Wood Street Clinic Blog

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What are the best dietary sources of vitamin D?

Vitamin D is a type of nutrient that the body produces when a person's skin has exposure to direct sunlight. People can also consume vitamin D, but it is not naturally present in many foods. High quantities of vitamin D are present in oily fish and certain types of mushrooms.

According to the Office of Dietary Supplements (ODS), the key benefit of vitamin D is that it helps keep a person's bones, muscles, and nerves healthy. It also contributes to a healthy immune system.

It is present in egg yolks if the chickens laying them are free-range. Some mushrooms also contain vitamin D.

However, no other plant-based foods produce vitamin D. For people whose diets are mostly vegetarian or vegan, and for people who do not or cannot spend a lot of time outdoors, it can be difficult to get enough vitamin D.

If a person has concerns that they are not getting enough vitamin D from direct sunlight, consuming the following foods will help increase the overall amount they have in their bodies.

Oily fish Vitamin d foods swordfish
Swordfish is an excellent source of vitamin D.

Oily fish, as well as oils from fish, have some of the highest quantities of vitamin D in food sources.

These may include:

Thank you for supporting Medical News Today Mushrooms If a person does not like fish, or if they are vegetarian or vegan, specific mushrooms may be an option. Some types of mushroom contain high amounts of vitamin D. These include: Raw maitake mushrooms: These contain 562 IU per 50 grams (g), which is 94 percent of a person's RDA. Dried shiitake mushrooms: These contain 77 IU per 50 g, which is 12 percent of a person's RDA. Mushrooms with exposure to ultraviolet (UV) light can also contain large amounts of vitamin D. These may include: UV-exposed raw Portobello mushrooms: These contain 568 IU per 50 g, which is 95 percent of a person's RDA. UV-exposed raw white mushrooms: These contain 523 IU per 50 g, which is 87 percent of a person's RDA. Egg yolks Egg yolks can also be high in vitamin D, especially if the chickens are free-range. For example, a dish of scrambled eggs using two large hen eggs contains 88 IU, which is 15 percent of a person's RDA. Thank you for supporting Medical News Today Fortified foods Manufacturers add vitamin D to many commercially available foods. People describe these foods as being fortified with vitamin D, or other nutrients. Common foods with extra vitamin D and other nutrients include: cow's milk orange juice various breakfast cereals Getting enough vitamin D Vitamin d foods orange juice
Vitamin D may provide resistance to some cancers and cardiovascular diseases. According to the ODS, if a person does not have enough vitamin D in their diet, they are at risk of developing weak bones. Symptoms of this might include pain in a person's bones or weakness in their muscles. These symptoms can be subtle initially. There is some research to suggest that vitamin D may contribute to other health benefits, such as: However, according to the ODS, there is not yet enough evidence to know whether this is the case. Existing research has yielded mixed results. The RDA of vitamin D for all people aged 1–70 is 600 IU. For children below the age of 1, it is 400 IU, and for adults over 70, it is 800 IU. This assumes that a person has the minimum amount of direct sun exposure. The general assumption is that a person who spends some time outside a few times per week will produce sufficient vitamin D. However, according to the ODS, this can vary considerably depending on: season time of day the presence of cloud cover or smog the color of a person's skin whether a person is wearing sunscreen Being in direct sunlight behind a window will not aid vitamin D production because glass cuts out the radiation that produces vitamin D. Thank you for supporting Medical News Today Summary Getting enough vitamin D is crucial to maintaining healthy bones. The easiest way of getting enough vitamin D is to regularly spend time outside, making sure that the arms, face, and legs have exposure. Depending on a person's dietary preferences, consuming enough vitamin D may be difficult. In this case, vitamin D supplements, which are available to purchase online, may be a beneficial choice. However, if this is not possible, try to consume oily fish, some mushrooms, and free-range egg yolks. We picked linked items based on the quality of products, and list the pros and cons of each to help you determine which will work best for you. We partner with some of the companies that sell these products, which means Healthline UK and our partners may receive a portion of revenues if you make a purchase using a link(s) above.
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What are the health benefits of water chestnuts?

Water chestnuts are an aquatic tuber vegetable. They grow in parts of Southeast Asia, Africa, Australia, and many Pacific islands. A water chestnut resembles an actual chestnut in both color and shape, but it is not a nut.

Water chestnuts are popular in many cuisines and have a variety of potential health benefits.

These benefits may include:

Providing antioxidants Whole and peeled chestnuts
Eating water chestnuts could help reduce the risk of cancer.

Water chestnuts are an excellent source of antioxidants. Antioxidants help the body's immune system fight free radicals, which are potentially harmful molecules.

When free radicals accumulate to a certain extent, they can cause a state of oxidative stress, impacting the body's natural defenses and damaging cells.

Oxidative stress is linked to an increased risk of developing chronic illnesses, including cancer.

However, some research suggests that the antioxidants found in water chestnut peel can help neutralize the effects of free radicals on the body.

Thank you for supporting Medical News Today Slowing tumor growth Water chestnuts contain an antioxidant called ferulic acid. There is some evidence that ferulic acid can help reduce or slow the growth of cancer cells. For example, a test tube study of breast cancer found that ferulic acid both helped kill and reduce the growth rate of the cells. However, determining whether the compounds in water chestnuts can help fight cancer will require more research in humans. Lowering calorie consumption Water chestnuts are very low in calories. Half a cup of sliced water chestnuts contains just 60 calories. Despite having a low calorie count, water chestnuts contain many nutrients, including: Thank you for supporting Medical News Today Lowering high blood pressure and associated risks Person cooking water chestnuts in street
Water chestnuts are rich in nutrients. High blood pressure can contribute to several health issues, including stroke and heart disease. Potassium, a nutrient in water chestnuts, is linked to reducing blood pressure. A 2013 review found that increasing the intake of potassium could help reduce blood pressure in people with hypertension. The researchers also found moderate-quality evidence to suggest that a higher potassium intake could reduce the risk of stroke by 24 percent. This review considered a higher intake to consist of 3,500–4,700 milligrams (mg). Another, smaller review of 11 studies found that higher potassium intake reduced both the risks of stroke and heart disease. Half a cup of sliced water chestnuts contains 362 mg of potassium. Adding extra potassium to a healthful diet may help lower high blood pressure and its associated risks. How to use water chestnuts Water chestnuts are easy to prepare and eat. Grocery stores that stock international foods often offer them canned or whole. People can also purchase them online. To use a whole, fresh water chestnut, peel away the outer brown skin to reveal the white flesh beneath. A person can eat the flesh raw. They can also be fried, grilled, boiled, or sautéed to provide a sweet, crunchy addition to a meal. Depending on the dish, a person may serve them whole, sliced, diced, or ground up. They are popular in stir-fries, chop suey, and many curries. People also enjoy candied or pickled water chestnuts as a snack. Or, to them in a flour mixture or as a thickening agent, dry water chestnuts out and grind them up. Thank you for supporting Medical News Today Summary Water chestnuts are an excellent source of nutrients and antioxidants, making them a good addition to a healthful diet. Some evidence suggests that consuming water chestnuts could help reduce free radicals in the body and lower blood pressure, among other benefits. Water chestnuts are quite versatile — people can use them in many types of cooking or eat them raw. We picked linked items based on the quality of products, and list the pros and cons of each to help you determine which will work best for you. We partner with some of the companies that sell these products, which means Healthline UK and our partners may receive a portion of revenues if you make a purchase using a link(s) above.
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Sleep apnea: Daytime sleepiness might help predict cardiovascular risk

A recent study categorizing people with obstructive sleep apnea based on their differing symptoms found a strong link between excessive daytime sleepiness and cardiovascular disease.
Older man asleep in pajamas
OSA increases hypertension risk.

Obstructive sleep apnea (OSA) causes sporadic airflow blockages during sleep.

All of the different types of sleep apnea, OSA is the most common.

Symptoms include snoring, daytime sleepiness, difficulty concentrating, and high blood pressure.

OSA occurs when the throat muscles relax too much to keep the airway open.

According to the National Sleep Foundation, more than 18 million adults in the United States have sleep apnea. If a person does not seek treatment, it can lead to several complications — one of which is cardiovascular disease.

Sleep apnea and cardiovascular problems

According to the American Thoracic Society, about 30 percent of people with high blood pressure, or hypertension, have OSA. Also, individuals with OSA have a 50 percent chance of developing hypertension.

However, researchers do not yet know why people with OSA are likelier to develop heart disease.

When these breathing pauses occur, the oxygen level in the blood gets low, and these frequent bouts of low oxygen levels during sleep may damage the blood vessels that supply the heart.

During these pauses, the heart beats faster and the blood pressure goes up. Severe OSA can also cause the heart to become enlarged. When this occurs, the heart receives less oxygen and works less efficiently.

Previous studies have identified a link between OSA and heart disease. However, to understand the association better, researchers categorized people with OSA based on their symptoms and conducted a new study.

Their results now appear in the American Journal of Respiratory and Critical Care Medicine.

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Excessive sleepiness: A marker of risk?

The researchers categorized the participants into four subtypes of OSA according to the symptoms they reported, which included: difficulty falling and staying asleep, snoring, fatigue, drowsy driving, disturbed sleep, moderate sleepiness, and excessive sleepiness. The four subtypes were:

those with disturbed sleep those with few symptoms those who felt moderately sleepy those who felt excessively sleepy

The study analyzed data from more than 1,000 adults who had moderate to severe OSA (which the scientists defined as having at least 15 breathing pauses while sleeping or reduced breathing).

All had participated in the Sleep Heart Health Study, which was available from the National Sleep Research Resource. The team followed the participants for about 12 years.

"Multiple studies from our group," explains study co-author Dr. Diego Mazzotti, at the University of Pennsylvania in Philadelphia, "have shown that patients with moderate to severe OSA throughout the world can be categorized into specific subtypes based on their reported symptoms."

"However," he notes, "until now, it was unclear whether these subtypes had different clinical consequences, especially in regard to future cardiovascular risk."

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A 'surrogate marker'

The analysis showed that participants with OSA who experienced excessive sleepiness had higher rates of cardiovascular disease at enrollment when compared with people without OSA.

Also, they were around twice as likely to experience cardiovascular issues during the follow-up period.

The researchers are aware that these results do not prove that excessive sleepiness is a causal factor for cardiovascular disease. That said, they do believe that this specific symptom of OSA could be a "surrogate marker of underlying cardiovascular risk pathways."

Despite the study's limitations, the team suggests that treatments for OSA, such as continuous positive airway pressure (CPAP), should focus on people who have the excessive sleepiness subtype, as they would benefit the most.

CPAP uses machines that keep airways open to allow people to breathe properly during sleep.

"Even without further research, clinicians should recognize that patients with OSA who complain of feeling tired when they wake up and sleepy during the day and have a high score on the Epworth Sleepiness Scale are at greater risk for cardiovascular disease."

Dr. Diego Mazzotti

He adds that his colleagues are developing a simple tool to categorize people into symptom subtypes, which should improve the clinical utility of their findings.

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Blueberries may lower cardiovascular risk by up to 20 percent

The phytochemicals that give blueberries their blue color can significantly improve cardiovascular health, finds a new two-part study.
person eating breakfast bowl with blueberries
The positive effect that blueberries can have on blood pressure is comparable to that of hypertension drugs.

Dubbed "the silent killer" because it has no visible symptoms in its early stages, hypertension affects approximately 1 in 3 adults in the United States.

The condition puts a strain on the cardiovascular system, which in the long run may contribute to heart failure, stroke, and kidney failure.

