Wood Street Clinic Blog

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Heart disease: Millions taking daily aspirin without doctor's advice

New research suggests that many adults in the United States who take low dose aspirin daily to prevent heart disease could be at risk of harm.
close up of woman's hands taking aspirin
New research finds that more than 6 million U.S. adults take aspirin to prevent heart disease without a recommendation from their doctor.

The individuals potentially at risk include older adults and those who have or have had peptic ulcers.

Peptic ulcers are open sores that can occur in the stomach and small intestine. These painful lesions, which are prone to bleeding, affect about 10% of people.

The recent study suggests that close to 6.6 million U.S. adults are taking aspirin every day to protect against heart disease without seeking medical advice.

Researchers at Beth Israel Deaconess Medical Center (BIDMC) and Harvard Medical School, both in Boston, MA, report these findings in a recent Annals of Internal Medicine paper.

The lead author is Dr. Colin W. O'Brien, who is a fellow at Harvard Medical School and also a senior resident in internal medicine at BIDMC.

He and his colleagues note that a key message of their findings is that people without a history of cardiovascular disease who are taking aspirin daily to prevent heart attack or stroke should talk to their doctor about whether it is wise for them to continue.

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Revised guidelines

Aspirin works by reducing the stickiness of blood platelets and, therefore, decreasing their ability to clot. However, this same property also raises the risk of bleeding.

Until recently, the medical community supported the daily use of low dose aspirin for the prevention of cardiovascular events — such as heart attack and stroke — by those at higher risk.

The view was that, for those individuals, the benefits outweighed the risks.

However, the publication of three major studies in 2018 revealed that for many people, the dangers of internal bleeding offset the few benefits of aspirin use.

Those findings prompted the American Heart Association and the American College of Cardiology to revise the guidelines on aspirin use for the prevention of cardiovascular disease.

The new guidelines now advise that adults aged 70 years and older should not use daily low dose aspirin for the primary prevention of cardiovascular disease. They define a daily low dose as 75–100 milligrams.

In addition, the guidelines explicitly recommend against daily low dose aspirin for the primary prevention of cardiovascular disease in people of any age who have a raised risk of bleeding.

The recommendations do not apply to individuals who have already experienced a heart attack or stroke or to those who have undergone procedures such as stent insertion or bypass surgery to prevent cardiovascular events.

In a message accompanying the revised guidelines, the American Heart Association advise that unless a doctor prescribes it, people should avoid taking aspirin every day.

Doctors should ask about aspirin use

Dr. O'Brien and colleagues sought to determine the extent of regular aspirin use for the prevention of cardiovascular disease in the U.S.

Their data came from the 2017 National Health Interview Survey and covered adults aged 40 years and older.

They found that 23.4% of adults aged 40 year and older — which equates to about 29 million individuals — who did not have cardiovascular disease reported that they were taking aspirin daily to prevent heart disease.

Of these people, some 6.6 million were doing so without a doctor's recommendation.

The team was equally concerned to find that nearly 50% of those aged 70 years and older with no existing or previous cardiovascular disease were also taking aspirin to prevent heart disease.

The findings also revealed no significant link between lower use of aspirin and a history of peptic ulcers. This result is surprising given that doctors advise against regular use of aspirin if there is a history of peptic ulcer disease.

"Our findings show a tremendous need for healthcare practitioners to ask their patients about ongoing aspirin use and to advise them about the importance of balancing the benefits and harms, especially among older adults and those with prior peptic ulcer disease."

Dr. Colin W. O'Brien

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Paleo diet may be bad for heart health

New research has found that people who follow the Paleolithic, or Paleo, diet have high levels of a blood biomarker tied to heart disease. The finding raises some red flags about this type of diet, which, the researchers suggest, is not balanced enough to ensure good health.
image of steak and salad
Following the Paleo diet could threaten heart health, a new study finds.

The Paleolithic diet — often known as the Paleo diet, for short — claims to emulate what the ancestors of modern humans used to eat.

People who follow a Paleo diet have a high intake of meats, fruits, vegetables, nuts, and seeds, but no dairy, legumes, or whole grains.

This type of diet has been surrounded by controversy, and researchers have been debating whether or not it is safe and healthful.

For example, one study from 2016 suggests that the Paleo diet could protect against heart attacks and cardiovascular disease by raising blood levels of a protective molecule.

Yet, another study from the same year made a completely opposite discovery, concluding that this type of diet led to unhealthful weight gain and raised the risk of diabetes and cardiovascular problems.

Now, research conducted by a team from Australia points to more evidence suggesting that people who follow Paleo diets may be placing their heart health at risk.

The investigators hail from four different research institutions in Australia: the School of Medical and Health Sciences and the School of Science, both at Edith Cowan University, in Joondalup; the School of Molecular and Life Sciences, at Curtin University, in Bentley; PathWest Laboratory Medicine, in Nedlands; and CSIRO Health and Biosecurity, in Adelaide. The researchers' findings appear in the European Journal of Nutrition.

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High levels of heart disease biomarkers

The researchers — led by Angela Genoni, Ph.D. — worked with 44 participants who followed Paleo diets, as well as 47 participants who followed typical diets that met national dietary recommendations.

The follow-up period was over a year, during which the researchers collected biological samples from all the participants, assessed their diets, and compared results between the Paleo cohort and the control group.

Moreover, in order to be more precise in their assessment, the investigators split the participants who followed a Paleo diet into two further groups, according to their specific preferences:

strict Paleolithic (22 participants), including individuals who ate less than one serving per day of grains and dairy pseudo Paleolithic ( 22 participants), including individuals who ate more than one serving of grains and dairy per day

The researchers found that, across Paleo groups, individuals presented heightened blood levels of a compound that specialists associate with heart disease: trimethylamine N-oxide.

Trimethylamine N-oxide first forms in the gut, and its levels depend on a person's diet and the bacteria that populate their gut, among other factors.

"Many Paleo diet proponents claim the diet is beneficial to gut health, but this research suggests that, when it comes to the production of [trimethylamine N-oxide] in the gut, the Paleo diet could be having an adverse impact in terms of heart health."

Angela Genoni, Ph.D.

"We also found that populations of beneficial bacterial species were lower in the Paleolithic groups, associated with the reduced carbohydrate intake, which may have consequences for other chronic diseases over the long term," she adds.

Why Paleo might increase health risks

Genoni and the team argue that people following Paleo diets have such heightened levels of trimethylamine N-oxide because they do not consume whole grains. These are a great source of dietary fiber, and they help reduce a person's risk of cardiovascular problems.

"We found the lack of whole grains [was] associated with [trimethylamine N-oxide] levels, which may provide a link [with] the reduced risks of cardiovascular disease we see in populations with high intakes of whole grains," says Genoni.

"The Paleo diet excludes all grains and we know that whole grains are a fantastic source of resistant starch and many other fermentable fibers that are vital to the health of your gut microbiome," the lead researcher continues.

Moreover, the investigators point out that participants in the Paleo diet groups also had higher concentrations of the gut bacteria — Hungatella — that generate the compound.

"Because [trimethylamine N-oxide] is produced in the gut, a lack of whole grains might change the populations of bacteria enough to enable higher production of this compound," Genoni explains.

"Additionally, the Paleo diet includes greater servings per day of red meat, which provides the precursor compounds to produce [trimethylamine N-oxide]," she notes, "and Paleo followers consumed twice the recommended level of saturated fats, which is cause for concern."

In the conclusion to their study paper, the researchers warn that excluding whole grains from the diet can seriously impact gut health, with implications for heart health, as well. They also argue for the necessity of further studies into the role of vegetables and saturated fats in regulating key biological mechanisms in the gut.

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Misdiagnosis of the 'big three' results in 'serious harm'

Diagnostic mistakes are the most frequent medical error as well as the most serious, according to researchers from Johns Hopkins Medicine in Baltimore, MD.
doctor writing a prescription to a patient
New research identifies 15 conditions that doctors often misdiagnose.

It is not clear exactly how many people errors in diagnosis affect.

However, between 40,000 and 80,000 deaths in United States hospitals each year might be related to misdiagnosis, according to a new study.

Misdiagnosis may also play a role in 80,000–160,000 serious cases of harm to people's health each year.

To see which conditions doctors are most likely to misdiagnose and which may lead to death or disability, researchers analyzed over 11,000 cases from an extensive database of U.S. malpractice claims. The findings now appear in the journal Diagnosis.

"We know that diagnostic errors happen across all areas of medicine," explains first study author Dr. David Newman-Toker, Ph.D., director of the Johns Hopkins Armstrong Institute Center for Diagnostic Excellence.

"There are over 10,000 diseases," he goes on, "each of which can manifest with a variety of symptoms, so it can be daunting to think about how to even begin tackling diagnostic problems."

However, the team's technique aimed to do something different. They classified the conditions according to a standard system, yet the grouping that followed was a new strategy.

"There are dozens of different diagnosis 'codes' that all represent strokes. The same is true for heart attacks and some of the other conditions as well," says Dr. Newman-Toker. "These differences often matter more for treatment than diagnosis."

"To my knowledge," he explains, "grouping these codes together to identify the most common harms from diagnostic error had not been done before, but doing so gives us an 'apples to apples' comparison of the frequency of different diseases causing harms."

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The 'big three'

The team saw that a "surprisingly small number of conditions" corresponded to the most significant diagnostic errors.

Three types of condition were responsible for nearly three-quarters of all "serious harm" related to misdiagnosis: infections, cancers, and vascular events. Combined, the researchers call these the "big three."

The scientists studied the severity and frequency of diagnostic errors in these conditions, along with where these faults took place.

Over one-third of the errors leading to death or permanent disability were linked to cancers. This figure reduced to 22% for vascular issues and 13.5% for infections.

Researchers broke down the "big three" into 15 specific conditions, the misdiagnosis of which often resulted in serious harm. Lung cancer, stroke, and sepsis came out on top.

The other 15 conditions included heart attacks, meningitis, pneumonia, blood clots in the legs and lungs, and cancers of the skin, prostate, and breast.

Most errors occurred during an emergency situation or in an outpatient setting. Cancer-related issues tended to occur in the latter location, while vascular and infection issues tended to occur in emergency departments.

"These findings give us a road map for thinking about what kind of problems we need to solve in which clinical settings," notes Dr. Newman-Toker.

The researchers' findings also showed the cause of most misdiagnoses: clinical judgment failures. There are a number of ways to combat this, according to the team, including improving teamwork skills and education, using technology to help with diagnosis, and giving people quicker access to medical specialists.

A funding fix

Dr. Newman-Toker says the findings will not provide "an easy or quick fix, but [they give] us both a place to start and real hope that the problem is fixable."

This fix, he says, will only become a reality if the government allocates enough funding.

"Our current annual federal investment to fix diagnostic errors is less than what we spend each year researching smallpox, a disease eradicated in the U.S. over half a century ago."

"If we devoted appropriate resources to tackling misdiagnosis of the 'big three' diseases we identified, we could potentially save half of the people who die or are permanently disabled from diagnostic errors."

Dr. David Newman-Toker, Ph.D.

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Study limitations and future research

However, the analysis did have a few limitations. The researchers remedied two of them — one that suggested a bias toward malpractice claims that are easier to bring forward, such as cancer, and the other being a dismissal of long term conditions that also cause serious harm.

