CNO Report 182

Release Date 02 JUN 2014

Draft Report Compiled by

Ralph Turchiano

http://www.clinicalnews.org

 

1. Sleeping pills increase CV events in heart failure patients
2. Windshield washer fluid a source of Legionnaires
3. For pregnant smokers, vitamin C supplements improve lung function of newborn
4. Olive oil supplements may protect against the adverse vascular effects of air pollution
5. Why you need olive oil on your salad
6. A full serving of protein at each meal needed for maximum muscle health
7. Pine bark substance could be potent melanoma drug
8. Not just for the heart, red wine shows promise as cavity fighter
9. Disruption of circadian rhythms may contribute to inflammatory disease
10. Healthy diet linked with better lung function in COPD patients
11. Fighting cancer with dietary changes
12. Poor diet before pregnancy is linked with preterm birth
13. Melatonin makes old bones stronger
14. Toxins in the environment might make you older than your years
15. Variety in Diet Can Hamper Microbial Diversity in the Gut
16. Flame retardant exposure linked to lower IQs – study
17. Some high blood pressure drugs may be associated with increased risk of vision-threatening disease
18. Zinc deficiency before conception disrupts fetal development
19. Eating prunes can help weight loss
20. Study explains how green tea could reduce pancreatic cancer risk
21. Risk of death highest following surgery in afternoons, at weekends, and in February

 

 

Sleeping pills increase CV events in heart failure patients

Athens, 17 May 2014: Sleeping pills increase the risk of cardiovascular events in heart failure patients by 8-fold, according to research from Japan. The study was presented today at the Heart Failure Congress 2014, held 17-20 May in Athens, Greece. The Congress is the main annual meeting of the Heart Failure Association of the European Society of Cardiology.

Dr Masahiko Setoguchi said: “Sleeping problems are a frequent side effect of heart failure and it is common for patients to be prescribed sleeping pills when they are discharged from hospital. They also have other comorbidities and may be prescribed diuretics, antiplatelets, antihypertensives, anticoagulants and anti-arrhythmics.”

He added: “Cardiac function of heart failure patients worsens with repeated hospitalisations. We therefore decided it was important to investigate the relationships between drugs prescribed at discharge, rehospitalisation and cardiovascular events in heart failure patients.”

The researchers retrospectively examined the medical records of 111 heart failure patients admitted to Tokyo Yamate Medical Center from 2011 to 2013. Information was collected on the presence of coexisting cardiovascular and other medical conditions, medications administered during hospitalisation and those prescribed at discharge, laboratory test results, electrocardiogram, echocardiogram and chest radiographic data and vital signs at admission and discharge.

Study participants were followed up for 180 days after they were discharged from hospital. The study endpoint was readmission for heart failure, or cardiovascular related death.

For the analysis, patients were divided into those who had heart failure with preserved ejection fraction (HFpEF) and those who had heart failure with reduced ejection fraction (HFrEF). Dr Setoguchi said: “Management and prognosis can vary between patients with HFpEF and HFrEF so we analysed the two groups separately.”

Of the 47 HFpEF patients, 15 reached the study endpoint during the 180 day follow up period. The only differences between patients who had events and those who did not were prescription of sleeping pills (benzodiazepine hypnotics), blood sodium levels at admission and blood haemoglobin levels at discharge.

Multivariate analysis showed that HFpEF patients who were prescribed sleeping pills were at eight times greater risk of rehospitalisation for heart failure or cardiovascular related death than HFpEF patients who were not prescribed sleeping pills (hazard ratio [HR]=8.063, p=0.010).

Dr Setoguchi said: “Our study clearly shows that sleeping pills dramatically increase the risk of cardiovascular events in patients with HFpEF. The finding was consistent across univariate and multivariate analyses. Given that many heart failure patients have difficulty sleeping, this is an issue that needs further investigation in larger studies.”

Of the 64 HFrEF patients, 24 reached the study endpoint during follow up. Multivariate analysis showed that HFrEF patients who were prescribed high blood pressure medications (ACE inhibitors or angiotensin receptor blockers) had less than one-quarter the risk of cardiovascular events compared to HFrEF patients not prescribed these drugs (HR=0.234, p=0.012).

Dr Setoguchi said: “The main finding of our study is that HFpEF patients prescribed sleeping pills have an increased risk of cardiovascular events. The number of HFpEF patients is increasing and becoming a larger proportion of heart failure patients overall. Our results therefore are of growing relevance to heart failure patients and the professionals who treat them.”

He added: “Benzodiazepine hyptonics may have cardiodepressant actions. They may also exert respiratory depressant actions which could exacerbate sleep disordered breathing and lead to a worse prognosis.”

Dr Setoguchi concluded: “Our results need confirmation in larger, prospective studies before heart failure patients can be advised to stop taking sleeping pills. But HFpEF patients who use sleeping pills, particularly those who have sleep disordered breathing, should be carefully monitored.”

Windshield washer fluid a source of Legionnaires

A form of bacteria responsible for respiratory illness, including the deadly pneumonia known as Legionnaire’s disease, may be able to grow in windshield washer fluid and was isolated from nearly 75% of school buses tested in one district in Arizona, according to research presented today at the annual meeting of the American Society for Microbiology.

“Washer fluid spray can release potentially dangerous numbers of these bacteria into the air. These results suggest that automobiles may serve as a source of transmission for Legionella infections,” says Otto Schwake, a doctoral student at Arizona State University, who presented the research.

Legionella are bacteria that are found naturally in the environment, usually in water. They are commonly associated with the cooling towers found in large-scale air conditioners and hot tubs. They are not spread from person to person but instead are transmitted via mist or vapor containing the bacteria. Most people exposed to the bacteria do not become ill, but in some people it can cause Legionnaires’ disease, a severe form of pneumonia. The bacteria can also cause Pontiac fever, a milder illness resembling the flu.

The results presented come from a series of experiments conducted in the summer of 2012. Schwake and his colleagues attempted to grow Legionella bacteria in a variety of different washer fluid preparations. They found that the bacterial concentrations increased over time and they were able to maintain stable populations for up to 14 months. In the second study, they tested the washer fluid from school buses in central Arizona and found culturable Legionella in approximately 75% of the samples.

Although windshield washer fluid is not normally associated with spreading disease, Schwake says this project was begun after a series of epidemiological studies found motor vehicle use to be associated with increased risk for Legionnaires’ disease. One such study attributed nearly 20 percent of Legionnaires’ disease cases in the United Kingdom not associated with hospitals or outbreaks to automobile windshield washer fluid.

“This study is the first to detect high levels of Legionella in automobiles or aerosolized by washer fluid spray,” says Schwake. “While potential transmission of a deadly respiratory disease from a source as common as automobile windshield washing systems is significant, the study also points to the fact people can be exposed to pathogens – particularly those occurring naturally in the environment – in previously unknown and unusual ways.”

For pregnant smokers, vitamin C supplements improve lung function of newborn

Supplemental vitamin C taken by pregnant smokers improved measures of lung function for newborns and decreased the incidence of wheezing for infants through 1 year, according to a study published by JAMA. The study is being released early online to coincide with its presentation at the American Thoracic Society International Conference.

