Wood Street Clinic Blog

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What hookah smoking can do to your blood vessels

New research is suggesting that hookah smoking can impair the endothelial function of blood vessels, which is a key indicator of cardiovascular health.
hookah smoking
Hookah smoking may harm your blood vessels, shows a recent study.

More and more people are giving up smoking, and they are sensible to do so.

Cigarette smoking is "the leading preventable cause of death in the United States," according to the Centers for Disease Control and Prevention (CDC), with cigarettes causing over 480,000 yearly deaths.

However, as the use of regular cigarettes is declining, more and more people are turning to alternatives that many perceive as safer, such as electronic cigarettes or hookah smoking.

However, is hookah smoking truly safe? Several recent studies suggest that the answer is "no." For example, a study that Medical News Today covered in 2016 found that a single session of hookah smoking delivers 10 times the amount of carbon monoxide present in a regular cigarette.

Another more recent study found that hookah, also known as shisha, smoking can stiffen the arteries to a degree comparable with that which normal cigarettes can achieve.

Arterial stiffness is a predictor for stroke, and so is the enlargement of the aorta, which is another effect that hookah smoking was found to have.

Now, new research presented at the American Heart Association's (AHA) Scientific Sessions 2018 — which took place in Chicago, IL — adds to the evidence that suggests hookah smoking may indeed harm cardiovascular health.

Mary Rezk-Hanna, Ph.D., an assistant professor at the University of California, Los Angeles School of Nursing, is the lead author of the study.

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Studying the effects of hookah smoking

Rezk-Hanna and colleagues examined 30 young, healthy adults before and after they took part in a session of hookah smoking. The participants were 26 years old, on average.

The team examined the participants' blood levels of nicotine before and after the smoking session and measured their exhaled carbon monoxide levels and a marker of artery function called flow-mediated dilation of blood vessels.

The latter measure describes the dilation, or widening, of blood vessels when blood flow increases. Flow-mediated dilation is a measure of the endothelial function of arteries, and many consider endothelial dysfunction to be "the initial phase of the atherosclerotic process."

In this study, the researchers compared the results of these measures with the effects of one normal cigarette in age-matched people who smoke regular cigarettes.

Also, Rezk-Hanna and team took the same measurements before and after hookah smokers were asked to use an electronic device to vape a mixture of carbon monoxide gas that mimicked the effects that people normally get from charcoal-heated hookah smoking.

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How hookah smoking may harm the arteries

The researchers revealed that exhaled carbon monoxide levels were nine to 10 times higher in charcoal-heated hookah smoking than in electronically heated hookah or regular cigarette smoking. Nicotine levels, however, were equally high across all smoking sessions.

Also, the study discovered that flow-mediated dilation was higher after charcoal-heated hookah smoking, while electronically heated hookah or traditional cigarette smoking lowered flow-mediated dilation. A lower flow-mediated dilation indicates endothelial dysfunction.

The researchers explain that the main difference between charcoal-heated and electrically heated hookah is that charcoal briquettes produce high levels of carbon monoxide.

This chemical, in turn, dilates blood vessels, which, the authors speculate, might mask the damaging effects of charcoal-heated hookah smoking on endothelial function.

So, hookah smoking may harm blood vessel function in the same way as cigarette smoking.

"Hookah is the only form of tobacco product that uses burning charcoal briquettes to heat the flavored tobacco in the water pipe. So, in addition to toxic substances from tobacco and nicotine, hookah smoke exposes users to charcoal combustion products, including large amounts of carbon monoxide."

Mary Rezk-Hanna, Ph.D.

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Can this Amazonian diet offer a solution to heart disease?

In the United States, hundreds of thousands of people die every year from causes related to heart disease. Cardiovascular health is a fragile asset, but one population from the Bolivian Amazon seems to possess the secret to a life free of heart disease. What is it?
rice plantain and beans
Researchers map out the diet that may have rendered a Bolivian people 'immune' to heart disease.

According to the Centers for Disease Control and Prevention (CDC), approximately 610,000 people die because of heart disease-related problems each year in the United States.

At global level, cardiovascular diseases caused around 31 percent of all deaths in 2016 alone, the World Health Organization (WHO) note.

The main modifiable factor that specialists focus on when it comes to prevention strategies against heart disease is diet.

American Heart Association (AHA) guidelines indicate that to keep heart disease at bay, a person should follow a diet that is rich in fruit, vegetables, whole grains, and oily fish.

Is this the best diet for the heart? A team of anthropologists from the University of California–Santa Barbara has recently decided to look for clues among the peoples of the Bolivian Amazon.

One particular population, called the Tsimane, are remarkable in that they almost never develop heart disease, and only very rarely do they have hypertension, unhealthful cholesterol levels, obesity, or type 2 diabetes.

The researchers thought that one key factor in the Tsimane's seeming imperviousness to heart disease might be their diets. The Tsimane, the investigators note, have so far been minimally influenced by globalization trends.

Their food tends to come from natural sources, and they purchase very little produce from markets. In this respect, the Tsimane differ from their neighbors, the Moseten, with whom they share the same language but not the same diets and lifestyles.

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A carb-rich diet

Unlike the Tsimane, who are more sheltered, the Moseten acknowledge outside influences, which have impacted their dietary habits as well as their lifestyles. As a result, the Moseten may also be more at risk of cardiovascular and metabolic diseases when compared with their more isolated "cousins."

"Our prior work," says senior study co-author Prof. Michael Gurven, "showed that the Tsimane have the healthiest hearts ever studied, so naturally there's a lot of interest in understanding why and how."

So, to understand what sets the Tsimane apart and allows them to enjoy such perfect heart health well into old age, the researchers interviewed them about their daily dietary and lifestyle choices.

"We conducted a detailed analysis of the Tsimane diet and then compared it to what modern Americans typically eat, and to the diets that claim to be heart healthy," says Prof. Gurven.

The investigators also compared the Tsimane's choices with those of the Moseten, the people with whom they are most closely related. In total, the team spoke to 1,299 Tsimane and 229 Moseten, and they compiled detailed profiles of the two people's diets.

In the study paper that appears in the American Journal of Clinical Nutrition, the researchers report that the Tsimane's usual diet was high in carbohydrates and protein but low in fat.

The Tsimane diet was high-calorie — amounting to 2,433–2,738 kilocalories per day — and it comprised 64 percent carbs, 21 percent protein, and 15 percent fats.

Perhaps surprisingly, the Tsimane do not appear to eat a variety of foods. Instead, their meals tend to gravitate around a few dietary staples. The researchers say that about two-thirds of calories come from complex carbohydrates, present in foods such as rice and plantain.

Around 16 percent of calories come from fish — of which they eat over 40 different species — and another 6 percent from wild game. The Tsimane buy only 8 percent of their foods from the market.

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The challenge of changing lifestyles

Another surprise, given the lack of great dietary diversity, is that the Tsimane do not have many micronutrient deficiencies. While this people tends to run low on calcium and some vitamins — such as D, E, and K — they absorb a lot of potassium, magnesium, and selenium.

These nutrients, the researchers say, may help boost cardiovascular health, and the Tsimane consume them at levels that are higher by far than the typical amount present in North American diets.

Furthermore, the Tsimane eat almost twice as many fiber-rich foods as the Moseten or U.S. populations. However, the researchers also express the concern that, as globalization trends increase, the Tsimane are slowly giving in to harmful influences from outside of their own society.

So, they found that over the 5-year period during which they conducted the present study, the Tsimane's total energy and carbohydrate intake soared, and many of them have started to add larger quantities of lard, oil, sugar, and salt to their diets.

"This is a key time," says the study paper's lead author, Thomas Kraft. "Roads are improving in the area, as is river transport with the spread of motorized boats, so people are becoming a lot less isolated compared to the past. And it's happening at a pretty rapid pace."

Prof. Gurven goes on to say that, given the opportunity to bulk-buy ingredients such as sugar, it is unsurprising that the Tsimane are, little by little, transitioning to less healthful diets. "Getting calories cheaply with less effort — who wouldn't?" he asks.

Yet, he also adds that the Tsimane's search for higher calorie counts may be due to the fact that they actually lead very active lifestyles.

"[They're] also physically active — not from routine exercise, but from using their bodies to acquire food from their fields and the forest, which is also an important lesson," says Prof. Gurven.

"You can't look at what you're eating irrespective of what you're doing with your body. If you're physically active, you can probably get away with more flexibility in the diet."

Prof. Michael Gurven

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Daily serving of nuts may stave off weight gain

Two new studies suggest that a small daily serving of nuts may benefit overall metabolic health and keep off the weight we tend to gain as we enter adulthood.
serving of nuts
A daily serving of nuts may prevent weight gain and improve metabolic health in the long run, two new studies suggest.

From providing cardiovascular benefits to potentially improving fertility, and even boosting memory and intelligence, the health benefits of nuts are numerous — and no wonder.

Nuts are packed with unsaturated fatty acids, fiber, protein, and other beneficial chemicals, which may all contribute to good health.

However, can nuts aid weight loss? Are certain types of nuts better able to support good metabolism?

Two new studies delved deeper into these questions. The authors will present the findings at Scientific Sessions 2018, a conference to be held by the American Heart Association (AHA) in Chicago, IL.

The first study — led by Xiaoran Liu, Ph.D., a research associate in the nutrition department of the Harvard T.H. Chan School of Public Health in Boston, MA — looked at the long-term effects of nuts and peanuts on body weight.

The second study examined the effects of Brazil nuts on satiety, blood sugar, and insulin response.

It was supervised by Mee Young Hong, Ph.D., a registered dietician and a professor in the School of Exercise & Nutritional Sciences at San Diego State University in California.

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Nuts prevent weight gain in adulthood

The first study explored nut consumption in:

25,394 healthy men who had taken part in the Health Professionals Follow-up Study 53,541 women who had participated in the Nurses' Health Study 47,255 women who had taken part in the Nurses' Health Study II

The three groups had filled in food frequency questionnaires once every 4 years.

The researchers discovered that replacing foods that had less nutritional value with a 1-ounce serving of nuts and peanuts lowered the risk of weight gain and obesity over the 4-year follow-up intervals.

More specifically, replacing a serving of red meat, processed meat, french fries, desserts, or potato chips with a serving of nuts correlated with significantly less weight gain in the long run.

The study's first author comments on the findings, saying, "People often see nuts as food items high in fat and calories, so they hesitate to consider them as healthy snacks, but they are in fact associated with less weight gain and wellness."

"Once people reach adulthood, they start to gradually gain about 1 pound a year of weight, which seems small. But if you consider gaining one pound over 20 years, it accumulates to a lot of weight gain," Liu notes.

"Adding 1 ounce of nuts to your diet in place of less healthy foods — such as red or processed meat, french fries or sugary snacks — may help prevent that slow, gradual weight gain after you enter adulthood and reduce the risk of obesity-related cardiovascular diseases."

Xiaoran Liu, Ph.D.

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Brazil nuts benefit insulin, glucose responses

In the second study, researchers examined the effects of consuming Brazil nuts in 22 healthy adult participants, 20 of whom were women.

The participants added either 36 grams of pretzels or 20 grams of Brazil nuts to their normal diet in two trials. At least 48 hours passed between trials.

The Brazil nuts and pretzels contained about the same number of calories and the same amount of sodium. Both triggered a sense of fullness, but the Brazil nuts contributed to an increased feeling of satiety.

Forty minutes after the participants had consumed their snacks, the researchers found that the pretzels had caused significant increases in blood sugar and insulin levels, whereas the Brazil nuts had not.