The team corrected these biases by further analyzing previous studies that used data unrelated to malpractice claims.

This strengthened the validity of the "big three" findings but turned the tables to make vascular events and infections the most prominent.

However, they could not fix some of the other limitations. They based their analysis on malpractice cases rather than original medical records, which may have reduced accuracy and may be difficult to apply to the real world, where not all misdiagnoses result in a legal claim.

Future research could rectify this. In fact, Dr. Newman-Toker and his colleagues are planning to continue focusing on misdiagnosis, eventually using a national dataset to estimate how many people in the U.S. diagnostic mistakes detrimentally affect.

Before that, there will be a deeper dive into the "big three." Specifically, the researchers wish to examine the 15 conditions identified in the three categories, as well as how often doctors misdiagnose them.

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How an omega-6 fatty acid may keep heart disease at bay

New research in a mouse model zooms in on the cellular mechanisms that may explain the cardiovascular benefits of a specific kind of omega-6 fatty acid.
illustration of a heart
New research explains the potential benefit of an omega-6 fatty acid for heart health.

A plethora of studies have tackled the role of omega-3 fatty acids in heart health.

With about 18.8 million adults in the United States taking fish oil supplements in the hope that they stave off cardiovascular disease, omega-3 fatty acids have come under the scrutiny of several clinical trials and reviews.

However, their lesser-known cousin, the omega-6 fatty acid, has received less attention in the medical community; studies have yet to fully explore the cardiovascular effects of this essential fatty acid.

New research aims to fill this gap by looking at the effects of omega-6 on artery health. Specifically, the new study — led by Prof. Dipak Ramji, from the School of Biosciences at Cardiff University, in the United Kingdom — examines the effect of an omega-6 on atherosclerosis.

Atherosclerosis is a condition in which a buildup of plaque in the arteries makes them rigid and narrow. Over time, atherosclerosis can lead to clotting and blocking within the arteries. This can cause life-threatening events, such as strokes or heart attacks.

In fact, Prof. Ramji and colleagues mention in their paper, which appears in the journal Biochimica et Biophysica Acta — Molecular Basis of Disease, that "Atherosclerosis and its complications are responsible for 1 in 3 global deaths."

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Prof. Ramji and the team studied the effects of an omega-6 polyunsaturated fatty acid called dihomo-gamma-linolenic acid (DGLA) in a mouse model system of atherosclerosis.

Previous research showed that DGLA improved atherosclerosis in a model of mice that had been engineered to lack apolipoprotein E. But the mechanisms behind this effect were unclear.

So, this new research focused on the effects of DGLA on mouse immune cells called macrophages and found several mechanisms through which the essential acid may alleviate or prevent atherosclerosis.

Namely, DGLA attenuated "pro-inflammatory gene expression by three key cytokines: chemokine-driven monocytic migration; foam cell formation; and [vascular smooth muscle cell] migration," report the researchers.

"Our research indicates that the omega-6 fatty acid DGLA can have a positive effect on atherosclerosis at several stages, particularly by controlling key processes associated with inflammation and the ability of the cells to take up and process cholesterol."

Prof. Dipak Ramji

"We also observed the protective effects of DGLA on key atherosclerosis-associated processes in endothelial cells and smooth muscle cells — two other important cell types involved in the disease," the professor goes on to explain.

Finally, DGLA also improved mitochondrial function by reducing proton leak.

The researchers say that this is the first study to provide "detailed mechanistic insight" into the benefits of DGLA for atherosclerosis.

"This collaborative work opens up new and exciting avenues for research on the use of DGLA in the prevention and treatment of atherosclerosis. The challenge now is to take our findings and examine whether they translate into humans," concludes the researcher.

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What causes a pulse in the stomach?

For some people, feeling a pulse in the stomach may be a regular harmless occurrence. For others, it may be a sign of something more serious.

In some cases, a pulse in the stomach, or abdomen, might be due to an abdominal aortic aneurysm. An aneurysm occurs when a weakened area of a blood vessel swells, forming a bulge. In people with an abdominal aortic aneurysm, this occurs in part of the aortic artery in the abdomen.

People with this condition rarely experience any other symptoms unless the swelling tears or ruptures, which is a medical emergency.

In this article, we outline the causes of a pulse in the stomach and explain when to see a doctor. We also provide information on abdominal aortic aneurysms, including the symptoms, risk factors, diagnosis, and treatment.

Common causes Holding the stomach to feel a pulse
A person who is at increased risk of cardiovascular problems should see a doctor if they can feel a pulse in the stomach.

Feeling a pulse in the abdomen can be normal for some people, particularly older adults with a healthy body mass index (BMI). These individuals may notice this sensation when they are lying down or if they gently press down between the ribs and the navel.

However, those who are at increased risk of cardiovascular problems, such as heart attack and stroke, should see a doctor if they have this symptom.

Many of the risk factors for cardiovascular problems overlap with those for aortic aneurysms. These include:

Thank you for supporting Medical News Today Abdominal aortic aneurysm An aortic aneurysm is when the aorta bulges outward. The aorta is the largest artery in the body. It begins at the heart and extends down through the chest and abdomen. The abdominal aorta is the section of the aorta that sits deep inside the abdomen, just in front of the spine. Certain factors, such as aging or disease, can lead to the walls of the aorta weakening. Blood pumping through the artery may cause the weakened section to bulge outward. If the bulging occurs in the abdominal aorta, it is called an abdominal aortic aneurysm. Without treatment, the aneurysm may weaken to the extent that it tears or ruptures. What causes it? Most abdominal aortic aneurysms are due to atherosclerosis, which is when fatty deposits build up along the insides of artery walls, restricting blood flow through the artery. Other causes include injury and infection. Risk factors The following factors may increase the risk of an abdominal aortic aneurysm: Sex, age, and lifestyle factors Senior man smoking
Older men who smoke may be most at risk from an abdominal aortic aneurysm. People with the highest risk appear to be men aged 65 years and over who smoke or have previously smoked. The Centers for Disease Control and Prevention (CDC) recommend that male smokers or ex-smokers aged 65–75 years get an abdominal ultrasound screening, even if they have no symptoms. The authors of a 2014 review concluded that these screenings lead to fewer incidents of abdominal aortic aneurysm rupture and a decrease in mortality rates relating to the condition. Family history According to the National Institutes of Health (NIH), 1 in 10 people who develop an abdominal aortic aneurysm have a family history of the condition. People who have a first degree relative, such as a parent or sibling, with the condition have a 20% chance of developing the condition. Other risk factors Other risk factors include: high cholesterol high blood pressure atherosclerosis inflamed arteries emphysema, a lung condition Marfan syndrome Ehlers-Danlos syndrome Symptoms Abdominal aortic aneurysms usually develop gradually over many years. Most people who develop one do not experience any symptoms besides a pulse in the stomach, although even this is rare. For this reason, experts recommend ultrasound screenings for people with specific risk factors. When symptoms do occur, they are often sudden. The following symptoms are usually the result of a tear or leak in the aorta: intense or persistent pain in the abdomen or back pain that radiates down to the buttocks and legs a rapid heart rate low blood pressure difficulty breathing fainting nausea and vomiting feeling sweaty or clammy dizziness sudden weakness on one side of the body shock A severe tear or rupture in the aorta is an emergency, so anyone who has the above symptoms or witnesses someone else experiencing them should call for immediate medical help. Diagnosis Senior man having an abdominal ulrasound
A doctor may order an ultrasound to diagnose an abdominal aortic aneurysm. People should see a doctor if they suspect that they have an abdominal aortic aneurysm or if they have a higher risk of developing one. A doctor will examine the abdominal area and may listen to the abdomen with a stethoscope. To confirm the diagnosis, the doctor may order one or more of the following diagnostic tests: Abdominal ultrasound: This imaging technique uses sound waves to see tissues inside the body and can help determine the size of the aneurysm. Doppler ultrasound: This type of ultrasound uses sound waves to assess blood flow through arteries and veins. Abdominal and pelvic CT scan: This scan combines a series of X-ray images to give a detailed picture of tissues inside the body. It helps determine the size and extent of an aneurysm. Angiography: This test combines X-ray, CT, or MRI scans with a contrast dye to show major blood vessels inside the body. Thank you for supporting Medical News Today Treatment Treatment options will vary depending on the size and location of the aneurysm. The doctor will also take other factors into account, such as the person's age and health. For people with an aneurysm that is smaller than 5 centimeters (cm) in diameter, a doctor may recommend the following treatment plan: follow-up ultrasounds or CT scans every 6–12 months medications to control high blood pressure medications to lower cholesterol treatments to help with quitting smoking A doctor may recommend surgery for an aneurysm that is more than 5 cm in diameter or is growing rapidly or leaking. Surgical options include open surgical repair (OSR) and endovascular aortic repair (EAR). When to see a doctor Some people with a healthy body weight may be able to feel a pulse in their stomach. This symptom is often harmless, especially in those without any cardiovascular problems. However, feeling a pulse in the stomach could indicate an abdominal aortic aneurysm. People should see a doctor if they are concerned about their risks, especially because this condition often causes no symptoms. Having regular medical check-ups is vital for people who are at increased risk of developing aneurysms. Thank you for supporting Medical News Today Summary In some cases, feeling a pulse in the stomach is not a cause for concern. Many people who are at a healthy weight and do not have risk factors for cardiovascular issues can feel their pulse in their abdomen. In other cases, it may indicate a serious issue called an abdominal aortic aneurysm. People who have an abdominal aortic aneurysm rarely experience any symptoms before it ruptures, and they may not know that they have the condition. Not being aware of an aneurysm is dangerous because they usually weaken over time and become more prone to tearing or rupturing. People should see a doctor if they experience symptoms of an abdominal aortic aneurysm, are at a higher risk of developing one, or have a family history of the condition. A doctor may recommend managing the condition with medication, or they may suggest surgery to repair the weakened artery.
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Higher iron levels may protect arteries but raise clot risk

Having higher natural levels of iron could be both good and bad for cardiovascular health, according to new research. On one hand, it may lower the risk of clogged arteries, but on the other hand, it may raise the risk of blood clots related to reduced flow.
illustration of veins
New research reveals the effects of high iron levels on arterial health.

These were the conclusions of a large study that examined the relationship between people's natural iron levels and three measures of cardiovascular disease: carotid artery wall thickness, deep vein thrombosis (DVT), and carotid artery plaque.

Thickening of the vessel wall and the buildup of plaque in the carotid artery are both signs of atherosclerosis.

DVT occurs when a blood clot, or thrombus, forms in a deep vein. DVT typically affects the leg.

The researchers found that having higher levels of iron appears to raise the risk of DVT yet reduce the risk of carotid plaque. There was "no significant effect" on carotid artery wall thickness.

They report their findings in a recent Journal of the American Heart Association study paper.

"These results," write the authors, "are consistent with previous studies that suggest higher iron status has a protective role in atherosclerosis but increases the risk of thrombosis related to stasis of blood."

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Genetic markers of iron status

The study is one of a series that scientists from Imperial College London in the United Kingdom are leading. In these studies, international teams are using genetic data from 500,000 people to explore links between iron levels and more than 900 conditions.