The National Institutes of Health (NIH) recommend that people with high blood pressure stay in control of the condition by eating healthfully, exercising, not smoking, and maintaining a healthy weight.

But should you eat anything in particular to keep your arteries healthy? In a previous Spotlight feature, we rounded up 16 foods that studies have suggested can improve cardiovascular health.

Along with broccoli, spinach, pulses, and fish, berries may also reduce heart disease, due to their antioxidant polyphenols.

New research zooms in on the cardiovascular effects of blueberries and finds that anthocyanins — the phytochemicals that give blueberries their color — mediate the beneficial effects that this fruit has on the cardiovascular system.

The lead author of the study is Ana Rodriguez-Mateos, Ph.D., from the Department of Nutritional Sciences at King's College London, in the United Kingdom. The researchers published their findings in The Journals of Gerontology: Series A.

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Anthocyanins and blood pressure

Rodriguez-Mateos and her colleagues recruited 40 study participants who were in perfect health and randomly divided them into two groups: One received a daily drink consisting of 200 grams (g) of blueberries, and another group received a control drink.

To examine the effects of the blueberries, the researchers took the participants' blood pressure and measured the flow-mediated dilation (FMD) of their brachial arteries.

FMD is a standard indicator of cardiovascular risk; it measures how much the brachial artery widens when blood flows at a higher rate.

In the second part of the study, the researchers compared drinking blueberries with drinking purified anthocyanins or control drinks that had concentrations of fiber, minerals, or vitamins equivalent to those in blueberries.

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Blood pressure decreases by 5 mm Hg

The scientists noticed the beneficial effects of the blueberry drinks only 2 hours after the participants had consumed them.

"Purified anthocyanins exerted a dose-dependent improvement of endothelial function in healthy humans, as measured by [FMD]," report the authors.

The endothelium is a type of membrane inside the heart and blood vessels. It contains endothelial cells that help control the dilation and contraction of the arteries.

Endothelial cells also help keep blood pressure in check and play a key role in blood clotting.

The authors continue, "[t]he effects were similar to those of blueberries containing similar amounts of anthocyanins, while control drinks containing fiber, minerals, or vitamins had no significant effect."

After a month of having 200 g of blueberries each day, the participants' blood pressure decreased by 5 millimeters of mercury (mm Hg), on average. The researchers note that such a decrease is usually obtained with medication.

"Our results identify anthocyanin metabolites as major mediators of vascular bioactivities of blueberries and changes of cellular gene programs," conclude the researchers.

Rodriguez-Mateos comments on the findings, saying, "although it is best to eat the whole blueberry to get the full benefit, our study finds that the majority of the effects can be explained by anthocyanins."

The scientists explain that anthocyanins "circulate in [the] blood as phenolic acid metabolites."

"If the changes we saw in blood vessel function after eating blueberries every day could be sustained for a person's whole life, it could reduce their risk of developing cardiovascular disease by up to 20 [percent]."

Ana Rodriguez-Mateos

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What to know about acute respiratory failure

When a person has acute respiratory failure, the usual exchange between oxygen and carbon dioxide in the lungs does not occur. As a result, enough oxygen cannot reach the heart, brain, or the rest of the body.

This can cause symptoms such as shortness of breath, a bluish tint in the face and lips, and confusion.

Acute respiratory failure has many possible causes. The cause may be acute, including pneumonia, or chronic, such as amyotrophic lateral sclerosis (ALS).

Acute respiratory failure is a serious illness. If a person thinks they or someone else has it, they should seek immediate medical attention.

A doctor can evaluate the person's breathing, the amount of oxygen and carbon dioxide in the blood, and the overall symptoms to determine appropriate treatments.

Causes Acute respiratory failure
The respiratory system cannot perform its usual functions when the lungs don't receive enough oxygen.

Acute respiratory failure usually stems from difficulty getting enough oxygen to the lungs, problems removing carbon dioxide from the lungs, or both.

As a result, the respiratory system cannot perform its usual functions.

Potential causes include:

disorders of the spine, such as scoliosis inhalation injuries, such as inhaling smoke from fires or fumes lung-related conditions, such as acute respiratory distress syndrome (ARDS), cystic fibrosis, chronic obstructive pulmonary disease (COPD), pneumonia, or a pulmonary embolism nerve or muscle conditions that affect a person's ability to breathe, such as ALS, muscular dystrophy, spinal cord injuries, or stroke an overdose from drugs or alcohol trauma to the chest, such as after a car accident

Determining the cause of acute respiratory failure helps a doctor determine the most appropriate treatments.

Types Doctors typically classify acute respiratory failure as one of four types: Type 1 Doctors call this hypoxemic respiratory failure. It means that a person is not exchanging oxygen properly in their lungs. This may be due to swelling or damage to the lungs. A person with type 1 acute respiratory failure has very low oxygen levels. Type 2 In a person with type 2 acute respiratory failure, the lungs are not removing enough carbon dioxide, which is a gas and a waste product. The lungs usually exchange carbon dioxide for fresh oxygen. This type of respiratory failure causes carbon dioxide levels to be high. It may result from a drug overdose that has caused a person to breathe too slowly, or because of lung damage from smoking, which causes COPD. Type 3 Doctors refer to this as perioperative respiratory failure. It occurs when a person has had surgery, and the small airways in the lungs have closed in greater numbers. Factors such as pain or stomach surgery, which places higher pressure on the lungs, can also contribute to this type of respiratory failure. Type 4 Type 4 respiratory failure is a shock state. It means that the body cannot adequately provide oxygen and maintain blood pressure on its own. This can result from serious illness or injury, such as when a person loses too much blood. Thank you for supporting Medical News Today Diagnosis A doctor will take into account a person's symptoms, as well as their laboratory and imaging results when diagnosing the cause of acute respiratory failure. They may use an arterial blood gas, or ABG, test. This involves drawing blood from an artery and testing the levels of oxygen and carbon dioxide. A doctor can use ABG results to determine if a person has type 1 or type 2 respiratory failure. Symptoms Acute respiratory failure tired
Appearing very sleepy is a symptom of acute respiratory failure. Symptoms may include changes in a person's appearance, ease of breathing, and how they act. Examples of symptoms include: appearing very sleepy a blue tinge to a person's fingernails, lips, or skin confusion irregular heart rhythms passing out rapid breathing shortness of breath Generally, the symptoms of acute respiratory failure depend on the underlying cause. Potential complications Acute respiratory failure can be fatal. According to a presentation on the website of the American Thoracic Society, about 360,000 people experience acute respiratory failure each year in the United States. Approximately 36 percent of these individuals die during a hospital stay. This figure may be higher, depending on the underlying cause. For example, authors of a study in the European Respiratory Review estimate that people in the hospital with the most severe form of ARDS have a 42 percent mortality rate. An episode of acute respiratory failure can cause damage to the lungs that requires a person to carry oxygen with them at all times. Some people require a tracheotomy, which creates a hole in the neck below the vocal cords to assist in breathing in the long term. Thank you for supporting Medical News Today Treatment Treatments for acute respiratory failure depend on the underlying cause. For example, respiratory failure from scoliosis may require surgical correction of the spine to enable the lungs and heart to work more efficiently. A person with acute respiratory failure will typically require extra oxygen. This may come in the form of mechanical ventilation, which involves a doctor inserting a plastic tube down a person's windpipe. The tube sits below the vocal cords and can deliver oxygen and pressure to inflate the lungs more effectively. Doctors typically use this method of delivering oxygen until they can slow, resolve, or reverse the underlying cause of respiratory failure. Other acute respiratory failure treatment strategies include: medications, such as antibiotics to treat infections and diuretics to reduce the mount of fluid in the lungs and body chest wall oscillation or vibration to loosen mucus in the lungs prone ventilation, which involves placing a person on their stomach and providing oxygen through a ventilator. extracorporeal membrane oxygenation, which involves using a cardiopulmonary bypass machine to take blood from the body and provide oxygen to reduce the workload on the heart and lungs A doctor may also prescribe medications to sedate a patient, making breathing with the ventilator easier to tolerate. Because acute respiratory failure is such a serious condition, treatments can take time and may be intensive. Prevention Acute respiratory failure smoking
Refraining from smoking cigarettes can help protect the lungs. Not all causes of acute respiratory failure, such as trauma, are preventable. However, in the case of pneumonia and some other airway-related illnesses, a person can take some steps to protect their lungs. These include: refraining from smoking cigarettes, which can damage the lungs seeing a doctor at early signs of a bacterial infection, such as a fever, cough, and high mucus production taking all medications a doctor prescribes to keep the heart and lungs healthy if necessary, using assistive devices to maintain oxygen levels, such as continuous positive airway pressure masks, which a person can wear at home engaging in appropriate levels of physical activity to enhance lung function If a person has a history of lung problems and hospitalization, they should talk to their doctor about strategies to enhance their overall health. Takeaway Acute respiratory failure is a serious medical condition that has many possible underlying causes. Symptoms include confusion, rapid breathing, and shortness of breath. Seek immediate medical attention at the first signs of respiratory failure to prevent the illness from worsening.
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Why sleep is good for your arteries

Fresh evidence suggests that sleep regulates a mechanism that can help to protect arteries from hardening. The finding reinforces the notion that good-quality sleep is important for cardiovascular health.
woman sleeping
Sleep is integral to good health, and a new study delves into how it keeps our cardiovascular system healthy.

Scientists from Massachusetts General Hospital (MGH) in Boston, MA, together with colleagues from other research centers, studied the development of atherosclerosis in mice.

Atherosclerosis is the process through which plaques, or fatty deposits, build up inside arteries, causing them to narrow and stiffen. It is a common reason for disease.

The researchers found that sleep-disturbed mice developed larger plaques in their arteries than mice that slept well.

The sleep-disturbed mice also had higher amounts of circulating, inflammatory cells and produced lower amounts of hypocretin, which is a brain hormone that controls wakefulness.

The researchers also saw a reduction in atherosclerosis and inflammatory cells in these mice after they received hypocretin supplementation.

Subject to confirmation in humans, the findings demonstrate that sleep influences cardiovascular health by regulating hypocretin production in the brain.

The journal Nature has recently published a paper about the study.

"We've identified a mechanism," says senior study author Filip K. Swirski, Ph.D., who is an associate professor at MGH and Harvard Medical School, also in Boston, "by which a brain hormone controls production of inflammatory cells in the bone marrow in a way that helps protect the blood vessels from damage."

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Sleep, health, and atherosclerosis

"Sleep is integral to life," note the authors, and yet insufficient or disturbed sleep is a significant public health issue that affects millions of people.

The Centers for Disease Control and Prevention (CDC) estimate that 35 percent of adults in the United States were regularly sleeping less than 7 hours per 24-hour period in 2014.

Studies have linked lack of sleep to long-term health conditions, such as obesity, type 2 diabetes, depression, and heart disease. However, they have not shed much light on the underlying biological mechanisms.

So, Dr. Swirski and his colleagues decided to investigate how sleep might help to protect cardiovascular health by focusing on the development of atherosclerosis.

The plaques that arise in atherosclerosis can take years to form and consist of calcium, fat molecules, cholesterol, and other substances. As they accumulate, they lessen the flow of nutrient- and oxygen-rich blood.

Atherosclerosis can lead to various other conditions, including coronary heart disease, which develops when plaques build up in the arteries that supply blood to the heart.

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Disturbed sleep increased atherosclerosis

Using mice that were genetically predisposed to develop atherosclerosis, the researchers allowed half of them to sleep well and disrupted the sleep of the other half.

Comparing them with the mice that slept well, the team found that the disrupted-sleep mice developed arterial plaques that were up to one third larger.