The study's senior author explains, "While both Brazil nuts and pretzels increased a sense of fullness after they were eaten, eating Brazil nuts stabilized postprandial (after eating) blood glucose and insulin levels, which may be beneficial in preventing diabetes and weight gain."

Although the study was observational, the researchers speculate that selenium may explain the benefits of Brazil nuts. Prior studies had linked the mineral with better insulin and blood sugar responses, and Brazil nuts are rich in selenium.

However, the researchers caution that because only 9 percent of participants were men, the study's findings may not apply to all.

"Our study allows researchers and clinicians to consider the possible beneficial role of Brazil nuts to help people feel full and maintain a healthy level of glucose, reducing the risk of obesity and diabetes."

Mee Young Hong, Ph.D.

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It may only take one energy drink to harm your blood vessels

Is it safe to consume energy drinks in any quantity? From students pulling all-nighters to fitness enthusiasts, many people use these boosters, but a new study suggests that a single energy drink could immediately harm blood vessel function.
colorful energy drink
How do energy drinks affect vascular health? A new study investigates.

According to the National Center for Complementary and Integrative Health (NCCIH), energy drinks are among the most commonly used dietary supplements in the United States.

The NCCIH note, specifically, that men "between the ages of 18 and 34 years consume the most energy drinks," and that "almost one-third of teens between 12 and 17 years drink them regularly."

Because they contain high levels of caffeine, taurine, and other stimulating substances, the safety of energy drinks has always been the subject of intense debate.

For instance, the authors of one study covered by Medical News Today expressed concerns that energy drinks may act as a gateway for illicit drug use. Other research indicates that having too many energy drinks may cause liver damage.

Mostly, however, researchers have been concerned about the impact of energy drinks on cardiovascular health. Reportedly, having more than two such drinks per day may endanger the heart.

Now, specialists from the McGovern Medical School at the University of Texas Health Science Center at Houston are preparing to present evidence that a single energy drink may have serious negative effects on blood vessel function.

Dr. John Higgins and colleagues are due to present their findings next week at the American Heart Association's (AHA) Scientific Sessions 2018, which will be held in Chicago, IL. During the 3-day summit, specialists will present the latest findings and advances related to cardiovascular health and care.

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The study included 44 young, healthy participants. All were medical students in their 20s who did not habitually smoke.

The researchers tested the participants' endothelial (blood vessel) function at baseline, to establish how energy drinks would affect it.

The participants then each had a 24-ounce energy drink. Ninety minutes later, the researchers again performed the endothelial function tests.

At the 90-minute mark, the tests showed that the students had poorer artery flow-mediated dilation than they had before consuming the energy drinks.

Artery flow-mediated dilation indicates blood vessel health. At baseline, it was about 5.1 percent in diameter, on average.

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Following energy drink consumption, this measurement fell to 2.8 percent in diameter. The researchers explain that this indicates acute impairment of blood vessel function.

The authors of the study speculate that the impairment of vascular function may result from a combination of substances typically used in energy drinks, including caffeine, taurine, sugar, and herbal stimulants.

Dr. Higgins and his team explain that it is still unclear whether energy drinks are safe to consume, and in what quantities. They add:

"As energy drinks are becoming more and more popular, it is important to study the effects of these drinks on those who frequently drink them and better determine what, if any, is a safe consumption pattern."

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Can cottonseed oil help lower your 'bad' cholesterol?

High levels of cholesterol can be harmful, and they can increase a person's risk of serious cardiovascular events, such as heart attack or stroke. A high-fat diet can contribute to raised cholesterol levels, but some researchers say that ingesting a specific type of oil may prevent this negative effect.
vial with cottonseed oil
A new study compares the effects of cottonseed oil and olive oil on cholesterol levels.

Generally speaking, there are two types of cholesterol: high-density lipoprotein (HDL) cholesterol, also known as "good" cholesterol, and low-density lipoprotein (LDL) cholesterol, which people describe as "bad" cholesterol.

Healthcare professionals often refer to LDL cholesterol as "bad" because the overaccumulation of this fatty substance can interfere with blood circulation and increase a person's risk of heart attack or stroke.

Conversely, they tend to say that HDL cholesterol is "good" because it helps remove LDL cholesterol from the body. It does this by taking the LDL cholesterol to the liver, which will break it down and process the resulting waste.

In order to prevent LDL cholesterol from reaching high levels in the blood, specialists advise people to adhere to diets that promote high HDL and low LDL cholesterol.

However, researchers from the University of Georgia in Athens have found that adding cottonseed oil to a high-fat diet can actually decrease a person's LDL cholesterol levels.

The study paper reporting these results appears in the journal Nutrition Research.

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Pitting cottonseed oil against olive oil

The researchers worked with a group of 15 male participants aged 18–45 who were within healthy weight ranges. They asked the participants to follow one of two versions of a high-fat diet, each of which included a particular component.

In one version of the diet, the researchers used olive oil to enrich the meals. In the other, they used cottonseed oil instead. All of the participants adhered to their assigned diet for a period of 5 days.

After comparing the effects of the two diet regimens on the participants, the investigators found that those who had followed the cottonseed oil-enriched diet had lower LDL cholesterol and triglyceride levels.

Conversely, the participants who had followed the olive oil-enriched diet saw no significant changes.

"One of the reasons these results were so surprising is because of the magnitude of change observed with the cottonseed oil diet," says study author Jamie Cooper, an associate professor at the University of Georgia.

"To see this amount of change in such a short period of time is exciting," she adds.

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Effects on LDL vs. HDL cholesterol levels

The individuals on the cottonseed oil-enriched diet saw, on average, a decrease of approximately 8 percent in total cholesterol levels. Their LDL cholesterol levels decreased by 15 percent on average, and their triglyceride levels decreased by 30 percent.

As for the levels of HDL cholesterol, these actually increased by about 8 percent for individuals on the cottonseed oil-enriched diet.

The researchers speculate that a specific type of fatty acid called dihydrosterculic acid, which is present in cottonseed oil but not in olive oil, may prevent triglyceride accumulation.

"By doing that," Cooper explains, "it pushes the body to burn more of that fat because it can't store it properly, so you have less lipid and cholesterol accumulation."

Cooper also suggests that the polyunsatured fats and omega-6 that are abundant in cottonseed oil may have beneficial effects.

The authors explain that several sponsors — including the nonprofit company Cotton Incorporated, the University of Georgia Clinical and Translational Research Unit, and the Augusta University and University of Georgia Medical Partnership — financially supported the recent study.

In the future, the investigators aim to learn more about the effects of cottonseed oil on health by recruiting older participants who already have high cholesterol levels and extending the dietary intervention period.

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What is obesity and what causes it?

Obesity is a medical condition that occurs when a person carries excess weight or body fat that might affect their health. A doctor will usually suggest that a person has obesity if they have a high body mass index.

Body mass index (BMI) is a tool that doctors use to assess if a person is at an appropriate weight for their age, sex, and height. The measurement combines height and weight.

A BMI between 25 and 29.9 indicates that a person is carrying excess weight. A BMI of 30 or over suggests that a person may have obesity.

Other factors, such as the ratio of waist-to-hip size (WHR), waist-to-height ratio (WtHR), and the amount and distribution of fat on the body also play a role in determining how healthy a person's weight and body shape are.

If a person does have obesity and excess weight, this can increase their risk of developing a number of health conditions, including metabolic syndrome, arthritis, and some types of cancer.

Metabolic syndrome involves a collection of issues, such as high blood pressure, type 2 diabetes, and cardiovascular disease.

Maintaining a healthy weight or losing through diet and exercise is one way to prevent or reduce obesity. In some cases, a person may need surgery.

Now read on to find out why obesity happens.

1) Consuming too many calories Person holding apple in one hand and doughnut in the other
A person has a lower risk of obesity if their diet consists mainly of fruits, vegetables, and whole grains.

When a person consumes more calories than they use as energy, their body will store the extra calories as fat. This can lead to excess weight and obesity.

Also, some types of foods are more likely to lead to weight gain, especially those that are high in fats and sugars.

Foods that tend to increase the risk of weight gain include:

fast foods fried foods, such as french fries fatty and processed meats many dairy products foods with added sugar, such as baked goods, ready-made breakfast cereals, and cookies foods containing hidden sugars, such as ketchup and many other canned and packaged food items sweetened juices, sodas, and alcoholic drinks processed, high-carb foods, such as bread and bagels

Some processed food products contain high-fructose corn syrup as a sweetener, including savory items, such as ketchup.

Eating too much of these foods and doing too little exercise can result in weight gain and obesity.

A person who consumes a diet that consists mainly of fruits, vegetables, whole grains, and water is still at risk of gaining excess weight if they overeat, or if genetic factors, for example, increase their risk.

However, they are more likely to enjoy a varied diet while maintaining a healthy weight. Fresh foods and whole grains contain fiber, which makes a person feel full for longer and encourages healthy digestion.

2) Leading a sedentary lifestyle

Couple walking dog outside
Regular physical activity can help prevent obesity.

Many people lead a much more sedentary lifestyle than their parents and grandparents did.

Examples of sedentary habits include:

working in an office rather than doing manual labor playing games on a computer instead of doing physical activities outside going to places by car instead of walking or cycling

The less a person moves around, the fewer calories they burn.

Also, physical activity affects how a person's hormones work, and hormones have an impact on how the body processes food.

Several studies have shown that physical activity can help to keep insulin levels stable and that unstable insulin levels may lead to weight gain.

Researchers who published a review in BMJ Open Sport and Exercise Medicine in 2017 noted that, while the designs of some studies make it hard to draw exact conclusions, "A lifestyle incorporating regular [physical activity] has been identified as a key factor for maintaining and improving many aspects of health, including insulin sensitivity."

Physical activity need not be training in the gym. Physical work, walking or cycling, climbing stairs, and household tasks all contribute.

However, the type and intensity of activity may affect the degree to which it benefits the body in the short- and long-term.