More than 50 percent of smokers who become pregnant continue to smoke, corresponding to 12 percent of all pregnancies. Smoking during pregnancy adversely affects lung development, with lifelong decreases in pulmonary (lung) function. At birth, newborn infants born to smokers show decreased pulmonary function test (PFT) results, with respiratory changes leading to increased hospitalization for respiratory infections, and increased incidence of childhood asthma, according to background information on the article. In a study involving primates, vitamin C blocked some of the in-utero effects of nicotine on lung development and pulmonary function in offspring.

Cindy T. McEvoy, M.D., M.C.R., of Oregon Health & Science University, Portland, and colleagues randomly assigned pregnant smokers to receive vitamin C (500 mg/d) (n = 89) or placebo (n = 90). One hundred fifty-nine newborns of pregnant smokers (76 vitamin C treated and 83 placebo treated) and 76 newborns (reference group) of pregnant nonsmokers were studied with newborn PFTs (performed within 72 hours of age)

The researchers found that newborns of women randomized to vitamin C, compared with those randomized to placebo, had improved measures of pulmonary function. Offspring of women randomized to vitamin C had significantly decreased wheezing through age 1 year (15/70 [21 percent] vs 31/77 [40 percent]. There were no significant differences in the 1-year PFT results between the vitamin C and placebo groups.

“Although smoking cessation is the foremost goal, most pregnant smokers continue to smoke, supporting the need for a pharmacologic intervention,” the authors write. Other studies have demonstrated that reduced pulmonary function in offspring of smokers continues into childhood and up to age 21 years. “This emphasizes the important opportunity of in-utero intervention. Individuals who begin life with decreased PFT measures may be at increased risk for chronic obstructive pulmonary disease.”

“Vitamin C supplementation in pregnant smokers may be an inexpensive and simple approach (with continued smoking cessation counseling) to decrease some of the effects of smoking in pregnancy on newborn pulmonary function and ultimately infant respiratory morbidities, but further study is required,” the researchers conclude.

Olive oil supplements may protect against the adverse vascular effects of air pollution

ATS 2014, SAN DIEGO ─ Taking olive oil supplements may counteract some of the adverse cardiovascular effects of exposure to air pollution, according to a new study presented at the 2014 American Thoracic Society International Conference.

“Exposure to airborne particulate matter can lead to endothelial dysfunction, a condition in which the endothelium (inner lining) of blood vessels does not function normally, which is a risk factor for clinical cardiovascular events and progression of atherosclerosis,” said lead study author Dr. Haiyan Tong, MD, PhD, a research biologist with the United States Environmental Protection Agency. “As olive oil and fish oil are known to have beneficial effects on endothelial dysfunction, we examined whether use of these supplements would counteract the adverse cardiovascular effects of exposure to concentrated ambient particulate matter in a controlled setting.”

The study involved 42 healthy adults who were randomized to receive either 3 gram/day of olive oil, fish oil, or no supplements for 4 weeks before undergoing controlled 2-hour exposures to filtered air, followed on the next day by exposure to fine/ultrafine concentrated ambient particulate matter (CAP, mean mass concentration 253±16 µg/m3) in a controlled-exposure chamber.

Endothelial function was assessed by sonographic measurement of flow-mediated dilation of the brachial artery before, immediately after, and 20 hours after exposure to air and CAP. Blood markers of vasoconstriction and fibrinolysis (a body process that keeps blood clots from growing) were also measured.

Immediately after exposure to CAP, significant particulate matter mass-dependent reductions in flow-mediated dilation were observed in the control (-19.4±8.4% per 100 µg/m3 increase in CAP concentration relative to pre-filtered air levels) and fish oil groups (-13.7±5.3%), while the decrease in the olive oil group was not significant (-7.6±6.8%).

Tissue plasminogen activator, a protein involved in the breakdown of blood clots, increased (11.6±5%) immediately after CAP exposure in the olive oil group, and this effect persisted up to 20 hours. Olive oil supplementation also ameliorated changes in blood markers associated with vasoconstriction and fibrinolysis, while fish oil supplementation had no effect on endothelial function or fibrinolysis after CAP exposure.

“Our study suggests that use of olive oil supplements may protect against the adverse vascular effects of exposure to air pollution particles,” said Dr. Tong. “If these results are replicated in further studies, use of these supplements might offer a safe, low cost, and effective means of counteracting some of the health consequences of exposure to air pollution.”

Main Outcome Measures: Endothelial function was assessed using sonographic measurement of flow-mediated dilation of the brachial artery (FMD) pre-, immediately post- and 20 hours post-exposure to air and CAP. Blood markers of vasoconstriction and fibrinolysis were also assayed before, immediately post-, and 20 hours post-exposure.

Results: Immediately after CAP exposure, there were statistically significant, PM-mass-dependent reductions of FMD in the control (-19.4±8.4% /100 µg/m3 increases in CAP concentration relative to pre-filtered air levels) and FO groups (-13.7±5.3%), but not in the OO group (-7.6±6.8%). Tissue plasminogen activator (tPA) increased (11.6±5%) immediately after CAP exposure in the OO group, and this effect persisted up to 20 hours. Twenty hours following CAP exposure, D-dimer decreased in the OO group (-11.6±5%), and endothelin-1 levels increased only in the control group (20.5±7%).

Conclusion: Short-term exposure to CAP impaired vascular endothelial function that persists 20 hours after exposure. OO supplementation ameliorated CAP-induced reduction of FMD and changes in blood markers associated with vasoconstriction and fibrinolysis. By contrast, FO did not affect endothelial function and fibrinolysis after CAP exposure. These data suggest that OO supplementation may offer protection against the adverse vascular effects of exposure to air pollution particles. This abstract does not necessarily reflect EPA policy.

Why you need olive oil on your salad

A diet that combines unsaturated fats with nitrite-rich vegetables, such as olive oil and lettuce, can protect you from hypertension, suggests a new study led by King’s College London. The findings, published in the journal PNAS, help to explain why some previous studies have shown that a Mediterranean diet can reduce blood pressure.

The Mediterranean diet typically includes unsaturated fats found in olive oil, nuts and avocados, along with vegetables like spinach, celery and carrots that are rich in nitrites and nitrates.

When these two food groups are combined, the reaction of unsaturated fatty acids with nitrogen compounds in the vegetables results in the formation of nitro fatty acids.

The study, supported by the British Heart Foundation, used mice to investigate the process by which these nitro fatty acids lower blood pressure, looking at whether they inhibited an enzyme known as soluble Epoxide Hydrolase which regulates blood pressure.

Mice genetically engineered to be resistant to this inhibitory process were found to maintain their high blood pressure despite being fed the type of nitro fatty acids that normally form when a Mediterranean diet is consumed. However, nitro fatty acids were found to lower the blood pressure of normal mice following the same diets.

Thus, the study concludes that the protective effect of the Mediterranean diet, combining unsaturated fats and vegetables abundant in nitrite and nitrate, comes at least in part from the nitro fatty acids generated which inhibit soluble Epoxide Hydrolase to lower blood pressure.