The researchers are using a tool called Mendelian randomization (MR) to investigate links between people's natural iron levels and disease risk.

The authors of the new study suggest that a strength of MR analysis is that it can overcome some of the problems that observational studies face with potential confounders. These can cloud the analysis of likely causes of the observed effects.

"Indeed," they note, "biomarkers of iron status are implicated in other pathologies, including inflammation, liver disease, renal failure, and malignancy, all of which could affect observational associations with thrombotic disease."

By searching DNA data on nearly 49,000 people of European descent, they found genetic markers that correlate with higher natural levels of iron.

The researchers then used the DNA iron level markers to screen other datasets of tens of thousands of people to find links to carotid artery wall thickness, DVT, and carotid artery plaque.

'Contrasting role' of iron status

Atherosclerosis is a major worldwide cause of conditions that affect blood vessels. It can give rise to heart disease, stroke, and peripheral artery disease.

The process of atherosclerosis begins when cholesterol and other fatty materials deposit in artery walls and develop into atheromas. These can eventually rupture and lead to a local clot.

The clot can partially or completely restrict blood flow and cause a stroke or heart attack, depending on which artery it affects.

The researchers suggest that their findings provide evidence of a "contrasting role" of higher natural iron levels on "different thrombotic disease processes."

Speculating on the implications of these findings, lead and corresponding author Dr. Dipender Gill — of the School of Public Health at Imperial College London — suggests that they open new avenues for further studies.

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These could address many unanswered questions, such as how iron affects cholesterol, influences the formation of blood clots, and promotes artery narrowing.

The new study, like others in the series, only investigated people's natural levels of iron using their genetic markers. It did not investigate the effect of taking iron supplements.

Dr. Gill also says that people should speak to their doctor before they start to take or stop taking iron supplements.

"Iron is a crucial mineral in the body and is essential for carrying oxygen around the body," he explains.

"However, getting the right amount of iron in the body is a fine balance — too little can lead to anemia, but too much can lead to a range of problems including liver damage."

Dr. Dipender Gill

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Air pollution may raise atherosclerosis, heart disease death risk

New research examines the link between exposure to air pollution and the risk of coronary artery calcification among Chinese adults.
woman with mask on her face
A new study provides additional evidence that pollution may affect our cardiovascular health.

Studies have linked air pollution with the risk of developing a range of conditions, from neurological disorders such as Parkinson's disease and Alzheimer's to diabetes and atherosclerosis, which is the hardening of the arteries.

For instance, early last month, Medical News Today reported on a study by researchers at the University at Buffalo School of Public Health and Health Professions in New York, which linked long-term exposure to air pollution with the risk of atherosclerosis in six cities across the United States.

Now, the same lead author, Meng Wang, has carried out similar research in China, making this new study the first to examine pollution and coronary artery calcification among Chinese adults.

Wang and team set out to examine whether "air pollution and proximity to traffic" correlate with coronary artery calcium score, a key marker of atherosclerosis.

Atherosclerosis refers to the buildup of plaque inside the artery walls, which, over time, may lead to serious cardiovascular conditions, such as high blood pressure, heart disease, and heart attacks.

Wang and team published their findings in the journal JAMA Network Open.

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Studying air pollution and artery health

Wang and colleagues examined data on 8,867 Chinese people aged between 25 and 92 years. The participants all had suspected coronary heart disease, and the team recruited them in 2015–2017.

The researchers assessed the coronary artery calcium and coronary heart disease score of each participant and excluded anyone who had had a myocardial infarction, stenting procedure, or coronary artery bypass surgery in the past. They also excluded those for whom the data on risk factors and exposure to pollution were insufficient.

Wang and team estimated the annual levels of pollution at the participants' residences by calculating their nitrogen dioxide, ozone, and fine particulate matter levels using a standard geostatistical prediction model.

In this case, fine particulate matter (PM2.5) describes particles with an aerodynamic diameter smaller than 2.5 micrometers that are very easy to inhale.

Particulate matter, or particle pollution, refers to "a mixture of solid particles and liquid droplets," including "dust, dirt, soot, or smoke," that can be present in the air and that a person cannot see with the naked eye.

In the new study, the researchers also estimated the participants' proximity to traffic, looking at the distance of their residences from nearby roads.

Pollution may raise heart disease death risk

The research revealed that for each nitrogen dioxide increase of 20 micrograms per cubic meter (μg/m3), the risk of a high coronary artery calcium score rose by 24.5%.

Additionally, for each increase of 30 μg/m3 of PM2.5 that the participants had exposure to in their apartments, there was an increase of 27.2% in the coronary artery calcium score.

"This finding should contribute to an understanding of air pollutant effects worldwide, providing both much-needed, locally generated data and supportive evidence to inform the air pollution standard-setting process on a global scale," comments Wang.

"This study may provide evidence that coronary atherosclerosis is a pathological pathway through which air pollution exposure increases risk of death from coronary heart disease."

Meng Wang

The lead author goes on to explain: "Atherosclerosis is a lifelong process. As such, the effects of air pollution exposure on atherosclerosis are likely to be chronic."

"Since more than 40% of all deaths are attributable to cardiovascular disease, the potential contribution of air pollutants to cardiovascular disease in China is very large," says the researcher, suggesting that "the current air pollution standard may need to be reevaluated."

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Why even slim people may benefit from calorie restriction

Even slim people may benefit from restricting their calories; reducing daily calorie intake by around 300 per day can significantly improve markers of cardiometabolic health.
green lettuce on a plate
Restricting our calorie intake may yield signficant benefits regardless of our weight.

This is the main takeaway of a randomized controlled trial that lasted for 2 years and included 218 people, ages 21–50, without obesity.

Dr. William E. Kraus — a cardiologist and distinguished professor of medicine at Duke University in Durham, NC — is the lead author of the new study.

Dr. Kraus and colleagues explain in their paper that some cardiometabolic markers — such as cholesterol, blood pressure, and blood sugar — can raise the risk of cardiovascular disease and cardiovascular death even when they are within ranges that healthcare professionals consider to be normal.

On the other hand, numerous studies have suggested that calorie restriction benefits both a person's health span and life span. However, are these benefits due to weight loss?

The researchers started their new study from the hypothesis that it isn't just losing weight, but also some other, more complex molecular mechanism that explains the benefits of calorie restriction for cardiometabolic health.

So, they set out to test their hypothesis, and they have since published their findings in the journal The Lancet Diabetes & Endocrinology.

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All the trial participants had an average body mass index (BMI) of between 22 and 27.9. To begin, the researchers randomly assigned them to one of two groups: one group reduced their caloric intake by 25% (the intervention group), and the other group did not change their caloric intake (the control group).

The participants in the intervention group ate three meals per day and were free to choose from six different meal plans. They also "attended group and individual counseling sessions for the first 6 months of the trial." The study started in May 2007 and continued through to February 2010.

During this time, the remaining participants — those in the control group — continued to follow their regular diet.

Not all the participants in the intervention group managed to maintain a 25% calorie reduction throughout the study period, but they did reduce their intake by almost 12%, on average.

After the intervention, the participants in this group lost and maintained the loss of 10% of their weight — 71% of which was fat mass. The calorie restriction resulted in significant cardiometabolic benefits.

Specifically, "Calorie restriction caused a persistent and significant reduction from baseline to 2 years of all measured conventional cardiometabolic risk factors," write the authors. This included changes in low density lipoprotein cholesterol, high density lipoprotein (HDL) cholesterol, and systolic and diastolic blood pressure.

Also, "calorie restriction resulted in a significant improvement at 2 years in C-reactive protein." This is a marker of inflammation that scientists have linked to heart disease, cancer, and cognitive decline. Insulin sensitivity and markers of metabolic syndrome also improved.

The benefits remained robust after Dr. Kraus and team conducted a sensitivity analysis that adjusted the results for relative weight loss.

"This shows that even a modification that is not as severe as what we used in this study could reduce the burden of diabetes and cardiovascular disease that we have in [the United States]."

Dr. William E. Kraus

"People can do this fairly easily by simply watching their little indiscretions here and there, or maybe reducing the amount of them, like not snacking after dinner."

"There's something about caloric restriction, some mechanism we don't yet understand that results in these improvements," he adds. "We have collected blood, muscle, and other samples from these participants and will continue to explore what this metabolic signal or magic molecule might be."

In an interview for The Lancet's podcast, Dr. Kraus said that this was the first long term study to examine the benefits of caloric restriction in humans.

Dr. Kraus also makes it clear that his study examined biomarkers for a person's health span, and he says that he and his colleagues were "impressed" by the "dramatic" improvements and "remarkably" positive effects that caloric restriction had on waist circumference, triglycerides, HDL cholesterol, glucose control, and blood pressure.

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High blood pressure: Could gut bacteria play a role?

In this Spotlight feature, we investigate whether the bacteria that live in our guts could influence our blood pressure. If so, could they guide future treatment?
Blood pressure home monitor
Hypertension is growing in prevalence, but can we blame gut bacteria?

Scientists are growing increasingly interested in the role of gut bacteria.

Each week, journals publish many study papers that examine how these microscopic visitors might play a role in health and disease.

As it stands, because the microbiome is a relatively new field of study, the full scope of gut bacteria's role in health is still up for debate.

However, it is becoming increasingly clear that the bacteria in our gut can open new avenues in our understanding of a wide range of conditions.

Scientists have studied the role of gut bacteria in conditions as varied as obesity, Parkinson's disease, depression, and blood pressure.

This Spotlight focuses on their role in hypertension. Elevated blood pressure is a risk factor for cardiovascular disease and affects almost 1 in 3 adults in the United States.

Because of this, it is vital that medical scientists unearth the various mechanisms that underpin blood pressure regulation.

One study paper puts hypertension's impact into sobering context: "Over 400 ,000 deaths in the United States are related to [hypertension] every year, more than all the Americans who died through all of World War II."

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Beyond standard risk factors

Although researchers have established certain risk factors for hypertension — such as smoking, obesity, and drinking excessive amounts of alcohol — there appears to be more to the condition.

More than 19% of the U.S. adults with hypertension have a treatment-resistant form of the condition, wherein medications do not bring blood pressure down to a healthful level. Also, lifestyle interventions do not work for everyone.

Some scientists are considering dysfunction of the immune system and autonomic nervous system. This is the branch of the nervous system that controls "automatic" functions, such as breathing, digestion, and blood pressure.

A relatively new addition to this list of potential risk factors is gut dysbiosis, which refers to an imbalanced microbial community.

A study in the journal Microbiome analyzed the gut bacteria of 41 people with ideal blood pressure levels, 99 individuals with hypertension, and 56 people with prehypertension.

Prehypertension refers to high blood pressure that is not yet high enough for a person to receive a diagnosis of hypertension. People in this range have an increased risk of developing hypertension in the future.

They found that in the participants with prehypertension or hypertension, there was a reduction in the diversity of gut bacteria. In particular, species such as Prevotella and Klebsiella tended to be overgrown.

Next, the scientists transplanted fecal matter from the participants into germ-free mice, which are animals that lack gut bacteria. The mice that received fecal matter from people with hypertension also developed hypertension.

