend that women over the age of 50 years and all adult men get 8 mg of iron daily. Women aged between 19 and 50 years should aim for 18 mg per day, while pregnant women require 27 mg of iron for fetal health. However, some sources suggest that vegetarians and vegans may need up to 1.8 times these amounts because the body does not absorb nonheme iron as easily as it does heme iron. Low iron intake or absorption can lead to iron deficiency anemia. Symptoms may include: tiredness weakness pale skin heart palpitations headaches cold hands and feet a sore tongue brittle nails poor appetite Anyone who is experiencing these symptoms should see a doctor. A person can increase the amount of iron that their body absorbs from plant-based sources by eating iron-rich foods alongside a source of vitamin C. Good sources of vitamin C include: bell peppers broccoli cantaloupe melon cauliflower citrus fruits kiwi fruit leafy green vegetables mango papaya strawberries sweet potatoes tomatoes They should also avoid foods, beverages, and supplements that reduce iron absorption for up to 2 hours before and after iron-rich meals. These include: black tea calcium supplements coffee dairy eggs peppermint tea red wine Antacid medications also inhibit iron absorption. Summary Vegetarian foods can be excellent sources of iron, especially when people eat them in combination with a food that is rich in vitamin C. People who do not eat meat can ensure that they get enough iron by consuming a wide variety of iron-rich, plant-based foods. Anyone who is concerned that they may not be getting enough iron from their diet should speak to a doctor or dietician.
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Are statins overprescribed for cardiovascular disease prevention?

For millions of people who take statins to prevent the onset of cardiovascular disease, the potential harms of the cholesterol-lowering medication may outweigh the benefits.
bowl of pills with heart made of string
Statins may be 'significantly overprescribed' for the primary prevention of cardiovascular disease, suggests a new study.

So concludes a recent modeling study from the University of Zurich in Switzerland that questions whether statins are "significantly overprescribed."

The research, which features in the Annals of Internal Medicine, concerns the use of statins for the "primary prevention" of cardiovascular disease in people with no history of the disease.

A primary prevention measure is one that intervenes to prevent a condition before it can impact health. Vaccinations, for example, are primary prevention measures.

Statins are some of the most prescribed classes of drugs worldwide. They work by blocking an enzyme called HMG-CoA reductase that helps the liver to make cholesterol.

Most medical guidelines recommend the use of statins for people with no history of symptoms when their expected risk of developing cardiovascular disease over the next 10 years is 7.5–10 percent.

Such a 10-year risk threshold places around 3 out of every 10 adults worldwide as eligible for treatment.

However, the authors note that "whether and how guideline developers weighed harms against benefits is often unclear."

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Statins for primary prevention

In 2013, the American College of Cardiology (ACC) and the American Heart Association (AHA) updated the recommendations that guide doctors in the treatment of cholesterol and use of statins.

One reason for the update was the argument that high blood cholesterol is one of the "most prevalent" of alterable cardiovascular risk factors.

Another argument was that there is evidence that treating cholesterol reduces numbers of people who develop cardiovascular diseases and who die of them.

The update caused controversy. This was mainly because it lowered the thresholds that doctors should use to help them decide whether to prescribe statins for primary cardiovascular disease prevention.

This recommended that doctors should consider adults with no history of heart problems as eligible for primary prevention if their risk of developing cardiovascular disease in the next 10 years is 7.5 percent or higher.

Also, the revision expanded the target of prevention to include not just coronary heart disease, but also atherosclerosis, stroke, and peripheral arterial disease.

Experts predicted at the time that full implementation of the guidelines would identify around 13 million people in the United States as "newly eligible for consideration" for treatment with statins.

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Thresholds are too high

The University of Zurich researchers used a computer model to assess the 10-year risk for cardiovascular disease "at which statins provide at least a 60 percent probability of net benefit."

They adjusted the results to take out any effects from "competing risk" of death that was not due to cardiovascular disease, as well as "baseline risk, frequencies of and preferences for statin benefits and harms."

The harms that they included in their calculations were "adverse events," such as myopathy (muscle weakness), liver dysfunction, and onset of diabetes.

The results showed that the 10-year cardiovascular risk thresholds at which benefits of statin use exceed the harms are consistently higher than those recommended in the guidelines.

For instance, in the case of men aged 70–75 years with no history of symptoms, the harms of taking statins were greater than the benefits until the risk of developing cardiovascular disease over 10 years was over 21 percent.

For women aged 70–75 years, the 10-year risk required for benefit to outweigh harms was 22 percent.

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For those aged 40–44, the benefits outweighed harms at 14 percent 10-year cardiovascular risk for men and 17 percent for women.

"Atorvastatin and rosuvastatin provided net benefit at lower 10-year risks than simvastatin and pravastatin," note the authors.

In an editorial linked to the findings, Drs. Ilana B. Richman and Joseph S. Ross of Yale University School of Medicine in New Haven, CT, note some concerns about the updated thresholds, particularly in relation to older adults.

They also comment that the guidelines have "largely dismissed" many of the side effects included in the study.

"The recommendation raised important questions about the 'right' risk threshold at which to start statin therapy for primary prevention, particularly because many older adults exceed this threshold on the basis of age alone."

Drs. Ilana B. Richman and Joseph S. Ross

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The health risks of being a night owl

The first international review to compare night owls with early risers outlines the health risks associated with preferring late nights. However, these risks may not be set in stone.
Woman drinking coffee at her laptop
A recent review takes a fresh look at the impact of being a night owl.

Most individuals fit one of two chronotypes: We are morning people or evening people.

Either we prefer to stay up late — and are referred to as night owls — or we rise earlier and go to bed earlier.

These patterns in circadian preferences are, to a certain extent, written in our genes.

Over the years, the medical community has debated the health impacts associated with each chronotype, and the findings have not always been conclusive.

To develop a clearer picture, a group of scientists from a number of institutions have conducted the most extensive review of relevant research to date. Their findings were published recently in the journal Advances in Nutrition.

Sleeping, eating, and health

The scientists were especially interested in understanding the relationship between circadian rhythms and eating patterns — called chrono-nutrition — and overall cardiometabolic health.

Because modern life is often hectic, eating and sleeping patterns may frequently be disturbed. Exposure to artificial light sources can also misalign our circadian patterns.

These disruptions can alter cyclical metabolic processes, such as glucose control, lipid metabolism, and blood pressure.

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Scientists are working to determine the long-term health effects of these changes.

Because this area of study is in its infancy, the authors of the recent review delved into previous studies, hoping to identify patterns in results.

The team found that individuals who went to bed later tended to have less healthful eating patterns.

For instance, they generally ate later in the day, at less regular times, and they consumed more alcohol, sugar, and caffeinated products than earlier risers. Night owls were also more likely to skip breakfast.

In addition, night owls were likelier to consume fewer vegetables and grains. They also ate less often but had bigger meals.

