The share of world population that is food insecure is projected to decline

The latest International Food Security Assessment suggests food security will improve over the next 10 years for the 76 low- and middle-income countries examined by ERS.  The improvement is driven by expectations of falling food prices and rising incomes across most of these countries. The share of the total population within these 76 countries that is food insecure is projected to fall from 17 percent in 2016 to 6 percent in 2026. The report estimates per capita food consumption and evaluates that against a nutritional target of 2,100 calories per person per day to determine whether population groups should be considered food secure. At the regional level, the greatest improvement in food security between 2016 and 2026 is projected for Asia, where the share of population that is food insecure falls from 13.2 to 2.4 percent. The share of population that is food insecure in the Latin America and the Caribbean region is projected to fall from 14.6 percent in 2016 to 6.4 percent in 2026. Sub-Saharan Africa is the most food-insecure region in the world, and like the other regions, its food-security situation is projected to improve over the decade—but at a slower rate. The share of the region’s population that is food insecure is projected to fall from 29 to 15 percent. This chart is from the ERS report, International Food Security Assessment: 2016-2026, released June 30. 

http://www.ers.usda.gov/data-products/chart-gallery/detail.aspx?chartId=59815&ref=collection

For Coffee Drinkers, the Buzz May Be in Your Genes

By ANAHAD O'CONNOR

Like most of my work, this article would not have been possible without coffee.

I’m never fully awake until I have had my morning cup of espresso. It makes me productive, energized and what I can only describe as mildly euphoric. But as one of the millions of caffeine-loving Americans who can measure out my life with coffee spoons (to paraphrase T.S. Eliot), I have often wondered: How does my coffee habit impact my health?

The health community can’t quite agree on whether coffee is more potion or poison. The American Heart Association says the research on whether coffee causes heart disease is conflicting. The World Health Organization, which for years classified coffee as “possibly” carcinogenic, recently reversed itself, saying the evidence for a coffee-cancer link is “inadequate.” National dietary guidelines say that moderate coffee consumption may actually be good for you – even reducing chronic disease.

Why is there so much conflicting evidence about coffee? The answer may be in our genes.

About a decade ago, Ahmed El-Sohemy, a professor in the department of nutritional sciences at the University of Toronto, noticed the conflicting research on coffee and the widespread variation in how people respond to it. Some people avoid it because just one cup makes them jittery and anxious. Others can drink four cups of coffee and barely keep their eyes open. Some people thrive on it.

Dr. El-Sohemy suspected that the relationship between coffee and heart disease might also vary from one individual to the next. And he zeroed in on one gene in particular, CYP1A2, which controls an enzyme – also called CYP1A2 – that determines how quickly our bodies break down caffeine.

One variant of the gene causes the liver to metabolize caffeine very quickly. People who inherit two copies of the “fast” variant – one from each parent – are generally referred to as fast metabolizers. Their bodies metabolize caffeine about four times more quickly than people who inherit one or more copies of the slow variant of the gene. These people are called slow metabolizers.

With funding from the National Institutes of Health, Dr. El-Sohemy and his colleagues recruited 4,000 adults, including about 2,000 who had previously had a heart attack. Then they analyzed their genes and their coffee consumption. When they looked at the entire study population, they found that consuming four or more cups of coffee per day was associated with a 36 percent increased risk of a heart attack.

But when they split the subjects into two groups – fast and slow caffeine metabolizers – they found something striking: Heavy coffee consumption only seemed to be linked to a higher likelihood of heart attacks in the slow metabolizers.

“The increased risk that we saw among the entire population was driven entirely by the people that were slow metabolizers,” said Dr. El-Sohemy, who is also on the science advisory board atNutrigenomix, a personalized nutrition company. “When you look at the fast metabolizers, there was absolutely no increased risk.”

The trend among fast metabolizers was quite the opposite. Those who drank one to three cups of coffee daily had a significantly reduced risk of heart attacks – suggesting that for them coffee was protective.

Dr. El-Sohemy suspects that because caffeine hangs around longer in a slow metabolizer, it has more time to act as a trigger of heart attacks. But fast metabolizers clear caffeine from their systems rapidly, allowing the antioxidants, polyphenols and coffee’s other healthful compounds to kick in without the side effects of caffeine, he said.