The sleep-disrupted mice also produced twice the amount of a certain type of inflammatory white blood cell in their bone marrow, and "the lateral hypothalamus" of their brains produced less hypocretin.

Atherosclerosis developed more slowly in sleep-disrupted mice that had hypocretin supplementation compared with those that did not.

The authors note that hypocretin controls blood cell production in bone marrow by regulating CSF1, which is a type of signaling protein.

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They conclude that the rise in white blood cells and acceleration of atherosclerosis in the sleep-disturbed mice were due to the reduction of hypocretin and increase in CSF1.

They suggest that undisturbed sleep protects blood vessels from atherosclerotic damage by regulating hypocretin production in the hypothalamus.

The National Heart, Lung, and Blood Institute (NHLBI), which is part of the National Institutes of Health (NIH), funded the research.

Michael Twery, Ph.D., who is director of NHLBI's National Center on Sleep Disorders Research, says that the study "appears to be the most direct demonstration yet of the molecular connections linking blood and cardiovascular risk factors to sleep health."

"This anti-inflammatory mechanism is regulated by sleep, and it breaks down when you frequently disrupt sleep or experience poor sleep quality."

Filip K. Swirski, Ph.D.

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Hipertensión: Causas, síntomas y tratamientos

La hipertensión es una forma alternativa de denominar a la presión arterial elevada. Puede derivar en complicaciones graves e incrementar el riesgo de sufrir una cardiopatía, un accidente cerebrovascular y la muerte.

La presión arterial se define como la fuerza que ejerce la sangre contra las paredes de los vasos sanguíneos. Esta presión depende del trabajo que realiza el corazón y de la resistencia de los vasos sanguíneos.

La hipertensión y la cardiopatía representan las mayores preocupaciones a nivel global. La Organización Mundial de la Salud (OMS) sugiere que, debido al crecimiento en la industria de los alimentos procesados, ha aumentado la cantidad de sal que llevan las comidas en todo el mundo, lo que juega un papel muy importante en la hipertensión.

Datos rápidos sobre la hipertensión:

A continuación, presentamos algunos puntos clave sobre la hipertensión: Puede encontrar más información en el artículo principal.

La presión arterial normal es de 120/80 mm de mercurio (mm Hg), pero la hipertensión es superior a 130/80 mm Hg. Las causas graves de la presión arterial elevada incluyen el estrés, pero puede aparecer por sí sola o como consecuencia de una enfermedad subyacente, como la insuficiencia renal. La hipertensión mal gestionada puede derivar en un ataque al corazón, un infarto cerebrovascular y otros problemas. Los factores del estilo de vida son la mejor manera de abordar la presión arterial elevada.
¿Qué es la hipertensión? Regular health checks are the best way to monitor your blood pressure.
Las revisiones de salud de forma regular son la mejor manera de monitorizar la presión arterial.

La hipertensión es el término médico para referirse a la presión arterial elevada.

Esto significa que la sangre hace demasiada fuerza contra las paredes de los vasos sanguíneos.

Alrededor de 85 millones de personas en Estados Unidos tienen la presión arterial elevada.

Según las pautas utilizadas por la Asociación Estadounidense del Corazón (AEC) en noviembre del 2017, las directrices de los médicos definen la presión arterial elevada en 130 sobre 80 milímetros de mercurio (mm Hg).

Tratamiento Aunque la mejor opción es regular la presión arterial a través de la dieta antes de que alcance la fase de hipertensión, existe una gran variedad de opciones para tratarla. Los cambios en el estilo de vida representan el tratamiento estándar de primera línea para la hipertensión. Ejercicio físico regular Los médicos recomiendan que los pacientes con hipertensión se comprometan a realizar 30 minutos de ejercicio aeróbico y dinámico con intensidad moderada. Esto puede incluir caminar, correr, pasear en bicicleta o nadar unos 5 o 7 días a la semana. Reducción del estrés Es muy importante evitar el estrés o desarrollar estrategias para gestionar el estrés inevitable, ya que puede ayudar a controlar la presión arterial. El consumo de alcohol, drogas y tabaco, junto a la alimentación no saludable para hacer frente al estrés, añadirá problemas hipertensivos, por lo que deberían evitarse. El tabaco puede aumentar la presión arterial, por lo que, si deja de fumar, podrá reducir el riesgo de sufrir hipertensión, enfermedades del corazón y otros problemas de salud. Medicamentos Las personas con presión arterial alta, por encima de 130/80 podrían utilizar medicamentos para tratar la hipertensión. Normalmente, los fármacos se empiezan de uno en uno con una dosis pequeña. Los efectos secundarios que se asocian con los medicamentos antihipertensivos suelen ser insignificantes. De forma eventual, se suele requerir una combinación de al menos 2 medicamentos antihipertensivos. Existen varios tipos de medicamentos que están disponibles para ayudar a reducir la presión arterial, como: Diuréticos, como las tiazidas, la clortalidona y la indapamida Bloqueadores alfa y beta Bloqueadores de los canales de calcio Agonistas centrales Inhibidor adrenérgico periférico Vasodilatadores Inhibidores de la enzima convertidora de angiotensina (ECA) Bloqueadores de los receptores de angiotensina La elección del medicamento depende del individuo y de cualquier otra enfermedad que éste pueda padecer. Cualquier persona que tome medicamentos antihipertensivos debería asegurarse de leer las instrucciones de forma cuidadosa, sobre todo, antes de ingerir fármacos sin receta, como los descongestionantes. Estos podrían interactuar con los medicamentos utilizados para disminuir la presión arterial. Thank you for supporting Medical News Today Causas Las causas de la hipertensión suelen ser desconocidas. 1 de cada 20 casos de hipertensión surge a consecuencia de una enfermedad subyacente o medicamento. La insuficiencia renal crónica (IRC) es la causa más común de la presión arterial alta, ya que los riñones no filtran los fluidos. Este exceso de líquido deriva en hipertensión. Factores de riesgo Un número de factores de riesgo incrementan las posibilidades de sufrir hipertensión. Edad: La hipertensión suele ser más común en personas mayores de 60 años. Con la edad, la presión arterial puede incrementar de forma paulatina, ya que las arterias se vuelven más rígidas y estrechas debido a la formación de placa. Etnia: Algunos grupos étnicos son más propensos a sufrir hipertensión. Altura y peso: La obesidad o sobrepeso representan un factor de riesgo clave. Consumo de alcohol y tabaco: El consumo de grandes cantidades de alcohol de forma regular puede incrementar la presión arterial de una persona, al igual que el tabaco. Sexo: El riesgo vitalicio es el mismo para hombres y mujeres, pero los hombres son más propensos a sufrirla a una edad más temprana. La frecuencia suele ser superior en las mujeres mayores. Enfermedades de salud existentes: Las enfermedades cardiovasculares, la diabetes, la enfermedad renal crónica y los niveles de colesterol elevados pueden derivar en hipertensión, sobre todo cuando la gente envejece. Otros factores que también contribuyen son: La inactividad física Una dieta rica en sal asociada a los alimentos procesados y grasos Bajos niveles de potasio en la dieta El consumo de alcohol y tabaco Algunas enfermedades y medicamentos Un historial familiar de presión arterial elevada y estrés mal gestionado también puede contribuir. A continuación, presentamos un modelo 3D sobre la hipertensión, totalmente interactivo. Explore el modelo con el ratón o la pantalla táctil para descubrir más detalles sobre la hipertensión. Signos La presión arterial puede medirse con un tensiómetro o un monitor específico. La presión arterial elevada durante un corto periodo de tiempo puede suponer una respuesta normal a muchas situaciones. El estrés agudo y el ejercicio intenso, por ejemplo, pueden elevarla por poco tiempo en una persona saludable. Por esta razón, un diagnóstico de hipertensión suele requerir varias lecturas que muestren presión arterial elevada durante mucho tiempo. La lectura de presión sistólica de 130 mm Hg es la presión que realiza el corazón para bombear sangre por todo el cuerpo. La diastólica de 80 mm Hg es la que lleva a cabo el corazón cuando se relaja y se recarga de sangre. Las directrices de la AEC definen los siguientes rangos de presión arterial: Sistólica (mmHg) Diastólica (mmHg) Presión arterial normal Inferior a 120 Inferior a 80 Elevada Entre 120 y 129 Inferior a 80 Fase 1 hipertensión Entre 130 y 139 Entre 80 y 89 Fase 2 hipertensión Al menos 140 Al menos 90 Crisis hipertensiva Superior a 180 Superior a 120 Si la lectura muestra una crisis hipertensiva cuando miden la presión arterial, espere 2 o 3 minutos y repita el análisis. Si la lectura es la misma o superior, se trata de una urgencia médica. La persona debería buscar atención inmediata en el hospital más cercano. Síntomas High blood pressure raises the risk of a number of health problems, including a heart attack.
La presión arterial elevada aumenta el riesgo de sufrir grandes problemas en el corazón, como un infarto. Una persona con hipertensión podría no experimentar ningún síntoma, de hecho, esta enfermedad es conocida como "el asesino silencioso". Aunque sea indetectable, puede causar daños en el sistema cardiovascular y los órganos internos, como los riñones. Las revisiones regulares de la presión arterial es vital, ya que generalmente no habrá síntomas que le avisen de la enfermedad. Se sabe que la presión arterial suele provocar sudores, ansiedad, problemas de sueño y enrojecimiento. Sin embargo, en la mayoría de los casos, no aparecerá ningún síntoma. Si la presión arterial alcanza el nivel de una crisis hipertensiva, el paciente podría experimentar cefaleas y hemorragias nasales. Complicaciones La hipertensión a largo plazo puede provocar complicaciones como la aterosclerosis, en la que la formación de la placa provoca el estrechamiento de los vasos sanguíneos. Esto provoca el empeoramiento de la hipertensión, ya que el corazón debe bombear más rápido para transportar la sangre al cuerpo. La aterosclerosis relacionada con la hipertensión puede derivar en: Fallo y ataque cardíaco. Un aneurisma, es decir, una protuberancia anómala en las paredes de la arteria que puede provocar quemazón, lo que causa un grave sangrado y, en algunos casos, la muerte. Insuficiencia renal. Accidente cardiovascular. Amputación. Retinopatías hipertensivas en el ojo, lo que puede provocar una ceguera. Los análisis regulares para medir la presión arterial pueden ayudar a las personas para evitar complicaciones más graves. Thank you for supporting Medical News Today Dieta Algunos tipos de hipertensión pueden gestionarse con cambios en el estilo de vida y la alimentación, como con la práctica del ejercicio físico, la reducción del alcohol y el tabaco, o la eliminación de dietas bajas en sodio. Reducción en la cantidad de sal La media en la ingesta de sal se encuentra entre 9 gramos (g) y 12 g al día en la mayoría de países de todo el mundo. La OMS recomienda reducir la ingesta por debajo de los 5 g al día para ayudar a disminuir el riesgo de hipertensión y los problemas relacionados con la salud. Esto puede beneficiar a las personas con y sin hipertensión, pero los que más se beneficiarán son los individuos con la presión arterial elevada. Moderación en el consumo de alcohol La moderación en el consumo de alcohol excesivo está relacionado con la presión arterial elevada y con un mayor riesgo de sufrir un ACV. La Asociación Estadounidense del Corazón (AEC) recomienda un máximo de 2 bebidas al día para los hombres y 1 para las mujeres: 355 ml de cerveza 118 ml de vino 44 ml de bebidas alcohólicas con 80 grados 30 ml de bebidas alcohólicas con 100 grados El médico puede ayudar a las personas que tengan dificultades para reducir el consumo de alcohol. Más frutas y verduras, menos grasa Se recomienda a las personas que tienen o que están en riesgo de sufrir presión arterial alta que coman la menor cantidad posible de grasas saturadas y totales. En su lugar, recomendamos: Alimentos ricos en fibras y cereales integrales Gran variedad de frutas y verduras Alubias, legumbres y nueces Pescado rico en omega 3 dos veces a la semana Aceites vegetales no tropicales, como el aceite de oliva Pescado y aves sin piel Productos lácteos bajos en grasas Es importante evitar las grasas trans, los aceites vegetales hidrogenados y las grasas animales. Coma porciones de tamaño moderado. Control del peso corporal La hipertensión está estrechamente relacionada con el exceso de peso y la reducción del mismo viene normalmente acompañada con una disminución en la presión arterial. Una dieta saludable y equilibrada, junta a una ingesta calórica que coincida con el tamaño de la persona, el sexo y el nivel de actividad, le ayudará a reducir la enfermedad. La dieta DASH El Instituto Estadounidense del Corazón, el Pulmón y la Sangre (NHLBI) recomienda la dieta DASH para las personas con presión arterial elevada. DASH, por sus siglas en inglés, significa "métodos dietéticos para detener la hipertensión" y se ha diseñado especialmente para ayudar a que las personas reduzcan su presión arterial. Se trata de un plan de alimentación flexible y equilibrado que se basa en los estudios de investigación patrocinados por el Instituto. Aseguran que la dieta:
Disminuye la presión arterial elevada Mejora los niveles de grasas en la flujo sanguíneo Reduce el riesgo de desarrollar enfermedades cardiovasculares Existe un libro de cocina escrito por el NHLBI llamado "Keep the Beat Recipes" (Recetas frescas, caseras y naturales) con ideas culinarias para obtener estos resultados. Algunas evidencias sugieren que el uso de suplementos probióticos durante 8 semanas o más podrían beneficiar a las personas con hipertensión. Tipos La presión arterial elevada que no es causada por otra enfermedad se llama primaria o hipertensión esencial. Si aparece como resultado de otra enfermedad, se denomina secundaria. La hipertensión primaria puede aparecer debido a múltiples factores, como la cantidad de plasma en sangre y la actividad de las hormonas que regulan el volumen y la presión sanguínea. También está influenciada por factores medioambientales, como el estrés y la falta de ejercicio. La hipertensión secundaria tiene causas específicas y suele ser una complicación de otro problema. Puede aparecer debido a: La diabetes, por problemas en los riñones o daños en los nervios La insuficiencia renal La feocromocitoma, una forma extraña de cáncer que aparece en una glándula suprarrenal El síndrome de Cushing, causado por los corticosteroides La hiperplasia suprarrenal congénita, una enfermedad de las glándulas suprarrenales que producen cortisol El hipertiroidismo o a hiperactividad de una glándula tiroidea El hiperparatiroidismo, que afecta a los niveles de calcio y fósforo El embarazo La apnea del sueño La obesidad La insuficiencia renal crónica El tratamiento de la enfermedad subyacente debería mejorar la presión sanguínea. Traducido por Carmen María González Morales Revisado por Brenda Carreras Leer el artículo en Inglés
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Ability to do pushups may predict cardiovascular risk