Conversely, the authors of a 2019 study in the journal Frontiers in Physiology transplanted feces from mice without hypertension into mice with hypertension. This resulted in a reduction in blood pressure in the mice with hypertension.

Another study investigated the bacterial residents of pregnant women with obesity and overweight pregnant women, both of whom are at increased risk of hypertension. They found that in both sets of participants, bacteria of the genus Odoribacter were significantly rarer.

Those with the lowest levels of Odoribacter had the highest blood pressure readings.

How do gut bacteria affect blood pressure?

Although evidence is mounting that gut bacteria can influence hypertension, most of the studies to date have been observational.

Anatomy model
From the gut, chemicals can quickly enter the rest of the body.

This means that it has not been possible to determine whether changes in gut bacteria influence blood pressure, or whether hypertension (or the factors that produce it) alter gut bacteria.

Also, it is still unclear exactly how gut bacteria drive these changes.

Although the gut and blood pressure might not seem like obvious companions, the connection is not, perhaps, so surprising.

Many of the factors that increase the risk of hypertension — such as the consumption of alcohol and salty food — enter the body through the digestive system.

Nutrients, along with certain chemicals that bacteria produce, have the opportunity to enter the blood supply; once in circulation, the body is their oyster.

Also, the gastrointestinal tract hosts a number of processes that have the potential to play a role in hypertension, including metabolism, the production of hormones, and a direct connection with the nervous system.

Short chain fatty acids

Some researchers believe that one of the links between the gut and hypertension could be short chain fatty acids (SCFAs). Some gut bacteria produce these molecules as they digest dietary fiber.

After bacteria have produced SCFAs, the host's blood suppy absorbs them. SCFAs affect a range of physiological processes, one of which appears to be blood pressure.

Backing this theory up, one study found differences in gut bacterial populations between participants with and without hypertension. Individuals with higher blood pressure had lower levels of certain species that produce SCFAs, including Roseburia spp. and Faecalibacterium prausnitzii.

One paper in the journal Hypertension investigated the role of gut bacteria in sleep apnea-induced hypertension. Sleep apnea is a condition wherein an individual's breathing is disrupted during sleep.

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The scientists simulated sleep apnea in rats. To so do, they fed half of the rats a standard diet and the other half a high fat diet. Hypertension only appeared in the rats that ate the fatty diet.

Next, they assessed the mice's microbiome and found that the high fat group had a significant reduction in numbers of bacteria responsible for producing SCFAs.

Finally, the scientists transplanted bacteria from the hypertensive rats into the rats who ate a normal diet and demonstrated normal blood pressure.

This fecal transplant produced hypertension in the previously healthy animals.

Nervous control

Most likely, if gut bacteria truly do have the power to produce hypertension, it is likely to be via a number of interlinked routes. Scientists have several theories. For instance, some experts see a role for the autonomic nervous system.

Nervous system anatomy
How does gut bacteria influence the nervous system?

Studies have shown that hypertension is associated with increased sympathetic nerve activity (a branch of the autonomic nervous system). This increases gut permeability.

If the gut walls become more permeable, it is easier for the gut's contents to leak through into the rest of the body.

This change in permeability impacts the gut environment and alters the microbiome. At the same time, bacterial products can pass more easily into the blood.

Interestingly, other factors — including smoking tobacco and being stressed — also alter the sympathetic system. This could help provide further reasons why these factors can also lead to cardiovascular changes.

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A probiotic for hypertension?

Designing a probiotic that reliably reduces high blood pressure will take some time, but some researchers are looking at this option.

A 2013 meta-analysis examined the effect of probiotic fermented milk on blood pressure. In all, they took data from 14 studies, which included 702 participants. Although the authors write that "[s]ome evidence of publication bias was present," they concluded that:

"[P]robiotic fermented milk has blood pressure-lowering effects in prehypertensive and hypertensive [people]."

A 2014 systematic review and meta-analysis investigated probiotics more generally. Its authors only included randomized controlled trials, and their search only turned up nine papers that fit their criteria.

Overall, they concluded, "The present meta-analysis suggests that consuming probiotics may improve [blood pressure] by a modest degree."

They also noted that the effect appeared to be more pronounced for people whose initial blood pressure readings were high, when the study used multiple bacterial species, and when the researchers tested the intervention for more than 8 weeks.

In the current scientific climate, the public has a substantial appetite for probiotics; however, outside of a small number of specific conditions, there is little evidence that they can benefit human health substantially or reliably.

With that in mind, it is likely to be a long time before a probiotic will bring blood pressure down.

For the future

Science is relatively new to the question of gut bacteria's impact on blood pressure, so plenty more work will be needed. Although some evidence now supports the interaction between gut bacteria and hypertension, it is a complex beast to dissect.

Our diet, the drugs we take (particularly antibiotics), other health conditions we might have, and many more variables can all influence our gut bacteria.

Bacteriophages (viruses that attack bacteria), fungi, and parasites also find a home in the gut and influence both bacterial populations and our physiology.

This mystery will only unravel slowly, but at least the wheels of research are now in motion. As one reviewer writes:

"Evidence is rapidly accumulating implicating gut dysbiosis in hypertension. However, we are far from understanding whether this is a cause or consequence of [hypertension], and how to best translate this fundamental knowledge to advance the management of [hypertension]."

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Top 13 high potassium foods

Potassium is an important nutrient for many body processes. Bananas are a well-known source of potassium, but many other foods contain just as much — if not more — of this nutrient.

Potassium is an electrolyte that helps regulate fluid and blood levels in the body. Many fruits and vegetables are excellent sources of potassium. Meat, milk, yogurt, and nuts are also good sources.

According to the Centers for Disease Control and Prevention (CDC), a diet high in potassium and low in sodium — an electrolyte in table salt and processed foods — can lower blood pressure and reduce the risk of heart disease and stroke.

The adequate intake (AI) of potassium for adults is currently 3,400 milligrams (mg) per day for men and 2,600 mg for women.

According to the Office of Dietary Supplements (ODS), the daily value (DV) of potassium — the daily intake that the Food and Drug Administration (FDA) recommend — will increase to 4,700 mg in January 2020.

Bananas contain 422 mg of potassium per medium fruit. In this article, we take a look at other good sources of potassium according to the ODS and the 2015–2020 Dietary Guidelines for Americans.

1. Dried apricots Dried apricots on a table which are a food high in potassium
Dried apricots are a good source of iron, antioxidants, and potassium.

Several dried fruits are high in potassium. Apricots are a bright orange fruit that people may eat either fresh or dried.

Half a cup of dried apricots contains 1,101 mg of potassium. These fruits also provide other key nutrients, such as iron and antioxidants.

When purchasing dried apricots, a person should look for those that contain no added sugar. They can eat dried apricots as a snack or add them to salads or main meals.

2. Potatoes Potatoes are an excellent source of potassium. Baked potatoes with the skin still on are the best option, as much of a potato's potassium is in the skin. One medium baked potato with skin contains 941 mg of potassium. By eating a baked potato with salt-free seasoning, a person can avoid extra sodium. French fries are usually lacking in nutrients and contain added fat from oil and the frying process, making them a less healthful option. Fries also typically contain high amounts of sodium, which can counteract the benefits of potassium. 3. Leafy greens Leafy greens are some of the most nutritious foods available. One study found that eating a serving per day of leafy green vegetables may help slow age-related cognitive decline. Leafy green vegetables are low in calories and contain many vitamins and minerals. Most also provide a good amount of potassium. For instance: A cup of cooked Swiss chard contains 962 mg of potassium. A cup of cooked amaranth leaves contains 846 mg. A cup of cooked spinach contains up to 838 mg. Thank you for supporting Medical News Today 4. Lentils cooked red lentils in a wooden bowl on table with garlic and chilies
Lentils contain potassium, fiber, and protein. Lentils are a small, round legume. They contain plenty of fiber and are also rich in protein. One cup of cooked lentils contains 731 mg of potassium. Lentils make a good addition to soups or stews. People looking for a quicker option can use canned rather than dried lentils. However, it is important to rinse canned lentils well before use to remove any sodium. 5. Prunes and prune juice Prunes are dried plums. Due to their high fiber content and other chemical properties, many people use prunes or prune juice to help relieve constipation. Juice companies usually make prune juice by adding water back into the prunes, cooking them, and then filtering out the solids. There are 707 mg of potassium in one cup of canned prune juice, while half a cup of dried prunes contains 699 mg. 6. Tomato puree or juice Fresh tomatoes offer several health benefits. To get more potassium, though, it is best to use concentrated tomato products, such as tomato puree or tomato juice. Half a cup of tomato puree contains 549 mg of potassium, and a cup of tomato juice contains 527 mg. Fresh tomatoes also contain potassium, with one medium raw tomato containing 292 mg. People often use tomato puree in cooking, for example, adding it to pasta sauces. Canned or bottled tomato juice is also suitable to use in many recipes, or people can drink it. 7. Certain fruit and vegetable juices Some varieties of juice contain high amounts of potassium. However, many health organizations recommend that people avoid juices with added sugar. Whole fruit contains more fiber than juice and often more nutrients as well. Still, 100% juice can be part of a healthy diet in limited amounts, according to the American Heart Association and the Dietary Guidelines for Americans. The following juices are high in potassium, containing the following amounts per cup: carrot juice (canned): 689 mg passion fruit juice: 687 mg pomegranate juice: 533 mg orange juice (fresh): 496 mg vegetable juice (canned): 468 mg tangerine juice (fresh): 440 mg 8. Raisins Raisins are another type of dried fruit that is high in potassium. Raisins are a popular snack food. Half a cup of raisins contains 618 mg of potassium. For the most healthful type, opt for raisins that contain only dried grapes with no added sugar, coatings, or other ingredients. 9. Beans Beans come in many sizes, shapes, and colors. Most contain a high amount of fiber, some protein, and a good dose of potassium. Kidney beans are red, kidney-shaped legumes that people often use in soups, chili, or as a side dish of baked beans. A cup of canned kidney beans contains 607 mg of potassium. Many other beans are also high in potassium. The amounts per half cup serving are as follows: adzuki beans: 612 mg white (cannellini) beans: 595 mg lima beans: 478 mg great northern beans: 460 mg black beans: 401 mg canned refried beans: 380 mg navy beans: 354 mg 10. Milk and yogurt People typically think of dairy products, such as milk and yogurt, as being rich sources of calcium. However, some dairy products are also a good way to add more potassium to the diet. Studies suggest that in the United States, milk is the top source of potassium among adults. A cup of 1% milk contains 366 mg. Many people also get their potassium from tea and coffee. An 8-ounce (oz) cup of brewed black coffee contains 116 mg of potassium, which would classify it as a low potassium food, but adding creamers and milk raises the potassium content considerably. Other dairy products also contain potassium. For instance, one cup of plain nonfat yogurt contains up to 579 mg. 11. Sweet potatoes sweet potato wedges
Sweet potatoes are rich in potassium. Sweet potatoes have orange flesh and a sweeter flavor than white potatoes. Their orange color means that they provide more beta carotene than other potatoes, but they also contain potassium. A baked sweet potato with the skin still on contains 542 mg of potassium. For the most healthful option, a person should eat baked or microwaved sweet potatoes without added sugar. It is also best to avoid canned sweet potatoes that the manufacturers have packaged in syrup. Thank you for supporting Medical News Today 12. Seafood Fish and shellfish contain heart-healthy omega-3 fats. The American Heart Association recommend eating fish (particularly fatty fish) at least twice a week. Certain types of seafood are also good sources of potassium. Wild Atlantic salmon and clams lead the way with 534 mg of potassium per 3-oz serving. The same serving size of other types of seafood high in potassium offers: mackerel: up to 474 mg halibut: 449 mg snapper: 444 mg rainbow trout: up to 383 mg 13. Avocado Avocado is a buttery fruit that contains a variety of nutrients, including heart-healthy monounsaturated fat and vitamins C, E, and K. Avocados also contain nearly 5 grams of fiber in half a cup. Avocados are a good source of potassium, providing 364 mg in a half-cup serving. People can eat avocados raw in salads, as dips, or on toast. They also work well in cooked meals, such as pasta dishes. What about potassium supplements? Some people may wonder about using supplements to boost their potassium intake. Only a few studies have investigated the effects of potassium supplements, and some suggest that the body can absorb potassium as well from supplements as it can from food. However, the ODS say that in many dietary supplements, manufacturers limit the amount of potassium to 99 mg — only about 3% of a person's DV — due to safety concerns about drugs that contain potassium. People with kidney problems should be cautious about consuming too much potassium, as this can lead to hyperkalemia, or high levels of potassium in the blood. Potassium from food, however, does not cause harm in healthy people who have normal kidney function. When the kidneys are functioning well, any excess potassium from food dissolves in water and leaves the body in the urine. Summary If a person eats a diet rich in vegetables, fruits, and legumes, they should get enough potassium in their diet. It is beneficial to balance this by eating low amounts of high sodium foods, such as processed foods and fast food. This dietary approach can not only help keep potassium at a healthy level, but it may help people obtain a variety of other vitamins and nutrients that occur in whole foods and contribute to better health.
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Are there any health benefits to a cold shower?