This eating pattern may explain the finding that night owls had an increased risk of heart disease and metabolic conditions, such as type 2 diabetes.

In fact, one study showed that night owls were 2.5 times more likely to have type 2 diabetes than early risers.

The leader of the study, Suzana Almoosawi, Ph.D., a research fellow at Northumbria University in the United Kingdom, explains that "In adulthood, being an evening chronotype is associated with greater risk of heart disease and type 2 diabetes, and this may be potentially due to the poorer eating behavior and diet of people with evening chronotype."

According to the researchers, being a night owl can even affect the way a person manages their diabetes: "Our review also found that people who have a poorer control of their diabetes are more likely to be evening types," says Almoosawi.

The body's circadian fluctuations in glucose metabolism may mediate the link with type 2 diabetes. Throughout the day, glucose levels decline, and by the evening they are at their lowest point.

However, because night owls eat later in the day, glucose levels spike just before bedtime. This goes against the body's regular biological processes, and so it could impact metabolism.

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Growing knowledge but gaps remain

The review uncovered some other interesting findings. Perhaps unsurprisingly, children were much more likely to be early risers, including 90 percent of 2-year-olds and 58 percent of 6-year-olds.

As people enter old age, they are more likely to revert to their early-rising preferences of youth.

Although this type of study is still in the initial stages, and much more research is needed, the findings to date may have huge implications for public health.

"Scientific evidence is providing increasing insight into the relationship between your chronotype, diet, and cardiometabolic health."

Study co-author Leonidas G. Karagounis, Nestlé Health Science

Karagounis continues, "Further research on the best methods to assess an individual's chronotype and how this may affect their long-term cardiometabolic health can potentially guide the development of health promotion strategies aimed at preventing and treating chronic diseases based on an individual's chronotype."

The review also highlights gaps in our understanding. For instance, the existing body of literature does not provide much information about why our circadian rhythms and eating patterns shift throughout our lifespans.

Though scientists are still unsure why our preferences morph as we age, modern living may drive this pattern, at least in part.

As children, we are more likely to rise early, but as we become embedded in society, we are more likely to develop into night owls. In older age, as we pull back from society's cut and thrust, we tend to go back to rising early.

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It will take far more research to determine whether this pendulum swing in chronotype results from social pressures — such as school and work start times — or whether it is triggered by hormonal changes, for example.

However, it seems that the adverse health effects of being a night owl may predominantly revolve around dietary habits that are, for the most part, modifiable.

For instance, by eating more healthfully, not skipping breakfast, and drinking less alcohol, a person may be able to avoid some of the risks.

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Snoring can worsen heart function, especially in women

Both snoring and obstructive sleep apnea could lead to earlier impairment of cardiac function in women, according to a new study.
Woman snoring
A recent study unlocks the health issues linked to snoring.

"Snoring" refers to a sleeping pattern in which a person breathes while emitting a snorting or grunting sound.

The National Sleep Foundation suggest that 90 million people in the United States snore.

Snoring might become more dangerous as people age, and it can also lead to heart disease.

There are different types of sleep apnea, but the most common is called obstructive sleep apnea (OSA). At least 18 million U.S. adults have sleep apnea.

This condition affects breathing patterns while sleeping, causing a person to stop breathing and start again repeatedly. About half of people who snore loudly have OSA.

When OSA occurs, the muscles in the throat that are responsible for keeping the airway open actually prevent the flow of air.

According to a new study presented recently at the annual meeting of the Radiological Society of North America — held in Chicago, IL — snoring and OSA may lead to earlier impairment of cardiac function in women than in men.

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Sleep apnea and heart disease?

It is unclear whether or not sleep apnea directly causes heart disease, but some specialists believe that people with sleep apnea are at risk of developing hypertension, or high blood pressure.

Many people who have sleep apnea also have co-existing diseases. This is one of the reasons why it is harder to establish a direct link between sleep apnea and heart disease.

According to the American Heart Association (AHA), some people living with sleep apnea and high blood pressure who received treatment for sleep apnea also saw their blood pressure drop. Such findings show a possible link between hypertension and sleep apnea.

OSA is also associated with obesity, which is a risk factor for heart disease.

Obesity contributes to sleep apnea, and the sleep deprivation that sleep apnea causes can give rise to further obesity, in the long-term. As a person gains more weight, the throat muscles that keep the airway open relax, and sleep apnea becomes more serious.

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Women who snore may be at greater risk

The researchers analyzed data associated with cardiac parameters in relation to diagnosed OSA and self-reported snoring using data from the UK Biobank.

The UK Biobank is an international health resource, open to researchers, that aims to improve the prevention, diagnosis, and treatment of diseases.

The data were of 4,877 participants who had received a cardiac MRI scan. The scientists divided them into three groups: those with OSA, those with self-reported snoring, and those with neither.

When the researchers compared the snoring group with the group without sleep disorders, they found a striking difference in the left ventricular mass in women compared with men.

Increased left ventricular mass means that the heart needs to work harder to fulfil the body's needs.

These patterns in people who self-reportedly snore may be an indication of undiagnosed OSA.

"We found that the cardiac parameters in women appear to be more easily affected by the disease and that women who snore or have OSA might be at greater risk for cardiac involvement."

Researcher Dr. Adrian Curta

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OSA may be vastly underdiagnosed

The researchers also found that the number of diagnosed OSA cases in the study was extremely low, suggesting that OSA may be underdiagnosed across the board.

Dr. Curta, a radiology resident at Munich University Hospital in Germany, urges people who snore to get screened for OSA and those with OSA to seek treatment.

"I would encourage people who snore to ask their partner to observe them and look for phases during sleep when they stop breathing for a short while and then gasp for air," says Dr. Curta.

He continues, "If unsure, they can spend the night at a sleep lab where breathing is constantly monitored during sleep and even slight alterations can be recorded."

The team now hopes to conduct more research to fully understand the sex differences linked to snoring and OSA.

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Infections could trigger cardiovascular disease

Researchers find a higher risk of coronary events during the 3 months after an infection. The body's immune response, they suggest, may explain why infections "trigger" heart attack and stroke.
woman sneezing
Scientists encourage everyone to have their flu shots this year, as simple influenza viruses may trigger cardiovascular events.

The term cardiovascular disease (CVD) covers a range of conditions: from heart attack and heart disease to stroke, hypertension, and heart failure.

As many as 84 million people in the United States are living with one of the conditions above, and 2,200 people die every day as a result.

Several factors may raise the risk of cardiovascular conditions. Some of these factors are modifiable, such as smoking, high cholesterol, and high blood pressure. Other factors, such as sex, race, age, and family history, cannot be modified.

However, there are also a number of "acute" risk factors, or triggers, that can lead to CVD. Some research has linked urinary infections and pneumonia, for instance, with the risk of having heart attacks and stroke.