Other more recent research seems to point in the same direction. In Italy, a team of scientists looked at hypertension in 553 fast and slow caffeine metabolizers. Once again, the subjects’ genetic profiles predicted whether coffee was potentially harmful or healthful. Heavy and even moderate coffee drinkers were significantly more likely to have hypertension if they were slow metabolizers. But fast metabolizers saw their risk of hypertension fall as their coffee intake rose.

That is not to say that every coffee drinker should run out and have their CYP1A2 genes analyzed by one of the many direct-to-consumer genetic testing companies. Dr. Marilyn Cornelis, an assistant professor at the Northwestern University Feinberg School of Medicine, said her research had identified many genes involved in caffeine metabolism, and that relying on only one or two genetic factors could provide people with a false sense of reassurance.

“There are clearly other genetic and environmental factors contributing to differences in caffeine metabolism,” she said. “And these are not captured by existing tests.”

Nonetheless, this greater understanding of the link between coffee and genetics has opened up a wide new area of research. Scientists are now studying whether the CYP1A2 gene and others might mediate coffee’s influence on breast and ovarian cancer, Type 2 diabetes and even Parkinson’s disease.

It has also prompted a closer look at the effects of caffeine on exercise. Though it has long been accepted that caffeine enhances sports performance, research by Christopher J. Womack, a professor of kinesiology at James Madison University, suggests that endurance athletes who are fast caffeine metabolizers may benefit more than others.

In one study in 2012, Dr. Womack and his colleagues studied the effect of caffeine pills and placebos on the performance of male cyclists. Dr. Womack found that the slow metabolizers completed a 40-kilometer race on a stationary bike one minute faster on caffeine. But the fast metabolizers improved their time by four minutes.

Dr. Womack suspects that the fast metabolizers saw greater benefits because the rapid metabolism of caffeine further heightened their sympathetic nervous systems — which control the so-called fight or flight response.

“In the broad sense, the average person is going to perform better with caffeine,” he said. “Some people have a huge effect. Not surprisingly, it has something to do with our genetics.”

As an avid coffee consumer, I was curious about my own genes. Through a company called FitnessGenes, which analyzes 41 different genes related to diet and exercise – including CYP1A2 – I learned that I was a so-called fast caffeine metabolizer. The company says that 40 percent of people are fast metabolizers. About 45 percent have both a slow and a fast copy, and 15 percent carry two copies of the slow allele.

Dan Reardon, a medical doctor who founded FitnessGenes, said that, anecdotally, slow metabolizers who drink coffee tend to report a very gradual wakefulness, sometimes lasting hours. But fast metabolizers often experience something very different with coffee: an immediate spike in alertness followed at times by a relatively quick dip in energy.

While my DNA results suggested that my twice-daily espresso habit might be for the best, researchers have only just begun to understand how our genes and coffee habits interact. In a 2015 study, Dr. Cornelis and a team of international scientists identifiedeight genetic variants that appear to make people more likely to seek out coffee, including at least two variants that are involved in the psychologically rewarding effects of caffeine.

The research could help to explain why some people see little or no appeal in a freshly brewed cup of coffee – while others, like me, can hardly fathom a morning without it.

Eat Well is a new weekly column on the science and culture of eating.

http://well.blogs.nytimes.com/2016/07/12/for-coffee-drinkers-the-buzz-may-be-in-your-genes/

No Health Benefit to Replacing Fat With Carbs

By NICHOLAS BAKALAR

 JULY 11, 2016 3:47 PM July 11, 2016 3:47 p

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Low-fat diets that are high in carbohydrates are unlikely to improve your health, a new study shows.

Researchers came to the conclusion after studying the eating habits and health behaviors of 126,233 men and women who completed health questionnaires every two to four years for up to 32 years. Then they calculated the effect of replacing just 5 percent of saturated fat calories with another type of fat or carbohydrates.

The study, in JAMA Internal Medicine, found that replacing 5 percent of daily calories from saturated fats (mainly animal fat) with foods high in polyunsaturated fats, such as the omega-3 and omega-6 fatty acids in fish and walnuts, was associated with a 27 percent reduction in total mortality and reduced death from cardiovascular disease, cancer and neurodegenerative disease.