Professor Philip Eaton, Professor of Cardiovascular Biochemistry at King’s College London, said: “The findings of our study help to explain why previous research has shown that a Mediterranean diet supplemented with extra-virgin olive oil or nuts can reduce the incidence of cardiovascular problems like stroke, heart failure and heart attacks.”

A full serving of protein at each meal needed for maximum muscle health

Most Americans eat a diet that consists of little to no protein for breakfast, a bit of protein at lunch and an overabundance of protein at dinner. As long as they get their recommended dietary allowance of about 60 grams, it’s all good, right?

Not according to new research from a team of scientists led by muscle metabolism expert Doug Paddon-Jones of the University of Texas Medical Branch at Galveston. This research shows that the typical cereal or carbohydrate-dominated breakfast, a sandwich or salad at lunch and overly large serving of meat/protein for dinner may not provide the best metabolic environment to promote healthy aging and maintenance of muscle size and strength.

The new study, now online in press in the Journal of Nutrition, shows that the potential for muscle growth is less than optimal when protein consumption is skewed toward the evening meal instead of being evenly distributed throughout the day.

Age-related conditions such as osteoporosis (bone weakening) and sarcopenia (muscle wasting) do not develop all of a sudden. Rather they are insidious processes precipitated by suboptimal lifestyle practices, such as diet and exercise, in early middle age, the study states.

The study’s results were obtained by measuring muscle protein synthesis rates in healthy adults who consumed two similar diets that differed in protein distribution throughout the day. One of the diets contained 30 grams of protein at each meal, while the other contained 10 grams at breakfast, 15 grams at lunch and 65 grams at dinner. Lean beef was the primary nutrient-dense source of protein for each daily menu. Using blood samples and thigh muscle biopsies, the researchers then determined the subjects’ muscle protein synthesis rates over a 24-hour period.

The UTMB researchers provided volunteers with a generous daily dose of 90 grams of protein — consistent with the average amount currently consumed by healthy adults in the United States. While very active individuals may benefit from a slightly higher protein intake, the team’s previous research suggests that, for the majority of adults, additional protein will likely have a diminishing positive effect on muscle metabolism, while any less may fail to provide optimal muscle metabolism support.

When study volunteers consumed the evenly distributed protein meals, their 24-hour muscle protein synthesis was 25 percent greater than subjects who ate according to the skewed protein distribution pattern. This result was not altered by several days of habituation to either protein distribution pattern.

The results of the study, Paddon-Jones points out, seem to show that a more effective pattern of protein consumption is likely to differ dramatically from many Americans’ daily eating habits.

“Usually, we eat very little protein at breakfast, a bit more at lunch and then consume a large amount at night. When was the last time you had just 4 ounces of anything during dinner at a restaurant?” Paddon-Jones said. “So we’re not taking enough protein on board for efficient muscle building and repair during the day, and at night we’re often taking in more than we can use. We run the risk of having this excess oxidized and ending up as glucose or fat.”

A more efficient eating strategy for making muscle and controlling total caloric intake would be to shift some of the extra protein consumed at dinner to lunch and breakfast.

“You don’t have to eat massive amounts of protein to maximize muscle synthesis, you just have to be a little more thoughtful with how you apportion it,” Paddon-Jones said. “For breakfast consider replacing some carbohydrate, particularly the simple sugars, with high-quality protein. Throw in an egg, a glass of milk, yogurt or add a handful of nuts to get closer to 30 grams of protein, do something similar to get to 30 for lunch, and then moderate the amount of protein for dinner. Do this, and over the course of the day you will likely spend much more time synthesizing muscle protein.”

Pine bark substance could be potent melanoma drug

A substance that comes from pine bark is a potential source for a new treatment of melanoma, according to Penn State College of Medicine researchers.

Current melanoma drugs targeting single proteins can initially be effective, but resistance develops relatively quickly and the disease recurs. In those instances, resistance usually develops when the cancer cell’s circuitry bypasses the protein that the drug acts on, or when the cell uses other pathways to avoid the point on which the drug acts.

“To a cancer cell, resistance is like a traffic problem in its circuitry,” said Gavin Robertson, professor of pharmacology, pathology, dermatology, and surgery and director of the Penn State Hershey Melanoma Center. “Cancer cells see treatment with a single drug as a road closure and use a detour or other roads to bypass the closure.”

Penn State researchers may have solved this problem by identifying a drug that simultaneously creates many road closures.

The researchers screened 480 natural compounds and identified leelamine, derived from the bark of pine trees, as a drug that can cause this major traffic jam in the cancer cell’s circuitry.

“Natural products can be a source of effective cancer drugs, and several are being used for treating a variety of cancers,” said Robertson. “Over 60 percent of anti-cancer agents are derived from plants, animals, marine sources or microorganisms. However, leelamine is unique in the way that it acts.”

Leelamine could be the first of a new unique class of drugs that will simultaneously target several protein pathways. Researchers found that this drug shuts down multiple protein pathways, such as PI3K, MAPK and STAT3, at the same time in melanoma cells. Thpse pathways are involved in the development of up to 70 percent of melanomas. Protein pathways like these help cancer cells multiply and spread, so shutting them down helps kill the cells.

“The cancer cell is addicted to these pathways,” Robertson said. “And when they are shut down, the bypass routes cannot be used. The result is the cancer cells die.”

Leelamine works by shutting down cholesterol transport and its movement around the cancer cell. By shutting down cholesterol transport and movement, the exceptionally active survival communication that cancer cells require is shut down. The end result is death of the cancer cell. Since normal cells are not addicted to the same high levels of activity in these pathways, the drug has a negligible effect on them.

“The cholesterol in a cancer cell is not like the cholesterol in our blood that causes heart disease,” said Robertson. “The cancer cells need it for the high protein pathway activity and it cannot be shut down by statins, like Lipitor, that lower serum cholesterol.”

The researchers showed the results of this unique drug on cells growing in culture dishes and in tumors growing in mice. Leelamine inhibited tumor development in mice with no detectable side effects.

Researchers report their results in two back-to-back articles in a recent issue of Molecular Cancer Therapeutics.

Leelamine is the first of a new class of potentially viable drugs for the treatment of melanoma. More research must be completed before it can be tested in humans. Penn State has a patent for this discovery and has licensed it to Melanovus Oncology for the next series of experiments to enable it to be tested in humans. Melanovus Oncology is partly owned by Penn State and Robertson.

Not just for the heart, red wine shows promise as cavity fighter

For anyone searching for another reason to enjoy a glass of red wine with dinner, here’s a good one: A new study has found that red wine, as well as grape seed extract, could potentially help prevent cavities. They say that their report, which appears in ACS’ Journal of Agricultural and Food Chemistry, could lead to the development of natural products that ward off dental diseases with fewer side effects.