A new study suggests that the more pushups a man is able to complete, the lower his cardiovascular risk and vice versa. These findings may establish a new measure of risk assessment that is simple and does not require costly specialized equipment.
man doing pushups
Being able to do more pushups may correlate with a lower cardiovascular risk in men, a new study shows.

World Health Organization (WHO) data indicate that every year there are 17.9 million deaths due to cardiovascular diseases (CVDs), accounting for approximately 31 percent of global deaths.

Many of the factors that increase the risk of CVD are modifiable, chiefly an unhealthful diet, a lack of physical activity, smoking, or frequent consumption of alcohol.

The link between exercise — particularly physical fitness — and CVD, therefore, is not a new one.

Yet current methods of correctly assessing physical fitness in relation to cardiovascular risk, such as the cardiac exercise stress test (or submaximal treadmill exercise test), are costly and can take a fair amount of time to conduct.

Now, the findings of a new study from the Harvard T.H. Chan School of Public Health in Boston, MA, may allow physicians to estimate risk more easily, based simply on a person's capacity to complete multiple pushups.

The results, which appear in JAMA Network Open and are accessible online, indicate that physically active men who are able to do more than 40 pushups may have a lower CVD risk than peers who can complete fewer pushups.

"Our findings provide evidence that pushup capacity could be an easy, no-cost method to help assess cardiovascular disease risk in almost any setting," says first author Justin Yang, M.D.

"Surprisingly, pushup capacity was more strongly associated with cardiovascular disease risk than the results of submaximal treadmill tests," he adds.

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In the current study — which is probably the first of its kind — the research team collected and analyzed the health information of 1,104 active male firefighters with a mean age of 39.6 and mean BMI of 28.7. These data covered a period of 10 years, between 2000 and 2010.

At the beginning of the study, the researchers measured both the pushup capacity and the submaximal treadmill exercise tolerance of each participant.

The investigators gathered the remaining relevant data through the participants' yearly physical exams and by asking them to fill in a series of medical questionnaires.

Throughout the 10-year period, the researchers registered 37 CVD-related events in the cohort of volunteers. Notably, all but one of these outcomes happened in men who had been able to do 40 or fewer pushups at the beginning of the study.

The investigators' analysis revealed that participants who had been able to complete over 40 pushups to begin with had a 96 percent lower cardiovascular risk than men who had completed 10 or fewer pushups.

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Moreover, the team notes, pushup capacity had a stronger link with lower CVD risk even than aerobic capacity, which is measured through the submaximal treadmill exercise test.

However, the researchers warn that because their cohort of participants was made up of individuals in a specific group — active men in their 30s and 40s — the findings may not apply to women, or to men who are older, younger, or less physically active than those in the cohort.

Still, the current findings remain important in establishing the link between cardiovascular health and exercise, the investigators maintain.

"This study emphasizes the importance of physical fitness on health and why clinicians should assess fitness during clinical encounters."

Senior author Prof. Stefanos Kales, M.D.

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Gender transition drugs could be bad for the heart

New research now published in the journal Circulation finds that some people who are gender transitioning may be at a higher risk of experiencing cardiovascular conditions due to the hormone therapy they are receiving.
gender fluid person having coffee
Some drugs required for gender transition may increase cardiovascular risk.

Previous studies have revealed that hormone therapy raises cardiovascular risk.

For instance, according to estimates from the National Institutes of Health (NIH), therapy with estrogen and progestin puts menopausal women at:

a 41 percent higher risk of stroke a 29 percent higher risk of a heart attack a 100 percent higher risk of blood clots

Estrogen alone increases stroke risk by 39 percent and blood clot risk by 47 percent, according to the same NIH estimates.

However, how does hormone therapy affect people who are gender transitioning? So far, scientists have not addressed this question fully, so a new study aimed to fill this gap in research.

Dr. Nienke Nota — a researcher in the Department of Endocrinology at the Amsterdam University Medical Center in the Netherlands — and her team examined the medical records of 3,875 Dutch transgender people who had hormone therapy between 1972 and 2015.

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Their study examined 2,517 transgender women and 1,358 transgender men. The women were 30 years old, on average, and they had received estrogen either alone or in combination with androgen suppressors.

The men were 23 years old, on average, and they received testosterone therapy as a part of their gender transition.

Dr. Nota and her colleagues clinically followed the trans women for an average period of 9 years and the trans men for an average of 8 years after they started hormone therapy.

The researchers examined the incidence of cardiovascular problems such as heart attacks, strokes, and blood clots among transgender people and compared it with the incidence of such events in cis men and cis women.

Cis people are those whose gender identity matches the biological sex assigned to them at birth.

The study found that trans women were more than twice as likely to have a stroke as cis women and almost twice as likely to have a stroke as cis men.

Trans women were also five times and 4.5 times more likely to develop blood clots than cis women and cis men, respectively.

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Trans women also had heart attacks more than twice as often as cis women, and trans men were over three times more likely to have a heart attack than cis women.

Dr. Nota comments on the findings, saying, "In light of our results, we urge both physicians and transgender individuals to be aware of this increased cardiovascular risk."

"It may be helpful to reduce risk factors by stopping smoking, exercising, eating a health[ful] diet and losing weight, if needed before starting therapy, and clinicians should continue to evaluate patients on an ongoing basis thereafter."

Dr. Nienke Nota

The authors caution that their analysis did not account for modifiable risk factors such as smoking, stress, diet, and exercise.

However, they say that hormone therapy may be largely to blame for the increased cardiovascular risk.

Specifically, estrogen promotes blood clotting, and testosterone could do the same by raising the concentration of red blood cells and increasing the levels of bad cholesterol, they explain.

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Marijuana may be risky for those with heart disease

Although marijuana may have some benefits, its use could cause health issues for older people with cardiovascular disease. One case, in particular, is sparking some questions.
Marijuana in hand
Marijuana in edible form may have cardiovascular risks for people at risk.

In recent years, the legalization of marijuana has become more widespread.

Some people use the drug recreationally, while some use it to relieve chronic pain and the impact of some mental health issues.

However, experts state that there needs to be more research into the effects of marijuana in older people.

Specifically, the scientific community needs to focus on educating the public on aspects such as potential effects and recommended dosages.

A Canadian Journal of Cardiology case report goes some way toward that. It examined a 70-year-old man who had a heart attack after eating a lollipop that was infused with 90 milligrams (mg) of tetrahydrocannabinol (THC) — which is largely responsible for marijuana's psychological effects.

The man lived with stable coronary artery disease, and he was taking cardiac medication. He ate most of the lollipop and did so to help minimize pain and improve sleep.

Dr. Alexandra Saunders — who works in Horizon Health Network's Department of Cardiology in New Brunswick, Canada — described the man's 90-mg dose as "inappropriate."

Smoking a typical joint would expose a person to just 7 mg of THC, while a starting dose of a synthetic THC called dronabinol is only 2.5 mg. People with AIDS or cancer tend to use this version, and it can also combat nausea and encourage appetite.

"Marijuana can be a useful tool for many patients, especially for pain and nausea relief. At the same time, like all other medications, it does carry risk and side effects."

Dr. Alexandra Saunders

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A cardiovascular link

The large amount of THC the man consumed caused him to experience anxiety and hallucinations. The strain that these effects put on his body is what likely caused his heart attack, by triggering a response in the sympathetic nervous sytem.

His cardiac event was demonstrated by a rapid heart rate, an abnormally high blood pressure, and the release of the stress hormone catecholamine. The man's chest pain went away as soon as the effects of the marijuana had worn off.

Previously, there had been reports of similar incidences showing a relationship between cannabis consumption and acute cardiovascular adverse events. These have ranged from an irregular heartbeat to stroke, and even sudden death.

However, Dr. Robert S. Stevenson — who also works at Horizon Health Network's Department of Cardiology — says, "Most previous research on marijuana-induced myocardial ischemia focused mostly on younger patients and did not focus on its different formulations and potencies."

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A word of warning

The doctors examining the most recent case have issued advice, particularly for older people who use marijuana.

They advise people to use the smallest dose possible for their chosen benefit. Anyone who has a cardiovascular condition or is at high risk of developing one should steer clear of THC. Instead, they can try cannabidiol, which is a nonpsychoactive alternative.

They should also take factors such as tolerance and consumption method into consideration. For example, a person who has smoked marijuana over a long period of time is likely to experience fewer distressing side effects than someone who is not used to the drug.