Many people prefer warm showers to cold showers. However, some studies have shown that using cold water may be beneficial to physical and mental health.

This article covers some of the scientific evidence supporting the benefits of cold showers for a variety of physical and mental benefits.

We also provide some tips for getting started with cold showers, and we discuss some of the things to be aware of when making the switch.

The following are some of the potential benefits of taking cold showers.

Increased alertness Image of a cold shower
Benefits of a cold water shower can include increased heart rate and elevated respiratory rate.

Taking a cold shower can make a person feel more alert, largely due to its effects on the body.

According to a meta-analysis of existing cold water immersion research in the British Journal of Sports Medicine, cold showers have many physiological effects on the body.

These include:

Cold water also increases the body's metabolism because it has to work harder to maintain a stable temperature. However, because the typical duration of a cold shower is only around 5–10 minutes, a person should not rely on its metabolism-boosting effects as a weight loss technique.

That said, cold showers do create a sense of invigoration and alertness, which may prompt a person to be more physically active.

Stronger immune system A study in the journal PLoS One found that people who take cold showers are 29% less likely to call in sick for work or school. The study enrolled 3,018 people who took a hot shower then used applications of cold water for 30–90 seconds based on their research group. One research group took warm showers as usual and did not use cold water at all. Although those who took cold showers were less likely to call in sick for work, they did not report fewer sick days. The researchers concluded that cold showers might make a person's illness feel less severe, allowing them to continue with their daily activities. They did not find a difference between the people who took a cold shower for 30, 60, or 90 seconds. This led them to conclude that cold water triggers the body's immune system regardless of duration. Thank you for supporting Medical News Today Boosted mood Some researchers theorize that cold showers can have mood boosting benefits. An older article in the journal Medical Hypotheses suggests that because cold showers activate the sympathetic nervous system and increase the availability of neurotransmitters such as norepinephrine and endorphins, people may be less likely to experience depressive symptoms after a cold shower. However, it is important to note that people should not replace their prescribed depression treatment with cold showers. Quicker cooling after sports activities Cold water immersion therapy (submerging the body in ice or a cold bath) is a common practice in many athletic activities. Physical therapists that specialize in sports have suggested that the cold temperatures can quickly relieve heat exertion and reduce inflammation. A study in the Journal of Athletic Training found that taking a cold shower can relieve exertional hyperthermia, compared with no treatment at all. However, the researchers did note that cold showers were not as effective as immersion therapy for the relief of exercise induced high body temperatures. Improved physical recovery A meta-analysis of 23 peer reviewed articles in the Journal of Strength and Conditioning Research found that cold water immersion and contrast water therapy (first using hot water, then cold) can help enhance recovery and reduce feelings of fatigue. This research could help athletes use cold water techniques to reduce feelings of fatigue related to their physical performance. Reduced pain According to an article in the North American Journal of Medical Sciences, applications of cold water can have local anesthetic-like effects for pain relief. Exposure to cold water can cause the blood vessels to constrict, which can help reduce any swelling and edema that causes pain. Cold water can also slow the speed at which nerve signals conduct impulses. This can reduce the rate at which nerves transmit pain signals to the brain, which can lower a person's perception of pain. Tips to start Hand checking the temperature of water
A person can gain positive effects from a brief cold shower. A lot of the research into the benefits of cold showers suggests that the water does not necessarily need to be cold for the entire duration of the shower for the person to experience positive effects. A person can start by taking a warm shower and then switching the water to cold for a brief time. This could be anywhere from 30 seconds to 2 minutes. Some people prefer to take just a brief cold shower of around 5–10 minutes. This may also be a practical approach to cold water therapy. Several studies cite a target cold temperature of about 68°F (20°C), according to an article in the journal Medical Hypotheses. However, most of the time, a person's own perceptions of cold water are enough to make changing the temperature effective. Things to be aware of A person should not use cold showers as a replacement for other prescribed medical therapies, especially those that doctors prescribe to treat depression. However, people can try cold water therapy to enhance the effects of other treatment methods. Some people should exercise caution when taking cold showers. This includes people with weaker immune systems and those with serious heart conditions, such as congestive heart failure. This is because the sudden changes to body temperature and heart rate may overwhelm the body. If a person is not sure if a cold shower could benefit them, they should ask their doctor. Thank you for supporting Medical News Today Summary People have used cold water therapies for centuries as a treatment to invigorate and enhance their overall well-being. Some scientific studies support the beneficial effects of cold showers on mental and physical health. Even brief bursts of cold water can be worth incorporating into a regular shower routine.
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How many calories do eggs contain?

Eggs are a good source of protein and contain many key vitamins and minerals, including calcium, potassium, and iron. All of these nutrients are vital components of a person's diet.

According to the United States Department of Agriculture (USDA), one large, hard-boiled egg contains around 78 calories.

Eggs were once a controversial choice due to concerns about saturated fats and cholesterol, but researchers have since proved that eggs have a number of dietary benefits.

This article looks at the nutritional profile of eggs, as well as some of the latest research into the risks and benefits associated with eating eggs.

Nutritional profile Boiled eggs on a table
Eggs are a good source of protein and antioxidants.

One large, hard-boiled egg weighing around 50 grams (g) contains the following nutrients, according to the USDA:

Calories: 78 Protein: 6.29 g Total fat: 5.3 g Carbohydrate: 0.56 g Dietary fiber: 0 g Sugars: 0.56 g Calcium: 25 milligrams (mg) Iron: 0.59 mg Phosphorous: 86 mg Potassium: 63 mg Zinc: 0.53 mg Cholesterol: 186 mg Folate: 22 micrograms Vitamin A: 260 international units (IU) Vitamin D: 44 IU

However, the way a person cooks an egg slightly alters its nutritional profile. For example, the same 50 g of a whole, scrambled egg has around 4.99 g of protein and 36 IU of vitamin D, according to the USDA.

Thank you for supporting Medical News Today Benefits Eggs have many benefits — they are a good source of protein, fatty acids, choline, and antioxidants. Eggs are also rich in vitamin D, a nutrient that does not occur naturally in many common foods. Several research studies have tested the nutritional value of eggs as part of the daily diet. For example, one study in The FASEB Journal included 26 participants, ages 60–75, with obesity. The researchers asked them to eat either an egg based, high fat diet or a carbohydrate based, low fat diet for 8 weeks. After 8 weeks, the scientists measured the participants' body fat composition. Those who ate three whole eggs per day in a low carbohydrate diet lost more fat than those who ate a high carbohydrate, low fat diet. However, it is important to note that the Egg Nutrition Center funded this study. A meta-analysis in the Journal of the American College of Nutrition examined seven research studies concerning egg consumption, heart disease, and stroke. The researchers found that eating up to one egg per day helped reduce a person's risk of stroke, but they did not see an increase or a decrease in the participants' risk of heart disease. However, one study in the journal Heart that included data from half a million adults found that eating an average of one egg per day was significantly associated with a lower risk of heart disease. A study in The American Journal of Clinical Nutrition looked at the effects of a high egg diet versus a low egg diet in people with diabetes. The team defined a high egg diet as eating two eggs per day on 6 days per week and a low egg diet as eating fewer than two eggs per week. After 3 months, the researchers found that high egg consumption did not affect the cholesterol levels of the participants. They did find, however, that a high egg diet can increase satiety, or feelings of fullness. Eggs can be a healthful addition to the diet. To reap the nutritional benefits, a person can incorporate them into a variety of meals. Risks Egg ramen
A person can include eggs as part of a healthful diet. Previous controversy surrounding eggs and their nutritional value concerned the amount of cholesterol in egg yolk. According to the American Heart Association (AHA), one large egg contains around 186 mg of cholesterol. However, the secretaries of the US Department of Health and Human Services and the USDA removed the recommended daily limit for cholesterol in 2016. This followed recommendations from dietary advisory committees, which noted that research has not shown that dietary cholesterol — in foods such as eggs — poses a danger to heart health or cholesterol levels in the body. Most recently, a 2019 study in the journal Nutrients found evidence to support the omission, concluding that eating eggs is not associated with excess cholesterol levels in the body. The results are based on the Hellenic National and Nutrition Health Survey, which asked more than 3,500 participants questions about their dietary habits. If a person typically has a healthful diet and is mindful of their total daily intake of foods high in saturated fat, trans fat, and cholesterol, eating cooked, whole eggs is unlikely to harm their health. A bigger concern regarding egg consumption is that allergies are common, especially among children. In fact, according to the American College of Allergy, Asthma & Immunology, around 2% of children are allergic to eggs. Although many outgrow this allergy by the age of 16, some people experience reactions so severe that they cause difficulty breathing. Some symptoms associated with an egg allergy include: coughing diarrhea dizziness a feeling of tightness in the throat stomach cramping swelling of the lips and tongue If a person suspects that they or someone they know is having an allergic reaction to eggs, they should seek medical aid. People with severe egg allergies may need to carry an epinephrine injector pen to treat the symptoms of an anaphylactic reaction. Adding eggs to the diet A person can incorporate eggs into their diet in a variety of ways, such as by: boiling, poaching, or scrambling the eggs making omelets or quiches that contain eggs or egg whites as well as vegetables and lean meats incorporating eggs into casseroles and adding vegetables or lean meats adding a boiled egg to a salad or having one as a snack Eating hard-boiled, poached, or scrambled eggs can be very nutritious. To ensure that the eggs are a healthful addition, refrain from cooking them in butter or high fat oils. Summary Eggs can be a healthful addition to any meal, or they can serve as a snack. A large, hard-boiled egg contains only 78 calories, as well as protein and vital nutrients, such as vitamin D. Although nutrition experts have expressed some concern surrounding eggs' cholesterol content, most current research suggests that eggs do not adversely affect people's cholesterol levels. Anyone who has concerns about egg consumption, however, should speak with a doctor.
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These diets and supplements may not really protect the heart

Doctors often recommend certain dietary interventions — such as following a Mediterranean-type diet or cutting salt intake — in the interest of protecting heart health. On top of this, many individuals believe that dietary supplements will help them stay healthy.
image of healthy foods vs supplements
Can supplements and dietary interventions protect the heart? Not according to a new meta-analysis.