M. Victoria Moreno-Arribas and colleagues explain that dental diseases are extremely common throughout the world. Cavities, periodontal disease and tooth loss affect an estimated 60 to 90 percent of the global population. The problems start when certain bacteria in the mouth get together and form biofilms, which are communities of bacteria that are difficult to kill. They form plaque and produce acid, which starts damaging teeth. Brushing, fluoride in toothpaste and water and other methods can help get rid of bacterial plaques, but the effects are limited. In addition, currently used antimicrobial rinses can change the color of the gums and alter taste, so people are less likely to use them for as long as they should. Some research has suggested that polyphenols, grape seed extract and wine can slow bacterial growth, so Moreno-Arribas’ team decided to test them under realistic conditions for the first time.

They grew cultures of bacteria responsible for dental diseases as a biofilm. They dipped the biofilms for a couple of minutes in different liquids, including red wine, red wine without the alcohol, red wine spiked with grape seed extract, and water and 12 percent ethanol for comparison. Red wine with or without alcohol and wine with grape seed extract were the most effective at getting rid of the bacteria.

Disruption of circadian rhythms may contribute to inflammatory disease

New study suggests chronic disruption negatively affects intestinal flora

A disruption of circadian rhythms, when combined with a high-fat, high-sugar diet, may contribute to inflammatory bowel disease and other harmful conditions, according to a recent study conducted by researchers at Rush University Medical Center. The study is online at the peer-reviewed, open-access journal, PLOS ONE.

“Circadian rhythms, which impose a 24-hour cycle on our bodies, are different from sleep patterns,” said Robin M. Voigt, PhD, assistant professor at Rush Medical College and first author of the study. “Sleep is a consequence of circadian rhythms,” Voigt said.

While circadian rhythm disruption may be common among some, the research suggests that it may be contributing to a host of diseases that may be prevented by regulating things such as sleep/wake patterns and times of eating to help prevent circadian rhythm disruption. Including prebiotics or probiotics in the diet can also help normalize the effects of circadian rhythm disruption on the intestinal microbiota to reduce the presence of inflammation.

“It’s something that needs to be addressed — not something people need to be very concerned about, but aware. If you have some of these other risk factors, like a high-fat, high-sugar diet,” or a genetic tendency toward disruption in circadian rhythms, “take precautions, watch your diet, take pre- and probiotics, monitor your health, be vigilant,” Voigt said.

The prevailing theory is that of a “second hit hypothesis” whereby individuals with at-risk lifestyle choices or genetic predispositions will only develop disease if a secondary insult is present. “We believe that chronic circadian rhythm disruption promotes/exacerbates inflammatory-mediated diseases, at least in part, due to changes in the intestinal microbiota,” she said.

Inflammation is associated with a number of diseases, including cardiovascular disease and cancer, and can cause organ damage and is associated with increased morbidity and mortality.

In the study, male mice had their cycles of exposure to light and dark reversed on a weekly basis (i.e., “shifted”), an experience that is known to disrupt an organism’s innate circadian rhythm. Some of the mice ate standard food; others ate a high-fat, high-sugar diet. Researchers found that the microbiota of the mice that had their circadian rhythms disrupted were significantly different from that of the control group — but only if they had consumed the high-fat, high-sugar diet.

All the mice that ate the high-fat, high-sugar diet displayed changes in the makeup of the microorganisms in their guts, regardless of circadian status. However, mice that ate the high-fat, high-sugar diet, and had circadian-rhythm disruptions, had higher concentrations of bacteria that are known to promote inflammation than any of the other mice in the study. Disrupting the circadian rhythms of the mice fed standard chow did not significantly affect the microbiota in their intestines.

These findings support previous studies that have shown that the negative effects of circadian disruption are subtle enough that “a second environmental insult is often necessary to reveal [their] deleterious effects,” the study says.

Many people have their circadian rhythms disrupted on a regular basis — shift workers like nurses, doctors, firefighters and policemen. “Other people have ‘social jet lag,’ a lifestyle pattern that leads them to maintain a normal schedule on weekdays, but then stay up late and sleep in on the weekends,” Voigt said.

“Looking forward, we would like to functionally evaluate how circadian rhythm disruption may influence diseases including colon cancer, which may in part be the consequence of altered intestinal microbiota,” she concluded.

Healthy diet linked with better lung function in COPD patients

ATS 2014, SAN DIEGO – Sure, everyone knows a healthy diet provides lots of health benefits for patients with respiratory diseases, but now a new study has shown a direct link between eating fish, fruit and dairy products and improved lung function among patients with chronic obstructive pulmonary disease (COPD). Conducted by researchers in the U.S. and Europe, the study specifically looked at COPD patients’ lung function within 24 hours of eating grapefruit, bananas, fish and cheese.

The study will be presented at the ATS 2014 International Conference.

“Diet is a potentially modifiable risk factor in the development and progression of many diseases, and there is evidence that diet plays a role in both the development and clinical features of COPD,” said study lead author Corinne Hanson, Ph.D. “This study aimed to evaluate that association.”

For their study, the researchers used data from the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints study (ECLIPSE). ECLIPSE was designed to help determine how COPD progresses and to identify biomarkers associated with the disease. Limited diet records were available for 2,167 ECLIPSE participants who provided dietary intake information at eight time points over a three-year period. Each participant reported the amount of a specific food they had consumed during the previous 24 hours.

Next, the researchers looked at specific standard lung function measurements for the same group of people, including the six-minute walk test (SMWT), St. George’s Respiratory Questionnaire (SGRQ) scores and inflammatory biomarkers. Results were adjusted for age, sex, body mass index (BMI) and smoking.

What they found was that people who reported recently consuming fish, grapefruit, bananas or cheese had showed improvement in lung function, less emphysema, improved six-minute walk scores, improved SGRQ scores, and a decrease in certain inflammatory markers associated with poor lung function including white blood cells and C-reactive protein.

“This study demonstrates the nearly immediate effects a healthy diet can have on lung function in in a large and well-characterized population of COPD patients,” Hanson said. “It also demonstrates the potential need for dietary and nutritional counseling in patients who have COPD.”

Based on these results and the results of other studies indicating a link between COPD and diet, the role of diet as a possible modifiable risk factor in COPD warrants continued investigation, she added.

Conclusion: Subjects who demonstrated recent consumption of foods associated with a healthy diet, including fish, fruit, and dairy products, had improved markers of lung function, less emphysema, improved 6-minute walk and SGRQ scores, and a decrease in certain inflammatory markers. The role of diet as a possible modifiable risk factor in COPD continues to warrant investigation.

 

Fighting cancer with dietary changes

Dieting may decrease chances for metastases in triple negative breast cancers by strengthening the tissue surrounding the tumor

(PHILADELPHIA) — — Calorie restriction, a kind of dieting in which food intake is decreased by a certain percentage, has been touted as way to help people live longer. New research suggests that there may be other benefits, including improving outcomes for women in breast cancer. According to a study published May 26th in Breast Cancer Research and Treatment, the triple negative subtype of breast cancer – one of the most aggressive forms – is less likely to spread, or metastasize, to new sites in the body when mice were fed a restricted diet.