A similar switch from saturated fat to monounsaturated fat, such as olive oil and avocados, was associated with a 13 percent reduction in total mortality and a 29 percent reduction in death from neurodegenerative diseases.

But replacing saturated fats with carbohydrates, such as sugars and refined grains, did not confer any health benefits.

“Not all fats are created equal,” said the senior author, Dr. Frank B. Hu, a professor of nutrition at the Harvard T.H. Chan School of Public Health. “We should eat more good ones from fish and avocados, instead of animal fats. And second, the low-fat, high-carbohydrate diet is not beneficial for improving health and longevity.”

https://www.blogger.com/blogger.g?blogID=3003974673401522042#editor/target=post;postID=4189859292417739537

U.S. Teen Diabetes Rate Exceeds Prior Estimates

By Steven Reinberg
HealthDay Reporter

TUESDAY, July 19, 2016 (HealthDay News) -- More American teens have diabetes or prediabetes than previously thought, and many don't know they have the blood-sugar disease, a new study finds.

Nearly 1 percent of more than 2,600 teens studied had diabetes -- with almost one in three cases undiagnosed, researchers found. Also, almost 20 percent of the group had prediabetes -- higher than normal blood sugar levels but not high enough to be classified as diabetes.

"These findings are important because diabetes in youth is associated with early onset of risk factors and complications," said lead researcher Andy Menke of Social & Scientific Systems in Silver Spring, Md.

One prior study estimated the prevalence of diabetes in teens at about 0.34 percent, but the current study shows it's double that -- 0.8 percent.

The researchers couldn't distinguish between teens who had type 1 or type 2 diabetes. However, previous research among children and teens with diabetes found that 87 percent had type 1 diabetes, previously called juvenile diabetes, the researchers said.

While type 1 diabetes, an autoimmune disease, isn't preventable, type 2 is usually related to lifestyle factors. Type 2 is generally seen in adults, but experts say it's risen among younger people as obesity rates have soared.

"It is alarming to see such a high incidence of [childhood] diabetes when it should be close to zero," said Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City.

"The very high prevalence of prediabetes, diabetes and especially undiagnosed diabetes in adolescents is worrisome," he said.

The majority of those with prediabetes will develop diabetes if nothing is done to change their lifestyle, Zonszein said.

Blacks and Hispanics were more likely than whites to have prediabetes or not know they had diabetes, the study found.

"There are effective treatments, but those treatments are not useful to people who have not been diagnosed," Menke said.

Untreated, diabetes can lead to heart disease, circulatory problems, vision loss and amputation of feet and legs.

In general, people with undiagnosed diabetes tend to have type 2 diabetes. "Symptoms will depend on diabetes type and may be subtle," Menke said, adding they may mimic signs of other conditions.

Classic symptoms include increased urination, increased thirst, weight loss (due to dehydration), and perhaps increased hunger and blurry vision, he said.

"Previous studies have found that both type 1 and type 2 diabetes are increasing among adolescents," Menke said.

Because type 2 is considered lifestyle-related, Menke called for better education on reducing risk factors for type 2 and improved screening for adolescents at high risk.

According to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases, being overweight or obese is the main cause of type 2 diabetes. People at high risk can prevent or delay its onset by losing 5 percent to 7 percent of their weight, the agency says.

The agency recommends at least 30 minutes of moderate-intensity physical activity five days a week, and reducing daily calorie consumption.

Parents can help by keeping kids and teens active and preparing healthy meals that are low in fat, sugar and salt. Limiting portion sizes is also key. Parents should also ask their doctor if their kids are at a healthy weight or if they are at risk for diabetes, the agency says.

For the study, Menke and his colleagues used data from the 2005-2014 National Health and Nutrition Examination Survey on 2,606 adolescents ages 12 to 19, who were randomly selected for fasting blood sugar tests.

Of 62 teens with diabetes, 29 percent didn't know it. Prevalence of prediabetes was 18 percent, and more common in boys.

Among the diabetic teens, nearly 5 percent of whites had not been diagnosed versus 50 percent of blacks and 40 percent of Hispanics.

"It is disturbing that we continue to see study after study, showing a high incidence and prevalence of prediabetes and diabetes in younger and younger populations, and how poorly it is diagnosed and treated," Zonszein said. "I see this study and others as a call to arms.