Common knowledge has it that diet and lifestyle play an important role in supporting a person's physical health and overall well-being.

That is why doctors may advise their patients to modify their diets and lifestyle habits by making them more conducive to good health.

In particular, dietary interventions can allegedly help individuals safeguard their cardiovascular health, preventing heart disease and events such as strokes.

Dietary guidelines for people in the United States advise that people adhere to healthful diets, such as a vegetarian diet or the Mediterranean diet, which is rich in vegetables, legumes, and lean meat.

On a related note, many individuals believe that taking dietary supplements can enhance different aspects of their health, including heart health, although recent studies have contradicted this assumption.

Now, a meta-analysis by researchers from different collaborating institutions — including The Johns Hopkins School of Medicine in Baltimore, MD, West Virginia University in Morgantown, and Mayo Clinic in Rochester, MN — suggests that many interventions and even more supplements may have no protective effect for the heart, and some may even harm cardiovascular health.

The review — the first author of which is Dr. Safi Khan from West Virginia University — appears in Annals of Internal Medicine.

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In their research, Dr. Khan and team analyzed the data from 277 randomized controlled trials that had involved almost 1 million participants between them. They looked at the effects of 16 nutritional supplements and eight dietary interventions on cardiovascular health and mortality.

The supplements that they took into consideration were: selenium, multivitamins, iron, folic acid, calcium, calcium plus vitamin D, beta carotene, antioxidants, omega-3 long-chain polyunsaturated fatty acids, and vitamins A, B complex, B-3, B-6, C, D, and E.

The dietary interventions included: modified dietary fat, reduced salt (in people with normal and high blood pressure), reduced saturated fat, Mediterranean diet, reduced dietary fat, higher intake of omega-6 polyunsaturated fatty acids, and higher intake of omega-3 alpha-linolenic acid.

Dr. Khan and colleagues did find that some of these interventions had a positive effect. For instance, eating less salt may reduce the risk of premature death in people with a normal blood pressure, although only with moderate certainty.

Moreover, they concluded that omega-3 long-chain polyunsaturated fatty acids protected against heart attacks and coronary heart disease and that there was an association between folic acid intake and a slightly lower risk of stroke, but all with only low certainty.

At the same time, however, other supplements and interventions seemed to either have no effect or be downright harmful.

The researchers found that taking multivitamins, selenium, vitamin A, vitamin B-6, vitamin C, vitamin D, vitamin E, calcium, folic acid, and iron did not significantly protect against cardiovascular problems and early death. They also noted that following a Mediterranean diet, reducing saturated fat intake, modifying fat intake, reducing dietary fat intake, and increasing the quantity of dietary omega-3 and omega-6 were not beneficial.

In fact, people who took calcium and vitamin D supplements together actually had a higher risk of experiencing a stroke, although only with moderate certainty.

However, in their paper, the investigators admit that "these findings are limited by suboptimal quality of the evidence." They are referring to the fact that, due to the different methodologies of the studies that they assessed, they "could not analyze interventions according to important subgroups, such as sex, body mass index [BMI], lipid values, blood pressure thresholds, diabetes, and history of [cardiovascular disease]."

Yet, they argue that their current review paves the way to better care and stronger research into the helpfulness and value of different dietary interventions:

"This study can help those who create professional cardiovascular and dietary guidelines modify their recommendations, provide the evidence base for clinicians to discuss dietary supplements with their patients, and guide new studies to fulfill the evidence gap."

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The authors of the accompanying editorial, doctors Amitabh Pandey and Eric Topol, both from the Scripps Research Translational Institute in La Jolla, CA, also emphasize that the quality of the data in many studies assessing the effects of dietary interventions and supplements on heart health can be questionable.

"[D]ifferences in geography, dose, and preparation — most studies rely on food diaries, which are based on a person's memory of what they consumed — raise questions about the veracity of the data," they write.

"Perhaps, however, the biggest difference that needs to be considered in the future is the individual," they add, advising that future research should pay more attention to the differences among participants.

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Could targeting this heart hormone help control blood pressure?

Recent insights into a hormone released by muscle cells could lead to improved ways to treat high blood pressure.
young doctor taking patient's blood pressure
Researchers find novel ways to tackle high blood pressure.

When the hormone, which has the name atrial natriuretic peptide (ANP), enters the bloodstream, it lowers blood pressure by triggering blood vessel dilation and excretion of sodium in urine.

Scientists from the University of Copenhagen and Rigshospitalet in Denmark studied the function of ANP in rats.

They report their findings in a paper that features in the Journal of Biological Chemistry.

The team discovered that ANP's effect on blood pressure appears to depend on the presence or absence of a certain sugar molecule on the peptide.

"We can see," says study author Katrine Schjoldager, assistant professor in the Copenhagen Center for Glycomics at the University of Copenhagen, "that when that particular sugar is located on the peptide hormone, it regulates the fluid balance and blood pressure differently than if the sugar is not located there."

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Molecular insights into blood pressure

The heart pumps blood around the body. This exerts pressure on the walls of arteries. If the pressure is too high or too low, it can cause health problems.

High blood pressure, or hypertension, affects around one in three adults, or 75 million people, in the United States, according to figures from the Centers for Disease Control and Prevention (CDC).

Having high blood pressure increases people's risk of developing heart disease or stroke, which are major killers in the US.

The new study is an example of glycoproteomics, a type of biological investigation that allows scientists to study glycosylation, or the way that cells tag different locations on proteins with sugar molecules to alter their function and make them stable.

Until recently, scientists did not have the tools to investigate the full scope of glycoproteomics.

In their study, Schjoldager and colleagues conducted a "comprehensive glycoproteomics analysis," using advanced technologies that included mass spectrometry and specialized software.

"In our animal models," Schjoldager notes, "we could see that the peptide hormone with and without sugar behaves differently."

A 'modern way to treat hypertension'

The researchers believe that their findings offer new insights into the regulation of blood pressure in the body.

Senior study author Jens Peter Gøtze, a professor in the Department of Clinical Biochemistry at Rigshospitalet, suggests that they could lead to a "modern way to treat hypertension without side effects, such as syncope [losing consciousness]."

He explains that scientists have known for some time that ANP is important for blood pressure, but until their findings, they had no clue about how it might serve as a target for treatment.

The researchers are planning a more detailed study of how the heart controls that particular sugar and where it attaches onto ANP.

After that, they want to find out how the function differs in humans with and without certain heart conditions, such as heart failure.

"This finding was only possible because we collaborated across disciplines and combined basic and clinical research."

Prof. Jens Peter Gøtze

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Very low levels of 'bad' cholesterol may raise stroke risk

New research examines the data of almost 100,000 participants and finds that excessively low levels of low-density lipoprotein cholesterol increase the risk of hemorrhagic stroke.
close up of healthcare professional handling blood samples
New research suggests that having too little LDL cholesterol may harm cardiovascular health.

The internet abounds with articles and scientific studies that warn healthcare consumers of the perils of high cholesterol levels.

Whether it is low-density lipoprotein (LDL) cholesterol — also known as "bad" cholesterol — raising heart disease and early death risk or high levels of "good" cholesterol increasing the risk of heart attacks and cardiovascular death, excessive cholesterol seems to link inextricably to poor health.

However, could it be the case that excessively low cholesterol also harms cardiovascular health? Some researchers have recently argued that this is the case.

For instance, a study that Medical News Today reported on earlier this year found that very low levels of bad cholesterol raise the risk of hemorrhagic, or bleeding, stroke in women over the age of 45 years.

Now, a new, large-scale study appearing in the journal Neurology confirms the idea that too little LDL cholesterol may increase the risk of bleeding stroke in both men and women.

Xiang Gao, associate professor of nutritional sciences and director of the Nutritional Epidemiology Lab at Pennsylvania State University (Penn State) in State College, is the senior author of the study.

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"For our study, we wanted to expand the scope of knowledge in this area by investigating the issue prospectively in a large cohort with multiple LDL cholesterol measurements to capture variation over time," explains the first author Chaoran Ma, who is a nutritional sciences graduate student at Penn State.

Specifically, Gao and team examined 96,043 participants who did not have a history of stroke, heart attack, or cancer at the start of the study. The researchers measured the participants' LDL cholesterol at baseline and then every year for 9 years.

Using data from the participants' medical records, the scientists examined the correlation between LDL cholesterol levels and the risk of hemorrhagic stroke, adjusting for potential confounders, including age, sex, blood pressure, and other medication.

They found that people whose LDL cholesterol levels were below 70 milligrams per deciliter (mg/dl) had a significantly higher risk of hemorrhagic stroke than those with LDL cholesterol levels greater than or equal to 70 mg/dl.

The likelihood of having a bleeding stroke was 169% higher among the participants whose LDL cholesterol levels were below 50 mg/dl than among those whose levels were 70–99 mg/dl.

For cholesterol levels between 70 and 99 mg/dl, stroke risk stayed the same among participants.

"Traditionally, an LDL cholesterol level of more than 100 mg/dl had been considered as optimal for the general population and lower in individuals at elevated risk of heart disease," explains Gao.

"We observed that the risk of hemorrhagic stroke increased in individuals with LDL cholesterol levels below 70 mg/dl. This observation, if confirmed, has important implications for treatment targets," he continues.

"As is true with many things in nutrition, moderation and balance [are] key when deciding the optimal target level of LDL cholesterol. You can't go to either extreme — too high or too low."

Xiang Gao

"And, if you're at a high risk for hemorrhagic stroke due to family history or risk factors like high blood pressure and heavy alcohol drinking, you may want to be extra careful about LDL cholesterol levels," continues the senior author.

Ma comments on the strengths of the study, saying, "The results were based on a large community-based study, which is an advantage because it focused on healthy people in a nonclinical setting."

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Cardiovascular risk linked not to weight, but to body fat storage

By studying a large cohort of women who had already been through menopause, researchers have found that cardiovascular risk is associated with body shape, which results from how fat is distributed in the body.
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A new study suggests that in women over 50, body shape is associated with cardiovascular risk.

Existing studies have suggested that a person's body mass index (BMI), calculated in reference to their total weight and height, is associated with the risk of experiencing cardiovascular events.

Thus, the higher a person's BMI, the greater their risk of experiencing stroke, heart disease, and similar events and conditions.