Similarly, eating a THC-infused brownie or lollipop would expose a person to more THC than if they had used a vaporizer.

With further decriminalization, it is hoped that scientists will work on conducting more research into the potential side effects of marijuana. For now, educating the public — especially aging members — should be a priority.

"For better or worse," concludes Dr. Neal L. Benowitz, chief of the Division of Clinical Pharmacology and Experimental Therapeutics at the University of California, "providing advice and care to such patients who are using cannabis is now necessary for the provision of optimal medical care to these patients."

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Exercise boosts well-being by improving gut health

Both bacterial diversity in the gut and regular exercise are important when it comes to health. But how are the two related? A new study uncovers the effect that exercise has on our health by adjusting the balance of the gut microbiome.
women at the gym
New research finds out how exercise could support bacterial diversity in the gut.

Though this may seem strange, human bodies are actually made, according to recent estimates, of about as many bacteria and other microorganisms as regular human cells.

In the colon alone — the tract that contains the largest number of bacterial cells — there are approximately 38 trillion bacteria.

These bacteria have important effects on the state of our health, and loss of bacterial diversity in the gut is linked to a heightened risk of disease.

Now, a new study suggests that the level of a person's physical activity may affect the bacterial diversity in their gut, and thus influence their health.

In a paper that appears in the journal Experimental Physiology, the authors, from Indiana University Bloomington and the University of Alabama at Birmingham, also explain the biological mechanism that makes this possible.

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The link between exercise and the gut

The researchers knew that cardiorespiratory fitness — the efficiency with which the circulatory and respiratory systems deliver oxygen during exercise — was associated with greater bacterial diversity, but it was unclear whether this was due to physical activity or an individual's percentage of body fat.

In order to find out, the team worked with a cohort of 37 participants who had been successfully treated for nonmetastatic breast cancer.

The decision to work with this cohort resulted from the fact that cancer treatment typically has a negative impact on metabolic health, including cardiorespiratory fitness.

The participants agreed to perform graded exercises so that the researchers could assess their peak cardiorespiratory fitness, as well as total energy expenditure. The investigators also collected fecal samples from the volunteers and used them to analyze the participants' gut microbiota.

Following all the assessments and analyses, the researchers established that participants with higher cardiorespiratory fitness also had more diverse bacterial populations in the gut, compared with peers who had low cardiorespiratory fitness.

Moreover, the team confirmed that cardiorespiratory fitness was linked with about a quarter of the variance in bacterial species diversity and that this effect was independent of that produced by an individual's body fat percentage.

The data thus indicate that exercising with an intensity that is adequately high and can boost cardiorespiratory effectiveness will improve overall health by supporting a better-balanced gut.

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New line of research

Still, the researchers warn that their findings are only correlative, and further research should aim to test the potential causational relationships.

Furthermore, the cohort was very restricted — a small group of women treated for breast cancer — so the team advises caution in applying the findings to other populations.

However, going forward, the investigators aim to address these shortcomings and find out how best to apply their findings to improve the health of at-risk individuals.

"Our group is actively pursuing an interventional study to determine how variation in exercise intensity can influence gut microbiota diversity under controlled-feeding conditions," says the study's lead author, Stephen Carter, Ph.D.

"[The aim is] to uncover how exercise may affect functional outcomes of gut microbiota, as well as studying how exercise prescription may be optimized to enhance health outcomes among clinical populations."

Lead author Stephen Carter, Ph.D.

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Diet drinks linked to a higher risk of stroke after the menopause

Fresh research offers further information on the potential for diet drinks — that is, beverages sweetened with artificial sugar substitutes — to harm cardiovascular health.
senior woman drinking coke
Artificially sweetened soft drinks may raise the risk of heart disease and death in postmenopausal women.

A study that followed tens of thousands of postmenopausal women for more than 10 years has linked a higher consumption of diet drinks to an increased risk of stroke, heart disease, and death.

The link between diet drinks and stroke was strongest for strokes that arise from blocked arteries, and from smaller blood vessels in particular.

The journal Stroke has now published a paper about the analysis. The lead author is Dr. Yasmin Mossavar-Rahmani, an associate professor of clinical epidemiology and population health in the Albert Einstein College of Medicine in the Bronx, NY.

Dr. Mossavar-Rahmani and her team point out that the findings do not prove that diet drinks harm the heart and circulation system. That is because the study was an observational one, and the figures on diet drink consumption came from self-reports.

However, Rachel K. Johnson — who chaired the panel that wrote the science advisory from the American Heart Association (AHA) about diet drinks and heart health — comments, "This study adds to the evidence that limiting use of diet beverages is the most prudent thing to do for your health."

Experts commenting in an editorial that accompanies the new study paper also suggest that until there is sufficient evidence regarding who might benefit from consuming diet drinks, the emphasis should be on drinking water as the most healthful no-calorie drink.

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Diet drinks and cardiovascular risks

The data for this study came from a racially diverse group of 81,714 postmenopausal women in the Women's Health Initiative Observational Study.

The women were all aged 50–79 years when they enrolled during 1993–1998. The study then tracked their health with regular evaluations for an average of 11.9 years afterward.

At the 3-year evaluation point, the women answered some questions regarding how often they had consumed diet drinks in the previous 3 months.

The researchers defined diet drinks as any low-calorie colas, soda, and fruit drinks sweetened with artificial sugar substitutes.

They did not ask the women to specify the which artificial sweeteners the drinks contained.

When they analyzed the data, they adjusted the results to eliminate the effect of other factors that influence stroke risk, such as age, smoking, and high blood pressure.

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The researchers found that compared with consuming fewer than one diet drink per week or none at all, consuming two or more per day was associated with:

a 23 percent raised risk of stroke a 31 percent higher risk of a stroke that results from a clot a 29 percent higher risk of heart disease, as in a fatal or nonfatal heart attack a 16 percent raised risk of death from any cause

They also revealed that a high intake of diet drinks among postmenopausal women with no history of heart disease or diabetes was linked to a more than twofold raised risk of strokes arising from blockages in small arteries in the brain.

Postmenopausal women with obesity who drank two or more diet drinks each day also had twice the risk of stroke than those who drank fewer than one per week.

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'Limit prolonged use of diet drinks'

Because they confined the study to postmenopausal women, the researchers cannot say whether the same would be true for men, or for women before the menopause. It is now up to further studies to determine this.

Also, because the data did not specify which artificial sweeteners the women had consumed, Dr. Mossavar-Rahmani says that the scientists could not distinguish the potentially harmful from the potentially harmless.

"Our research and other observational studies have shown that artificially sweetened beverages may not be harmless and high consumption is associated with a higher risk of stroke and heart disease."

Dr. Yasmin Mossavar-Rahmani

While the AHA advise that people drink water as their preferred no-calorie drink, they acknowledge that diet drinks might help them move away from sugar-sweetened beverages.

However, Dr. Johnson cautions, "Since long-term clinical trial data are not available on the effects of low-calorie sweetened drinks and cardiovascular health, given their lack of nutritional value, it may be prudent to limit their prolonged use."

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Study finds new cognitive decline mechanism in Alzheimer's

People with Alzheimer's disease experience poor blood flow to the brain, which affects cognitive function. A new study conducted in a mouse model has finally uncovered the reason behind this reduced blood flow.
elderly woman
Reduced blood flow to the brain contributes to Alzheimer's, but what mechanism leads to this vascular problem in the first place?

For a while now, researchers have been aware that Alzheimer's disease goes hand in hand with vascular dysfunction, and reduced blood flow to the brain, in particular.

However, it is only recently that investigators have begun to focus their efforts on understanding just how and why poor vascular health can contribute to cognitive decline in this type of dementia.

A study published last month in Alzheimer's and Dementia, the journal of the Alzheimer's Association, calls vascular dysfunction "the disregarded partner of Alzheimer's disease." It argues that researchers must first fully understand all the factors involved in the pathology of this type of dementia before they can develop a pluripotent treatment for it.

"Individualized, targeted therapies for [Alzheimer's disease] patients will be successful when the complexity of [this condition's] pathophysiology is fully appreciated," the study authors write.

Now, in a study in mice, a team of investigators from Cornell University in Ithaca, NY has identified a mechanism — tied to poor blood flow to the brain — that directly contributes to cognitive decline.

The study paper detailing the researchers' findings appears in the journal Nature Neuroscience.

In its introduction, the authors explain that "[v]ascular dysfunction is implicated in the pathogenesis of Alzheimer's disease," and that "[b]rain blood flow is also severely compromised; cortical cerebral blood flow reductions of [approximately] 25 percent are evident early in disease development in both patients with Alzheimer's disease, and in mouse models."

"People probably adapt to the decreased blood flow, so that they don't feel dizzy all of the time, but there's clear evidence that it impacts cognitive function," notes study author Chris Schaffer.

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Researchers find cellular mechanism

According to the researchers, the reduction of blood flow to the brain immediately impairs cognitive function — including attention — when it happens in otherwise healthy humans. In their mouse study, the investigators wanted to find out why this poor blood flow occurs in the first place.

In a past study, co-author Nozomi Nishimura had tried to induce clotting in the brain blood vessels of mouse models to see how that would affect their cognitive abilities. However, Nishimura and team soon found that the vascular problems were already present in rodent models of Alzheimer's pathology.

"It turns out that [...] the blockages we were trying to induce were already in there," she said. "It sort of turned the research around — this is a phenomenon that was already happening," says Nishimura.

The new research revealed that white blood cells — called neutrophils — get stuck inside brain capillaries, which are minuscule blood vessels that usually carry oxygenated blood to this organ. Although few capillaries become clogged in this way, this means that blood flow to the brain decreases considerably.

"What we've done is identify the cellular mechanism that causes reduced brain blood flow in Alzheimer's disease models, which is neutrophils [white blood cells] sticking in capillaries," says Schaffer.

"We've shown that when we block the cellular mechanism [that causes the clogging], we get an improved blood flow, and associated with that improved blood flow is immediate restoration of cognitive performance of spatial- and working-memory tasks."

Chris Schaffer

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'A complete game-changer?'

The researchers add that these findings provide a new potential clinical target for Alzheimer's disease. As Schaffer also notes, "Now that we know the cellular mechanism, it's a much narrower path to identify the drug or the therapeutic approach to treat it."

In fact, the researchers have already identified about 20 different drugs — a good number of which the Food and Drug Administration (FDA) have already approved — that they believe could address this new target. Right now, the investigators are testing these drugs in mouse models.

Though the team acknowledges that further research is necessary in order to ascertain that the same cellular mechanism seen in mice is also present in people with Alzheimer's, its members are happy about their current findings.

Schaffer has even gone so far as to declare himself "super-optimistic" that, in the future, research stemming from these findings "could be a complete game-changer for people with Alzheimer's disease."

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Top 12 healthful fruits

Eating more fruit is an excellent way to improve overall health and reduce the risk of disease.

Fruits are an excellent source of essential vitamins and minerals, and they are high in fiber. Fruits also provide a wide range of health-boosting antioxidants, including flavonoids.

Eating a diet high in fruits and vegetables can reduce a person's risk of developing heart disease, cancer, inflammation, and diabetes. Citrus fruits and berries may be especially powerful for preventing disease.

A 2014 study ranked "powerhouse" fruit and vegetables by high nutrient density and low calories. Lemons came out top of the list, followed by strawberry, orange, lime, and pink and red grapefruit.

In this article, we look at the nutrition and the many and varied health benefits of these and other fruits you can find in the supermarket.