"If we were able to screen, prevent and treat HIV/AIDS, we can or should certainly be able to do it in diabetes, a much more common and costly disease," he said.

The report was published July 19 in the Journal of the American Medical Association.

More information

For more on type 2 diabetes, visit the American Diabetes Association.

SOURCES: Andy Menke, Ph.D., Social & Scientific Systems, Silver Spring, Md.; Joel Zonszein, M.D., director, Clinical Diabetes Center, Montefiore Medical Center, New York City; July 19, 2016, Journal of the American Medical Association

https://consumer.healthday.com/diabetes-information-10/misc-diabetes-news-181/u-s-teen-diabetes-rate-exceeds-prior-estimates-713035.html

Big Soda Has Lost a Big Fight Against Sugar Warningshttp://fortune.com/2016/05/18/san-francisco-warnings-soda-ads/

Big Soda has reportedly failed to stop a new San Francisco law requiring ads for sugary drinks to display warnings about the products’ possible negative health effects.

http://fortune.com/2016/05/18/san-francisco-warnings-soda-ads/

Too Few Americans Take Advantage of Local Parks

 Most neighborhood parks in the United States are geared toward younger people, which limits their use, a new study suggests.

"Relatively modest investments could make parks much more conducive to physical activity for everyone, regardless of age, gender or income level," said study author Dr. Deborah Cohen, a senior natural scientist at the Rand Corp.

https://consumer.healthday.com/fitness-information-14/misc-health-news-265/too-few-take-advantage-of-loacl-parks-in-u-s-711003.html

The dark side of trendy food trucks: A poor health safety record

It’s a daily culinary performance that plays out across Los Angeles: Top food truck chefs whipping up gourmet meals in spaces no bigger than a restaurant’s stockroom or walk-in freezer.

But even as the trucks have become a popular staple of the local food scene, with Twitter followers and long queues, they have been lagging behind restaurants and even sidewalk food carts in one important category -- health safety, a Times data analysis found.

http://www.latimes.com/local/california/la-me-food-trucks-20160518-snap-story.html

Uncle Sam Wants You ... Slimmer

Military personnel are expected to meet strict weight and body fat standards. But one in five U.S. military service members is obese, new research shows.

"We count on our military to be in the best shape both physically and mentally, and these data show there is a need to improve efforts to maintain a healthy weight within our Armed Forces," said Catherine Champagne, a member of The Obesity Society's advocacy committee.

https://www.nlm.nih.gov/medlineplus/news/fullstory_159658.html

Inherited Cholesterol Disorder Significantly Boosts Heart Risks

People who inherit a genetic disorder that causes high levels of "bad" LDL cholesterol have an increased risk for heart disease and hardened arteries, a new study finds.

The condition is called heterozygous familial hypercholesterolemia. It's believed to affect about 1.5 million people in the United States, the researchers said.

https://www.nlm.nih.gov/medlineplus/news/fullstory_159660.html

3 Treatments Seem to Help Combat Binge-Eating Disorder

New research finds that people struggling with binge-eating disorder -- America's most common, yet likely least-known eating disorder -- may have at least three treatment options to help them curtail their eating.

People diagnosed as chronic binge eaters can benefit from cognitive-behavioral therapy, a form of therapy that helps patients understand the reasons behind their actions. That understanding can then help them change their behavior, said study lead author Kimberly Brownley. She's an associate professor with the University of North Carolina Center of Excellence for Eating Disorders.

https://www.nlm.nih.gov/medlineplus/news/fullstory_159650.html

Is U.S. Government Subsidizing Fattening Foods?

 Americans get more than half of their daily calories from seven farm foods that are subsidized by the U.S. government, but a new study suggests those subsidies may be contributing to the obesity epidemic.

The problem, according to the researchers: The biggest consumers of such food products are also much more likely to be obese, and to struggle with high cholesterol, high inflammation levels or high blood sugar. The foods include grains, dairy and livestock products.

https://consumer.healthday.com/vitamins-and-nutrition-information-27/obesity-health-news-505/is-u-s-government-subsidizing-fattening-foods-712585.html

Vitamin D levels linked to weight-loss surgery outcomes

Low levels of vitamin D have long been identified as an unwanted hallmark of weight loss surgery, but now findings of a new Johns Hopkins study of more than 930,000 patient records add to evidence that seasonal sun exposure -- a key factor in the body's natural ability to make the "sunshine vitamin" -- plays a substantial role in how well people do after such operations.