A new study, published in the Journal of the American Heart Association, zooms in on the link between infections and adverse cardiovascular events.

Dr. Kamakshi Lakshminarayan, a neurologist and associate professor of epidemiology at the University of Minnesota in Minneapolis, is the senior author of the study.

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Studying infections and coronary events risk

Dr. Lakshminarayan and colleagues examined 1,312 people who had had a coronary event such as a heart attack, or myocardial infarction, and compared them with 727 people who had had an ischemic stroke.

The study included both outpatients and people who were hospitalized to receive treatment for their infection.

The researchers looked for infections that these people developed up to 1–2 years before the cardiovascular event. The most commonly reported infections were urinary tract infections, pneumonia, and respiratory infections.

Overall, the study found that approximately 37 percent of the participants with heart disease had developed an infection in the 3 months leading up to the coronary event. Among people with stroke, this number was almost 30 percent.

In the first 2 weeks after having an infection, the risk of a stroke or a heart attack was the highest.

Though the analysis found this link among both inpatients and outpatients, people who received care in the hospital were more likely to have a coronary event.

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Immune response may elicit coronary events

Although the study was observational, the scientists speculate on the mechanism that may explain the results.

During an infection, explains Dr. Lakshminarayan, the body's immune system produces more white blood cells to fight it off. However, this immune response also makes small blood cells, called platelets, stickier.

In a healthy body, the role of platelets is to bind to a damaged blood vessel and create a blood clot. This is very useful for accidental cuts, for example, but too many platelets, or platelets that are too sticky, can raise the risk of blood clots.

"The infection appears to be the trigger for changing the finely tuned balance in the blood and making us more prone to thrombosis, or clot formation," says Dr. Lakshminarayan. "It's a trigger for the blood vessels to get blocked up and puts us at higher risk of serious events like heart attack and stroke."

"One of the biggest takeaways is that we have to prevent these infections whenever possible [...] and that means flu shots and pneumonia vaccines, especially for older individuals."

Dr. Kamakshi Lakshminarayan

In an accompanying editorial, Juan Badimon — who was not involved in the research — explains why the risk of a coronary event may have been higher in the hospitalized group. He says that for these people, the infection might have been more severe.

"And if the infection is that severe, we can assume a stronger inflammatory response will result in a higher cardiovascular risk," he said in an interview.

Badimon is a professor of medicine and the director of the atherothrombosis research unit at Mount Sinai School of Medicine's Cardiovascular Institute in New York City, NY.

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Regular exercise can keep the body decades younger

In a new study involving people over 70 who have exercised regularly for years, scientists discovered that the participants' hearts, lungs, and muscles were in equivalent shape to those of people in their 40s.
woman on bicycle
Regular exercise could help keep the body young, new research shows.

Researchers from the Human Performance Laboratory at Ball State University in Muncie, IN recently assessed the physical condition of people in their 70s who have been exercising regularly for decades.

The team compared the health measurements of these participants with those of their more sedentary peers and with the measurements of healthy people in their 20s.

Specifically, the investigators measured heart and lung capacity, as well as muscle fitness. They have published their findings in the Journal of Applied Physiology.

"'Exercise wins' is the take-home message. We saw that people who exercise regularly year after year have better overall health. These 75-year-olds — men and women — have similar cardiovascular health to a 40–45-year-old."

Lead researcher Scott Trappe, director of the Human Performance Laboratory

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Leisure exercise can keep you young

The researchers worked with three types of participants: seven women and 21 men in their 70s who exercised regularly, 10 women and 10 men in their 70s who led sedentary lifestyles, and 10 women and 10 men in their 20s, who were all healthy and who exercised regularly.

Participants in the first category reported having exercised throughout their lives, and they described enjoying frequent physical activity on a leisurely basis. Each of these participants worked out, on average, 5 days per week for a combined total of about 7 hours.

At one stage, the investigators sought to determine the participants' aerobic endurance by evaluating their VO2 max measurements. This assesses the maximum amount of oxygen that an individual can use during bouts of intense aerobic exercise. The researchers did so by asking the participants to cycle on indoor bikes.

The marker is important because, as the team explains, VO2 max tends to decline by approximately 10 percent every 10 years after a person reaches the age of 30, and this reduction corresponds to an increased risk of disease.

The researchers also performed muscle biopsies on the participants to assess the formation and distribution of small blood vessels in the muscles and to evaluate aerobic enzyme activity, which drives the metabolism of oxygen at the cellular level.

At another stage of the study, the team split the male participants into two groups: the performance group, which trained to compete, and the fitness group, which exercised for leisure.

They found that "For some of the variables, the performance group had some metrics that were superior to the fitness people, and cardiovascular capacity was one of those," as Trappe notes.

"But things like muscle health and capillaries to support blood flow, they were equivalent between the two groups. Higher intensity didn't necessarily take them to a higher place," he adds.

The researchers suggest that the health measurements of the physically active participants in their 70s look like those of healthy people decades younger and that these benefits seem to apply to women and men alike.

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30–45 minutes of exercise per day

The team notes that the older participants belong to a generation that received a lot of encouragement to take up sports.

"What was really interesting about this study is: These folks came out of the exercise-boom generation, which really started in the 1970s, when running and tennis became popular [for] the masses," Trapp states.

The 1970s, the lead researcher explains, was also the decade in which women were permitted to join in more competitive sports, thanks to new federal laws adopted in the United States. "You did have some interesting things that happened back in that era," he notes, referring to the adoption of Title IX of the Education Amendments Act of 1972.

This law states that "No person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any education program or activity receiving federal financial assistance."

Thanks to this type of legislative change, Trappe says, researchers have been able to recruit female participants who practice sports at competitive levels.

But he emphasizes that it is not necessary to be competitive to reap the benefits of exercise.

"If you want to put 30–45 minutes of walking in one day, the amount of health benefit you are going to get from that is going to be significant and substantial," Trappe says.

"Will it equal the person training for competitive performances? No. But, it will outdo the couch potato. In basic terms, 30–45 minutes of any type of exercise a day is beneficial," he stresses.

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Exercise may prevent heart attacks in otherwise healthy people

New research published in the European Heart Journal suggests that even people with no signs of cardiovascular disease should exercise to prevent a heart attack. Cardiorespiratory fitness can be a predictor of future problems, warn the researchers.
woman exercising on a treadmill
Even fit and healthy people should exercise regularly to keep heart disease at bay.

Heart disease remains the leading cause of death among men and women in the United States, responsible for the deaths of around 610,000 people each year.

Coronary artery disease is the most common form of heart disease, which often results in a heart attack.

However, even healthy people might be at risk of a heart attack, new research points out.

Even if someone has no signs of cardiovascular problems, low cardiorespiratory fitness may predict future heart disease. For this reason, healthy individuals should exercise regularly to keep heart disease at bay.