1. Lemons Healthiest fruits lemons
Lemons contain vitamin C and other antioxidants that benefit health.

Lemons are a citrus fruit that people often use in traditional remedies because of their health benefits. Like other citrus fruits, they contain vitamin C and other antioxidants.

Antioxidants are essential for human health. These compounds mop up free radicals in the body that can damage the body's cells and lead to diseases, such as cancers.

Researchers believe that the flavonoids in lemon and other citrus fruits have antibacterial, anticancer, and antidiabetic properties.

Citrus fruits, including lemons, contain active components called phytochemicals that benefit health. These include:

The juice from one 48 g lemon contains the following nutrients in grams (g) or milligrams (mg):

Lemons also contain thiamin, riboflavin, niacin, vitamin B-6, folate, and vitamin A.

Read more about the health benefits of lemons and lemon water here.

How to eat lemons

Use the juice of a lemon to flavor drinking water or squeeze over a salad or fish. Try adding lemon juice to boiling water with a teaspoon of honey to help soothe a sore throat. It is also possible to eat the rind of organic lemons. Some people use the rind in recipes.

2. Strawberries Strawberries are a juicy, red fruit with a high water content. The seeds provide plenty of dietary fiber per serving. Strawberries contain many healthful vitamins and minerals. Of particular note, they contain anthocyanins, which are flavonoids that can help boost heart health. The fiber and potassium in strawberries can also support a healthy heart. In one study, women who ate 3 or more servings per week of strawberries and blueberries — which are both known for their high anthocyanin content — had a lower risk of having a heart attack than those with lower intake. Strawberries and other colorful berries also contain a flavonoid called quercetin. This is a natural anti-inflammatory compound. A serving of 3 large strawberries provides the following nutrients: 17 calories 4.15 g carbohydrate 1.1 g of fiber 9 mg of calcium 7 mg of magnesium 83 mg of potassium 31.8 mg of vitamin C Strawberries also contain thiamin, riboflavin, niacin, folate, and vitamins B-6, A and K. Read more about strawberries. How to eat strawberries Strawberries are a versatile fruit. People can eat them raw or add them to breakfast cereals or yogurt, blend them into a smoothie, or make them into jam. 3. Oranges Oranges are a sweet, round citrus fruit packed with vitamins and minerals. Oranges are among the richest sources of vitamin C, with one medium fruit providing 117 percent of a person's daily value of vitamin C. A 141 g orange also contains the following nutrients: 65 calories 16.27 g carbohydrate 3.4 g of fiber 61 mg of calcium 14 mg of magnesium 238 mg of potassium 63.5 mg of vitamin C Vitamin C acts as a powerful antioxidant in the body. This vitamin is also essential for immune system function. It boosts immune function by helping the body to absorb iron from plant-based foods. The human body cannot make vitamin C itself, so people need to get this vitamin from their diet.Oranges also contain high levels of pectin, which is a fiber that can keep the colon healthy by binding to chemicals that can cause cancer and removing them from the colon. Oranges also provide the following healthful vitamins: vitamin A, a compound that is important for healthy skin and eyesight B-vitamins, including thiamin and folate, which help keep the nervous and reproductive systems healthy and help create red blood cells. Read more about the benefits of oranges. How to eat oranges People can eat oranges on their own as a refreshing snack or by drinking a glass of pure orange juice. Juice oranges at home or choose a brand of fresh juice whose label states it is not from concentrate. People can also grate orange peel into a salad, yogurt, or as a cereal topping to add extra flavor. 4. Limes Limes are a sour citrus fruit that provide a range of health benefits. Like other citrus fruits, limes provide a healthful dose of vitamin C. They also have similar health benefits, antibacterial, and antioxidant properties. The juice of one lime provides the following nutrients: 11 calories 3.7 g carbohydrate 6 g calcium 4 mg magnesium 51 mg potassium 13.2 mg vitamin C Read more about the benefits of limes and lime water here. How to eat limes Limes work well in savory foods. Try adding the juice or grated peel of a lime to flavor salad dressings or rice dishes. Otherwise, juice a lime and add to hot or cold water for a refreshing drink. Thank you for supporting Medical News Today 5. Grapefruit Healthiest fruits grapefruit
Grapefruits contain flavonoids, which can help protect against some cancers, inflammation, and obesity. Grapefruits are sour fruits full of health-inducing vitamins and minerals. Grapefruits can be pink, red, or white. Half a grapefruit contains the following nutrients: 52 calories 13.11 g carbohydrate 2.0 g fiber 27 g calcium 11 g magnesium 166 g potassium 38.4 g vitamin C The flavonoids in grapefruits can help protect against some cancers, inflammation, and obesity. A review study suggests the compounds called furanocoumarins found in grapefruits can help protect against oxidative stress and tumors and may support healthy bones. Some research from this review suggests that grapefruit furanocoumarins may have anticancer properties, which may be especially effective against breast cancer, skin cancer, and leukemia. Researchers still need to carry out more studies on animals and humans to confirm these properties. People may wish to see a doctor before adding grapefruit to their diet, as it can interact with certain medications. Read more about grapefruit benefits. How to eat grapefruit Try adding grapefruit slices to a fruit salad, or squeeze the juice into water to make a drink. Otherwise, people can buy pure grapefruit juice from the supermarket. 6. Blackberries Like other berries, blackberries contain health-boosting anthocyanins. Blackberries contain many seeds, so they have a high fiber content. This means they can help improve gut health and heart health. Half a cup of blackberries contains the following nutrients: 31 calories 6.92 g carbohydrate 3.8 g fiber 21 mg calcium 14 mg magnesium 117 mg potassium 15.1 mg vitamin C Read more about blackberries here. How to eat blackberries People can eat blackberries fresh, add them to yogurt for breakfast or dessert, or add frozen blackberries to smoothies. 7. Apples Apples make a quick and easy addition to the diet. Eat them with the skin on for the greatest health benefits. Apples are high-fiber fruits, meaning that eating them could boost heart health and promote weight loss. The pectin in apples helps to maintain good gut health. One medium apple contains the following nutrients: 95 calories 25.13 g of carbohydrate 4.4 g of fiber 195 mg of potassium 11 mg calcium 8.4 mg vitamin C Research has shown that there is a link between eating apples regularly and a lower risk of cardiovascular disease, certain cancers, and diabetes. Apples also have high levels of quercetin, a flavonoid which may have anti-cancer properties. One study found that people who ate whole apples were 30 percent less likely to be obese than those who did not. This can lower the risk for diabetes and heart disease. Read more about apples. How to eat apples Raw apples make a great snack and combining them with almond butter helps balance protein and fat intake. People can also add raw or stewed apples to yogurt, or use applesauce in cooking. 8. Pomegranate Many people consider pomegranates to be a 'superfood.' They are high in antioxidants and polyphenols, which help to combat the oxidative stress that can cause disease in the body. Eat pomegranates with the seeds to get the fiber benefits. One raw pomegranate contains: 234 calories 52.73 g of carbohydrate 11.3 g of fiber 666 mg of potassium 28 mg calcium 28.8 mg vitamin C One pomegranate also contains 46.2 micrograms (mcg) of the recommended 80 mcg daily allowance of vitamin K. This vitamin is essential for strong bones and healthy blood cells. A review study about the health benefits of pomegranates suggests that they have anti-inflammatory effects and may help protect against brain-related diseases, such as Alzheimer's disease and Parkinson's disease. This may be because pomegranates contain particularly high levels of polyphenols. Research discussed in this review also suggests that pomegranates may restrict the growth of human prostate cancer cells. Read more about the benefits of pomegranate juice. How to eat pomegranate Pomegranates can make a great addition to salads, or to couscous or rice dishes. Pomegranates are sweet, so people can also add them to yogurt and fruit salads. 9. Pineapple Pineapple is an exotic fruit that may help reduce inflammation and promote healthy tissue growth. Pineapple contains an active compound called bromelain, which many people take as a dietary supplement because of its potential health benefits. The National Center for Complementary and Integrative Health state that bromelain can help with reducing nasal inflammation or sinusitis. However, scientists need to carry out more research into its benefits for osteoarthritis and its anticancer potential. Pineapples contain manganese, which the body uses to build bone and tissue. A medium slice of pineapple also contains the following nutrients: 42 calories 11.02 g carbohydrate 1.2 g fiber 92 mg potassium 40.2 mg vitamin C 11 mg calcium Read more about the benefits of pineapple, the pineapple juice, and potential bromelain benefits. How to eat pineapple People can enjoy fresh pineapple by itself or in fruit salads. They can also use pineapple to make a tropical salsa or add it as a topping on fish tacos. Try adding frozen pineapple to smoothies. Thank you for supporting Medical News Today 10. Bananas Healthiest fruits banana
Bananas are rich in potassium, which helps the body control heart rate and blood pressure. Bananas are well known for their high potassium content. A medium banana contains 422 mg of the adequate adult intake of 4,500 mg of potassium. Potassium helps the body control heart rate and blood pressure. Bananas are also a good source of energy, with one banana containing 105 calories and 26.95 g of carbohydrate. The 3.1 g of fiber in a regular banana can also help with regular bowel movements and stomach issues, such as ulcers and colitis. A medium banana also contains the following nutrients: 1.29 g protein 6 mg calcium 32 mg magnesium 10.3 mg vitamin C Read more about bananas. How to eat bananas A banana is an excellent fruit to use to thicken a smoothie. People can also use them in baking as a natural sweetener or to make banana bread or pancakes. 11. Avocado Many people refer to avocados as a superfood because of their healthful qualities. Avocados are rich in oleic acid, a monounsaturated fat which helps lower cholesterol levels. The American Heart Association say that maintaining healthy cholesterol levels with healthful fats could reduce the risk of heart disease and stroke. Like bananas, avocados are rich in potassium. They also contain lutein, an antioxidant which is important for healthy eyes and skin. Half an avocado contains the following nutrients: 161 calories 2.01 g protein 8.57 g carbohydrate 6.7 g fiber 12 mg calcium 29 mg magnesium 487 mg potassium 10.1 mg vitamin C Avocados also contain folate, vitamin A, and beta-carotene. Read more about avocados. How to eat avocado People can add avocado to salads, or mix with lime, garlic, and tomatoes to make guacamole. Add avocado to smoothies or hummus, or use avocado instead of other fats in baking. 12. Blueberries Blueberries are another superfood that can provide many health benefits. Like strawberries, blueberries contain anthocyanin, which is a powerful antioxidant. Because of this, they might protect against heart disease, stroke, cancers, and other diseases. Blueberries also contain pterostilbene, a compound that may help prevent plaque from collecting in the arteries. Half a cup of blueberries provides the following nutrients: 42 calories 10.72 g carbohydrate 1.8 g fiber 4 mg calcium 57 mg potassium 7.2 mg vitamin C Read more about blueberries. How to eat blueberries Fresh or frozen blueberries are a great addition to breakfast cereals, desserts, yogurt, or smoothies. Summary Fruits come in all shapes and sizes, and different fruits have different health benefits. For the best results, add a variety of fruits to the diet. By eating fruit, a person is providing their body with key vitamins, antioxidants, and dietary fiber. This can have significant benefits for heart health, digestion, weight management, and skin health. People can enjoy a wide variety of fruits to improve their health and lower the risk of inflammation, heart disease, cancer, obesity, and diabetes.
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How to avoid getting sick

Most people experience colds or the flu from time to time. However, there are some proven ways to reduce the chances of becoming infected.

Although most cold and flu infections occur during the fall and winter seasons, the viruses responsible for these illnesses are present year-round.

Fighting off a viral infection takes its toll on most people, causing them to miss days at work and valuable time with their friends and families.