Results of the study, published online Dec. 14 in the journal Obesity Science & Practice, reveal interplay among vitamin D status, seasons, geography and surgery outcomes, according to Leigh Peterson, Ph.D., M.H.S., a nutritionist and postdoctoral research fellow at the Johns Hopkins Center for Bariatric Surgery, who led the research.

Specifically, the researchers found that patients undergoing bariatric surgery in the United States during winter -- January to March, the time of lowest vitamin D levels -- fared worse than patients who had procedures in the summer. Similarly, patients having surgery in the north seemed to have more complications than those in the south.

"Sun exposure is critical in the synthesis of vitamin D, so the notion that people living in less sunny northern states may suffer from vitamin D deficiency is not surprising," says Peterson. "What is remarkable is how closely sun exposure, vitamin D and surgical outcomes were linked."

For the study, researchers reviewed records of more than 930,000 bariatric operations performed in the United States between 2001 and 2010. Overall, they report, post-procedural complications were rare, with fewer than 1 percent of patients developing infections. A more common outcome was spending a few extra days in the hospital, and this showed the strongest relationship with both season and geography.

The researchers found, Peterson says, a disproportionate number of those who fared worse hailed from areas north of latitude 37 degree -- roughly South Carolina -- than areas south of it. For example, areas north of latitude 37 degrees yielded almost 150,000 more patients with an extended length of stay -- more than three days in the hospital -- after surgery than areas south of that latitude. Considering that more than 300,000 of the operations, or over one-third of the total in the study, led to extended hospitalization, 71 percent of these surgical complications occurred north of 37 degrees.

Furthermore, the researchers noticed, adverse outcomes, such as nonhealing wounds, wound infections, wound separation and delayed wound healing, clustered in colder seasons marked by less sunshine. For example, more than twice as many patients experienced delayed wound-healing complications in the winter -- 349 patients, or 0.16 percent of operations reviewed -- than in the summer -- 172 patients, or 0.07 percent of operations reviewed.

The investigators caution that this observational study using medical records has limitations, and it is not enough to recommend the routine use of vitamin D supplements as a strategy to prevent or reduce the risk of postsurgical complications. Vitamin D supplements are often prescribed after weight loss surgery because of evidence that the operations reduce the ability of the gut to absorb the nutrient.

The investigators emphasize that further research is needed to determine the appropriate pre-emptive treatment with vitamin D in patients undergoing bariatric surgery. Experts believe that most people can and should get Vitamin D from brief, regular sun exposure, a healthy diet and possibly supplementation. While it is rare, excessive vitamin D intake can cause symptoms, such as nausea, constipation, confusion and abnormal heart rhythm. However, the researchers note, obesity is a well-known risk factor for vitamin D deficiency, and patients preparing to undergo weight loss operations should be screened for it.

Bariatric surgery serves to reduce weight for obese individuals or patients with diabetes and other conditions by reducing stomach size and/or bypassing a portion of the intestines. Nearly 200,000 bariatric surgeries occur annually in the United States. Costs for the procedure vary from $15,000 to $30,000 and are frequently covered by insurance.

"The growing rates of obesity and increased popularity of bariatric surgeries mean that primary care clinicians and bariatric surgeons should consider screening their patients and correcting any confirmed vitamin D deficiency," says Peterson.

In general, she says, nutritional deficiencies can fuel inflammation, higher infection risk and delayed wound healing.

The researchers say they are next planning a study measuring patients' vitamin D levels before and after surgery to help determine optimal doses for supplementation.

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Story Source:

The above post is reprinted from materials provided by Johns Hopkins Medicine. Note: Materials may be edited for content and length.

Mothers should be cautious when discussing weight with daughters

In an article recently published in the journal Body Image, Hillard and her colleagues, fellow Notre Dame psychology graduate student Rebecca A. Morrissey, and Notre Dame faculty members Dawn M. Gondoli, associate professor of psychology, and Alexandra F. Corning, research associate professor of psychology, reported on results from their study of a representative group of sixth- through eighth-grade girls and their mothers.