However, new research, from the Albert Einstein College of Medicine, in New York, NY, and other institutions, points to another potential factor, namely, where fat is stored in the body — for women over the age of 50, at least.

The new study — the findings of which appear in European Heart Journal — has looked at data from 161,808 women aged 50–79 to find out whether BMI or fat distribution was associated with cardiovascular risk.

All of the participants had enrolled in the Women's Health Initiative between 1993 and 1998. Follow-up information on the participants' health was available from that period to the end of February 2017.

None of these women had cardiovascular disease at baseline. Throughout the study period, however, the researchers recorded 291 new cases of cardiovascular disease.

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Body shape matters

In the study, the investigators measured body fat mass through dual-energy X-ray absorptiometry, a type of scan that assesses a person's fat, muscle, and bone density.

The team found a pattern. Women with the highest percentage of fat stored around their middles and trunks and the lowest percentage of fat around their legs, giving them an "apple" body shape, also had the highest risk of cardiovascular disease.

These women had more than thrice the risk of cardiovascular disease of peers with a low percentage of fat around their middles and a higher percentage of fat around the legs: the "pear" shape.

Moreover, women in the top 25th percentile with the most body fat around their middles had almost double the risk of experiencing heart problems or a stroke, compared with the top 25% of women with the least body fat around their middles.

At the same time, women with the most fat around their legs had a lower risk of cardiovascular disease — 40% lower than those who had the least amount of fat around their legs.

Yet, the researchers add, body weight seems not to affect this risk.

"Our findings suggest that postmenopausal women, despite having normal weight, could have varying risk of cardiovascular disease because of different fat distributions around either their middle or their legs. In addition to overall body weight control, people may also need to pay attention to their regional body fat, even those who have a healthy body weight and normal BMI," says lead author Qibin Qi, Ph.D.

Furthermore, the investigators argue that reducing the amount of midriff body fat alone could help reduce the risk of cardiovascular disease.

Thus, by looking at the women who did not change their amount of leg fat during the study period but who reduced the proportion of middle fat — from over 37% to under 27% — the researchers calculated that, among 1,000 participants, around six cases of cardiovascular disease per year could be prevented.

They estimated a similar outcome for women who do not lose any midriff fat but who increase the proportion of leg fat: Among 1,000 women who increase leg fat from under 42% to over 49%, around three cases of cardiovascular disease per year could be prevented, the researchers found.

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A need for better assessments

However, Qi warns, these associations may not apply to everyone.

"It is important to note that participants of our study were postmenopausal women who had relatively higher fat mass in both their trunk and leg regions. Whether the pattern of the associations could be generalizable to younger women and to men who had relatively lower regional body fat [levels] remains unknown," he says.

At the same time, the researchers believe that their current findings make a good case for using measurements other than just BMI when considering the risk of cardiovascular disease.

"In routine clinical practice, BMI is a common approach to assessing a person's risk of cardiovascular disease. Measurement of waist circumference is also recommended by [a] national organization to provide additional information, but usually only in those with a BMI between 25 to 34.9 [kilograms per square meter]," explains Qi.

"As such," he adds, "some people who are categorized as [having] a normal weight may not be recognized as being at increased risk of cardiovascular disease due to the distribution of their body fat, and so may not have preventive measures recommended for them."

"Our findings highlight the need for using anthropometric measures that better reflect regional fat distribution to identify increased risk of cardiovascular disease. These are important research directions for future population studies."

Qibin Qi, Ph.D.

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What are some slow-release carbs?

Carbohydrates are one of three essential nutrient groups necessary for survival. The other two are proteins and fats. Carbohydrates are the primary source of energy for the body. The body converts carbs into the sugar glucose, which then enters the bloodstream to fuel the body's cells.

Not all carbohydrates release energy at the same rate. The Glycemic Index (GI) is a scale that measures how quickly specific foods release glucose into the bloodstream.

Fast-release carbs, or high GI foods, release glucose into the bloodstream rapidly, causing a spike in blood sugar levels. Slow-release, or low GI, carbs foods provide a slower and more sustained release of energy.

This article focuses on some of the slow-release carbs within common food groups. It also provides information on the health benefits of low GI foods, as well as some important considerations when following a low GI diet.

Benefits of low GI foods Quinoa and vegetables on a plate which are slow release carbs
Quinoa and vegetables including carrots and sweet potatoes are slow-release carbs that are low on the GI scale.

Foods on the GI scale range from 0 to 100, with 0 representing the lowest GI and 100 representing the highest. Pure glucose has a GI of 100.

According to the American Diabetes Association (ADA), low GI foods score less than 55 on the index, medium GI foods score between 56-69, and high GI foods score 70 or above.

A diet that consists primarily of low GI foods can help people maintain blood glucose levels and sustain energy levels.

A low GI diet can also lead to improvements in:

Weight management: Low GI foods decrease feelings of hunger and increase fat metabolism. Cardiovascular health: Improved blood flow due to increased elasticity of the blood vessels. Cholesterol levels: High fiber, low GI foods help decrease levels of low-density lipoprotein (LDL), or bad cholesterol. Cognitive performance: Slow-release carbs help to sustain energy levels, leading to increased alertness and better cognitive performance. Low GI cereals According to the ADA, many types of breakfast cereals, such as corn flakes, bran flakes, or puffed rice, contain added sugars and are high on the GI scale. Try replacing these cereals with a slow-release option, such as rolled oats porridge, which has a GI score of 55, according to a detailed list of the glycemic values of a wide variety of foods compiled by the University of Sydney in Australia. Try serving low GI cereals with other low GI foods, such as unsweetened plant milk, yogurt, nuts, or low GI fruits. Thank you for supporting Medical News Today Quinoa Quinoa is a seed harvested from the goosefoot plant. Quinoa is technically a pseudo-cereal, which is a food that has similar nutrients to grains and requires a similar cooking process. In addition to a low GI of 53, per 150 gram (g) serving, quinoa is an excellent source of protein and contains a lot of potassium, iron, and vitamin B. It is a particularly nutritious option for people following a gluten-free diet. Quinoa is a highly versatile food. People can try adding it to salads or soups or making a quinoa porridge to serve with low GI fruits and nuts. Make sure to rinse quinoa well until the water runs clear to remove the bitter saponin compounds. Pressure cooking is an excellent cooking method for this pseudo-cereal and can help people tolerate it well. Vegetables Most vegetables on the glycemic index have a low GI. According to the University of Sydney, examples include: Vegetable (per 80g unless otherwise stated) GI score carrots 35 sweet potato (150g) 44 butternut squash 51 parsnips 52 yam (150g) 54 sweet corn 55 Starchy vegetables, such as pumpkin and parsnips, tend to have a higher GI. The following factors can also affect the GI of vegetables: Ripeness and storage: Riper produce has a higher GI. Processing: Fresh fruits and vegetables release their carbs more slowly than juiced, mashed, or pureed vegetables. Cooking: Different methods of cooking can alter the GI of vegetables. For example, the ADA state that boiled white potatoes have a GI of 74–82, instant mashed potato has a GI of 84–90, and French fries have a GI between 58–68. Legumes and pulses Pulses are the harvested beans, peas, or lentils that derive from plants belonging to the Leguminosae or pea family. Most legumes have a GI of 50 or below. Examples include: Legume (per 150g) GI score kidney beans 19 red lentils 21 pinto beans 33 chickpeas 36 butter beans 36 green lentils 37 Legumes also have a high fiber and protein content, both of which help people to feel fuller for longer. They may, therefore, be beneficial in aiding weight loss, when eaten as part of a healthful, balanced Mediterranean-style diet. Legumes also provide a range of important micronutrients, including B vitamins, iron, copper, magnesium, phosphorous, manganese, and zinc. Nuts and nut butters peanut butter in a jar from above
Nuts and nut butters are high in protein and fiber, so they release their energy slowly. Nuts and no added sugar nut butters are low in carbohydrates. They are also high in fiber and protein, which increases the amount of time the body takes to digest them. As a result, nuts release their energy slowly without spiking blood glucose levels. Nuts may be a particularly healthful snack for people with type 2 diabetes. Not only do they have a low GI, but they also contain a high amount of healthful, monounsaturated fats (MUFAs), which may aid blood glucose control and improve cardiovascular health. A 2013 study found that women with type 2 diabetes who consumed peanuts or peanut butter each day had reduced appetite and improved blood glucose control compared with people who did not consume these foods. For a filling, low GI snack, try spreading almond or peanut butter on low GI fruits, such as sliced apple. Fresh fruits Fresh fruits tend to have a low GI, which raises blood sugar levels at a fairly slow and steady rate. However, tropical fruits tend to have a higher GI. Examples of low GI fruits include: Fruit (per 120g) GI score plum 24 grapefruit 25 peach 28 apricot 34 apple 40 orange 40 strawberry 40 pear 42 grapes 43 Examples of fruits with a higher GI include: Fruit (per 120 g unless otherwise stated) GI score lychee (100g) 57 mango 60 papaya 60 pineapple 66 watermelon 80 People who are looking to stabilize their blood sugar levels should opt for low GI fruits wherever possible. When buying canned fruits, avoid those canned in sweetened fruit juices or those containing added sugars. This type of fruit will have a higher GI. Dried fruits also tend to be higher in calories and higher on the GI scale. Dairy various dairy products
Dairy products are low on the GI scale. Many dairy products, such as milk and yogurt, are low on the GI scale. For example, according to the ADA, whole milk has a GI of 36-42, and a fruit flavored yogurt has a GI of 39–43. Both have a minimal effect on blood glucose levels. Dairy products are also a good source of protein and calcium. For a low GI breakfast, combine yogurt with low GI fruits and nuts or blend the ingredients with vegetables for a healthful breakfast smoothie. For vegans and people allergic or sensitive to dairy, soy milk has a GI of 30–38. This makes it a good, low GI alternative. Thank you for supporting Medical News Today White bread alternatives The ADAlist white bread as having a GI of 73–77. White bread releases its carbs very quickly, causing a significant peak and subsequent crash in blood glucose levels. To help maintain a healthy blood glucose level, try swapping white bread for one of the following low GI breads: Bread (per 30g) GI score mixed grain 34 pumpernickel 41 sourdough rye 48 rye 50 soy and linseed 50 sourdough wheat bread 54 Other important considerations The following factors are also important when attempting to follow a healthful low GI diet: Portion size Smaller meals have less effect on blood glucose levels than larger meals. Food combinations The GI of a food describes how it affects blood glucose when eaten alone. However, combining high and low GI foods in the same meal increases the digestion time of high GI foods. This means they will release glucose into the bloodstream at a steadier rate. Nutritional content Many high GI foods have a higher nutrient content than low GI foods. People who follow a low GI diet should ideally avoid the low GI foods that offer little nutritional value. Examples of such foods include: chocolate bars cakes jams corn chips rice noodles Summary Following a diet that consists mainly of low GI foods can have a range of health benefits. There are many low GI options to suit a variety of diets and nutritional needs. When creating a low GI meal plan, consider other factors that can affect blood glucose levels, such as cooking methods, portion sizes, and the ripeness of fresh produce. It is also important to consider that the GI of a food does not reflect its overall nutritional content. People should aim to eat a variety of foods, especially of nutrient-dense fruits and vegetables, to fulfill their dietary requirements.
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Sitting at home or at work: Which is worse for heart health?