Thank you for supporting Medical News Today 3) Not sleeping enough Research has suggested that missing sleep increases the risk of gaining weight and developing obesity. Researchers reviewed evidence for over 28,000 children and 15,000 adults in the United Kingdom from 1977 to 2012. In 2012, they concluded that sleep deprivation significantly increased obesity risk in both adults and children. The changes affected children as young as 5 years of age. The team suggested that sleep deprivation may lead to obesity because it can lead to hormonal changes that increase the appetite. When a person does not sleep enough, their body produces ghrelin, a hormone that stimulates appetite. At the same time, a lack of sleep also results in a lower production of leptin, a hormone that suppresses the appetite. 4) Endocrine disruptors A team from the University of Barcelona published a study in the World Journal of Gastroenterology that provides clues as to how liquid fructose — a type of sugar — in beverages may alter lipid energy metabolism and lead to fatty liver and metabolic syndrome. Features of metabolic syndrome include diabetes, cardiovascular disease, and high blood pressure. People with obesity are more likely to have metabolic syndrome. After feeding rats a 10-percent fructose solution for 14 days, the scientists noted that their metabolism was starting to change. Scientists believe there is a link between high consumption of fructose and obesity and metabolic syndrome. Authorities have raised concerns about the use of high-fructose corn syrup to sweeten drinks and other food products. Animal studies have found that when obesity occurs due to fructose consumption, there is also a close link with type 2 diabetes. In 2018, researchers published the results of investigations involving young rats. They, too experienced metabolic changes, oxidative stress, and inflammation after consuming fructose syrup. The researchers note that "increased fructose intake may be an important predictor of metabolic risk in young people." They call for changes in the diets of young people to prevent these problems. Avoiding high-fructose corn syrup Sauces often contain additives
Ready-made sauces often contain high-fructose corn syrup, which scientists have linked to a risk of obesity. Foods that contain high-fructose corn syrup include: sodas, energy drinks, and sports drinks candy and ice cream coffee creamer sauces and condiments, including salad dressings, ketchup, and barbecue sauce sweetened foods, such as yogurt, juices, and canned foods bread and other ready-made baked goods breakfast cereal, cereal bars, and "energy" or "nutrition" bars To reduce your intake of corn syrup and other additives:
check the labels before you buy opt for unsweetened or less processed items where possible make salad dressings and bake other products at home Some foods contain other sweeteners, but these can also have adverse effects. 5) Medications and weight gain Some medications can also lead to weight gain. Results of a review and meta-analysis published in The Journal of Clinical Endocrinology and Metabolism in 2015 found that some medicines caused people to gain weight over a period of months. atypical antipsychotics, especially olanzapine, quetiapine, and risperidone anticonvulsants and mood stabilizers, and specifically gabapentin hypoglycemic medications, such as tolbutamide glucocorticoids used to treat rheumatoid arthritis some antidepressants However, some medications may lead to weight loss. Anyone who is starting a new medication and is concerned about their weight should ask their doctor whether the drug is likely to have any effect on weight. Thank you for supporting Medical News Today 6) Is obesity self-perpetuating? The longer a person is overweight, the harder it may be for them to lose weight. Findings of a mouse study, published in the journal Nature Communications in 2015, suggested that the more fat a person carries, the less likely the body is to burn fat, because of a protein, or gene, known as sLR11. It seems that the more fat a person has, the more sLR11 their body will produce. The protein blocks the body's ability to burn fat, making it harder to shed the extra weight. 7) Obesity gene A faulty gene called the fat-mass and obesity-associated gene (FTO) is responsible for some cases of obesity. A study published in 2013 points to a link between this gene and: obesity behaviors that lead to obesity a higher food intake a preference for high-calorie foods an impaired ability to feel full, known as satiety The hormone ghrelin plays a crucial role in eating behavior. Ghrelin also affects the release of growth hormones and how the body accumulates fat, among other functions. The activity of the FTO gene might impact a person's chances of having obesity because it affects the amounts of ghrelin a person has. In a study involving 250 people with eating disorders, published in Plos One in 2017, researchers suggested that aspects of FTO might also play a role in conditions, such as binge eating and emotional eating. Takeaway Many factors play a role in the development of obesity. Genetic traits can increase the risk in some people. A healthful diet that contains plenty of fresh food, together with regular exercise, will reduce the risk of obesity in most people. However, those that have a genetic predisposition may find it harder to maintain a healthy weight.
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Can fermented dairy shield you against heart disease?

Many experts have debated the effect of dairy on cardiovascular health. A recent study in Finland has shown that consuming a particular type of dairy, namely fermented dairy, may actually have a protective effect against heart disease.
assortment of dairy products
How does fermented dairy, in particular, affect heart health?

Coronary heart disease (CHD) is a condition in which the blood supply to the heart becomes restricted, usually because of a buildup of fat in the arteries that carry blood to the heart muscle.

This condition can lead to serious health events, such as chest pain, heart failure, and heart attack. Some of the main risk factors for CHD are smoking, high cholesterol, and high blood pressure.

There is still a lack of consensus on whether consuming dairy is good or bad for a person's health. However, it is important to distinguish between different types of dairy, which may vary in their effects on long-term physical health.

The results of a new study by researchers from the University of Eastern Finland, which has campuses in Joensuu, Kuopio, and Savonlinna, suggest that consuming fermented dairy products may actually protect the heart. Such products include cheese, kefir, yogurt, quark, and sour milk.

The team's findings, which appear in the British Journal of Nutrition, indicate that men who consume fermented dairy have a lower risk of incident CHD than men who prefer non-fermented dairy products.

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Fermented dairy linked to lower risk

This research was part of the ongoing Kuopio Ischaemic Heart Disease Risk Factor (KIHD) Study. In their current project, the scientists studied associations between incident CHD and the consumption of different types of dairy product.

The team analyzed the data of 1,981 men aged 42–60 years who joined the KIHD study in the years 1984–1989. None of the participants had CHD at baseline, and they all provided details on their dietary habits when they joined the project.

Over an average follow-up period of 20 years, the participants reported 472 cardiovascular events relating to incident CHD.

To determine how the consumption of dairy products might influence the participants' risk of CHD, the researchers divided them into different groups depending on their dietary intake of various fermented and non-fermented dairy foods.

Among the men who consumed fermented dairy products with less than 3.5 percent fat content, those in the highest consumption group had a 27 percent lower risk of CHD compared with those in the lowest consumption category.

The researchers also observed that the most widely consumed low-fat fermented dairy product was sour milk, and that eating high-fat fermented dairy foods, such as cheese, did not appear to sway CHD risk one way or the other.

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Milk tied to higher risk of CHD

At the same time, the team found that people who consumed a lot of non-fermented dairy products, of which regular milk had the greatest use, had a higher risk of incident CHD.

More specifically, those who had a very high intake — referring to an average of 0.9 liters of milk per day — were the most vulnerable to heart disease.

However, there was no association between low consumption of non-fermented dairy products and a heightened risk of CHD.

"Here in Finland, people's habits of consuming different dairy products have changed over the past decades," notes study co-author Jyrki Virtanen, adding:

"For instance, the consumption of milk and sour milk have declined, while many fermented dairy products, such as yogurt, quark, and cheeses, have gained in popularity."

Although the researchers cannot yet confirm the underlying mechanisms that are possibly at play in these associations, they speculate that certain compounds that form during the fermentation of milk-derived products may have a protective cardiovascular effect.

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Spider phobia: Using the heartbeat to improve treatment

Computerized therapy for phobia involves exposing the person to triggers of their specific fear, such as showing images of spiders to someone with arachnophobia. Now, for the first time, a recent study reveals that timing the exposure with heartbeats can improve the treatment.
heartbeat illustration with stethoscope
Syncing exposure to fear triggers with a person's heartbeat improves phobia treatment, a new study shows.

In previous work, scientists at Brighton and Sussex Medical School (BSMS) in the United Kingdom demonstrated that the amount of fear that exposure to a potential threat can generate depends on the stage of the heart's pumping cycle with which it coincides.

They found that the emotional impact was greater when threat exposure coincided with heartbeats as opposed to occurring between them.

This finding motivated them to see if they could apply the effect to "influence the outcomes of computerized exposure therapy for spider phobia." The journal Psychosomatic Medicine has recently published this new research.

"Many of us," says senior study author Prof. Hugo D. Critchley, the chair of psychiatry at BSMS, "have phobias of one kind or another — it could be spiders, or clowns, or even types of food."

He goes on to explain that most treatments for phobia involve exposure to the specific fear trigger but notes that "this can take a long time."

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Irrational, intense fear

A phobia is an irrational, intense fear that is vastly out of proportion to the actual danger or risk that the perceived threat poses.

Common examples include: a fear of spiders, dogs, or insects; a fear of heights, water, or storms; a fear of being in an elevator, enclosed, or on an airplane; and a fear of needles, injections, or surgical procedures.

The anxiety that the perceived threat generates can be so great as to disable the person. Just thinking about the feared situation or object can trigger severe symptoms, even though the person knows that their fear is irrational.

Estimates for the United States suggest that 12.5 percent of adults will have some kind of specific phobia during their lifetime.

Treatment for phobia typically takes a long time, and it usually involves gradually increasing exposure to triggers of the specific fear. One method that is gaining ground is computerized therapy, which it is possible to deliver over the Internet.

The recent study is a "proof-of-concept clinical trial" that demonstrates how computerized therapy for phobia could be even more effective if it were to sync trigger exposure with the individual's own heart rhythm.

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Timing with heartbeat led to best results

Prof. Critchley and his team combined the computerized exposure with online monitoring of heart rhythm.

They assigned 53 otherwise healthy individuals with severe spider phobia to one of three computerized therapy groups. In all groups, the treatment involved exposure to images of spiders.

In the first group, the spider images appeared at the same time as the individuals' heartbeats, while the participants in the second group viewed them between heartbeats. In the third group, the images appeared at random with respect to the cardiac cycle.

The team assessed improvement by measuring changes in the participants' levels of anxiety, self-reported fear of spiders, and skin conductance.

All groups showed some improvement, as they all received exposure therapy in some form. However, the greatest improvement occurred in the group whose spider image exposures coincided with their heartbeats.

The improvement was particularly marked in individuals who were able to sense their heartbeat in their chests. The researchers suggest the possibility of using people's differences in this ability to personalize the therapy.

"You could say we're within a heartbeat of helping people beat their phobias."

Prof. Hugo D. Critchley

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Is chest pain during exercise serious?

Everyone, including people in excellent shape, can experience pain in their chest during exercise. The many potential causes range from benign to potentially life-threatening.

Everyone who exercises regularly should recognize the symptoms that can accompany chest pain when the underlying issue is serious.

Read on to learn more about the causes of chest pain during exercise and how to treat and prevent them.

Causes Serious conditions, such as heart attacks, and less serious issues, such as muscle strains and asthma, can lead to chest pain during exercise. Heart attack Woman holding chest due to chest pain during exercise<!--mce:protected %0A-->
Chest pain during exercise may be caused by asthma, angina, or a heart attack.

Myocardial infarction is the medical term for a heart attack. A heart attack occurs when the coronary arteries become blocked. The blockage causes the heart to lose oxygen. If a person does not receive treatment, the heart muscle can die.

A heart attack can cause pain in the jaw, back, chest, and other parts of the upper body. The pain may go away and return, or it may last longer than a few minutes.

Other symptoms of a heart attack include:

pressure or pain in the chest sweating nausea dizziness anxiety shortness of breath

Heart attack symptoms can vary. Both men and women are likely to report chest pain, but women are more likely to experience:

back pain nausea vomiting jaw pain shortness of breath

If a person experiences any symptoms of a heart attack, they should seek immediate medical attention.

According to the American Heart Association, the most common risk factors for a heart attack include:

Age. People ages 65 and older are most at risk. Sex. Men have a much higher risk, even when they are younger, than women. Genetics. African-Americans and people with a family history of heart disease are more vulnerable to heart attacks and heart disease.

Angina pectoris

Angina pectoris, or angina, is a pain that stems from the heart. The main cause of angina is a lack of blood flow to the area. When this occurs, a person may feel tightness, pain, or pressure in their chest.

Some additional symptoms of angina include:

tightness in the arms or jaw shortness of breath fatigue nausea

Exercise and stress can cause angina, and people often mistake this pain for a heart attack. A person should seek immediate medical attention if they experience any symptoms of a heart attack.

According to the American College of Cardiology, women are three times more likely than men to experience throat discomfort and jaw tightness or pain because of angina.

Women may also experience sharper pain, while men are more likely to experience feelings of pressure associated with angina.

Hypertrophic cardiomyopathy (HCM)

According to the American Heart Association, HCM is a common condition that can affect nearly anyone.

HCM occurs when the cells of the heart muscle enlarge, causing the walls of the ventricles to thicken.

HCM can also result if the wall dividing the left and right sides of the heart grows and puts pressure on the ventricles.

In either case, the heart has to work harder to pump blood, and a person may experience:

dizziness shortness of breath chest pain fainting

In some people, HCM presents no symptoms. In rare cases, a person may experience sudden cardiac arrest during physical activities.


Man using an asthma inhaler whilst holding his bike
Asthma can cause coughing and chest tightness.