"Generally, we found that for the daughters who were being encouraged to lose weight by their mothers, outcomes were worse if their mothers were not also discussing their own weight concerns," Hillard said. "The daughters who were being encouraged to lose weight but whose moms were not also discussing their own weight concerns were more at risk for development of disordered eating, based on the higher scores on measures of dieting behavior and drive for thinness they reported in eighth grade."

Hillard acknowledged that the study findings as a whole suggested more about what mothers should not be talking about than what they should. "After all," she said, "the best outcomes were found for daughters whose mothers were not engaging in either type of conversation. They do shed light on the complexity of the issue of talking to children about their weight in ways that don't lead to poor health outcomes in the long run."

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Story Source:

The above post is reprinted from materials provided by University of Notre Dame. The original item was written by Michael O. Garvey. Note: Materials may be edited for content and length.

Study Suggests Link Between Gum Disease, Breast Cancer Risk

 Gum disease might increase the risk for breast cancer among postmenopausal women, particularly those who smoke, a new study suggests.

Women with gum disease appeared to have a 14 percent overall increased risk for breast cancer, compared to women without gum disease. And that increased risk seemed to jump to more than 30 percent if they also smoked or had smoked in the past 20 years, researchers said.

"These findings are useful in providing new insight into what causes breast cancer," said lead author Jo Freudenheim, a professor of epidemiology at the University at Buffalo's School of Public Health and Health Professions in New York.

"There is good evidence, though, that good dental care is important in any case and that treatment of periodontal disease is important for the health of the mouth," she said.

But more study is needed before there is enough evidence to say that gum disease causes breast cancer or other diseases, Freudenheim said. This study did not prove a cause-and-effect link between the two, a point made by several experts not involved with the study.

A number of studies have found an association between gum disease and other chronic diseases, including stroke, heart attack and other cancers, Freudenheim said.

"There is much to learn about why we see these associations," she said. "In particular, we don't know yet if treating the gum disease would decrease risk of these other diseases."

The report was published Dec. 21 in the journal Cancer Epidemiology, Biomarkers & Prevention.

Dr. Ashish Sahasra, an orthodontist in Garden City, N.Y., said, "This is going to open a lot of people's eyes to the potential link between gum disease and breast cancer."

Periodontal disease can cause many health problems, he said. "Gum disease is very common, and sometimes it goes undiagnosed or misdiagnosed and many people don't pay attention to it, but it's a serious disease that needs to be treated immediately," he added.

For the study, Freudenheim and her colleagues collected data on nearly 74,000 postmenopausal women who took part in the Women's Health Initiative study. None of the women had a history of breast cancer. After an average follow-up of almost seven years, more than 2,000 women were diagnosed with breast cancer.

The researchers found that women who were smoking at the time of the study appeared to have a 32 percent higher risk for breast cancer if they had gum disease, but the association was not statistically significant, Freudenheim said, because there weren't many current smokers among the women in the study. Among women who had quit smoking sometime within the past 20 years, those with gum disease seemed to have a 36 percent higher risk of breast cancer.

In addition, women who had never smoked but had gum disease seemed to have a 6 percent increased risk of developing breast cancer, and those who had quit more than 20 years before and had gum disease had an 8 percent higher risk, the study suggested.

Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City, said, "Although there is a possibility that there is a direct link between gum disease and an increased risk of breast cancer, this study does not prove a direct link."

More study needs to be done to see if inflammatory factors such as gum disease contribute to the development of breast cancer, she said.

"Women with gum disease may lead lives that are less healthy overall, such as eating poorly, not exercising and drinking excessively," Bernik explained.

Dr. Leonard Lichtenfeld, deputy chief medical officer for the American Cancer Society, said, "We have to be cautious about putting too much emphasis on this study, but look at it in the context of overall health." Gum disease might be a sign of overall poor health and not the specific cause of breast cancer, he said.

SOURCES: Jo Freudenheim, Ph.D., professor, epidemiology, School of Public Health and Health Professions, University at Buffalo, New York; Stephanie Bernik, M.D., chief, surgical oncology, Lenox Hill Hospital, New York City; Ashish Sahasra D.M.D., orthodontist, Garden City, N.Y.;Leonard Lichtenfeld, M.D., deputy chief medical officer, American Cancer Society; Dec. 21, 2015, Cancer Epidemiology, Biomarkers & Prevention

Sudden Cardiac Arrest May Not Be So Sudden

Sudden cardiac arrest may not be as sudden as doctors have thought, researchers report.