“The diet turned on a epigenetic program that protected mice from metastatic disease,” says senior author Nicole Simone, M.D., an associate professor in the department of Radiation Oncology at Thomas Jefferson University. Indeed, when mouse models of triple negative cancer were fed 30 percent less than what they ate when given free access to food, the cancer cells decreased their production of microRNAs 17 and 20 (miR 17/20). Researchers have found that this group of miRs is often increased in triple negative cancers that metastasize.

Breast cancer patients are often treated with hormonal therapy to block tumor growth, and steroids to counteract the side effects of chemotherapy. However, both treatments can cause a patient to have altered metabolism which can lead to weight gain. In fact, women gain an average of 10 pounds in their first year of treatment. Recent studies have shown that too much weight makes standard treatments for breast cancer less effective, and those who gain weight during treatment have worse cancer outcomes. “That’s why it’s important to look at metabolism when treating women with cancer,” says Dr. Simone.

In earlier studies, Dr. Simone and colleagues had shown that calorie restriction boosted the tumor-killing effects of radiation therapy. This study aimed to examine which molecular pathways were involved in this cooperative effect.

The investigators noticed that microRNAs – a type of RNA that regulates other genes in the cell – specifically miR 17 and 20, decreased the most when mice were treated with both radiation and calorie restriction. This decrease in turn increased the production of proteins involved in maintaining the extracellular matrix. “Calorie restriction promotes epigenetic changes in the breast tissue that keep the extracellular matrix strong,” says Dr. Simone. “A strong matrix creates a sort of cage around the tumor, making it more difficult for cancer cells to escape and spread to new sites in the body.”

Understanding the link to miR 17 also gives researchers a molecular target for diagnosing cancers that are more likely to metastasize and, potentially, for developing a new drug to treat the cancers. In theory, a drug that decreased miR 17 could have the same effect on the extracellular matrix as calorie restriction. However, targeting a single molecular pathway, such as the miR17 is unlikely to be as effective as calorie restriction, says Dr. Simone. Triple negative breast cancers tend to be quite different genetically from patient to patient. If calorie restriction is as effective in women as it is in animal models, then it would likely change the expression patterns of a large set of genes, hitting multiple targets at once without toxicity.

In order to test that this hypothesis is true in humans, Dr. Simone is currently enrolling patients in the CaReFOR (Calorie Restriction for Oncology Research) trial. As the first trial like it in the country, women undergoing radiation therapy for breast cancer receive nutritional counseling and are guided through their weight loss plan as they undergo their treatment for breast cancer.

Poor diet before pregnancy is linked with preterm birth

University of Adelaide research has for the first time confirmed that women who eat a poor diet before they become pregnant are around 50% more likely to have a preterm birth than those on a healthy diet.

Researchers at the University of Adelaide’s Robinson Research Institute investigated the dietary patterns of more than 300 South Australian women to better understand their eating habits before pregnancy.

It’s the first study of its kind to assess women’s diet prior to conception and its association with outcomes at birth.

The results, published in The Journal of Nutrition, show that women who consistently ate a diet high in protein and fruit prior to becoming pregnant were less likely to have a preterm birth, while those who consistently ate high fat and sugar foods and takeaway were about 50% more likely to have a preterm birth.

“Preterm birth is a leading cause of infant disease and death and occurs in approximately one in 10 pregnancies globally. Anything we can do to better understand the conditions that lead to preterm birth will be important in helping to improve survival and long-term health outcomes for children,” says the lead author of the paper, Dr Jessica Grieger, Posdoctoral Research Fellow with the Robinson Research Institute, based at the Lyell McEwin Hospital.

“In our study, women who ate protein-rich foods including lean meats, fish and chicken, as well as fruit, whole grains and vegetables, had significantly lower risk of preterm birth.

“On the other hand, women who consumed mainly discretionary foods, such as takeaway, potato chips, cakes, biscuits, and other foods high in saturated fat and sugar were more likely to have babies born preterm,” Dr Grieger says.

“It is important to consume a healthy diet before as well as during pregnancy to support the best outcomes for the mum and baby,” Dr Grieger says.

“Diet is an important risk factor that can be modified. It is never too late to make a positive change. We hope our work will help promote a healthy diet before and during pregnancy. This will help to reduce the number of neonatal deaths and improve the overall health of children,” she says.

Dr Grieger will present her research findings at the upcoming SA Annual Scientific Meeting of the Australian Society for Medical Research during ASMR Medical Research Week on Wednesday 4 June.

Melatonin makes old bones stronger

Research on elderly rats suggests possible avenue for prevention of osteoporosis

Faleh Tamimi, a professor in McGill’s School of Dentistry, is the leader of a research team that has just discovered that melatonin supplements make bones stronger in elderly rats and therefore, potentially, in elderly humans too. “Old rats are tedious to work with because they get sick a lot and that means they also cost a lot more. But if you’re interested in diseases like osteoporosis, they’re an essential part of the process.”

Dem bones, dem bones, dem dry bones – sleep and bone regulation

The process of bone breakdown and buildup is affected by our circadian rhythms. The cells which break down our bones (known as osteoclasts) are more active at night, while those responsible for bone formation (osteoblasts) are more active during daylight hours. “As we age, we sleep less well, which means that the osteoclasts are more active,” says Tamimi. “This tends to speed up the process of bone breakdown.”

It is already well established that melatonin plays a role in regulating our body clocks and can potentially help us sleep better. So the researchers suspected that a melatonin supplement would help regulate the circadian rhythms of the elderly rats, thus reducing the activity of the osteoclasts and slowing down the process of bone breakdown. And that is exactly what they found.

22-month-old rats are the equivalent of 60-year-old humans

Researchers at the University of Madrid, where the rats were housed, gave twenty 22-month-old male rats (the equivalent of 60 year-old humans) melatonin supplements diluted in water for 10 weeks (the equivalent of six years in human years). The femurs taken from the elderly rats which had received the melatonin supplements were then compared with those of a control group (which had not received the supplements) using a series of tests to measure bone density and strength.

The researchers found that there was a significant increase in both bone volume and density among the rats that had received melatonin supplements. As a result, it took much more force to break the bones of rats that had taken the melatonin supplements, a finding that suggests to the researchers that melatonin may prove a useful tool in combatting osteoporosis.

For Tamimi and his colleagues the next big question is whether melatonin is preventing or actually reversing the process of bone breakdown. “Until there is more research as well as clinical trials to determine how exactly the melatonin is working, we can’t recommend that people with osteoporosis go ahead and simply take melatonin supplements,” says Tamimi. “I am applying for funding to pursue the research and we hope to have answers soon.”

Toxins in the environment might make you older than your years

Why are some 75-year-olds downright spry while others can barely get around? Part of the explanation, say researchers writing in the Cell Press journal Trends in Molecular Medicine on May 28, is differences from one person to the next in exposure to harmful substances in the environment, chemicals such as benzene, cigarette smoke, and even stress.

While the birth date on your driver’s license can tell you your chronological age, that might mean little in terms of the biological age of your body and cells. The researchers say that what we need now is a better understanding of the chemicals involved in aging and biomarkers to measure their effects.