Asthma is a common condition that affects the airways in the lungs.

People with asthma have inflamed airways that tighten in response to triggers, including exercise. The medical term for this is exercise-induced bronchoconstriction.

A person with a family history of asthma is more likely to develop it. People with asthma may experience:

wheezing coughing chest tightness shortness of breath

Muscle strain and injuries

According to a research paper published in 2013, nearly half of all reported cases of muscle strains in the chest involve the intercostal muscles. These help a person breathe and stabilize the chest.

Common symptoms of muscle strains in the chest include:

sharp pain bruising swelling pain while breathing difficulty moving the area

The most common cause of a muscle strain is overuse. As a result, people who regularly exercise the chest muscles are more likely to experience a strain or tear.

The risk of chest muscle strains varies by age group:

Older adults are more likely to get this type of strain from a fall. Children are least likely to develop this strain. Adults are most likely to sustain this strain from exercise, sports, or high-impact crashes. Thank you for supporting Medical News Today When to see a doctor Speak to a doctor about any new, unidentified, or worsening chest pain. A doctor can help determine the underlying cause and recommend a treatment plan, which may include lifestyle changes. Seek emergency medical treatment for any symptoms of a heart attack. Chest pain is the most common symptom, and certain other symptoms, such as nausea, are more common in women than men. A person with exercise-induced asthma should seek specific treatment. A doctor may be able to prescribe medication and suggest other ways to reduce symptoms. This may enable a person to continue exercising or participating in sports. Prevention and precautions Not all chest pain is preventable. However, there are some general tips for preventing some causes of chest pain, such as heart attacks, strains, and asthma. A person may be able to prevent chest pain by: eating a balanced diet exercising regularly avoiding tobacco smoke and alcohol managing high blood pressure with medications avoiding activities that increase the risk of physical injury controlling asthma with medications Thank you for supporting Medical News Today Outlook A range of conditions, from muscle strains to heart attacks, can cause chest pain during exercise. Anyone who experiences this pain should consult a healthcare provider about the best course of treatment. Some causes of chest pain can be serious. Many people can prevent chest pain by making lifestyle changes and following a doctor's treatment plan. If any symptoms of a heart attack occur, seek immediate medical attention.
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Too much iron may raise the risk of certain strokes

The risk of having a stroke — particularly the kind that results from a blood clot or other obstacle traveling from the heart — appears to be greater in people who have higher levels of iron, according to recent research.
scientist looking at brain scans
New research finds a link between increased levels of iron and the risk of having certain strokes.

Scientists from Imperial College London in the United Kingdom examined stroke risk in people for whom they had information on their levels of iron and whether they had genetic differences that altered their iron status.

This yielded evidence suggesting that those with "genetically determined higher" iron levels were at greater risk of having a stroke, they note in a report on the study that now features in the journal Stroke.

In addition, it seems "that this effect is driven by an increased risk of cardioembolic stroke," a type of stroke in which blood in a vessel supplying the brain is blocked due to an obstruction that has traveled from the heart.

The study authors caution, however, that people should not use these findings as a reason to try to alter their iron levels, and they call for further research to confirm their results and also find out why iron may have this effect.

"This is an early-stage finding," notes lead study author Dr. Dipender Gill, from the School of Public Health at Imperial College London, "and we would certainly not recommend that patients at risk of stroke reduce their iron intake, as it has many crucial roles in the body."

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Cardioembolic stroke and iron status

According to the World Health Organization (WHO), around 15 million people have a stroke every year. Of these, 5 million die as a result and another 5 million will be disabled for the rest of their lives.

In the United States, more than 795,000 people have a stroke every year and about 140,000 die, accounting for 1 out of 20 deaths.

The majority of strokes are of the ischemic type, which occurs when a blockage in a blood vessel has stopped oxygen- and nutrient-rich blood reaching the affected part of the brain.

Cardioembolic stroke accounts for a notable proportion of ischemic strokes and is often linked to a heart condition called atrial fibrillation, wherein the heart beats irregularly and often faster than normal.

Iron has many uses in the body, the main one being to carry oxygen in red blood cells. The authors explain that studies have examined links between iron levels and stroke risk, but the results have been "conflicting."

Some studies, for example, have tied a raised risk of stroke to low levels of iron, while others have tied it to high levels of iron. In addition, there have also been studies that have found no link at all.

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Genetically driven iron status

Dr. Gill explains that they decided to investigate further because there have also been studies that have "suggested that in some cases iron can [actually] trigger blood to form a clot."

The first part of the team's investigation involved identifying genetic differences that influence how much iron people have, which is known as their "iron status."

They searched public data sources that held genetic information on more than 48,000 people.

Using a technique called Mendelian randomization, the scientists identified three "single-letter alterations," or single nucleotide polymorphisms (SNPs), in their DNA that can raise or reduce an individual's iron status.

They then used the three SNPs to screen another genetic dataset covering 60,000 people who had experienced strokes.

They found that people with SNPs that can raise iron status were the ones most likely to have cardioembolic strokes.

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'Avenues for further study'

The team has also used Mendelian randomization to explore other factors that may have an impact on stroke risk.

This revealed that people who have more blood platelets, or cells that promote clotting and stop bleeding, could be at higher risk for ischemic stroke.

Another investigation led to the discovery that individuals low in Factor XI, which is a compound that also helps blood clotting, could be at reduced risk of cardioembolic stroke.

"All these findings highlight potential treatments or lifestyle interventions that may help reduce stroke risk, and that they may offer avenues for further study."

Dr. Dipender Gill

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How much should I weigh? Ways of measuring

Many people want to know the answer to this question: How much should I weigh? However, there is not one ideal healthy weight for each person, because a number of different factors play a role.

These include age, muscle-fat ratio, height, sex, and body fat distribution, or body shape.

Having excess weight can affect a person's risk of developing a number of health conditions, including obesity, type 2 diabetes, high blood pressure, and cardiovascular problems.

Not everyone who carries extra weight develops health problems. However, researchers believe that while these extra pounds might not currently impact a person' s health, a lack of management could lead to problems in the future.

Read on to find out about four ways of working out your ideal weight.

Method 1: Body mass index (BMI) BMI takes into account height and weight.
BMI takes into account both height and weight but not body composition.

Body mass index (BMI) is a common tool for deciding whether a person has an appropriate body weight. It measures a person's weight in relation to their height.

According to the National Institutes of Health (NIH):

A BMI of less than 18.5 means that a person is underweight. A BMI of between 18.5 and 24.9 is ideal. A BMI of between 25 and 29.9 is overweight. A BMI over 30 indicates obesity.

Calculate your BMI

To calculate your BMI, you can use our BMI calculators or review our charts below.

2) Imperial BMI Calculator

Weight and height guide chart

The following weight and height chart uses BMI tables from the National Institute of Health to determine how much a person's weight should be for their height.

Height Weight
Normal Overweight Obesity Severe obesity
4ft 10"
91 to 115 lbs. 119 to 138 lbs. 143 to 186 lbs. 191 to 258 lbs.
4ft 11"
94 to 119 lbs. 124 to 143 lbs. 148 to 193 lbs. 198 to 267 lbs.
97 to 123 lbs. 128 to 148 lbs. 153 to 199 lbs. 204 to 276 lbs.
5ft 1"
100 to 127 lbs. 132 to 153 lbs. 158 to 206 lbs. 211 to 285 lbs.
5ft 2"
104 to 131 lbs. 136 to 158 lbs. 164 to 213 lbs. 218 to 295 lbs.
5ft 3"
107 to 135 lbs. 141 to 163 lbs. 169 to 220 lbs. 225 to 304 lbs.
5ft 4"
110 to 140 lbs. 145 to 169 lbs. 174 to 227 lbs. 232 to 314 lbs.
5ft 5"
114 to 144 lbs. 150 to 174 lbs. 180 to 234 lbs. 240 to 324 lbs.
5ft 6"
118 to 148 lbs. 155 to 179 lbs. 186 to 241 lbs. 247 to 334 lbs.
5ft 7"
121 to 153 lbs. 159 to 185 lbs. 191 to 249 lbs. 255 to 344 lbs.
5ft 8"
125 to 158 lbs. 164 to 190 lbs. 197 to 256 lbs. 262 to 354 lbs.
5ft 9"
128 to 162 lbs. 169 to 196 lbs. 203 to 263 lbs. 270 to 365 lbs.
5ft 10"
132 to 167 lbs. 174 to 202 lbs. 209 to 271 lbs. 278 to 376 lbs.
5ft 11"
136 to 172 lbs. 179 to 208 lbs. 215 to 279 lbs. 286 to 386 lbs.
140 to 177 lbs. 184 to 213 lbs. 221 to 287 lbs. 294 to 397 lbs.
6ft 1"
144 to 182 lbs. 189 to 219 lbs. 227 to 295 lbs. 302 to 408 lbs.
6ft 2"
148 to 186 lbs. 194 to 225 lbs. 233 to 303 lbs. 311 to 420 lbs.
6ft 3"
152 to 192 lbs. 200 to 232 lbs. 240 to 311 lbs. 319 to 431 lbs.
6ft 4"
156 to 197 lbs. 205 to 238 lbs. 246 to 320 lbs. 328 to 443 lbs.
BMI 19 to 24 25 to 29 30 to 39 40 to 54

What is the problem with BMI?

BMI is a very simple measurement. While it takes height into consideration, it does not account for factors such as:

waist or hip measurements proportion or distribution of fat proportion of muscle mass

These, too, can have an impact on health.

High-performance athletes, for example, tend to be very fit and have little body fat. They can have a high BMI because they have more muscle mass, but this does not mean they are overweight.

BMI can also offer a rough idea of whether or not a person's weight is healthy, and it is useful for measuring trends in population studies.

However, it should not be the only measure for an individual to assess whether their weight is ideal or not.