Jon Magne Letnes, Ph.D., of the Norwegian University of Science and Technology (NTNU) in Trondheim, is the lead author of the new paper.

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Studying cardiorespiratory fitness levels

Letnes and colleagues analyzed the cardiorespiratory fitness of 4,527 "healthy and fit" individuals who enrolled in the large HUNT3 study in 2006–2008.

As part of the study, the participants ran on a treadmill while wearing an oxygen mask and a heart rate monitor. The researchers measured the participants' cardiorespiratory fitness, which is the body's ability to supply the muscles with sufficient oxygen during a workout.

The standard measure of cardiorespiratory fitness is VO2max — that is, "the maximum amount of oxygen the body can use during a specified period of usually intense exercise." This depends on a person's weight, as well on the health and strength of their respiratory system.

The scientists also had access to data about the participants' smoking status, alcohol intake, family history of heart disease, physical activity, body mass index (BMI), blood pressure, and cholesterol levels.

Letnes and team followed the participants for almost 9 years.

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'Exercise as preventive medicine'

Over the 9-year follow-up period, only 147 (3.3 percent) of the participants developed heart disease, died from it, or required coronary artery bypass graft. This is a surgical procedure that unclogs the arteries and releases the blood flow to the heart.

However, Letnes and colleagues also found that better cardiorespiratory fitness correlated with a decreased cardiovascular risk — including the risk of a heart attack — throughout the study period.

Bjarne Nes, a researcher at the NTNU and the corresponding author of the study, sums up the findings, saying, "We found a strong link between greater fitness and reduced risk of a coronary event during the 9 years of follow-up in a very healthy sample of adults."

"In fact, the participants who were in the 25 [percent] of those with the highest cardiorespiratory fitness had nearly half the risk compared [with] those in the 25 [percent] with the lowest fitness levels."

Bjarne Nes

More specifically, the risk of experiencing heart problems dropped by 15 percent with every metabolic equivalent. This is a unit of measurement that expresses the "cost of physical activities as a multiple of the resting metabolic rate."

"This indicates that greater cardiorespiratory fitness protects against both chronic and acute heart and blood vessel problems," says Nes. "Even a small increase in fitness could have a large impact on health."

The study's lead author adds that the study should "encourage the use of exercise as preventive medicine. A few months of regular exercise may be an efficient way of reducing the cardiovascular risk."

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Is peanut butter good for you?

Peanut butter is a firm favorite among adults and children alike. Although tasty, many people wonder about the health benefits of peanut butter.

Peanuts and peanut butter contain nutrients that may boost a person's heart health and improve blood sugar levels.

Depending on how people use peanut butter in their diet, it can help them lose weight, or put on pounds during weight training or bodybuilding.

However, peanut butter is high in calories and fat, so people should enjoy it in moderation.

In this article, we look at the benefits of eating peanut butter and explain the risks associated with consuming it.

Nutritional benefits of peanut butter Peanut butter in a jar from above
Peanut butter is a good source of protein and vitamin B-6.

Peanut butter provides a good amount of protein, along with essential vitamins and minerals, such as magnesium, potassium, and zinc.

Most notably, each 2-tablespoon (tbsp) serving of smooth peanut butter provides the following nutrients, minerals, and vitamins:

Protein. Peanut butter contains 7.02 grams (g) of protein per 2-tbsp serving. This counts toward the recommended dietary allowances (RDA) for women of 46 g and 56 g for men, which varies by age and activity level. Magnesium. With 57 milligrams (mg) of magnesium, each serving helps towards the RDA of 400–420 mg in men and 310–320 in women. Magnesium is essential for health, playing a role in over 300 chemical processes in the body. Phosphorous. Each serving contains 107 mg of phosphorus, which is about 15.3 percent of the RDA of 700 mg for adults. Phosphorus helps the body to build healthy cells and bones and helps cells to produce energy. Zinc. A serving of peanut butter provides 0.85 mg of zinc. This is 7.7 percent of the recommended daily intake of 11 mg for men, and 10.6 percent of the RDA of 8 mg for women. Zinc is necessary for immunity, protein synthesis, and DNA formation. Niacin. Peanut butter contains 4.21 mg of niacin per serving, which makes a useful contribution towards a person's recommended intake of 14 to 16 mg. Niacin benefits digestion and nerve function and helps produce energy. Vitamin B-6. With 0.17 g of vitamin B-6 per serving, peanut butter provides almost 14 percent of an adult's RDA of 1.3 mg. Vitamin B-6 plays a role in over 100 enzyme reactions in the body and may be necessary for heart and immune system health.

However, there are also nutritional disadvantages if a person eats more than the recommended amount of peanut butter.

Peanut butter is high in calories, saturated fats, and sodium.

Each serving contains 3.05 g of saturated fats, which is 23.5 percent of the American Heart Association's maximum recommended daily intake of saturated fat for those consuming 2,000 calories a day. People should aim for less than 13 g of saturated fat per day.

It also contains 152 mg of sodium, which is 10.1 percent of an adult's ideal daily upper intake of sodium of 1,500 mg.