“The rate of physiologic, or molecular, aging differs between individuals in part because of exposure to ‘gerontogens’, i.e., environmental factors that affect aging,” said Norman Sharpless from the University of North Carolina, Chapel Hill. “We believe just as an understanding of carcinogens has informed cancer biology, so will an understanding of gerontogens benefit the study of aging. By identifying and avoiding gerontogens, we will be able to influence aging and life expectancy at a public health level.”

In the future, blood tests evaluating biomarkers of molecular age might be used to understand differences amongst individuals in aging rates. Those tests might measure key pathways involved in the process of cellular senescence or chemical modifications to DNA. In fact, Sharpless said in the interest of full disclosure that he has founded a company to commercialize molecular tests of aging.

From a public health perspective, cigarette smoke is likely the most important gerontogen, Sharpless said. Cigarettes are linked with cancers but also with atherosclerosis, pulmonary fibrosis, and other diseases associated with age. UV radiation from the sun makes us older too, and Sharpless and his colleagues recently showed that chemotherapy treatment is also a strong gerontogen. With the aid of a mouse model that they developed, his team is prepared to study these gerontogens and others in much greater detail.

The researchers call for a concerted research effort to understand the clinical uses for molecular tests of aging as well as the epidemiology of accelerated aging.

“We believe the comparison of molecular markers of aging to clinical outcomes should begin in earnest,” Sharpless said. For example, he asked, can biomarkers to aging predict toxicity from surgery or chemotherapy in patients in whom chronological age is already a known risk factor?

Sharpless does caution against making tests of molecular age available to consumers and patients directly. “The potential for miscommunication and other harm seems real,” he said.

 

Variety in Diet Can Hamper Microbial Diversity in the Gut

Wednesday, May 28, 2014

Scientists from The University of Texas at Austin and five other institutions have discovered that the more diverse the diet of a fish, the less diverse are the microbes living in its gut. If the effect is confirmed in humans, it could mean that the combinations of foods people eat can influence the diversity of their gut microbes.

 

The research could have implications for how probiotics and diet are used to treat diseases associated with the bacteria in human digestive systems.

 

Fish that are picky eaters, focusing on just one type of food, such as small crustaceans (top) or chironomid insect larvae (bottom), have more diverse microbial communities in their intestines. In contrast, fish eating a more diverse mixture of foods have less diverse microbes in their intestine (middle). This is illustrated with a cartoon of multiple species of microbes (shaded shapes) inside the fish intestine (tan cylinders on right). Image courtesy of Dan Bolnick.

Fish that are picky eaters, focusing on just one type of food, such as small crustaceans (top) or chironomid insect larvae (bottom), have more diverse microbial communities in their intestines. In contrast, fish eating a more diverse mixture of foods have less diverse microbes in their intestine (middle). This is illustrated with a cartoon of multiple species of microbes (shaded shapes) inside the fish intestine (tan cylinders on right). Image courtesy of Dan Bolnick.

A large body of research has shown that the human microbiome, the collection of bacteria living in and on people’s bodies, can have a profound impact on human health. Low diversity of bacteria in the human gut has been linked to a plethora of diseases.

 

“There’s been a lot of work done showing that what people eat influences what gut microbes they have, and that can affect risk of obesity, diabetes, heart disease and other things,” said Daniel Bolnick, professor in The University of Texas at Austin’s College of Natural Sciences and lead author of the study, published this week in the journal Ecology Letters.

 

Researchers have already established that environment and diet can affect the kinds of bacteria that live in the human digestive system. Unfortunately, most studies on the effect of diet on the microbiome only look at one thing at a time — such as a high-fat versus a low-fat diet.

 

Bolnick and his colleagues decided for the first time to look at the effect of combinations of different foods on gut bacteria. They used two species of fish, the threespine stickleback and the Eurasian perch, to model the human gut.

 

Populations of both fish were studied in the wild, where the fish typically dine on two major types of prey. The fish eat large insect larvae that live in the soil near the lakeshore, as well as small crustaceans that live in the open water far from shore. Because the individual fish vary in what they eat — some feasting mainly on insect larvae, others favoring the small crustaceans and the rest feeding on a varying mixture of the two — they proved to be perfect subjects for the study.

 

The scientists also manipulated the diet of a population of sticklebacks in the laboratory, feeding some frozen insect larvae, others tiny crustaceans, and a third group an equal mixture of the two foods.

 

The researchers expected that the generalists, the fish dining on the mixed diet, would have more diversity in their gut microbes than the fish that specialized in one type of prey. Because the mixed diet would expose the fish to a larger variety of microbes and their guts would hold a more diverse buffet for the microbes to munch on, it seemed a logical conclusion.

 

The researchers found the opposite to be true: The fish that favored one type of food item had more bacterial diversity in their guts than fish that ate a mixture of prey.

 

The authors have suggested some possible explanations for these results. It could be that the larger diversity of foods in the gut gave an advantage to some generalist bacteria, allowing them to thrive at the expense of more specialized bacteria. They found that one strain of bacteria dominated the guts of stickleback that ate a larger variety of prey, supporting this concept. Another possibility is that the prey items give off an inhibitory chemical that suppresses certain bacteria. If the fish ingest a variety of prey, and thus multiple inhibitors, then fewer gut microbes would survive. These hypotheses still need to be rigorously tested.

 

One thing is clear though. If these results translate to humans, then scientists may have to rethink how they study the effects of different foods on the human microbiome.

 

“Our results suggest that what we know about diet effects really has to change to account for mixing of things, because humans don’t eat just one thing at a time,” said Bolnick. “The effect of a mixed diet isn’t easily deduced from the two diets separately. The whole is less than the sum of its parts.”

 

 

Flame retardant exposure linked to lower IQs — study

A new study involving Simon Fraser University researchers has found that prenatal exposure to flame retardants can be significantly linked to lower IQs and greater hyperactivity in five-year old children. The findings are published online today in the journal Environmental Health Perspectives.

The researchers found that a 10-fold increase in PBDE concentrations in early pregnancy, when the fetal brain is developing, was associated with a 4.5 IQ decrement, which is comparable with the impact of environmental lead exposure.

SFU health sciences professor Bruce Lanphear is part of the research team that measured the levels of flame retardants, or polybrominated diphenyl ethers, (PBDEs) in 309 U.S. women at 16 weeks of pregnancy, and followed their children to the age of five.

Researchers say their results confirm earlier studies that found PBDEs, which are routinely found in pregnant women and children, may be developmental neurotoxicants.

PBDEs have been widely used as flame retardants in furniture, carpet padding, car seats and other consumer products over the past three decades. While most items containing PBDEs were removed voluntarily from the market a decade ago, some are still in commerce and others persist in the environment and human bodies. Nearly all homes and offices still contain some PBDEs.

“The results from this and other observational human studies support efforts to reduce Penta-BDE exposures, especially for pregnant women and young children,” says Lanphear. “Unfortunately, brominated flame retardants are persistent and North Americans are likely exposed to higher PBDE levels than people from other parts of the world. Because of this it is likely to take decades for the PBDE levels in our population to be reduced to current European or Asian levels.”