Thank you for supporting Medical News Today Method 2: Waist-hip ratio (WHR) Measuring the waist
A person's waist-hip ratio (WHR) can give an idea about whether they have more abdominal fat than is healthy. A person's waist-hip measurement compares their waist size with that of their hips. Research has shown that people who have more body fat around their middle are more likely to develop cardiovascular disease (CVD) and diabetes. The higher the waist measurement in proportion to the hips, the greater the risk. For this reason, the waist-hip ratio (WHR) is a useful tool for calculating whether a person has a healthy weight and size. Measure your waist-hip ratio 1. Measure around the waist in the narrowest part, usually just above the belly button. 2. Divide this measurement by the measurement around your hip at its widest part. If a person's waist is 28 inches and their hips are 36 inches, they will divide 28 by 36. This will give them 0.77. What does it mean? How WHR affects the risk of cardiovascular disease (CVD) is different for men and women, because they tend to have different body shapes. Evidence suggests that WHR can impact the risk of CVD as follows: In males Below 0.9: The risk of cardiovascular health problems is low. From 0.9 to 0.99: The risk is moderate. At 1.0 or over: The risk is high. In females Below 0.8: The risk is low. From 0.8 to 0.89: The risk is moderate. At 0.9 or above: The risk is high. However, these figures can vary, depending on the source and the population to which they apply. WHR may be a better predictor of heart attacks and other health risks than BMI, which does not take fat distribution into consideration. A study of health records for 1,349 people in 11 countries, published in 2013, showed that those with a higher WHR also have a greater risk of medical and surgical complications relating to colorectal surgery. However, WHR does not accurately measure a person's total body fat percentage, or their muscle-to-fat ratio. Method 3: Waist-to-height ratio Waist-to-height ratio (WtHR) is another tool that might predict the risk of heart disease, diabetes, and overall mortality more effectively than BMI. A person whose waist measurement is less than half their height has a lower risk of a number of life-threatening health complications. Measure your waist-to-height ratio A person's height
A person's height should be at least twice their waist measurement for a healthy WtHR. To calculate the WtHR, a person should divide their waist size by their height. If the answer is 0.5 or less, the chances are that they have a healthy weight. A woman who is 5 feet and 4 inches tall (163 cm), should have a waist measurement below 32 inches (81 cm). A man who is 6 feet or 183 centimeters (cm) tall, should have a waist measurement below 36 inches or 91 cm. These measurements will give a WtHR of just under 0.5. In a study published in 2014 in Plos One, researchers concluded that WtHR was a better predictor of mortality than BMI. The authors also cited findings from another study — involving statistics for around 300,000 people from different ethnic groups — which concluded that WHtR is better than BMI at predicting heart attacks, strokes, diabetes, and hypertension. This suggests that the WHtR could be a useful screening tool. Measurements that take waist size into account can be good indicators of a person's health risks because fat that collects around the middle can be harmful for the heart, kidneys, and liver. The Centers for Disease Control and Prevention (CDC) note that a man with a waist size of 40 inches or above, or a woman with a waist size of 35 inches or above has a higher risk than other people of: This does not, however, take a person's height or hip size into consideration. Thank you for supporting Medical News Today Method 4: Body fat percentage Body fat percentage is the weight of a person's fat divided by their total weight. Total body fat includes essential and storage fat. Essential fat: A person needs essential fat to survive. It plays a role in a wide range of bodily functions. For men, it is healthy to have 2 to 4 percent of their body composition as essential fat. For women, the figure is 10 to 13 percent, according to the American Council on Exercise (ACE). Storage fat: Fatty tissue protects the internal organs in the chest and abdomen, and the body can use it if necessary for energy. Apart from the approximate guidelines for men and women, the ideal total fat percentage can depend on a person's body type or activity level. ACE recommend the following percentages: Activity level Male body type Female body type Athletes 6–13% 14–20% Fit non-athletes 14–17% 21–24% Acceptable 18–25% 25–31% Overweight 26–37% 32–41% Obesity 38% or more 42% or more A high proportion of body fat can indicate a greater risk of: diabetes heart disease high blood pressure stroke Calculating body fat percentage may be a good way to measure a person's fitness level because it reflects the person's body composition. BMI, in contrast, does not distinguish between fat and muscle mass. How to measure body fat Calipers measure body fat
Calipers measure body fat. The result can give an indication of whether a person is likely to have certain health risks. The most common ways of measuring body fat percentage is to use a skinfold measurement, which uses special calipers to pinch the skin. The health professional will measure tissue on the thigh, abdomen, chest (for men) or upper arm (for women). The techniques provide an accurate reading within around 3.5 percent, according to ACE. Other techniques include: hydrostatic body fat measuring, or "underwater weighing" air densitometry, which measures air displacement dual energy X-ray absorptiometry (DXA) ï bioelectrical impedance analysis None of these can give a 100-percent accurate reading, but the estimates are close enough to give a reasonable assessment. Many gyms and doctor's offices have devices for measuring a person's body fat percentage. Video In this video by What Matters Nutrition, David Brewer, a registered dietician, takes a look at the question of ideal weight, discussing many of the points raised above. Thank you for supporting Medical News Today Takeaway Body mass index (BMI), waist-hip ratio (WHR), waist-to-height ratio (WtHR), and body-fat percentage are four ways of assessing a healthy weight. Combining them may be the best way to get an accurate idea of whether you should consider taking action or not. Anyone who is concerned about their weight, waist size, or body composition should speak to a doctor or nutritionist. They will be able to advise about suitable options. Q: Does it matter if a person if overweight, as long as they are healthy and comfortable? A: It is important to remember that there is a link between being overweight and a higher risk of many chronic diseases, including diabetes, hypertension, and metabolic syndrome.  Additionally, carrying extra weight can be tough on the skeletal system and joints, and it can result in changes in motor function and postural control. This may be because having extra body weight can reduce muscular strength and endurance, distort a person’s posture, and cause discomfort with normal body movements. For young people excess weight during the growth development stages can contribute to unusual motor patterning. This can remain into adulthood. Daniel Bubnis, MS, NASM-CPT, NASE Level II-CSS Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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Stroke: Can lifestyle changes trump genetic risk?

Strokes happen when an obstruction restricts the blood supply to the brain, and so the brain does not receive enough oxygen. A person's genetic makeup and their lifestyle both influence their risk of stroke, but which is more important?
mature man holding his head
If you are genetically predisposed to stroke, can you offset that risk?

According to the Centers for Disease Control and Prevention (CDC), every 40 seconds, a person in the United States has a stroke, and more than 795,000 people experience this cardiovascular event each year.

So far, specialists have identified a range of modifiable and nonmodifiable factors that influence an individual's risk of stroke.

Thus, on the one hand, a person may be predisposed to such cardiovascular events due to their genetic makeup. At the same time, numerous lifestyle factors — such as smoking or drinking habits, level of physical activity, and diet — also affect stroke risk.

But which factors are more critical, and to what extent can we prevent stroke?

We may now, finally, have an answer to this question, thanks to a new study that specialists from numerous prestigious institutions across Europe — including the University of Cambridge in the United Kingdom, the Karolinska Institutet in Stockholm, Sweden, and the German Center for Neurodegenerative Diseases in Bonn, Germany — have conducted.

Together, the scientists report their findings in a study paper that appears in The BMJ and whose first author is Loes Rutten-Jacobs.

According to the authors, the results "highlight the potential of lifestyle measures to reduce risk of stroke across entire populations, even in those at high genetic risk of stroke."

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In the current study, the researchers analyzed the genetic information of 306,473 participants from the U.K., which they sourced via the UK Biobank. All the individuals were between 40 and 73 years old, with no history of heart attack or stroke.

The investigators looked for 90 gene variants that scientists know are associated with stroke risk. Also, they determined whether each participant was leading a healthful lifestyle by looking at four factors — namely:

whether or not they smoked whether or not they consumed a diet rich in fish, fruit, and vegetables whether they had a body mass index (BMI) below 30, indicating that they were not overweight whether they exercised on a regular basis

Over an average follow-up period of 7 years, the researchers then collected hospital and death records to discover occurrences of stroke.

Overall, they noted that in terms of both genetic and lifestyle risk, men tended to be more predisposed to stroke than women.

Furthermore, stroke risk was 35 percent higher in people with a high genetic predisposition versus those with a low genetic predisposition, regardless of their lifestyle choices.

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At the same time, people who led an unhealthful life had a 66 percent higher risk of stroke than those who made healthful lifestyle choices. The increase was the same across all the genetic risk categories.

The most critical lifestyle factors that swayed a person's risk of stroke appeared to be a smoking habit and whether or not they were overweight, the authors observed.

Finally, people who had both a high genetic risk of stroke and led an unhealthful life had more than twice as high a risk of stroke compared with peers who had a low genetic risk and made healthful lifestyle choices.

As the authors note in their paper:

"The risk reduction associated with adherence to a healthy lifestyle in the present study was similar across all stratums of genetic risk, which emphasizes the benefit for entire populations of adhering to a healthy lifestyle, independent of genetic risk."

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This unlikely culprit may cause drug-resistant high blood pressure

Accumulation of lead in the body — as measured by the amount deposited in the outer layer of shin bone — is linked to a greater risk of having high blood pressure that is hard to treat.
person having their blood pressure measured
Lead accumulation could be a risk factor for drug-resistant hypertension.

So concludes a study of 475 veterans with high blood pressure that appears in the Journal of the American Heart Association.

The findings not only expand our understanding of how lead buildup in the body might affect the management of high blood pressure, but they could also lead to new treatment targets, note the authors in their study paper.

"Our study," says lead author Dr. Sung Kyun Park, who is an associate professor of epidemiology and environmental health sciences at the University of Michigan School of Public Health in Ann Arbor, "demonstrates that cumulative lead burden, as measured by cortical bone in the tibia (shin bone), may be an unrecognized risk factor for drug-resistant hypertension."

Cortical bone is the hard outer layer of bone. The recent findings are the first to suggest that lead buildup in the tibia could be a biomarker for the risk of developing hard-to-treat high blood pressure.

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Resistant hypertension and lead in the body

Resistant hypertension is high blood pressure that persists following measures to lower it. These measures include making changes to lifestyle and taking medication.

The American Heart Association (AHA) and American College of Cardiology define resistant hypertension as blood pressure that, despite treatment with three or more drugs from different classes, remains above the goal set in their guidelines.

Doctors also class people who have to take four or more drugs from different classes to bring their blood pressure below the threshold given in the guidelines as having resistant hypertension.

In their study report, Dr. Park and his colleagues cite studies that have found links between blood lead and raised blood pressure and, more recently, suggested that blood lead might be a factor in "cardiovascular-related deaths."

Others have also proposed various biological mechanisms through which lead in the body can lead to hypertension — for example, by disrupting blood vessel regulation and the progression of atherosclerosis.

However, none of these, Dr. Park and his team note, "have assessed the relationship between cumulative lead exposure and risk of resistant hypertension."

So, they set out to confirm their theory that researchers could use the lead level in bone as a biomarker of "cumulative lead exposure" that independently influences "the development of resistant hypertension."

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Shin bone lead linked to resistance risk

The team analyzed data from the Veterans Affairs Normative Aging Study on 475 "predominantly white" men with high blood pressure.

The dataset included measures of blood pressure, blood pressure medication, and levels of lead in blood, kneecaps (patella), and shin bones (tibia). Of the men, 97 met the criteria for resistant hypertension.

After adjusting for age, race, income, education, weight, smoking status, and further lifestyle, socioeconomic, and demographic factors, the analysis revealed a statistically significant relationship between increasing lead buildup in the shin bone and an increased risk of resistant hypertension.

Every extra 15 micrograms of lead per gram of bone in the tibia linked to a 19 percent higher risk of developing resistant hypertension.

The research team found no such statistically significant links for lead buildup in the kneecaps or blood lead.

The scientists say that more research is now needed to confirm the results of their study, particularly because of its limitations — such as the fact that they only studied men, most of whom were white.

The team also points out that resistant hypertension in the men it studied could have been the result of the participants using over-the-counter medication, or not taking their blood pressure drugs as prescribed.

Other factors that might affect the results include variations in blood pressure measurements due to differences in doctors' offices.

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Lead exposure 'still with us'

"Laws limiting lead exposure," comments Dr. Park, "have been on the books for decades, but, in recent years, it is recognized that lead remains an environmental toxin that is still with us."

Before the United States phased out the use of lead in gasoline some 30 years ago, breathing road traffic fumes was a primary source of lead exposure. Lead in exhaust fumes was also a major cause of soil contamination near roads, and this type of contamination can persist for decades.

Dr. Park suggests that while lead buildup in the body "likely reflects the after-effects of historically high lead exposures," another reason could be continuing exposure. He gives the example of "an aging infrastructure where water pipes in many urban areas are older and contain lead."

"Since the lead problems in the drinking water in Flint, Michigan, have surfaced, the issue has become more troubling, especially in older U.S. cities."

Dr. Sung Kyun Park

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Heart attack: New finding may change the face of treatment

Heart attacks are medical emergencies in which blood supply to the heart is blocked — usually by a blood clot. A new study from Sweden has made an intriguing discovery that may change existing guidelines about treating heart attacks.
concept image illustrating a heart attack
Do certain antibodies play a role in heart attacks?