In this article, we describe eight evidence-based ways to avoid getting sick, so people can maintain their health and make the most of their time.

1. Getting vaccinated how to not get sick vaccination
Getting vaccinated offers the strongest protection against seasonal flu infections.

According to the Centers for Disease Control and Prevention (CDC), getting vaccinated is the best way to protect against seasonal flu infections.

The flu occurs when a person becomes infected with an influenza virus. Flu vaccines contain influenza antigens, which signal the immune system to produce antibodies. These antibodies can protect against invading flu viruses and keep people from getting sick.

There are four types of influenza virus, all of which can mutate throughout the year. These mutations can reduce the effectiveness of seasonal flu vaccines. If the vaccine is well-matched to the circulating influenza virus, it can prevent 40–60 percent of flu infections.

While flu vaccines do not guarantee total immunity, they can reduce the severity of symptoms and lower the risk of flu-related hospitalizations and deaths.

Below are some other reasons to get a flu shot:

The CDC estimate that flu vaccination prevented 5.3 million influenza illnesses between 2016 and 2017. According to a 2018 study, during 2012–2015, adults in New Zealand who had received a flu vaccination were 59 percent less likely to be admitted to an intensive care unit due to the flu, compared with individuals who were not vaccinated. A 2017 study found that flu vaccinations reduced the number of flu-related deaths in children aged 6 months to 17 years by 65 percent. 2. Disinfecting surfaces Viruses can survive on many different types of surface, including: metal plastic fabrics paper glass How long a virus can remain infectious on these surfaces depends on a variety of factors, such as the temperature and humidity. However, a 2016 study suggests that influenza viruses can survive outside the body for extended periods, possibly even months. People can lower their risk of infection by using products that contain alcohol or bleach to disinfect frequently used objects, such as countertops, desks, and keyboards. When using disinfectants and cleaning products, it is essential to read the labels and follow the instructions carefully to ensure that surfaces are properly disinfected. Thank you for supporting Medical News Today 3. Keeping the air clean Common colds and the flu are types of respiratory infection. The viruses that cause these illnesses replicate in the mucus membranes that line the respiratory tract, and they can travel through the air in tiny droplets of mucus. This means that people with a cold or the flu can spread the virus whenever they cough or sneeze. For example, influenza viruses can travel up to 3.7 meters, around 12.2 feet, through the air after a person coughs or sneezes. People can reduce the risk of infecting others by staying home when they are ill and covering their faces when they sneeze or cough. 4. Practicing good hygiene how to not get sick wash hands
Washing the hands regularly is an effective way to protect against viral infections. Viruses can enter the respiratory tract through a person's eyes, nose, or mouth. A person can infect themselves by touching a contaminated surface and then touching their face. Washing the hands regularly and thoroughly with clean water and soap is an effective way to protect against viral infections. According to the CDC, proper hand washing can result in a 16–21 percent decrease in respiratory illnesses, such as colds and the flu. If soap is not available, a person can use an alcohol-based hand sanitizer. A range of hand sanitizers are available to purchase online. 5. Taking zinc supplements Zinc is an important micronutrient that occurs naturally in meat, fish, nuts, and other foods. According to a 2016 review, zinc deficiency can lead to a weakened immune response and inflammatory skin conditions. People with a weakened immune response are less able to fight off infections. A 2017 meta-analysis suggests that zinc lozenges can reduce the duration of common colds by about 33 percent. Participants in the study were consuming between 80 and 207 milligrams of zinc per day. Thank you for supporting Medical News Today 6. Eating more fiber Dietary fiber has many health benefits, including regulating digestion, preventing constipation, and lowering the risk of a number of health conditions. A 2018 study in mice suggests that dietary fiber may also boost the immune system. The researchers compared the immune responses in mice that ate a low-fiber diet with those that ate a high-fiber diet. The results of the study suggest that the short-chain fatty acids present in dietary fiber enhanced the mice's immunity to influenza infections. 7. Avoiding cigarette smoke Smoking is a known risk factor for several diseases, such as cancer, asthma, and respiratory infections. Breathing in secondhand smoke can also increase a person's risk of developing these conditions. People who smoke or regularly inhale cigarette smoke are also more likely to experience severe symptoms when they get colds or the flu. According to a 2018 review, cigarette smoke can affect the immune system and reduce a person's ability to fight off infections. Quitting smoking and avoiding secondhand smoke are great ways to improve overall health and reduce the chances of getting sick. 8. Exercising how to not get sick exercise
Participating in regular physical activity reduces the risk of a number of illnesses. Regular physical activity can improve a person's general health and wellbeing and reduce the risk of a number of illnesses, including: In addition to these benefits, research from 2016 indicates that physical activity can also improve a person's immune function and decrease their risk of respiratory infections. A 2018 study also examined the benefits of meditation and exercise for preventing acute respiratory infections. The 8-week study followed 390 participants, who the researchers had randomly assigned to one of three groups: no training (control group) mindfulness-based stress reduction (MBSR) training moderate-intensity exercise (EX) training The researchers reported a 14–33 percent reduction in the number of acute respiratory infections among participants in the MBSR and EX groups, compared with the control group. People in the MBSR and EX groups who developed acute respiratory infections also experienced less severe symptoms. The United States Department of Health and Human Services state that any physical activity is better than none. However, to experience substantial health benefits, they recommend that adults do at least 150 minutes of moderate-intensity exercise per week or 75 minutes of vigorous-intensity aerobic exercise per week. A person can spread this activity throughout the week. Thank you for supporting Medical News Today Summary Viruses are present all year, but there are ways to prepare for cold and flu season and to reduce the chances of becoming sick. Getting an annual flu vaccine and practicing good hygiene are great ways for a person to protect themselves and others. Some lifestyle and dietary changes that can reduce the likelihood of getting sick include regular exercise, increasing zinc and fiber intake, and quitting smoking.
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What to know about the warfarin diet

People taking the blood thinning medication warfarin may need to moderate vitamin K levels in their diets. Vitamin K may interfere with the effectiveness of warfarin.

A doctor may prescribe warfarin to someone who has had a blood clot in the past, as they are at a higher risk of blood clots in the future. Other factors that increase the chances of a blood clot include:

Warfarin works by slowing the production of clotting factors, which the body makes by using vitamin K from food. Levels of vitamin K in a person's diet could influence the effects of warfarin.

It is possible that vitamin-K rich diets can reduce the effectiveness of warfarin.

The warfarin diet Asparagus being washed under a tap
Asparagus is high in vitamin K.

Vitamin K, which is in some foods, has an important role in blood clotting, and how warfarin works.

The liver uses vitamin K to produce clotting factors, which are cells that help to control bleeding and enable blood clots to form.

Warfarin disrupts this clotting process by inhibiting an enzyme in the liver that uses vitamin K to form clotting factors.

Warfarin can reduce the chances of a dangerous blood clot forming by increasing the time it takes for the liver to produce clotting factors.

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It is possible that eating a diet rich in vitamin K could reduce the effect of warfarin on clotting factors.

The American Heart Association (AHA) suggest that eating vitamin K-rich foods may counteract the effects of warfarin, and lower the prothrombin time. This is the time it takes for a blood clot to form.

The AHA'a list of 19 foods high in vitamin K includes:

It is not necessary to cut out foods that contain vitamin K entirely. The foods that contain vitamin K also have other nutritional properties that contribute to a healthful diet.

It is important to note that the guidance varies on how much vitamin K people on warfarin can consume.

For example, a recent systematic review suggests a diet that restricts vitamin K intake is unlikely to improve the efficacy of warfarin. The authors suggest that keeping vitamin K levels consistent may be more beneficial.

The average person only needs a small amount of vitamin K, around 60 to 80 micrograms (mcg) per day. As this amount is so small, it can be easy for vitamin K levels to fluctuate across different days, creating a problem for people on warfarin.

Keeping vitamin K levels stable, and within a normal range, may reduce its effect on the actions of warfarin. Keeping a food diary and being aware of foods that are high in vitamin K can help a person keep track.

Thank you for supporting Medical News Today Alcohol and warfarin alcohol increases risk of cluster headaches
Drinking alcohol can be harmful for people taking warfarin. Alcohol can also affect the action of warfarin and, therefore, the risk of developing blood clots. High levels of alcohol consumption can alter the way the body metabolizes warfarin. The AHA suggest that, on average, men should drink no more than one or two drinks per day, and women should drink no more than one drink per day. Examples of one drink are a 12-oz beer, a 4-oz glass of wine, 1/5 oz of 80-proof spirits, or 1 oz of 100-proof spirits. Drinking too much alcohol can be particularly harmful for people taking warfarin. A study of 570 people in 2015 found that alcohol misuse has links to a higher risk of major bleeding in people taking warfarin. Thank you for supporting Medical News Today Summary Warfarin can help to prevent dangerous blood clots. It works by slowing the production of clotting factors, which the body makes by using vitamin K from food. Levels of vitamin K in a person's diet could influence the effects of warfarin. People taking warfarin must avoid eating too many foods that are high in vitamin K, but it is not necessary to avoid these foods entirely. A stable diet, containing around 60 to 80 mcg of vitamin K is desirable. People on warfarin must also ensure that they only consume alcohol in moderation. High levels of alcohol may affect the metabolism of warfarin and increase the risk of major bleeding.
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Blood-clotting protein contributes to Alzheimer's

It is still unclear exactly what causes Alzheimer's disease, which is a neurodegenerative condition chiefly characterized by memory loss and other forms of cognitive impairment. However, new research is uncovering more of the factors that contribute to its pathology.
portrait of older woman
According to a new study, a blood protein leaked into the brain contributes to cognitive decline.

According to existing guidelines, the main mechanism associated with cognitive problems in the brains of people with Alzheimer's disease is the formation of beta-amyloid plaques.

These are buildups of toxic proteins that disrupt the normal functioning of synapses. Synapses are the connections formed between brain cells that allow information to circulate within and to and from the brain.

However, in a new study from the Gladstone Institutes in San Francisco, CA, a team of researchers has identified another mechanism that affects how synapses work, contributing to Alzheimer's pathology.

The researchers began by investigating problems that appear in the blood vessel network in the brain, which is another biological characteristic of this form of dementia.

Senior investigator Prof. Katerina Akassoglou and her team have for the first time identified a blood-derived protein that leaks into the brain disrupting cell-to-cell communication.

The findings, which appear in the journal Neuron, indicate that in Alzheimer's, fibrinogen, a protein that usually contributes to blood clotting, plays a vital role in cognitive dysfunction.

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New factor: 'Blood leaks in the brain'

In this study, the investigators used sophisticated imaging technology to scan both the brains of mice simulating a form of dementia and those of people with an Alzheimer's diagnosis.

Through their analyses, the researchers found that fibrinogen passes from blood vessels into the brain, triggering immune cell activity, which in turn leads to the breakdown of synapses.

To confirm the protein's role in synaptic breakdown, the team tried blocking fibrinogen's action on the brain's immune cells in a mouse model of Alzheimer's. This strategy protected the rodents from experiencing the type of memory loss typically associated with this condition.

"We found that blood leaks in the brain can cause elimination of neuronal connections that are important for memory functions. This could change the way we think about the cause and possible cure of cognitive decline in Alzheimer's disease and other neurological diseases."

Prof. Katerina Akassoglou

Moreover, Prof. Akassoglou and her team found that leaked fibrinogen can lead to synaptic breakdown even in the absence of beta-amyloid plaques.

When the researchers injected even the smallest of quantities of fibrinogen into healthy brains, they saw that the protein triggered the same mechanism that caused the loss of synapses as it did in brains affected by Alzheimer's disease.