Roughly half of cardiac arrest patients experience telltale warning signs that their heart is in danger of stopping in the month preceding their attack, new study findings suggest.

Those symptoms can include any combination of chest pain and pressure, shortness of breath, heart palpitations, and flu-like sensations (such as nausea, back pain and/or abdominal pain), the researchers said.

The problem: less than one in five of those who experience symptoms actually reach out for potentially lifesaving emergency medical assistance, the investigators found.

"Most people who have a sudden cardiac arrest will not make it out alive," warned study co-author Dr. Sumeet Chugh, associate director of the Heart Institute and director of the Heart Rhythm Center at Cedars-Sinai Medical Center in Los Angeles. "This is the ultimate heart disease, where you die within 10 minutes. And less than 10 percent actually survive," he said.

"For years we have thought that this is a very sudden process," Chugh added. "But with this study we unexpectedly found that at least half of the patients had a least some warning signs in the weeks before. And this is important, because those who react by calling their loved ones or calling 911 have a fivefold higher chance of living. So, this may open up a whole new paradigm as to how we may be able to nip this problem in the bud before a cardiac arrest even happens."

Chugh and his colleagues published their findings in the Jan. 5 issue of the Annals of Internal Medicine.

Though many people use the terms interchangeably, cardiac arrest is not the same as a heart attack. While a heart attack results from arterial blockage that cuts off blood flow to the heart, a cardiac arrest occurs when the heart's electrical activity goes awry and the heart stops working.

Upwards of half of all heart-related deaths in the United States occur as the result of cardiac arrest, killing 350,000 Americans every year, the study authors noted.

The new study focused on nearly 840 patients, aged 35 to 65, whose symptoms were tracked prior to experiencing a cardiac arrest between 2002 and 2012. Three-quarters were men, and all were enrolled in an ongoing study in Oregon.

The result: 50 percent of men and 53 percent of women experienced at least some warning symptoms before their hearts stopped.

Chest pain, said Chugh, was the most common symptom among men, while shortness of breath was the most common among women.

More than nine in 10 of those who had symptoms said they resurfaced 24 hours before their cardiac arrest, according to the study.

But only 19 percent called 911. Those who did were more likely to have a history of heart disease or chest pain that wouldn't subside.

The upside: nearly one-third of those who called 911 survived, versus 6 percent among those who did not, the researchers reported.

"It's not that everyone with chest pain is going to get a cardiac arrest," stressed Chugh. "It could just be too much exercise or heartburn."

But for people with a history of heart disease, it is more likely that these symptoms signal a real problem, he added.

"Still, this is our first foray into symptom identification," Chugh said. "We cannot yet say what patients should do until we look into this further."

Nevertheless, Dr. John Day, president of the Heart Rhythm Society and director of Heart Rhythm Services at Intermountain Medical Center Heart Institute in Murray, Utah, described the study findings as a "wake-up call for patients and doctors."

Day said that "the problem, of course, is that many of these symptoms may have other explanations. Flu-like symptoms, which can affect nearly everybody at some point during the winter, is a vague thing to really put your finger on and know that it's about your heart. So it's certainly challenging to find the right signal through all the noise," he added.

"But these signs should not be ignored," Day said. "Particularly if you have risk factors for heart disease, such as a family history of heart problems or high blood pressure, cholesterol, diabetes or a known heart condition."

SOURCES: Sumeet Chugh, M.D., associate director, Heart Institute, and director, Heart Rhythm Center, Cedars-Sinai Medical, Los Angeles; John Day, M.D., president, Heart Rhythm Society, and director, Heart Rhythm Services, Intermountain Medical Center Heart Institute, Murray, Utah; Jan. 5, 2016, Annals of Internal Medicine

Being 'Fat But Fit' Won't Cut Your Risk of Premature Death

New research seems to contradict the idea that people might escape the health hazards associated with obesity if they're "fat but fit."

The new study suggests that the health benefits of physical fitness are offset by obesity. No matter their fitness level, normal-weight men had a lower risk of dying during the study than did the most physically fit obese men, the researchers said.