Antibodies, or immunoglobulins (Ig), are a type of protein produced by plasma cells (a kind of blood cell). The immune system often co-opts these to fight potentially harmful foreign bodies.

Now, researchers from the Karolinska Institutet in Solna, Sweden, have discovered that certain antibodies — once associated with rheumatic diseases — are also present in high numbers inside the bodies of people who have had a heart attack.

These are the antiphospholipid antibodies (aPLs), which are abnormal antibodies that react to types of tissue produced by the body itself, such as cardiolipin (a lipoprotein) and beta-2-glycoprotein-I (a plasma protein).

Th scientists note that aPLs typically appear in the context of rheumatic diseases, such as systemic lupus erythematosus, or lupus.

The presence of these antibodies, they continue, can increase a person's risk of blood clots. This happens in antiphospholipid syndrome (APS), an autoimmune condition in which the body overproduces aPLs.

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Antibodies are present at high levels

In the recent study — the findings of which appear in the Annals of Internal Medicine — the authors note that aPL is distinctly present in the bodies of many people who have experienced heart attacks and are free of autoimmune conditions.

They also report that it has so far remained unclear just how common aPLs are in the case of such people, because scientists have conducted previous studies at too small a scale to provide the appropriate data.

For the new study, the investigators worked with 800 people admitted as patients at 17 Swedish hospitals after having experienced a heart attack for the first time.

To be able to compare data, the researchers also recruited an equal number of healthy participants to act as the control group.

The researchers analyzed blood samples from the first group at 6 and then again at 10 weeks after the heart attack. They looked for three distinct types of aPL: immunoglobulin G (IgG), M (IgM) and A (IgA).

When they looked at the data, the investigators saw that 11 percent of the participants who had experienced heart attacks had aPL that reacted to both cardiolipin and beta-2-glycoprotein-I. That was 10 times more people than in the control group.

"I've long been convinced that the antibodies are more common than we think and have now been able to analyze their presence in a large patient material," says study author Prof. Elisabet Svenungsson.

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'This would change prevailing guidelines'

"It was a surprisingly high proportion of the patients and the levels were also clearly high," explains Prof. Svenungsson.

Specifically, the volunteers had high levels of IgG antibodies, which are most commonly associated with a heightened risk of blood clots.

However, the researchers admit that they only collected one set of blood samples, which may not accurately reflect the levels of aPL over time and may instead be a one-off reaction to the heart attack.

Still, should their aPL levels remain high over 3 months, this would mean that the participants have APS, which would predispose them to blood clots.

"In which case they should," notes Prof. Svenungsson, "according to current recommendations, be prescribed lifelong treatment with the anticoagulant warfarin, which reduces the risk of new blood clots," concluding:

"This would change the prevailing guidelines for the investigation and treatment of heart attacks."

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What to know about aortic dissection

An aortic dissection happens when tears appear in the inner lining of the aorta, which is the main artery leaving the heart. Blood surges into the tears, causing the aorta lining to split, or dissect.

Aortic dissection is a medical emergency. The condition can quickly become fatal if the blood breaks through the aorta's outer lining.

Aortic dissection is not common. It affects between 5 and 30 people out of every 1 million each year, and it is most likely to affect older men.

In this article, we describe the two types of aortic dissection, their symptoms and treatment options, and the outlook for people with this condition.

Symptoms Man with aortic dissection suffering from abdominal pain sitting on bed clutching stomach
Severe pain in the abdomen is a potential symptom of aortic dissection.

Due to its symptoms, aortic dissection can resemble other high-risk conditions that are more common, so it can be challenging to diagnose.

People with risk factors for aortic dissection, such as high blood pressure or a family history of aortic dissection, should have regular heart checkups with their doctor.

Aortic dissection symptoms usually appear quickly after the tear occurs. They often resemble the symptoms of other heart problems and may include:

severe pain in the chest, back, or abdomen, which occurs in up to 90 percent of cases anxiety difficulty speaking difficulty walking a fast, weak pulse in one arm or leg leg pain loss of consciousness nausea paralysis of one side of the body shortness of breath sweating weakness Types of aortic dissection There are two types of aortic dissection: Type A is the most common and dangerous form of aortic dissection. It occurs when the upper aorta, called the ascending aorta, tears. The tear may spread to the abdomen. Type B refers to a tear in the lower aorta, called the descending aorta. This tear may also extend to the abdomen. Medical professionals may classify aortic dissection in other ways, including the following: acute: the tear has been present for less than 14 days chronic: the tear has been present for 14 days or more complicated: the tear has caused other issues, such as poor blood supply to some organs uncomplicated: the tear has not led to any complications Thank you for supporting Medical News Today Causes and risk factors Anatomy model of heart showing valves
Aortic dissection affects the walls of the aortic valve. Aortic dissection occurs when a weak section of the aorta wall rips or tears. Factors that increase a person's risk of aortic dissection include: Age and sex Most cases occur in men between the ages of 50 and 65 years, but both men and women of any age can develop the condition. Approximately two-thirds of people who experience aortic dissection are male. However, females tend to have worse outcomes. High blood pressure Long-term hypertension places greater pressure on the artery walls, making them more likely to tear. Certain genetic disorders People with specific genetic conditions have a higher risk of aortic dissection. These conditions include: An infectious or inflammatory condition A syphilis infection or inflammation of the arteries, which can occur as a result of giant cell arteritis or Takayasu's arteritis, can increase the risk of aortic dissection. Other artery problems Having a preexisting aortic issue may increase the risk of the artery separating. These issues include: hardening of the arteries, or atherosclerosis valve defects, such as a bicuspid aortic valve a narrow aorta, or aortic coarctation a weak and bulging artery, or an aortic aneurysm Trauma to the chest Less commonly, a severe chest injury may contribute to a tear in the aorta. Pregnancy Aortic dissections can occur during pregnancy in rare cases. Cocaine use Cocaine raises blood pressure, which increases a person's risk of aortic dissection. High-intensity weightlifting Intense resistance training increases blood pressure, which may result in an aortic tear. When to see a doctor People who develop any of the symptoms of aortic dissection or experience another cardiac event should call 911 immediately. Aortic dissection can have severe consequences, including organ failure or death, especially if a person does not receive urgent treatment. Diagnosing aortic dissection To diagnose aortic dissection, a doctor will take a medical history and carry out a physical examination. The signs and symptoms that will help them make a diagnosis include: an abnormal heartbeat differences in blood pressure between the left and right arms sudden, intense pain in the chest, back, or abdomen Doctors will typically also carry out imaging tests to confirm or rule out a diagnosis of aortic dissection. These include: Chest X-ray. A chest X-ray can reveal a widening of the aorta. However, the images may appear normal in an estimated 10 to 20 percent of people with aortic dissection so additional tests may be necessary. Transesophageal echocardiogram (TEE). A TEE involves placing a probe down the food pipe, close to the aorta. Sound waves produce an image of the heart, which the doctor can check for irregularities. Aortic angiogram. During this procedure, the doctor will inject a contrast liquid into the arteries. They will then take X-rays which may show up any abnormalities in the aorta. Magnetic resonance angiogram (MRA). This test uses a magnetic field and radio waves to examine the blood vessels. Additional tests, such as blood tests, may help the doctor rule out the possibility of other conditions and events with similar symptoms, including heart attack. Thank you for supporting Medical News Today Treatment Immediate medical treatment is necessary for aortic dissection to prevent complications or death. This treatment typically involves medications, surgery, or both. Medications A doctor may prescribe medication to treat aortic dissection.
A doctor may prescribe medication to treat aortic dissection. A doctor may give people with a type B aortic dissection beta-blockers and nitroprusside to lower their heart rate and blood pressure and to prevent the tear from getting worse. People with a type A aortic dissection might also take these medications to help stabilize their condition, but they typically require surgery as well to correct the tear. Most people who have an aortic dissection will need to take medications to reduce blood pressure for the rest of their lives. Surgery People with a type A aortic dissection will usually undergo surgery to remove the damaged section of the aorta and replace it with a tube. This procedure prevents blood from flowing into the aortic wall. The surgeon will also replace the aortic valve if it is leaking. People with type B aortic dissection may undergo a similar procedure, but their surgery may also include the use of stents, which are small mesh tubes, to repair the aorta. Follow-up treatment In addition to taking hypertension medications for life, people may need to have regular imaging scans to allow the doctor to monitor their condition. Prevention People who are at risk of developing aortic dissection, including those with a family history of the condition, can use lifestyle methods to reduce their risk. These include: going for regular heart checkups monitoring their blood pressure regularly and receiving treatment for hypertension eating a healthful diet that is high in whole grains, fruits, and vegetables and low in salt exercising regularly maintaining a healthy body weight avoiding smoking following a treatment plan for any existing medical conditions that increase the risk of aortic dissection wearing a seat belt in the car to reduce the risk of chest injuries Outlook and survival Aortic dissection has a high rate of mortality. According to some sources, approximately 40 percent of people die after getting to the emergency department, and 20 to 30 percent of people die after surgery. The highest mortality rates occur within the first 10 days of aortic dissection. The likelihood of fatality increases by 1 percent for every hour a person goes without treatment. The condition can cause complications, such as: internal bleeding organ failure stroke For the best chance of recovery, individuals should call 911 or go directly to the emergency department if they experience any of the symptoms of an aortic dissection. Early treatment can be life-saving.
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What to know about cardiac tamponade

Cardiac tamponade is the accumulation of fluid around the heart muscle, which places excessive pressure on this organ.

In people with cardiac tamponade, also known as pericardial tamponade, fluid or blood builds up between the heart and the sac that surrounds the heart. This sac is called the pericardium.

The pericardium consists of two thin layers of tissue. This area usually contains a small amount of fluid to prevent friction between the layers.

However, an abnormally high level of fluid puts pressure on the heart and affects its ability to pump blood around the body properly. If the level of fluid builds up quickly, it can be life-threatening.

Doctors consider cardiac tamponade to be a medical emergency.

In this article, we discuss the causes and symptoms of cardiac tamponade. We also describe the treatment options and the outlook for people with this condition.

Causes cardiac tamponade
A buildup of fluid around the heart muscles causes cardiac tamponade.
Image credit: Blausen.com staff, 2014.

Cardiac tamponade results from the buildup of fluid between the layers of the pericardium. In acute cardiac tamponade, this fluid accumulation occurs quickly, while it happens slowly in subacute cardiac tamponade.

The most common causes of cardiac tamponade are:

severe chest injury heart attack hypothyroidism, or an underactive thyroid inflammation of the pericardium, which is called pericarditis aortic dissection bacterial infection tuberculosis (TB) kidney failure cancer lupus, an autoimmune condition the bursting of an aortic aneurysm, or a bulge in the aorta

Complications arising from heart surgery may also cause cardiac tamponade.

According to some research, cardiac tamponade is the cause of surgical reintervention in 0.1–6.0 percent of cardiac surgery cases.