"Traditionally, the buildup of amyloid plaques in the brain has been seen as the root of memory loss and cognitive decline in Alzheimer's disease," explains the study's first author, Mario Merlini.

"Our work identifies an alternative culprit that could be responsible for the destruction of synapses," he notes.

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'Far-reaching therapeutic implications'

The team that conducted the current study explains that existing research has shown that cerebrovascular problems, as well as the formation of beta-amyloid plaques, each contribute to cognitive decline.

Moreover, both of these pathologies contribute to the cognitive decline at similar rates. However, the researchers add that people who present both pathologies at the same time experience much quicker neurodegeneration.

Prof. Akassoglou and colleagues believe that their current findings finally offer an explanation for these phenomena.

"Given the human data showing that vascular changes are early and additive to amyloid, a conclusion from those studies is that vascular changes may have to be targeted with separate therapies if we want to ensure maximum protection against the destruction of neuronal connections that leads to cognitive decline," notes the senior researcher.

So far, researchers have been developing therapies targeting beta-amyloid, but these new findings suggest that other therapeutic targets may also be valuable.

"These exciting findings greatly advance our understanding of the contributions that vascular pathology and brain inflammation make to the progression of Alzheimer's disease," says study co-author Dr. Lennart Mucke.

"The mechanisms our study identified may also be at work in a range of other diseases that combine leaks in the blood-brain barrier with neurological decline, including multiple sclerosis, traumatic brain injury, and chronic traumatic encephalopathy. It has far-reaching therapeutic implications," he adds.

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Immunosuppressants reduce artery plaque in people with psoriasis

New research finds that treatment with biologic drugs reduces coronary plaque buildup among people with severe psoriasis.
nurse giving senior drugs
An immunosuppressant drug for psoriasis can also improve heart artery health for those with the skin condition.

Psoriasis is a chronic, inflammatory skin condition that affects 7.5 million people in the United States and approximately 125 million worldwide. Psoriasis is also the most widely spread autoimmune disorder in the U.S.

Scientists have previously linked the condition with a higher risk of heart disease, but the connection is still unclear.

People with psoriasis have a higher incidence of cardiovascular disease than others, partly because the inflammation present in psoriasis raises the risk of blood vessel damage.

New research delves deeper into the link between inflammation, immunity, and heart disease in people with psoriasis.

Dr. Nehal N. Mehta, head of the Lab of Inflammation and Cardiometabolic Diseases at the National Heart, Lung, and Blood Institute, and colleagues have investigated the effect of immunotherapy on heart artery disease in those who live with psoriasis.

Dr. Mehta and team examined the effect of so-called biologic drugs — that is, a medication that suppresses the immune system — in people who have psoriasis.

The researchers published their results in the journal Cardiovascular Research.

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Dr. Mehta and team analyzed the data available from the National Institutes of Health Psoriasis Atherosclerosis Cardiometabolic Initiative cohort — a prospective, observational study of 290 participants who the project clinically followed between January 1, 2013, and October 31, 2018.

Of the total number of participants, 121 qualified for biologic treatment, as they had a moderate-to-severe skin condition.

Dr. Mehta and colleagues also clinically followed these participants for a year and compared them with those who chose not to take biologic drugs.

The researchers assessed the health of the participants' arteries by using coronary computed tomography angiography.

Overall, the study revealed that a reduction of coronary artery plaque of 8 percent correlated with taking biologic drugs.

Coronary plaque builds up inside a person's arteries, narrowing them and reducing their elasticity. A buildup of plaque in these blood vessels can lead to heart attacks and stroke over time.

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"The findings that intrigued us most were that coronary plaque sub-components changed over one year," explains Dr. Mehta, "including the necrotic core and non-calcified components, which are the culprits for most heart attacks."

The researcher also speculates on the potential mechanisms that may explain the findings. "This appears to be an anti-inflammatory effect," he says.

"In the absence of improvement in other cardiovascular risk factors, and without adding new cholesterol medications, patients' soft-plaque still improved. The only change was the severity of their skin disease," says Dr. Mehta.

The researcher also highlights the importance of inflammation in the development of cardiovascular disease. "Classically, a heart attack is caused by one of five risk factors: Diabetes, hypertension, high cholesterol, family history, or smoking," he states.

"Our study presents evidence that there is a sixth factor, inflammation, and that it is critical to both the development and the progression of atherosclerosis to heart attack."

The authors concede, however, that they need to do more research. Their study is an observational one, and so the cause and effect cannot be established. For future study, says Dr. Mehta, "the next steps should be randomized, controlled trials."

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Cardiovascular deaths on the rise in the US

According to the American Heart Association (AHA), nearly half of all adults in the United States have cardiovascular disease. It caused more deaths in 2016 than previous years, despite rates of cardiovascular deaths having declined worldwide.
man having his blood pressure taken
The amended hypertension guidelines explain the high prevalence of cardiovascular disease in the U.S., say the AHA.

Heart disease is the leading cause of mortality in the United States, followed closely by cancer and chronic respiratory diseases.

In fact, heart disease causes almost 1 in 4 deaths in the U.S.

Staying abreast of the latest statistics on the prevalence of this condition is key for prevention.

Physicians, governmental organizations, and patients alike can benefit from information on heart disease death rates and risk factors that stave off cardiovascular conditions.

In this context, the American Heart Association (AHA) have just published their 2019 updated Heart and Stroke statistics in the journal Circulation.

The report is a compilation of the latest statistics on the prevalence of cardiovascular disease both in the U.S. and across the globe. The AHA worked in collaboration with the National Institutes of Health (NIH) and other governmental organizations to put the report together.

According to the report, about 48 percent of all U.S. adults — or almost half of the adult population — are living with a form of cardiovascular disease.

Cardiovascular disease is an umbrella term for several conditions, including atherosclerosis, heart disease, heart failure, stroke, heart attack, arrhythmia, and heart valve problems.

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Hypertension and cardiovascular risk

The updated AHA report found that in the U.S., cardiovascular deaths have increased significantly in recent years, despite the fact that across the globe, the number of cardiovascular deaths has declined.

Specifically, in the U.S., 840,678 cardiovascular deaths were registered in 2016, a number that has gone up from 836,546 deaths in 2015.

However, worldwide, 17.6 million people died from a cardiovascular condition in 2016, compared with 17.9 million in 2015.

Importantly, the recently reported high prevalence of cardiovascular disease is mainly due to the fact that the definition of what constitutes high blood pressure has changed.

According to the AHA's updated 2017 hypertension guidelines, a reading of 130/80 millimeters of mercury (mm Hg) or above counts as high blood pressure, whereas previously this reading was 140/90 mm Hg.

Dr. Ivor J. Benjamin, the president of the AHA and the director of the Cardiovascular Center at the Medical College of Wisconsin in Milwaukee, comments on the importance of high blood pressure for cardiovascular risk.

"As one of the most common and dangerous risk factors for heart disease and stroke," he states, "this overwhelming presence of high blood pressure can't be dismissed from the equation in our fight against cardiovascular disease."

"Research has shown that eliminating high blood pressure could have a larger impact on [cardiovascular] deaths than the elimination of all other risk factors among women and all except smoking among men."

Dr. Ivor J. Benjamin

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Fewer people smoke and more are exercising

The recent report also notes some encouraging improvements in risk reduction. The proportion of teenagers who do not smoke, for example, has increased by almost 20 percent in 1999–2016.

Meanwhile, 94 percent of adolescents aged 12–19 did not smoke in 2015–2016, whereas only 76 percent did not smoke in 1999–2000.

Additionally, the number of teenagers aged 12–17 who smoked in the past month decreased by two-thirds between 2002 and 2016.

Approximately 80 percent of adults did not smoke in 2015–2016, and the number of male adults who smoke has dropped from 51 percent in 1965 to 16.7 percent in 2015. Also, 34 percent of females smoked in 1965, while only 13.6 percent smoked in 2015.

Finally, the report also mentions that the rate of physical inactivity has declined, as more and more U.S. individuals are engaging in various types of exercise.

Namely, over half of U.S. students engage in muscle-strengthening exercise on 3 days per week or more, and the number of physically inactive adults has dropped by over a third between 2005 and 2016.

However, the report authors warn that obesity and sleep deprivation remain significant risk factors for cardiovascular disease and other chronic conditions. The rates of obesity in the U.S. are still high, as are the number of adults who do not get enough sleep.

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High blood pressure linked to zinc deficiency

A new study demonstrates a link between zinc deficiency and high blood pressure. The findings could help scientists design new ways of intervening in at-risk patient populations.
Woman checking blood pressure
Hypertension is incredibly common; understanding how it works is vital.

High blood pressure, or hypertension, is a huge and growing health concern in the United States.

According to the American Heart Association, hypertension affects more than 100 million people in the U.S.

Over recent years, researchers have noted a relationship between lower zinc levels and hypertension.

However, to date, scientists have been unable to pinpoint zinc's exact role in the development of hypertension.

For instance, individuals with certain conditions, such as type 2 diabetes and chronic kidney disease, commonly have a zinc deficiency and high blood pressure. Scientists are still unclear whether zinc levels are a cause or an effect of elevated blood pressure.

Similarly, other studies have shown that individuals with lower zinc levels are more likely to be hypertensive.

As further evidence of zinc's involvement in hypertension, rats that are particularly sensitive to salt and readily develop high blood pressure have lower levels of zinc in their blood.

Recently, a group of researchers set out to investigate the links between zinc and blood pressure. They wanted to dig a little deeper into the mechanisms of action. The team published their findings in the American Journal of Physiology–Renal Physiology.

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Kidneys and blood pressure

Sodium absorption plays a vital role in moderating blood pressure. The sodium chloride cotransporter (NCC) in the kidney is particularly important. It reabsorbs sodium from the fluid that is destined to become urine and feeds it back into the body.

Generally, lower levels of sodium in the urine correspond with increased blood pressure. In other words, when the NCC is too active, it pumps more sodium back into the body, the urine removes less, and blood pressure rises.

As the authors write, "Renal modulation of urinary sodium excretion is the cornerstone of [blood pressure] control."

A number of proteins can interact with the NCC to alter the amount of sodium that the body reabsorbs and excretes.

Zinc acts as a cofactor, which means that it influences the activity of a wide range of proteins, including enzymes, transcription factors, and regulatory proteins.

Researchers think that zinc impacts one of the proteins that moderates the NCC, although they have struggled to find evidence for this.

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Zinc and hypertension

In this latest study, the scientists ran a series of experiments to investigate the relationship between zinc and hypertension, and observe the role of the NCC.

Firstly, they demonstrated that mice that ate a diet with lower levels of zinc developed hypertension. Then, they split these animals into two groups. They fed half of the animals on a diet that contained adequate levels of zinc. As expected, their blood pressure soon returned to normal.

The researchers gave the remaining mice hydrochlorothiazide, a drug that inhibits the NCC. The blood pressure of these animals also returned to normal. This is because the NCC stopped pumping sodium back into the body, which allowed the urine to flush it away.

In other experiments, the researchers worked on animal tissue in the laboratory. They demonstrated that the NCC is responsible for hypertension that is mediated by zinc deficiency.

They also showed that NCC activity is altered by the presence of zinc — specifically, NCC activity increases when zinc is at a lower level. The scientists believe that when zinc is in short supply, the NCC is more stable and therefore able to function for longer.

These results tie together findings from earlier work and confirm the role of zinc in hypertension. The authors write:

"Understanding the specific mechanisms by which [zinc deficiency] contributes to [blood pressure] dysregulation may have an important effect on the treatment of hypertension in chronic disease settings."

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