Health benefits of peanut butter Eating peanut butter in moderation and as part of an overall healthful diet may provide the following benefits: 1. Weight loss Several studies suggest that eating peanuts and other nuts can help people maintain their weight, or even help with weight loss. This may be because peanuts improve satiety, which is the feeling of fullness, thanks to their protein, fat, and fiber content. A 2018 study suggests that eating nuts, including peanuts, reduces a person's risk of being overweight or obese. This study compared the dietary and lifestyle data for over 373,000 people from 10 European countries over 5 years. Earlier research based on data gathered from over 51,000 women suggested that those who ate nuts twice weekly or more experienced slightly less weight gain over an 8-year period than women who rarely ate nuts. 2. Boosting heart health Peanut butter contains many nutrients that can improve heart health, including: monounsaturated fatty acids (MUFAs) polyunsaturated fatty acids (PUFAs) niacin magnesium vitamin E The proportion of unsaturated fats (PUFAs and MUFAs) to saturated fats in the diet plays a particularly important role in heart health. Peanut butter has a similar ratio to olive oil — which is also known as a heart-healthy option. A high intake of nuts may have links to a reduced risk of mortality from heart disease or other causes. The researchers recommend peanuts in particular as a cost-effective way to improve heart health for some people. Research also suggests that including 46 g per day of peanuts or peanut butter into an American Diabetes Association (ADA) diet plan for 6 months could benefit the heart, improve blood lipid profiles, and control weight for people with diabetes. However, as peanut butter is high in calories, it is crucial that a person limits their intake if they do not want to put on weight. Eating more than the recommended amount will also increase fat and sodium intake, which does not benefit the heart. 3. Bodybuilding Senior lady working out at the gym
Peanut butter is an easy way to increase calorie intake. Many bodybuilders and fitness enthusiasts include peanut butter in their diets for various reasons. Although calorie amounts will vary based on stature, activity level, and metabolic rate, the typical daily recommended calorie intake ranges from around 1,600–2,400 calories per day for women and up to 3,000 calories per day for men. However, active adult men should consume up to 3,000 calories daily, while active women need up 2,400 calories per day. Thanks to its high-calorie content, peanut butter is an easy way to increase calorie and unsaturated fat intake. Nut butter is also a source of protein, which is essential for building and repairing muscles. Although peanut butter is not a complete protein — meaning it does not contain all of the essential amino acids the body needs — it does count toward a person's daily protein intake. Spreading peanut butter on whole-grain bread makes a more complete protein meal, as the bread contains the amino acid methionine, which peanut butter lacks. 4. Managing blood sugar levels Peanut butter is a relatively low-carbohydrate food that contains good amounts of fats and protein, as well as some fiber. These characteristics mean that peanut butter, with no added sugar, does not have a significant impact on blood glucose levels. This means it can be a good option for those with diabetes. The ADA recommend that people replace saturated fats with monounsaturated fats in their diets. They suggest peanut butter, peanuts, and peanut oil as good sources of monounsaturated fat. A small 2013 study suggests that eating peanut butter or peanuts for breakfast could help women with obesity and an increased risk of type 2 diabetes to manage their blood glucose levels. According to the survey, the women who added nuts to their breakfast had lower blood sugar levels and reported less hunger compared to women who ate a breakfast that contained the same amount of carbohydrates but no nuts. Peanut butter is a good source of magnesium, which is an essential nutrient for people with diabetes. Continuous periods of high blood sugar may reduce magnesium levels in the body. Low magnesium levels are linked to prediabetes and type 2 diabetes. 5. Reducing the risk of breast disease Eating peanut butter, especially from a young age, may reduce the risk of benign breast disease (BBD), which increases the risk of breast cancer. A study in the journal Breast Cancer Research and Treatment, reports that eating peanut butter and nuts at any age may result in a lower risk of developing BDD by age 30. The researchers examined the data for over 9,000 schoolgirls in America. Other types of pulses, such as beans and soy, along with vegetable fats and other nuts, may also offer protection from BBD. Even those with a family history of breast cancer had a significantly lower risk if they ate peanut butter and these other foods. Thank you for supporting Medical News Today Nutritional profile The table below provides a detailed nutritional profile of 2 tbsp of smooth peanut butter: Calories 188 Protein 7.02 g Saturated fats 3.05 g Monounsaturated fats 6.63 g Polyunsaturated fats 3.63 g Carbohydrates 7.67 g Fiber 1.80 g Sugars 2.08 g Calcium 17 mg Iron 0.69 mg Magnesium 57 mg Phosphorus 107 mg Potassium 189 mg Sodium 152 mg Zinc 0.85 mg Niacin 4.21 mg Vitamin B-6 0.18 mg Vitamin E 1.90 mg Peanut allergies Peanuts and other nuts are common allergens, with a peanut or tree nut allergy affecting over 3 million Americans, according to the National Institutes of Health (NIH). Those with a known peanut allergy should avoid peanut butter and foods containing the nuts. The NIH also note that just 20 percent of those with an allergy will eventually outgrow the allergy and stop having reactions to nuts. Which peanut butter is best? When selecting a peanut butter product, look for one that contains just peanuts and few or no other ingredients. Some peanut butter brands will contain other ingredients, such as sugar, salt, and added oils. Avoid these where possible. Try adding a little honey to peanut butter dishes as a sweetener instead. It is normal for pure peanut butter to separate into solid and liquid form. Stir the contents thoroughly, and the consistency will return to normal. People can buy natural peanut butter in health food stores and online. To stop the peanut butter going off, store it in the refrigerator. Thank you for supporting Medical News Today How to add peanut butter to your diet Peanut butter, rice cakes and banana
Peanut butter is a healthful option when enjoyed as part of a balanced diet. Eating more peanut butter is easy. Sometimes, it can be too easy — so be sure to be mindful of your intake to avoid eating more calories than you may need in a day. Remember 2 tbsp of peanut butter is close to 200 calories. People can include peanut butter in their diets by: Making a classic peanut butter and jelly sandwich, using whole fruit, low sugar jelly, and whole-grain bread. Spreading peanut butter on rice cakes and top with banana slices. Whipping up a Thai peanut dressing for salads, using lime juice, rice vinegar, soy sauce, and honey. Adding a spoonful of the nut butter to smoothies to make them more filling. Dipping apple and pear slices into peanut butter for an easy snack. Stirring peanut butter into yogurts or warm oatmeal. Summary Peanut butter can be a healthful option when people enjoy it as part of a balanced diet. It is rich in several nutrients, including protein and magnesium, which may help protect the heart and manage blood sugar and body weight. However, eating too much peanut butter can increase a person's daily intake of saturated fat, sodium, and calories. Those who have a peanut allergy should avoid peanut butter as it could trigger a potentially deadly reaction. We picked linked items based on the quality of products, and list the pros and cons of each to help you determine which will work best for you. We partner with some of the companies that sell these products, which means Healthline UK and our partners may receive a portion of revenues if you make a purchase using a link(s) above.
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Could managing cholesterol prevent Alzheimer's?

The largest genetic study of Alzheimer's disease to date finds that a "handful of gene variants" increases some people's risk of both dementia and cardiovascular disease. The findings imply that, in principle, we may be able to repurpose some cardiovascular drugs to prevent or treat Alzheimer's.
two seniors taking drugs
The findings of a new study raise the question: could drugs for cardiovascular problems prevent Alzheimer's?

Alzheimer's disease already affects a large number of older adults in the United States and worldwide, but the Centers for Disease Control and Prevention (CDC) warn that the burden of the condition will double in the U.S. by 2060.

Currently, about 5.7 million Americans are living with the condition, and experts expect this number to reach almost 14 million in the next four decades.

As a result, both tracking down the root cause of Alzheimer's and moving closer to a cure are of critical importance.

Researchers know that this neurodegenerative condition has a strong genetic component. For instance, a person with one copy of the APOE4 gene variant is twice as likely to develop Alzheimer's as someone without it, while having two copies may increase the risk up to 12-fold.

The APOE gene encodes a protein called apolipoprotein E. In combination with fats, or lipids, this protein forms a type of molecule called a lipoprotein.

Lipoproteins play a role in the transportation of cholesterol and other types of fat through the bloodstream, so there is already an established link between Alzheimer's disease and cholesterol.

However, new research has now uncovered many other genes that connect the risk of Alzheimer's with that of cardiovascular disease.