Signs and symptoms Cardiac tamponade impairs the ability of the heart to pump blood around the body. As a result, blood does not circulate properly, which can lead to chest pains and lightheadedness. The three classic signs of cardiac tamponade, which doctors refer to as Beck's triad, are: low blood pressure in the arteries muffled heart sounds swollen or bulging neck veins, called distended veins People with cardiac tamponade may also experience the following symptoms: a weak pulse bluish skin that is cool to the touch lightheadedness a rapid heart rate fainting drowsiness anxiety sharp pain in the chest, back, abdomen, or shoulder shortness of breath Thank you for supporting Medical News Today Diagnosis Electrocardiogram or ECG showing heart beat or rate
A doctor may recommend an ECG to accurately diagnose cardiac tamponade. To diagnose cardiac tamponade, a doctor will look for Beck's triad of medical signs. They will do this by checking the individual's blood pressure, listening to their heart, and examining the appearance of their veins. The doctor is likely to carry out additional tests to support their diagnosis. These may include: Echocardiogram. Doctors commonly carry out an echocardiogram, or echo, if they suspect cardiac tamponade. This scan provides a detailed image of the heart, which may help the doctor detect fluid in the pericardial sac or a collapsed ventricle. Chest X-ray. An X-ray of the chest shows if the heart is abnormally large or an unusual shape due to fluid buildup. Electrocardiogram (ECG). This test allows the doctor to examine the electrical activity of the heart. Computerized tomography (CT) scan. A CT scan of the chest can confirm the presence of extra fluid in the pericardium. Magnetic resonance angiogram (MRA). An MRA uses a magnetic field and radio waves to detect any abnormalities in how the blood flows through the blood vessels of the heart. The doctor may order blood tests to measure the levels of red and white blood cells too. Blood tests may also detect higher levels of specific enzymes that the body releases in response to damage to the heart muscle. Is cardiac tamponade common? Cardiac tamponade is not a common condition, but it can affect anyone. A 2018 study reports 5 cases of cardiac tamponade per 10,000 hospital admissions (0.05 percent) in the United States. People with certain medical conditions are more likely than the general population to experience cardiac tamponade, including people with: HIV end-stage renal disease a history of heart failure tuberculosis lupus and some other autoimmune conditions malignant tumors injuries to the chest Treatments As cardiac tamponade can result in shock or death, it always requires emergency medical treatment. This treatment involves draining excess fluid from around the heart. A doctor may use the following methods to remove the fluid and reduce the pressure on the heart: Pericardiocentesis. The removal of fluid from the pericardium using a needle. Pericardiectomy. The surgical removal of part of the pericardium to relieve pressure on the heart. Thoracotomy. A surgical procedure that allows the draining of blood or blood clots around the heart. According to some research, doctors should choose minimally invasive procedures, such as pericardiocentesis, as the first treatment option. Such options carry a less significant risk of complications and have lower mortality rates. However, more complicated cases of cardiac tamponade will often require surgery, including a thoracotomy. After surgery, the individual may receive the following as they stabilize: intravenous (IV) fluids to maintain normal blood pressure medications to increase blood pressure oxygen to reduce stress on the heart Once the person is stable, the doctor will need to determine and treat the underlying cause of the cardiac tamponade to prevent further complications. Thank you for supporting Medical News Today Outlook An early diagnosis can improve the outlook for people with cardiac tamponade.
An early diagnosis can improve the outlook for people with cardiac tamponade. The outlook for people with cardiac tamponade depends on: how quickly they receive treatment for the condition possible complications the underlying cause People with a non-cancerous cause of cardiac tamponade have a mortality rate of less than 15 percent. Cases in which cancer is the underlying cause have an estimated mortality rate of 80 percent within 1 year. Mortality rates are also higher among those who have sepsis, acute kidney injury, or chest injury. Prompt diagnosis and early treatment significantly improve the outlook for people with cardiac tamponade. Without treatment, the condition is fatal. Prevention It is not possible to prevent all cases of cardiac tamponade. However, people can reduce their risk by doing the following: reducing exposure to bacterial or viral infections receiving treatment for medical conditions, such as lupus and hypothyroidism protecting heart health through a balanced diet and regular exercise attending regular medical checkups avoiding smoking Summary Cardiac tamponade is an uncommon but severe medical condition that can result in shock or death. It is vital that anyone who suspects that they have cardiac tamponade seeks emergency treatment. The treatment for cardiac tamponade involves draining the excess fluid from the pericardium, stabilizing blood pressure, and treating the underlying cause. People who receive prompt diagnosis and appropriate treatment generally have a better outlook. Although it is not possible to prevent all cases of cardiac tamponade, people should be aware of their risk factors and discuss preventive methods with their doctor.
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Can a vitamin combo prolong your life?

Vitamins are nutrients that when synthesized or assimilated in the right quantities support our health and well-being. A new review suggests that a set of known and newly categorized vitamins can help prolong a person's lifespan, and promote health well into old age.
wooden spoon with supplements
A series of crucial nutrients may be 'longevity vitamins' that help fend off disease and prolong our lives.

The review, recently published in Proceedings of the National Academy of Sciences, was conducted by Dr. Bruce Ames, Senior scientist at Children's Hospital Oakland Research Institute (CHORI) in Oakland, CA.

This work analyzes the results of numerous studies conducted in Dr. Ames's CHORI laboratory, as well as those carried out by researchers from other institutions.

In the published paper, Dr. Ames identifies a set of vitamins, which he calls "longevity vitamins." He contextualizes the importance of these nutrients by suggesting that people can classify the proteins (or enzymes) that they need to stay healthy as either "survival proteins" or "longevity proteins."

While all these nutrients are essential for well-being, they play different roles. The scientist explains that "survival proteins" support our basic processes for survival and reproduction, whereas "longevity proteins" play an additional role in protecting against further damage to the human body.

When nutrients are deficient, Dr. Ames says, the body tends to favor the production of "survival proteins," which can lead to a decrease in "longevity proteins," and thus to a heightened risk of disease.

"Longevity vitamins," according to the researchers, are the nutrients which support the function of "longevity proteins," and allow the human body to remain healthy, and live for an extended period.

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Over 30 vitamins sustain longevity

Dr. Ames explains that these key nutrients — which include vitamin K, vitamin D, omega-3 fatty acids, magnesium, and selenium — contribute to the processes that keep the cells in our bodies healthy.

These nutrients play many roles in the body, including repairing DNA, maintaining cardiovascular health, and preventing cellular damage due to oxidative stress, the scientist argues.

"The prevention of the degenerative diseases of aging is a different science than curing disease: it will involve expertise in metabolism, nutrition, biochemistry, and genetic regulatory elements and polymorphisms," he writes.

"This approach is critical for lowering medical costs. It has been estimated that the [European Union] would save 4 billion euros [$4.6 billion] from osteoporosis alone by utilizing vitamin D and calcium supplementation," the researcher further notes.

In the current review, Dr. Ames argues that 30 known vitamins and essential minerals, taken at adequate doses, can help extend a person's lifespan and ensure healthy aging.

To these, he adds 11 compounds, which, although not currently categorized as "vitamins," Dr. Ames thinks fit in with the concept of "longevity vitamins" as described in his review.

These substances include taurine, ergothioneine, pyrroloquinoline quinone, queuine, lutein, zeaxanthin, lycopene, alpha-carotene, beta-carotene, beta-cryptoxanthin, and astaxanthin.

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'Diet is very important'

Previous studies conducted by Dr. Ames and his team found that individuals with chronic, low-level deficiencies of vitamin K, which is a constituent of 16 different enzymes, and the mineral selenium, which is a key component of 25 enzymes, have a higher risk of experiencing health problems, particularly cardiovascular issues.

Vitamin K is crucial to blood coagulation. When levels of this vitamin are low, the body is unable to produce enough of the enzymes that help keep the arteries clear, allowing blood to flow smoothly.

Considering these observations and the findings of the review, Dr. Ames urges people to be more mindful about following a balanced, healthful diet.

"Diet is very important for our long-term health, and this theoretical framework just reinforces that you should try to do what your mother told you: eat your veggies, eat your fruit, give up sugary soft drinks and empty carbohydrates."

Dr. Bruce Ames

In the future, the researchers believe that specialists might identify even more "longevity vitamins." However, discovering these nutrients requires long periods of observation because their absence from the system does not necessarily cause immediate, visible effects.

Instead, the impact of "longevity vitamin" deficiencies causes disruptions in a person's system over time.

For now, as Dr. Ames notes: "[The current review] may be a theoretical paper, but I hope it can add a few years to everyone's lives."

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Heart surgery: Does it impact cognitive ability?

A recent systematic review and meta-analysis concluded that, following open heart surgery, a person's cognitive ability might be reduced — at least in the short-term.
Surgical tools
A new analysis investigates the impact of heart surgery on cognitive performance.

Almost 8 million people in the United States undergo cardiovascular surgery or other related procedures each year.

Thanks to the steady improvements made by medical science, the procedures are becoming ever safer and can give people a new lease of life.

Aware of improvements in physical health due to cardiovascular surgery, scientists know less about the cognitive impact of open heart surgery.

A recent study set out to understand precisely how heart surgery might influence the mind. In particular, the researchers were interested in heart valve surgery.

Previous studies have looked at cognitive decline following some types of heart operation, but scientists know little about the impact on this particular group of surgical patients.

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Valve surgery and the mind

Each year in the U.S., around 150,000 heart valve surgeries take place. In most cases, surgeons operate to treat aortic stenosis. This is a condition where the aortic valve becomes narrowed, partially blocking blood flow from the heart to the rest of the body.

Generally, aortic stenosis occurs in people aged 65 or older. Because of the aging population, the number of cases of aortic stenosis is predicted to increase significantly over the coming decades.

As people age, their cognitive ability tends to decline, so understanding how heart surgery might further impact cognitive ability is crucial.

To investigate, the researchers pooled data from 12 existing studies. They assessed the cognitive performance of all the participants before and after surgery. In this analysis, the scientists also compared the effects of two types of valve surgery — aortic and mitral. Their findings were published recently in the Journal of the American Geriatrics Society.

The authors found that in the first month after surgery, there was a decline in cognitive ability. However, they also showed that by 6 months post-surgery, a person's thinking abilities had almost returned to normal.

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In fact, some of the studies analyzed for the review suggested that cognitive ability was slightly improved 6 months after surgery, compared with before surgery.

The analysis also showed that the patients' cognitive performance responded differently depending on the type of surgery they had. Those who had surgery on the aortic valve saw more significant cognitive deficits in the first month following surgery, while those who had mitral valve surgery experienced a less significant cognitive decline.

Over the following 6 months, however, the difference in deficits steadily disappeared as the cognitive abilities of those who underwent aortic valve procedures caught up.

However, this difference might not have been due to the procedures themselves. It is possible that the differences were due to age — individuals who underwent aortic valve procedures were, on average, 9 years older than those who had mitral valve procedures.

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More questions than answers

Overall, the researchers conclude that individuals who undergo heart valve surgery are likely to have reduced cognitive ability for the first few months after the procedure.

Although mental ability is likely to return to normal within 6 months, this is a matter for further research. The authors of the study note this as one of the study's shortfalls — they did not investigate cognitive performance past the 6-month point.

The authors also note that, for some of the studies they analyzed, it was not clear whether the participants had undergone previous surgery, or whether this was the first event.

Also, the researchers did not know about some other factors that might have influenced cognitive changes, such as level of education, social support, depression, blood pressure, and the severity of cardiovascular disease a person had.

The authors hope that their findings "encourage routine preoperative cognitive assessment to establish cognitive baseline and postoperative assessment to monitor trajectory."

According to the authors, it would be useful if future studies focused on the specific factors that made valve surgery patients more susceptible to cognitive decline. This could guide clinicians as they help patients and their families through the recovery process.

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Can you take too much magnesium?

Magnesium is an essential mineral. However, having too much magnesium in the blood can be dangerous. The medical term for this is hypermagnesemia, and a magnesium overdose is one possible cause.

The body needs magnesium for more than 300 biochemical processes.