New research has found that not all forms of sedentariness are equal when it comes to the extent to which they put heart health at risk.
couple watching tv
Sitting on the couch, watching TV could increase heart risk more than sitting at a desk doing office work.

We already know that a sedentary lifestyle, in which a person sits down for long periods every day and gets little exercise, is bad for health in general and heart health in particular.

However, in a new study, researchers from the Vagelos College of Physicians and Surgeons at Columbia University in New York City, NY, have found that there is a difference between occupational sitting (sitting at work) and leisure time sitting (sitting at home, watching TV).

The researchers worked specifically with a cohort of African American people, aiming to fill a gap in the research to date, which has primarily focused on white Europeans. Nevertheless, they believe that despite the specificity of the study cohort, the findings could apply to everyone, regardless of ethnicity.

And, the investigation revealed a — perhaps surprising — distinction: The time that a person spends sitting on the couch at home, watching TV, is much more likely to increase their risk of heart problems than the time they spend sitting at work.

"Our findings show that how you spend your time outside of work may matter more when it comes to heart health," explains study author Keith Diaz, Ph.D.

The solution to this problem may be to spend more time being not just active, but intensely active, the researcher notes.

"Even if you have a job that requires you to sit for long periods of time, replacing the time you spend sitting at home with strenuous exercise could reduce your risk of heart disease and death," says Diaz.

Diaz and team explain their findings and suggest a possible explanation for these results in a study paper that appeared yesterday in the Journal of the American Heart Association.

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Chilling on the couch raises risk by half

The researchers analyzed data for a cohort of 3,592 participants who had enrolled in the Jackson Heart Study, a community-based study focused on the causes of cardiovascular, renal, and respiratory diseases among African Americans.

All of the participants lived in Jackson, MS, and the health and lifestyle data available about them covered a period of 8.5 years. The information included how much time the participants spent sitting at work, as well as how much time they spent watching TV versus exercising in their spare time.

Diaz and team found that people who reported sitting and watching TV for 4 or more hours each day had a 50% higher risk of cardiovascular problems and premature death compared with individuals who sat in front of the television for 2 hours or less per day.

However, the same increase in risk did not apply when the hours of sitting took place at work — participants who sat for extended periods in the office did not have a higher cardiovascular risk than those who spent little time sitting at work.

The fix? The researchers suggest that replacing some TV downtime with moderate to vigorous exercise could counteract the increase in cardiovascular risk. In fact, they noted that individuals who sat watching TV for 4 or more hours each day but also did 150 minutes or more of exercise per week did not have a heightened risk of heart health issues or premature death.

When possible, opt for movement

It is unclear why leisure time sitting is potentially more harmful than occupational sitting, but the investigators believe that fully uninterrupted sitting might explain the distinction.

"It may be that most people tend to watch television for hours without moving, while most workers get up from their desk frequently," says Diaz.

Another possible explanation may simply be the timing of leisure time sitting. "The combination of eating a large meal, such as dinner, and then sitting for hours could also be particularly harmful," adds the researcher.

Although the study suggested that leisure time sitting trumps occupational sedentariness when it comes to health risk increases, its authors point out that any type of sedentariness has the potential to harm health.

Thus, Diaz continues, while "[w]e recognize that it isn't easy for some workers, like truck drivers, to take breaks from sitting, [...] everyone else should make a regular habit of getting up from their desks."

The takeaway from the current research, this author points out, is that "what you do outside of work may be what really counts" when it comes to safeguarding well-being. Moreover, he stresses that any and all activity is important — what matters is to get up and move a little.

"More research is needed, but it's possible that just taking a short break from your TV time and going for a walk may be enough to offset the harm of leisure time sitting. Almost any type of exercise that gets you breathing harder and your heart beating faster may be beneficial."

Keith Diaz, Ph.D.

In the future, the researchers want to conduct further studies to try to find out exactly what makes sitting in front of the TV such an important risk factor for cardiovascular problems.

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Statins may double the risk of type 2 diabetes

New research finds an elevated risk of type 2 diabetes among people who take statins in an effort to lower their cholesterol levels and keep heart disease at bay.
woman looking at bottle of pills
Among statins' unwanted effects may be an increased risk of type 2 diabetes, new research suggests.

Many people take statins to lower cholesterol and reduce the risk of cardiovascular events, such as coronary heart disease and heart attacks. In the United States, about 83% of people between 40 and 59 years of age who take cholesterol-lowering medication are taking statins.

Although statins are effective at staving off cardiovascular disease, some previous trials have suggested that they may raise the risk of diabetes.

A new study, led by Victoria Zigmont, a graduate researcher in public health at The Ohio State University in Columbus, further explores this link. The findings, which appear in the journal Diabetes Metabolism Research and Reviews, suggest that statins may indeed raise the risk for this chronic condition.

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Statins and a heightened diabetes risk

Zigmont and team examined the health records of 4,683 men and women who were diabetes-free at the start of the study but were at risk of heart disease. Of the total number of participants, 16% — or 755 people — were taking prescription statins at the start of the study, in 2011. The study ended in 2014.

Zigmont and team accounted for confounders such as gender, age, ethnicity, education, cholesterol and triglyceride levels, body mass index (BMI), waist circumference, and how many times the participants visited their doctors.

The analysis revealed that people who took statins were more than twice as likely to receive a diabetes diagnosis than those who did not take the medication. Additionally, people who took statins for longer than 2 years were more than three times as likely to develop diabetes.

"The fact that increased duration of statin use was associated with an increased risk of diabetes — something we call a dose-dependent relationship — makes us think that this is likely a causal relationship," explains Zigmont.

Additionally, the analysis revealed that those who took statins had a 6.5% higher risk of elevated blood sugar, as checks determined by HbA1c values.

"That said, statins are very effective in preventing heart attacks and strokes. I would never recommend that people stop taking the statin they've been prescribed based on this study, but it should open up further discussions about diabetes prevention and patient and provider awareness of the issue."

Victoria Zigmont

Study strengths and limitations

The researchers note some of the strengths of their study, such as having a large study sample of almost 5,000 people and using "real world" data from doctors. Also, having access to biometric measurements meant the researchers could consider and adjust for values before statin use.

Using pharmacy data allowed the researchers to "accurately measure statin class and intensity," but a weakness of the study is that researchers could not account for the participants' compliance with their prescriptions.

Also, the study is limited to "insured individuals who are routinely monitored by a healthcare provider," and so the researchers are unable to generalize about their results beyond this group. Furthermore, all participants were white.

Finally, the researchers could not account for other medications that the participants might have taken, nor did they consider other health habits, such as smoking status or alcohol use. Similarly, the researchers were unaware whether the participants had prediabetes at the start of the study or not.

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Hypertension: Looking beyond the classic risk factors

A recent study examines the relationship between where people live and the risk of developing hypertension and metabolic syndrome. The authors conclude that the location and type of home could play a significant role.
Couple walking through estate
How does the local environment impact hypertension risk?

According to the Centers for Disease Control and Prevention (CDC), hypertension, or high blood pressure, affects almost 1 in 3 adults in the United States.

Hypertension forms part of metabolic syndrome, which is a cluster of conditions that also includes excess body fat around the waist, high blood sugar levels, and abnormal levels of cholesterol or triglyceride in the blood.

Risk factors for metabolic syndrome include obesity, increasing age, genetics, and diabetes.

The above are also risk factors for hypertension, as are smoking, dietary factors, such as high salt intake, drinking too much alcohol, and stress.

Because both hypertension and metabolic syndrome affect a growing number of people, understanding the range of factors that leads to these conditions is vital.

Some researchers are investigating the potential impact of where we live. In this vein, scientists from the Lithuanian University of Health Sciences and Vytautas Magnus University, also in Lithuania, recently published new findings in the Journal of Public Health.

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Air pollution and hypertension

Earlier studies investigating exposure to air pollution and its relationship with hypertension produced conflicting results. However, a meta-analysis of 17 studies published in the journal Hypertension in 2016 concluded:

"Our results suggest that short-term or long-term exposure to some air pollutants may increase the risk of hypertension."

The authors of the latest study, which uses data from Kaunas, in Lithuania, paid particular attention to average exposure to ambient air pollution and the distance to green spaces and major roads. They also examined differences between living in multifamily homes, such as blocks of flats, and private single-family homes.

Specifically, they looked for links between these factors and the risk of developing arterial hypertension and certain measures of metabolic syndrome: reduced levels of high-density lipoprotein cholesterol (HDL, or "good," cholesterol), high triglyceride levels, obesity, and elevated blood sugar.

The study utilized data from three questionnaires taken by a total of 1,354 individuals; all of these participants had lived at the same location throughout the 10-year duration of the study.

The questions covered factors such as education level, alcohol consumption, smoking status, level of physical activity, blood pressure medication, and lipid-lowering treatment.

By using each participant's address, the scientists could predict their exposure to pollution. They also calculated the distance to the nearest green space, which they defined as a park larger than 1 hectare (10,000 square meters), and proximity to major roads.

The researchers also controlled for a number of variables, including body mass index, salt consumption, and education level.

All things considered, they found that long-term exposure to air pollution levels that were above the median increased the risk of having lower HDL. Higher than average exposure to pollution also increased the risk of having higher levels of triglycerides.

They also concluded that living closer than 200 meters to a major road increased the risk of hypertension.

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Multifamily living and increased risk

Importantly, the scientists found that the impact of traffic-related exposure to air pollution was only significant for those who lived in multifamily homes. For individuals residing in single-family homes, their risk for hypertension did not increase, even if they were exposed to the same level of pollution as those in multifamily homes.

The authors believe that this is most likely because of other factors, aside from pollution, that go hand in hand with living in these types of complexes. For instance, living in relatively cramped conditions in a built-up environment might play an independent role in increasing risk.

On the other side of the coin, the researchers found a positive effect of living near public green spaces. The authors write that "The risk of the incidence of [arterial hypertension] was higher for persons living further than 300 meters from a [green space]."

"Our research results enable us to say that we should regulate as much as possible the living space for one person in multifamily houses, improve the noise insulation of apartments, and promote the development of green spaces in multifamily houses."

Lead author Agne Braziene

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Some limitations

The authors' conclusions are interesting, and the results add weight to similar previous findings, but this topic is notoriously difficult to study for a number of reasons.

For instance, people who live in multifamily homes are more likely to have a lower overall income; earlier research has shown a relationship between socioeconomic status, metabolic syndrome, and coronary heart disease risk.

The researchers also explain that from the start of the study people in multifamily homes were significantly more likely to have diabetes and low HDL cholesterol than individuals in single-family homes.

Also, it is impossible to ascertain exact levels of exposure to noise and pollution for each participant. Someone who spends a great deal of time at home will have very different exposure levels from her neighbor who commutes a long distance for work, for instance.

Although the researchers attempted to control for some of these factors, it is not possible to remove their influence entirely.

That said, the evidence is mounting. Exactly how much impact air pollution and proximity to traffic have on our health is yet to be defined, but it seems increasingly likely that it is having at least some negative impact.

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