The new study, which appears in the journal Acta Neuropathologica, is the largest genetic study of Alzheimer's disease to date. The supervisors of the study were co-senior authors Celeste M. Karch, Ph.D., an assistant professor of psychiatry at Washington University School of Medicine in St. Louis, Missouri, and Dr. Rahul S. Desikan, Ph.D., an assistant professor of neuroradiology at the University of California, San Francisco.

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Alzheimer's and cardiovascular disease

The research team used "large genome-wide association studies and validated tools" to examine the DNA of over 1.5 million people.

Specifically, the team examined the differences in the DNA of people who had risk factors for heart disease, such as a high body mass index (BMI), type 2 diabetes, and high triglyceride and cholesterol levels.

Overall, the analysis found 90 points in the genome, called single nucleotide polymorphisms (SNPs), that had an associated risk of both Alzheimer's and cardiovascular disease.

The scientists identified these 90 SNPs across a total of 19 chromosomes.

Six of these 90 SNPs both strongly influenced Alzheimer's disease risk and raised the levels of blood lipids — a finding that confirmed the results of previous studies.

Some of the SNPs that the team identified were in genes that scientists had not previously associated with Alzheimer's risk. These included several SNPs in the CELF1/MTCH2/SPI1 region on chromosome 11, which previous studies had linked to immunity.

The researchers replicated their findings in a large genetic study of healthy individuals. They found that the participants with a family history of Alzheimer's were more likely to have the newly identified risk genes, even if they themselves had no symptoms.

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Can lower cholesterol prevent Alzheimer's?

Co-senior author Karch reports on the findings, saying, "The genes that influenced lipid metabolism were the ones that also were related to Alzheimer's disease risk."

However, she notes, "Genes that contribute to other cardiovascular risk factors, like body mass index and type 2 diabetes, did not seem to contribute to genetic risk for Alzheimer's."

"These findings represent an opportunity to consider repurposing drugs that target pathways involved in lipid metabolism," Karch adds. "Armed with these findings, we can begin to think about whether some of those drugs might be useful in preventing or delaying Alzheimer's disease."

Dr. Desikan notes that the findings indicate that keeping cholesterol and triglyceride levels in check could help manage Alzheimer's risk in some people. However, he stresses that more research is necessary to confirm this.

"These results imply that, irrespective of what causes what, cardiovascular and Alzheimer's pathology co-occur because they are linked genetically. That is, if you carry this handful of gene variants, you may be at risk not only for heart disease but also for Alzheimer's."

Dr. Rahul S. Desikan

Karch summarizes the study, saying it "emphasizes that there's much to learn about how genes driving Alzheimer's disease risk also increase the risk for other health problems, particularly cardiovascular disease, and vice versa."

"So, we really need to think about these risks more holistically," concludes the author.

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What an exotic fish can do for human heart health

People with heart failure experience heart cell loss that can damage the heart muscle to such an extent that they need a transplant. One species of exotic fish, the tetra fish, has the amazing ability to repair its own heart. Can we apply this mechanism to healing human hearts?
tetra fish
The tetra fish can regenerate heart tissue following heart damage.

The tetra fish is a type of freshwater fish hailing from regions of South America and southern North America. Many tetra species are popular with aquarium owners due to their unique coloring and the fact that they are fairly easy to keep.

A new study suggests that they are now also popular with researchers, although for an entirely different reason. Most species of tetra fish are able to heal their own hearts following heart damage.

Dr. Mathilda Mommersteeg, an associate professor at the University of Oxford in the United Kingdom, recently led a team of researchers who were striving to understand how tetra fish are able to regenerate heart tissue.

The team looked at two different subspecies of tetra fish, Astyanax mexicanus, that are native to Mexico. One of these subspecies lives in rivers, is beautifully colored, and can heal its own heart.

Fish belonging to the other subspecies, known as the "blind cave tetra," populate the waters of the Pachón cave in Mexico. These fish have not only lost their color and their eyesight, neither of which serves them in the darkness of the cave, but they no longer have the ability to regenerate heart tissue.

In a recent study, Dr. Mommersteeg's team has compared the genetic profiles of the two types of tetra fish in order to understand what genetic features may be responsible for the self-healing abilities.

The findings of the study, which the British Heart Foundation supported, appear in the journal Cell Reports.

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The gene that drives heart repair

Dr. Mommersteeg's team analyzed and compared the genetic profiles of both kinds of fish. In doing so, they identified three areas on their genomes that were relevant to the ability to regenerate damaged heart tissue.

In further analyzing these genetic areas, the researchers were also able to identify the genes that were the most important for heart regeneration.

When they compared the activity of these genes in the river tetra and the blind cave tetra following heart damage, the scientists saw that two genes, lrrc10 and caveolin, had increased activity only in the river tetra.

"A real challenge until now was comparing heart damage and repair in fish with what we see in humans. But, by looking at river fish and cave fish side by side, we've been able to pick apart the genes responsible for heart regeneration," says Dr. Mommersteeg.

Previous research in mice has shown that lrrc10 is linked to a heart condition called dilated cardiomyopathy, in which the heart becomes excessively enlarged and is no longer able to pump blood properly. The results of further studies have suggested that lrrc10 plays a key role in heart cell contraction and expansion.

To confirm that this gene is also involved in the regeneration of damaged heart tissue, the researchers behind the current study turned to zebrafish, another freshwater species that is popular among aquarists. Like the tetra fish, zebrafish also have the ability to regenerate heart tissue if necessary.

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New hopes for future treatments

In the second part of their study, the researchers blocked lrrc10 gene expression in zebrafish. These animals became unable to effectively repair heart damage. This, the researchers say, indicates that lrrc10 is indeed responsible for heart regeneration.

"It's early days, but we're incredibly excited about these remarkable fish and the potential to change the lives of people with damaged hearts," Dr. Mommersteeg remarks.

In the future, the research team hopes to learn more about the mechanisms behind the ability to heal damaged heart tissue. They want to use this knowledge to repair heart tissue in people facing problems with this organ, such as heart failure.

Heart failure often occurs due to a heart attack, during which the heart muscle becomes damaged and progressively loses cells, which scar tissue replaces. This process can render the heart unable to function correctly, and, as a result, many people with severe heart failure require a heart transplant.

However, if tetra fish can teach us how to heal the heart, transplants may become less of a necessity in the future.

"These remarkable findings show how much there is still to learn from the rich tapestry of the natural world," says Prof. Metin Avkiran, an associate medical director at the British Heart Foundation.

"It's particularly interesting that the ability of the river fish to regenerate its heart may arise from an ability to suppress scar formation. We now need to determine if we can exploit similar mechanisms to repair damaged human hearts."

Prof. Metin Avkiran

"Survival rates for heart failure have barely changed over the last 20 years, and life expectancy is worse than for many cancers. Breakthroughs are desperately needed to ease the devastation caused by this dreadful condition," he adds.