The United Nations Environment Program (UNEP) added two of three existing commercial PBDE formulas to the list of banned Persistent Organic Pollutants (PIPs) due to concerns over toxicity in wildlife and mammals in 2009. While PBDEs were voluntarily withdrawn from the U.S. market in 2004, products manufactured before then may still contain PBDEs, which can continue to be released into the environment and accumulate via indoor dust.

The latest research highlights the need to reduce inadvertent exposure to PBDEs in the home and office environment (e.g., via dust), and in diet (e.g., via fish or meat products), to avert potential developmental neurotoxicity in pregnant women and young children.

Lanphear says additional research is needed to highlight the impact of PBDE exposure on the developing brain. He also notes that it is important to investigate related chemicals and other flame retardants used to replace PBDEs.

Link to paper: http://at.sfu.ca/LnTzTN

Some high blood pressure drugs may be associated with increased risk of vision-threatening disease

Major population study finds vasodilators may raise likelihood of age-related macular degeneration

SAN FRANCISCO – May 28, 2014 – There may be a connection between taking vasodilators and developing early-stage age-related macular degeneration (AMD), the leading cause of vision loss and blindness among Americans who are age 65 and older, according to a study published online in Ophthalmology, the journal of the American Academy of Ophthalmology.

AMD – the deterioration of the eye’s macula, which is responsible for the ability to see fine details clearly – affects an estimated 11 million people in the United States. In addition to increased age, the cause of AMD may be attributed to several risk factors, including hereditary risk and smoking. Some studies have also found an association between AMD and high blood pressure, but this has been inconsistent. To help clarify the relationship between AMD incidence and blood pressure lowering medications, including vasodilators, researchers from the University of Wisconsin School of Medicine and Public Health conducted a long-term population-based cohort study from 1988 to 2013 of nearly 5,000 residents of Beaver Dam, Wis., aged 43 to 86 years. The research is part of the National Eye Institute -funded Beaver Dam Eye Study, which has since 1987 collected information on the prevalence and incidence of AMD, macular degeneration and diabetic retinopathy.

The researchers found that, after adjusting for age, sex and other factors, using any vasodilator such as Apresoline and Loniten, which open (dilate) the blood vessels – was associated with a 72 percent greater risk of developing early-stage AMD. Among people who were not taking vasodilators, an estimated 8.2 percent developed signs of early AMD. In comparison, among those taking a vasodilator medication, 19.1 percent developed the disease.

The researchers also found that taking oral beta blockers such as Tenormin and Lopressor was associated with a 71 percent increase in the risk of neovascular AMD, a more advanced and vision-threatening form of the disease. Among those who were not taking oral beta blockers an estimated 0.5 percent developed signs of neovascular AMD. In comparison among those taking oral beta blockers, 1.2 percent developed neovascular AMD.

While the study provides risk estimates of associations between blood pressure lowering medications and AMD at various stages, the researchers caution that their study was not able to discern effects of the medications themselves and the conditions for which participants were taking those medications.

“As significant as these results may be, it’s important that they be replicated first, and if possible tested in a clinical trials setting before changing anyone’s medication regimens,” said Ronald Klein, M.D., MPH, lead researcher of the study. “Further research is needed to determine the cause of these increased risks.”

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For more information about AMD and general eye health, visit the American Academy of Ophthalmology’s public education website at http://www.geteyesmart.org.

The May 2014 issue of Ophthalmology, in print now, features a number of new research reports, including:

• The Neovascular Age-Related Macular Degeneration Database: Multicenter Study of 92,976 Ranibizumab Injections: Report 1 – Visual Acuity. This study showed that a well-designed electronic medical record system rapidly produces large volumes of high-quality real-world outcome data to model predictors of vision and treatment burden and to facilitate phase 4 and 5 clinical trial designs.
• Qualitative and Quantitative Characteristics of Near-Infared Autofluorescence in Diabetic Macular Edema. A mosaic pattern seen on near-infrared autofluorescence images is related to macular thickening, photoreceptor damage, and visual impairment, and eyes with hypofluorescence had increased macular thickness and serous retinal detachment in diabetic macular edema.
• Use of Health Care Claims Data to Study Patients with Ophthalmologic Conditions. Analyses of claims data are potentially valuable in examining specific research questions, but these analyses can vary in their methodological rigor. Common advantages and issues are described, and guidance is given for readers to interpret studies properly.

Zinc deficiency before conception disrupts fetal development

Female mice deprived of dietary zinc for a relatively short time before conception experienced fertility and pregnancy problems and had smaller, less-developed fetuses than mice that ingested zinc during the same times, according to researchers in Penn State’s College of Agricultural Sciences.

The findings have implications for human reproduction, scientists suggest.

Going without zinc prior to ovulation had marked effects on the mice’s reproductive functions. Zinc deficiency caused a high incidence of pregnancy loss, and embryos from the zinc-deficient diet group were an average of 38 percent smaller than those from the control group. Preconception zinc deficiency also caused approximately half of embryos to exhibit delayed or aberrant development.

Defects in placenta development are a major cause of delayed embryo/fetal development because the developing embryos do not get enough nutrients to support normal growth. In the zinc-deficient group, the fetal side of the placenta was much less developed. Consistent with delayed development of the placenta, expression of key placental genes was sharply curtailed in mice with zinc-deficient diets.

Collectively, the findings provide evidence for the importance of preconception zinc in promoting optimal fertility and embryo, fetal and placenta development, explained Francisco Diaz, assistant professor of reproductive biology.

“The mineral zinc acts as a catalytic, structural and signaling factor in the regulation of a diverse array of cellular pathways involving hundreds of enzymes and proteins,” he said. “Given these wide-ranging roles, it is not surprising that insufficient zinc during pregnancy causes developmental defects in many species. We have known that for a long time.

“However, the role of zinc during the preconception period in promoting later development during pregnancy is not clearly understood.”

In the six-month study, which was published online in a recent edition of Biology of Reproduction, female mice were fed a control or a zinc-deficient diet for four to five days before ovulation. Then, embryonic and/or placental development was evaluated on days three, six, 10, 12 and 16 of pregnancy.

At each of those intervals, Xi Tian, recent Penn State doctoral student and now a postdoctoral scholar at the University of North Carolina, Chapel Hill, measured and evaluated fetuses, examining them with light microscopy and magnetic resonance imaging. She was assisted by co-authors Thomas Neuberger, assistant professor of biomedical engineering in Penn State’s Huck Institutes of Life Sciences, working with the Penn State’s High-Field Magnetic Resonance Imaging Facility, and Kate Anthony, research technician in animal science.

“What these results demonstrate is that a relatively short dietary disruption in nutrients that are available can have an impact on the ovary, the quality of the egg that the ovary produces, and the quality of the embryo and placenta that the egg develops into after fertilization,” Diaz said. “We know that dietary restrictions can have an effect on pregnancy and on fetal and placental development, but we are not as familiar with preconception effects that are relatively acute and then seeing the effect later on in pregnancy. That is the most novel aspect of our work here.”