Magnesium blood levels of 1.7–2.3 milligrams per deciliter (mg/dl) are within the normal range, while levels above 2.6 mg/dl can indicate hypermagnesemia.

Having too much magnesium in the blood is uncommon. It is more likely to occur in people with existing health conditions, such as kidney failure.

Excessive dosage of supplements or medications can also cause hypermagnesemia.

In this article, we discuss the risk factors and symptoms of a magnesium overdose. We also describe why it is important to get enough magnesium from the diet and supplements.

Symptoms of a magnesium overdose magnesium overdose supplements
Excessive dosage of magnesium supplements can cause hypermagnesemia.

If the body has absorbed too much magnesium, a person may notice any of the following symptoms, which can range from mild to very severe:

lethargy facial flushing diarrhea nausea stomach cramps vomiting depression muscle weakness an irregular heartbeat low blood pressure urine retention breathing difficulties cardiac arrest How likely is a magnesium overdose? Severe overdoses of magnesium are rare in otherwise healthy people. Getting too much magnesium from the diet is not typically a cause for concern. Occasionally, a high dosage of magnesium from supplements or medications can cause mild symptoms of an overdose, including diarrhea, nausea, and stomach cramps. The following forms of magnesium are most likely to cause these symptoms: magnesium carbonate magnesium chloride magnesium gluconate magnesium oxide Rarely, a very high dosage of a supplement or medication provides more than 5,000 mg of magnesium per day. This can cause magnesium toxicity. The medicines involved are typically laxatives or antacids. The kidneys clear excess magnesium from the body, and people with renal problems or kidney failure are more likely to absorb too much magnesium. Doctors usually advise people with this risk to avoid supplements and medications that contain magnesium. Thank you for supporting Medical News Today Risk factors magnesium overdose kidney disease
Kidney disease can increase the risk of a magnesium overdose. The risk factors for a magnesium overdose include: having kidney disease having other medical conditions, such as hypothyroidism, Addison's disease, or gastrointestinal disorders taking too many supplements or medications that contain magnesium The first treatment for hypermagnesemia is to stop consuming magnesium in supplements or medications. Other treatments include: intravenous fluids diuretics dialysis If hypermagnesemia is severe, treatment may also involve intravenous calcium. Medications that contain magnesium Laxatives, in particular, often contain high levels of magnesium, due to its natural laxative effects. Although these medications provide more than the recommended amount of magnesium, the body usually does not absorb it all. For example, 1 tablespoon of Milk of Magnesia contains 500 mg of elemental magnesium. A daily dose for adults is up to 4 tablespoons per day, but the body excretes much of the magnesium because of the medication's laxative effects. Some migraine medications also contain magnesium, as do some drugs for indigestion and heartburn. Only take a medication that contains magnesium with medical supervision. Why we need magnesium The body requires magnesium to stay healthy. It is essential for over 300 processes, including: muscle function nerve function protein synthesis bone formation DNA synthesis energy production heart health maintaining blood sugar levels maintaining blood pressure Some studies suggest that magnesium may help treat or prevent: However, confirming the effects of magnesium on these conditions will require more research. Magnesium deficiency, or hypomagnesemia, is much more common than hypermagnesemia, especially in otherwise healthy individuals. Some research indicates that 10–30 percent of people have low levels of magnesium. The Office of Dietary Supplements at the American National Institutes of Health recommend the following daily allowances of magnesium: 400–420 mg for adult males 310–320 mg for adult females 350–360 mg during pregnancy Risk factors for magnesium deficiency include: Crohn's disease, celiac disease, and other gastrointestinal diseases type 2 diabetes alcohol use disorder advanced age certain medications, such as proton pump inhibitors and diuretics being an adolescent female — on average, this group may receive less magnesium from the diet Thank you for supporting Medical News Today Sources of magnesium People can meet their magnesium needs through the diet and dietary supplements: Foods black beans magnesium overdose
Black beans are a source of magnesium. Magnesium is present in many foods, including: legumes, such as black beans and kidney beans nuts, including almonds, cashews, peanuts, and peanut butter whole grains, such as brown rice and oats potatoes, when a person eats the skin leafy green vegetables, such as spinach fortified breakfast cereals soy products, including soymilk and edamame dairy products, such as milk and yogurt There is no need to limit the amount of magnesium in the diet if the body can excrete it through the kidneys. Supplements People can take supplements to meet their magnesium requirements. According to the Office of Dietary Supplements, most people in the United States do not get enough magnesium from their diets alone. However, by taking supplements, most people get more magnesium than necessary. To avoid an overdose, do not take more than 350 mg of magnesium a day. Topical magnesium sources Some believe that the body can absorb magnesium particularly well through the skin, in a process called transdermal absorption. For this reason, a person may try meeting their requirements by using Epsom salts or topical magnesium oils. However, little if any scientific research currently supports the idea. Takeaway Magnesium is essential for well-being, but too much can cause problems, including digestive issues, lethargy, and an irregular heartbeat. In rare cases, a magnesium overdose can be fatal. Magnesium toxicity is rare in otherwise healthy people, and levels are more likely to be low than high. People with conditions affecting the kidneys are among those at risk of absorbing too much magnesium. The risk of death is highest in older adults with renal failure. A person is unlikely to overdose from magnesium in the diet, but supplements and medications can provide too much magnesium. Early diagnosis of a magnesium overdose is important. Treatment is usually effective if a doctor detects the overdose in an early stage.
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What tests are used to diagnose COPD?

Chronic obstructive pulmonary disease or COPD is the medical name for a group of long-term lung conditions. Doctors use a number of tests to diagnose people with COPD.

Symptoms of COPD, such as wheezing, shortness of breath, and fatigue, can be similar to the signs of other lung conditions.

COPD often gets progressively worse over time. Getting an accurate and early diagnosis allows doctors to develop an effective treatment plan that can help slow the progression of a person's disease.

Doctors begin diagnosing COPD by carrying out a physical exam and reviewing a person's medical history. They will usually then order one or more tests to help them confirm a diagnosis.

Common tests doctors use to diagnose people with COPD include:

Pulmonary function tests copd tests spirometry
Spirometry is a type of pulmonary function test and helps determine how well a person's lungs are functioning.

Doctors consider pulmonary function tests to be one of the best diagnostic tools for diagnosing COPD. Spirometry is one of the main pulmonary function tests.

Spirometry helps determine how well a person's lungs are functioning. The test measures the amount of air they can breathe in, and how much and how fast they can expel the air back out of their lungs.

Spirometry can also help a doctor determine if a person has a restrictive or obstructive lung disease.

People with restrictive lung disease have difficulty completely expanding their lungs when they inhale.

Individuals with obstructive lung disease, such as COPD, have trouble getting air completely out of their lungs when they exhale.

For the spirometry test:

The person wears a clip on their nose to prevent breathing in or out through this. The individual puts their lips around a tube-like device that is attached to the spirometry machine. When ready, the technician will instruct the person to take a deep breath and then exhale, as quickly and forcefully as possible, until their lungs are empty. Usually, a person repeats this process three times, and the technician records the highest value of the test for the final results.

Sometimes, the doctor or technician will ask the person to inhale a bronchodilator before doing the test again.

A bronchodilator is a medication that relaxes the muscles of the airways and opens them up. This allows the doctor to determine if the bronchodilator affects how much air a person can get in and out of their lungs.

Although spirometry is the most common pulmonary function test, a doctor may recommend other types, such as lung diffusion capacity or body plethysmography.

What do the results mean?

The amount of air a person exhales is called the forced vital capacity (FVC). The percentage of air they exhale during the first second is called the forced expiratory volume (FEV1).

Doctors base the diagnosis of COPD on the ratio between FEV1 and FVC. They compare FEV1 and FVC measurements with a predicted value that they base on a person's age, height, and weight.

An FEV1 and FVC ratio of less than 70 percent of the predicted value indicates that a person may have COPD.

Doctors can also use the FEV1 measurement to help determine the severity of COPD. According to a 2017 report from the Global Initiative for Chronic Obstructive Lung Disease, classification of COPD based on FEV1 is as follows:

FEV1 above 80 percent is mild FEV1 of 50 to 79 percent is moderate FEV1 of 30 to 49 percent is severe FEV1 of 29 percent or less is very severe Thank you for supporting Medical News Today Arterial blood gas copd tests blood
An arterial blood gas test allows doctors to measure oxygen levels in the blood. An arterial blood gas test is a blood test that doctors use to measure: oxygen levels in the blood carbon dioxide levels in the blood pH, or the acidity, of the blood bicarbonate levels in the blood During this test, a healthcare professional will draw a small sample of blood from the person's artery. Typically, this will be the radial artery, which is on the inside of the wrist. The doctor or nurse will then use a machine to analyze the blood sample. What do the results mean? The results of a blood gas test let the doctor know how efficiently a person is getting oxygen into their lungs and carbon dioxide out. People with COPD often have problems getting all the air out of their lungs due to damage to the air sacs. When air becomes trapped, carbon dioxide levels can rise. Lung damage can also impact oxygen levels, which may be lower than normal in someone with COPD. Different levels of oxygen and carbon dioxide in the blood can also affect pH and bicarbonate levels. A doctor will not make a diagnosis of COPD based on arterial blood gas alone, but the results can be helpful in reaching a diagnosis. Alpha-1 antitrypsin (ATT) deficiency screening The most common cause of COPD is cigarette smoking. Rarely, COPD can develop as a result of AAT deficiency, which is due to a faulty gene that can run in families. The liver makes AAT, which is a protein that helps protect the lungs and other organs from damage. People with AAT deficiency lack this protein, which increases their risk of developing COPD and liver disease. AAT deficiency can also cause COPD to develop at an earlier age than usual. Doctors can determine if a person has AAT deficiency by taking a blood sample to measure the amount AAT in the blood. What do the results mean? Low levels of AAT in the blood indicate that an individual may have AAT deficiency. Usually, the lower the AAT levels in the blood, the higher the risk of developing COPD. Doctors can use AAT deficiency screening to help them confirm a diagnosis of COPD when there is no obvious cause. Thank you for supporting Medical News Today Imaging tests Doctors sometimes also use imaging tests, such as a CT scan or chest X-ray, to help diagnose COPD. These tests create an image of the inside of the lungs and chest. Often, a CT scan can provide a greater level of detail than an X-ray. What do the results mean? Imaging tests cannot aid a doctor in determining the severity of a person's COPD. However, they can help confirm a diagnosis or rule out whether another condition is causing the symptoms. As an example of this, these imaging tests allow a doctor to see if the lungs appear hyperinflated or if the diaphragm is flat, both of which are signs of COPD. Differential diagnosis copd tests struggle breathing
Coughing, wheezing, and shortness of breath are common symptoms of COPD. A differential diagnosis is important when confirming COPD. Symptoms of COPD can be variable but typically include: wheezing shortness of breath coughing increased mucus fatigue chest pain Many of the symptoms are also present in other lung and heart diseases, including: Making a diagnosis of COPD is sometimes a process of elimination. Doctors need to consider other conditions with similar symptoms and rule them out. To complicate matters further, a person can have COPD along with another condition, making diagnosis more difficult. Identifying other conditions is also essential for developing the best treatment plan. Takeaway Along with carrying out a physical examination and checking a person's medical history, doctors use several tests to diagnose people with COPD. These tests may include pulmonary functions tests, blood tests, and imaging tests. A doctor will typically order more than one test to help them reach a correct diagnosis. Because COPD is a progressive condition with symptoms that can be similar to other illnesses, getting an accurate diagnosis is vital. Early detection and treatment can help slow the progression of COPD and significantly improve a person's quality of life.
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