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Strength training tied to better heart health than aerobic

Exercises that build strength can benefit the heart more than aerobic activities, such as walking and cycling, according to recent research.
woman's hand holding weight
New research suggests that strength training is the best exercise for heart health.

A survey of 4,000 adults revealed that static activity, such as strength training, had stronger links to reduced risk of cardiovascular diseases than dynamic activity, such as walking and cycling.

The researchers point out, however, that any amount of either kind of exercise brings benefits, and that it is probably better to do both than to increase either.

"Both strength training and aerobic activity appeared to be heart healthy, even in small amounts, at the population level," says Dr. Maia P. Smith, who is an assistant professor in the Department of Public Health and Preventive Medicine at St. George's University in Grenada.

She explains, however, that while "static activity appeared more beneficial than dynamic," the findings also revealed that those who engaged in both kinds of activity "fared better" than those who just increased the amount of only one type.

The study featured at the 2018 American College of Cardiology Latin America Conference that took place last week in Lima, Peru.

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Recommended amounts and type of exercise

According to the American Heart Association (AHA), guidelines recommend that adults in the United States should be physically active for at least 150 minutes each week.

This activity should consist of at least 150 minutes of moderate-intensity or 75 minutes per week of vigorous-intensity aerobic exercise, or a combination. It is better to spread the exercise across the week than complete it all in 1 or 2 days.

The guidelines also advise doing exercise that strengthens the muscles, such as resistance or weight training. People should do this on at least 2 days per week.

Even greater benefits accrue from 300 minutes of exercise per week, say the AHA. They also recommend breaking up prolonged bouts of sitting — even getting up and doing some light activity is better than just sitting, they add.

The Go4Life program from the National Institute of Aging (NIA), which is one of the National Institutes of Health (NIH), advises older adults to do four types of exercise:

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Endurance, or aerobic, exercises that increase breathing and raise heart rate. Strength, or resistance, exercises that strengthen major muscle groups in the upper and lower body and improve their function. Balance exercises to reduce the risk of falls and the disabilities that they can cause. Flexibility exercises that stretch the body and increase a person's range of movement.

Aerobic activity includes walking, jogging, cycling, swimming, gardening and all forms of sports, such as golf, tennis, and volleyball.

Push-ups, static rowing, resistance training, dips, arm and leg raises, and hand grips are all examples of strength-building exercises.

Practicing Tai Chi and yoga can improve balance and flexibility as can simple exercises that involve the use the body or everyday objects, such as a chair.

Types of exercise and cardiovascular risk

Dr. Smith and her colleagues used data from the 2005-2006 National Health and Nutrition Examination Survey on 4,086 adults in the U.S.

This included information that individuals gave about types of physical activity and the presence of cardiovascular risk factors, including high blood pressure, being overweight, having high cholesterol, and having diabetes.

The team analyzed the cardiovascular risk factors against the type of activity in terms of whether it was static, such as weight training, or dynamic, such as walking or cycling.

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After adjusting the people for age, gender, ethnicity, and smoking status, they looked at the results in two age groups: 21-44 years (younger adults) and over 45 years (older adults).

These revealed that 36 percent of the younger adults compared with 25 percent of the older adults reported doing static exercise.

For dynamic exercise, 28 percent of the younger adults compared with 21 percent of the older adults said that they engaged in this type.

'Both activity types were beneficial'

Doing either type of exercise was linked to a lowering of cardiovascular risk factors of between 30 and 70 percent. The link was strongest for younger adults and doing static exercises.

Dr. Smith suggests that future studies should do more to differentiate between the two types of exercise so that scientists can see their separate effects on health more clearly.

Only around 1 in 5 adults and teens in the U.S. meet the recommended 150 minutes per week of "heart-pumping" activity, say the AHA.

With this in mind, perhaps the more pressing message of the recent study, as Dr. Smith concludes, is that – since "both activity types were beneficial" – clinicians should encourage people to "exercise regardless."

"The important thing is to make sure they are engaging in physical activity."

Dr. Smith

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Blood pressure medications: Everything you need to know

Medications for high blood pressure are vital for helping to prevent a range of complications, including heart disease and stroke.

This article outlines the various blood pressure medications along with their associated side effects and risks.

Diuretics blood pressure medication
Blood pressure medications may cause different side effects.

Excess salt can cause a buildup of fluid within the blood vessels, which raises blood pressure. Diuretics help the body eliminate excess salt and water by increasing urine output.

Possible side effects of diuretics include:

weakness dizziness or light-headedness heightened sensitivity to sunlight rashes muscle cramps vomiting diarrhea constipation low blood pressure electrolyte imbalances

People taking diuretics may also experience a decreased libido, though this is less common.

Some medications can interact with diuretics, so a person should speak to a doctor about all of the drugs they are taking. Drugs that may interact with diuretics include:

Diuretics may not be suitable for people who tend to become dehydrated quickly. They can also make the following conditions worse:

Beta-blockers Beta-blockers reduce blood pressure by blocking the effects of certain stress hormones, such as epinephrine. Blocking these hormones slows down the nerve impulses traveling through the heart. As a result, the heart rate slows down and pumps blood less forcefully around the body. Some side effects of beta-blockers may include: Less common side effects include: slow heartbeat wheezing or difficulty breathing swelling of the hands or feet rash or itchy skin insomnia depression low blood pressure Some drugs and medications can change the effectiveness of beta-blockers. These include: alcohol caffeine other blood pressure medications cough and cold medications, including antihistamines and decongestants insulin and some oral medications for diabetes allergy shots medicines to treat asthma, chronic bronchitis, emphysema, or chronic obstructive pulmonary disease (COPD) some antidepressants Beta-blockers may not be suitable for people with the following conditions or problems: ACE inhibitors woman outdoors with flu or cold infection coughing
A side effect of ACE inhibitors is a dry cough. ACE (angiotensin-converting enzyme) is an enzyme that causes the body's blood vessels to narrow, which leads to an increase in a person's blood pressure. ACE inhibitors lower blood pressure by blocking ACE, thereby relaxing the blood vessels and allowing blood to flow more freely. A dry cough is the most common side effect of ACE inhibitors. Less common side effects include: loss of taste a metallic taste in the mouth loss of appetite an upset stomach diarrhea constipation headaches tiredness and fatigue feeling dizzy or lightheaded skin that is sensitive to sunlight low blood pressure Medications that may interact with ACE inhibitors include: diuretics other blood pressure medications medications and supplements containing potassium People who have any of the following medical conditions should speak to a doctor before taking ACE inhibitors: diabetes heart disease lupus kidney disease allergies to other medications ACE inhibitors may also be unsuitable for people who have had a heart attack, and those who have received a kidney transplant. Angiotensin II receptor blockers Angiotensin II is an enzyme that narrows the blood vessels. Angiotensin II receptor blockers (ARBs) block the enzyme's path to specific receptors, which allows the blood vessels to remain open. Headaches and dizziness are the most common side effects of ARBs. Less common side effects include: The following medications can increase or decrease the effect of ARBs: diuretics medications and supplements containing potassium other blood pressure medications some heart medications over the counter medicines for allergies, colds, and flu ARBs may not be suitable for people who have previously had a bad reaction to ACE inhibitors. They may also not be suitable for people with the following conditions: Thank you for supporting Medical News Today Calcium channel blockers Calcium causes the smooth muscles of the heart and arteries to contract more strongly. Calcium channel blockers slow the entry of calcium into these muscles, which reduces the strength of the contractions and lowers the blood pressure. Common side effects of calcium channel blockers include: tiredness flushing swollen feet or ankles Less common side effects include: palpitations nausea dizziness shortness of breath upset stomach constipation rash or itchy skin Drinking grapefruit juice while taking some calcium channel blockers can increase the risk of side effects. Calcium channel blockers may interact with the following medications and supplements: diuretics other blood pressure medications some heart medications, such as antiarrhythmics and digitalis some eye medications People taking more than 60 milligrams per day of some calcium channel blockers may experience low blood sugar levels. Also, calcium channel blockers may not be suitable for people with the following conditions: very low blood pressure heart failure or other conditions affecting the heart or blood vessels kidney or liver disease depression Alpha-blockers man with a headache sat on his sofa
Headaches are a possible side effect of alpha-blockers. Certain hormones in the body, such as norepinephrine, can bind to chemical receptors called alpha-receptors. When this happens, the blood vessels narrow and the heart pumps blood faster, causing a rise in blood pressure. Alpha-blockers reduce blood pressure by preventing norepinephrine from binding to alpha-receptors. This relaxes the blood vessels, which allows blood to flow more freely. Possible side effects of alpha-blockers include: rapid heart rate a drop in blood pressure when standing up dizziness headaches nausea feeling tired, weak, or lethargic disturbed sleep skin rash or itchiness loss of bladder control in women erectile dysfunction in men Other substances that lower blood pressure may cause a dangerous drop in blood pressure when taken alongside alpha-blockers. These substances include: alcohol medications containing benzodiazepine or barbiturates other blood pressure medications Alpha-blockers may make the following medical conditions worse: Alpha-2 receptor agonists Similar to alpha-blockers, these drugs lower blood pressure by preventing the release of norepinephrine. Alpha-2 receptor agonists may cause the following side effects: tiredness feeling faint or dizzy after standing up slow heart rate anxiety a headache dry mouth nausea upset stomach constipation fluid retention erectile dysfunction Alpha-2 receptor agonists may react with some anesthetics and other blood pressure medications. Combined alpha- and beta-blockers A doctor may prescribe a drug that has both alpha- and beta-blocker activity. The alpha-blocker activity decreases the narrowing of blood vessels, while the beta-blocker activity slows the heart rate, causing it to pump blood less forcefully. Doctors usually give combined alpha- and beta-blockers in an intravenous (IV) drip to people experiencing a hypertensive crisis. This is when blood pressure rises rapidly to a dangerously high level. Doctors may also prescribe combined alpha- and beta-blockers for people who are at high risk of heart failure. People may experience the side effects of both alpha- and beta-blockers. Some types of combined alpha- and beta-blockers may interact with the following medications: insulin digoxin some general anesthetics They may also not be suitable for people with the following conditions: asthma severe bradycardia (slow heart rate) liver disease decompensated heart failure diabetes allergies to other medications pheochromocytoma Central agonists Central agonists lower blood pressure by preventing the brain from sending signals to the nervous system to increase heart rate and constrict blood vessels. As a result, the heart pumps blood less forcefully, and blood vessels remain open. Central agonists can cause the following side effects: feeling faint or weak when standing slow heart rate drowsiness or lethargy anemia dizziness headaches sleep disturbances fever dry mouth an upset stomach or nausea constipation swollen legs or feet The following side effects may also occur, but are less common: depression anxiety erectile dysfunction The following substances can cause a person's blood pressure to drop too low when combined with central antagonists: alcohol sleeping pills and anti-anxiety medications containing benzodiazepines and barbiturates Central agonists may make the symptoms of the following medical conditions worse: Thank you for supporting Medical News Today Peripheral adrenergic inhibitors doctor speaking with patient
If another blood pressure medication is ineffective, a doctor may prescribe PAIs. Peripheral adrenergic inhibitors (PAIs) block the neurotransmitters in the brain that cause blood vessels to constrict. Blocking these receptors allows the blood vessels to stay relaxed and open, lowering a person's blood pressure. Doctors usually prescribe PAIs only if other blood pressure medications have been ineffective. There are several types of PAI, and the side effects differ between types. Possible side effects include: nasal congestion dry mouth a headache heartburn diarrhea lightheadedness, dizziness, or weakness when standing fainting erectile dysfunction Some PAIs may interact with the following substances: alcohol asthma medications diuretics other blood pressure medications Additionally, people who are taking tricyclic antidepressants and intend to come off these medications should speak to a doctor. Stopping these medications too quickly while taking certain PAIs can cause a dangerous drop in blood pressure. Some types of PAIs may not be suitable for people with certain medical conditions, including: congestive heart failure diseases of the vascular system asthma peptic ulcers fluid retention pheochromocytoma depression ulcerative colitis Direct-acting vasodilators Vasodilators, or blood vessel dilators, relax and widen the walls of the blood vessels, allowing blood to flow through them more easily. Direct-acting vasodilators specifically target the arteries. The two main types of direct-acting vasodilator are hydralazine hydrochloride and minoxidil. Minoxidil is the more potent of the two drugs. Doctors usually prescribe it to people with persistent and severe high blood pressure. Hydralazine hydrochloride may cause the following side effects, which usually subside within a few weeks of beginning treatment: heart palpitations headaches swelling around the eyes joint pain Possible side effects of minoxidil include: weight gain due to fluid retention excessive hair growth, in rare cases The following drugs may enhance the effects of vasodilators: diuretics and other blood pressure medications medications for erectile dysfunction, such as sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra) Taking erectile dysfunction medications in combination with a vasodilator can cause a life-threatening drop in blood pressure. Some types of vasodilators may not be suitable for people with the following conditions: Risks during pregnancy Some blood pressure medications are not safe to take during pregnancy due to the risk to the pregnant woman or unborn child. Some medications may be suitable during specific trimesters, while others pose risks throughout pregnancy. Women who are pregnant or planning on getting pregnant should talk to their doctor about treatment options for high blood pressure. Summary There are many types of blood pressure medications. Which one a doctor prescribes will depend on the underlying cause of a person's high blood pressure, as well as their existing conditions and other regular medications. Anyone experiencing long-term or intolerable side effects from a blood pressure medication should speak to a doctor, who may be able to prescribe an alternative.
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