One way that zinc may affect egg development is by promoting the epigenetic programming of the DNA of the oocyte, or immature egg cell. During egg development, “methyl groups,” or chemical tags, are added at specific locations on the DNA and are essential for that egg to fully support embryo and placenta development later on.

“We found much less DNA methylation in eggs from zinc deficient mice, suggesting that programming of the egg is defective,” Diaz said.

Diaz noted that this research and follow-up studies may result in a recommendation for women intending to get pregnant to make a special effort to eat foods containing zinc in the weeks prior to ovulation, or even to take zinc supplements. Foods containing higher levels of zinc include meats, seafood and milk. Fruits and vegetables contain lower amounts of the mineral.

“It looks like zinc is similar to folic acid, which is one of the few nutrients that are prescribed before a woman becomes pregnant, because it is needed preconception to ensure the quality of the egg,” Diaz said. Zinc is very similar in that it is needed before conception — so giving multivitamins or supplements to a woman after she has found out that she’s pregnant doesn’t really address the issue.”

“It is certainly important during pregnancy, but if the egg development is already compromised, it may not help that aspect of development. I think our work suggests that you need zinc preconception, just like you need folic acid.”

A woman’s requirement for zinc is not large — unlike for calcium or iron — but there is a fairly rapid turnover of zinc in the body, so humans need a steady supply, Diaz pointed out.

“Actually, our mice become zinc deficient rather quickly,” he said. “Animal studies have shown that some tissues can become zinc deficient within a few days.”

Eating prunes can help weight loss

Research by the University of Liverpool has found that eating prunes as part of a weight control diet can improve weight loss.

Consumption of dried fruit is not readily recommended during weight loss despite evidence it enhances feelings of fullness.

However, a study by the University’s Institute of Psychology, Health and Society of 100 overweight and obese low fibre consumers tested whether eating prunes as part of a weight loss diet helped or hindered weight control over a 12-week period.

It also examined if low fibre consumers could tolerate eating substantial numbers of prunes in their diet, and if eating prunes had a beneficial effect on appetite.

To assess the effects of prunes on weight and appetite, participants in the study were divided into two groups – those who ate prunes every day (140g a day for women and 171g a day for men) and those who were given advice on healthy snacks over the period of active weight loss.

The researchers found that members of the group which ate prunes as part of a healthy life-style diet lost 2kg in weight and shed 2.5cm off their waists. However, the people in the group which was given advice on healthy snacks lost only 1.5kg in weight and 1.7cm from their waists.

The study also found that the prune eaters experienced greater weight loss during the last four weeks of the study. After week eight, participants showed increased feelings of fullness in the prune group. Moreover, despite the high daily doses, prunes were well tolerated.

Liverpool psychologist, Dr Jo Harrold who led the research, said: “These are the first data to demonstrate both weight loss and no negative side effects when consuming prunes as part of a weight management diet. Indeed in the long term they may be beneficial to dieters by tackling hunger and satisfying appetite; a major challenge when you are trying to maintain weight loss.”

Professor Jason Halford, Professor of Experimental Psychology and Director of the University’s Human Ingestive Behaviour Laboratory, added: “Maintaining a healthy diet is challenging. Along with fresh fruit and vegetables, dried fruit can provide a useful and convenient addition to the diet, especially as controlling appetite during dieting can be tough.”

Study explains how green tea could reduce pancreatic cancer risk

Findings open a new area for research into cancer prevention

LOS ANGELES – (May 30, 2014) – Green tea and its extracts have been widely touted as potential treatments for cancer, as well as several other diseases. But scientists have struggled to explain how the green tea and its extracts may work to reduce the risk of cancer or to slow the growth of cancer cells.

A study recently published online by the journal, Metabolomics, offers an explanation that researchers say could open a new area of cancer-fighting research. The study reports that EGCG, the active biologic constituent in green tea, changed the metabolism of pancreatic cancer cells by suppressing the expression of an enzyme associated with cancer, LDHA.

The researchers also found an enzyme inhibitor, oxamate, which is known to reduce LDHA activity, operated in the same manner: It also disrupted the pancreatic cancer cells metabolic system.

“Scientists had believed they needed a molecular mechanism to treat cancer, but this study shows that they can change the metabolic system and have an impact on cancer,” said Wai-Nang Lee, MD, corresponding author of the study and a Los Angeles Biomedical Research Institute (LA BioMed) lead researcher. “By explaining how green tea’s active component could prevent cancer, this study will open the door to a whole new area of cancer research and help us understand how other foods can prevent cancer or slow the growth of cancerous cells.”

Using sophisticated metabolic profiling methods, the researchers found EGCG disrupted the balance of “flux” throughout the cellular metabolic network. Flux is the rate of turnover of molecules through a metabolic pathway. The researchers found the EGCG disrupted this balance in the same manner that oxamate, a known LDHA inhibitor, did.

Based on this finding, they concluded that both EGCG and oxamate reduced the risk of cancer by suppressing the activity of LDHA, a critical enzyme in cancer metabolism, thereby disrupting the balance in the cancer cells metabolic functions.

“This is an entirely new way of looking at metabolism,” said Dr. Lee. “It is no longer a case of glucose goes in and energy comes out. Now we understand how cancer cell metabolism can be disrupted, and we can examine how we can use this knowledge to try to alter the course of cancer or prevent cancer.”

Risk of death highest following surgery in afternoons, at weekends, and in February

New research presented at this year’s Euroanaesthesia show that on weekends, in the afternoons and in February are the times when the risk of death following surgery is the highest. The research is by Dr Felix Kork and Professor Claudia Spies, Charité – University Medicine Berlin, Germany and colleagues.

Hospital mortality is subject to day-night, weekly and seasonal variability. This has been shown for various populations, settings, and in different regions of the world. However, a cyclic influence on hospital mortality has not been shown in patients after surgery. In this study, the researchers investigated the daily, weekly, and seasonal variability of hospital mortality in patients after surgery.

A retrospective analysis was carried out patients who underwent surgery between 2006 and 2011 at the two University Hospital Campuses of Charité Tertiary Care University Center, Berlin. Data was then modelled to work out cyclical patterns.

In this first analysis of the data, a total of 218,758 patients were included. Hospital mortality showed variability over the course of the day, during different weekdays, and different months. Surgery conducted in the afternoon was associated with 21% increased risk of death compared with surgery conducted at other times of day. Surgery at the weekend was associated with a 22% increased risk of death compared with surgery on weekdays. February was the highest risk month for surgery, with surgery in February associated with a 16% increased risk of death compared with surgery in all other months. Further work on the data will be carried out in the coming months, including looking at the possible reasons behind the variations.

The authors say: “Several factors may have influenced this outcome. For example, it may be that standard of care differs throughout the day and between weekdays and weekends. Although we controlled for risk factors including emergency surgery in our study, it may very well be that the patients treated in the afternoon and on the weekends were more severely ill. We need more data to draw conclusions regarding seasonal variation in postoperative outcome.”

They add: “Despite having an accredited quality management system in place in our hospitals, as well as having the European Society of Anaesthesiology’s Helsinki Declaration of Patient Safety in Anaesthesiology implemented, this study shows that we should seek to further improve patient safety.”