Still, it's important to note that the study wasn't designed to prove a cause-and-effect relationship. This type of study can only show a link between physical fitness and the risk of premature death.

Findings were published in the Dec. 20 issue of the International Journal of Epidemiology.

The study included more than 1.3 million Swedish men. Their health was followed for an average of almost 30 years, according to the researchers, led by Peter Nordstrom from Umea University in Sweden.

To measure aerobic fitness, the men rode an exercise bicycle until they were too tired to continue.

The men in the top 20 percent of aerobic fitness had a 48 percent lower risk of death from any cause during the study period compared with those in the bottom 20 percent, the investigators found.

However, the beneficial effects of physical fitness decreased as obesity increased, the researchers said. And, for the most obese, even the highest levels of physical fitness couldn't provide health benefits to offset the risks from obesity.

The study authors concluded that being "fat but fit" still poses health risks.

SOURCE: International Journal of Epidemiology, news release, Dec. 20, 2015

U.S. Task Force Stays Neutral on Cholesterol Screening for Kids

There's not enough evidence to recommend screening all children and teens for high cholesterol, experts say.

It's not clear if such screening up to age 20 reduces the risk of cardiovascular disease in adulthood, the U.S. Preventive Services Task Force said in a draft recommendation released Monday. This is unchanged from a 2007 recommendation.

"There is currently not enough research to determine whether screening all average-risk children and adolescents without symptoms leads to better cardiovascular health in adulthood," task force vice chair Dr. David Grossman said in a news release from the task force.

"In addition, the potential harms of long-term use of cholesterol-lowering medication by children and adolescents are not yet understood," Grossman added.

The task force is an independent, volunteer panel of national experts in prevention and evidence-based medicine.

All children and teens should eat a healthy diet, exercise and maintain a normal weight, the task force advised.

"The task force recognizes the importance of cardiovascular health for young people and calls for more research on the benefits and harms of screening and treating young people for high cholesterol," task force member Dr. Douglas Owens said in the news release.

SOURCE: U.S. Preventive Services Task Force, news release, Dec. 21, 2015

HealthDay

Newest miracle food may be avocado, which has potential cancer-busting properties

First it was blueberries. Then the tart, deep red seeds of pomegranates. Now it's avocado's turn in the spotlight.Long revered as a superfood with good vitamin and fat content, the fleshy green fruit is being used in the development of a drug that researchers hope will one day be able to fight blood cancer.

In a study published in the journal Cancer Research, Paul Spagnuolo, a professor at the University of Waterloo in Ontario, Canada, writes of a fat in avocados that combats acute myeloid leukemia (AML), a rare and deadly form of cancer, by targeting leukemia stem cells while leaving healthy cells unharmed
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Newest miracle food may be avocado, which has potential cancer-busting properties

First it was blueberries. Then the tart, deep red seeds of pomegranates. Now it's avocado's turn in the spotlight.

Long revered as a superfood with good vitamin and fat content, the fleshy green fruit is being used in the development of a drug that researchers hope will one day be able to fight blood cancer.

In a study published in the journal Cancer Research, Paul Spagnuolo, a professor at the University of Waterloo in Ontario, Canada, writes of a fat in avocados that combats acute myeloid leukemia (AML), a rare and deadly form of cancer, by targeting leukemia stem cells while leaving healthy cells unharmed.

“The stem cell is really the cell that drives the disease,” Spagnuolo said in a statement accompanying the publication of the study, explaining that the continued presence of those cells is why so many patients with leukemia relapse.

The prognosis for AML patients is devastating because there are few treatment options. For 90 percent of those who are older than 65, the disease is fatal in five years. Spagnuolo hopes a new drug made from avocatin B -- the name of the lipid that has been shown to destroy leukemia stem cells -- may help increase their life expectancy or quality of life.

A drug for leukemia derived from avocados is still years away, but even those without cancer can still benefit from the food.

Past studies have shown that eating a lot of avocados is associated with lower blood cholesterol. In one study that involved putting people with slightly elevated levels on a diet rich in avocados for just seven days, researchers saw a 17 percent decrease in cholesterol levels.

http://www.washingtonpost.com/news/to-your-health/wp/2015/06/18/newest-miracle-food-is-avocado-which-has-potential-cancer-busting-properties/