ACTIVITY IN OLDER ADULTS HELPS REVERSE NEURODEGENERATION IN THOSE WITH MILD MENTAL DECLINES

A new small study suggests starting an exercise program helps protect older adults' brains from deterioration and can even help to reverse some early mental decline.  In the study, researchers placed 34 inactive persons, aged 61-88, on an exercise program that consisted of moderate-intensity treadmill walking four times a week for 12 weeks.

By the end of the study period, cardiorespiratory fitness improved on average by 8%.  MRI scans of the brain  revealed an increase in the thickness of participants' cerebral cortex, the outer layer of the brain critical in cognitive function. Shrinkage of the brain's cortical layer is a marker of Alzheimer's disease progression and decline in cortex volume correlates closely with cognitive impairment.  Notably, researchers found those with the greatest improvements in physical fitness exhibited the most cerebral cortex growth. While both the healthy and cognitively impaired participants showed increases in cortex thickness, the impaired individuals had greater improvements in two specific regions of the cortex known to be especially effected by Alzheimer's disease.  Brain growth was also positively correlated with improvements in memory recall. Previous research by the same team has also shown moderate intensity physical activity, helps to stave off shrinkage of the hippocampus which is located near the center of the brain and is associated with long-term memory and spatial navigation.

What to do:  It's never too late to get moving!  Improved fitness pays off at all stages of life and for nearly all aspects of our physiology.  And, it looks like we do not have to become a gym rat to realize these benefits.  Getting a half-hour of moderate activity such as brisk walking four times per week demands a relatively modest time commitment and is realistic for individuals over a range of fitness levels.  So, start moving more.  Your body, mind, and mood will thank you.

Adapted from articles available at:

https://www.nlm.nih.gov/medlineplus/news/fullstory_155965.html

http://www.sciencedaily.com/releases/2015/11/151119113458.htm

Source:

Reiter K, Nielson KA, Smith TJ et al.  Improved cardiorespiratory fitness is associated with increased cortical thickness in mild cognitive impairment. Journal of the International Neuropsychological Society. 2015; 21 (10): 757.  DOI: 10.1017/S135561771500079X

     

EVEN AT HEALTHY WEIGHT EXCESS BELLY FAT INCREASES RISK OF PREMATURE DEATH

New research indicates normal weight people with excess fat around the waistline appear to be at higher risk of early death than overweight or obese people.  Previous research has definitively found that overweight and obese persons with central obesity (defined as a waist greater than 40 inches in men and a waist over 35 inches in women) are at increased risk of heart disease, stroke, and diabetes but it has not been well understood the extent to which an apple shape body type in a normal weight individual increases chronic disease risk.

The study was based on data from a national survey of 15,000 adults ages 18 to 90.  Participants’ weight, hip and waist measurements were measured periodically over 14 years.  At every BMI level, people with thicker middles had a higher risk of death than those with trimmer waists.  Notably, normal weight adults with central obesity had the worst long-term survival.  Normal weight women with abdominal obesity were 32% more likely to die over the study period than overweight/obese women with a pear-shaped body type and for men those with normal weight but central obesity were 87% more likely to die.   

Why is central obesity, even at normal weight so deadly?  Centrally located fat often accumulates inside the abdomen around organs such as the liver, pancreas and intestines.  This internal fat (known as visceral fat) interferes with the proper functioning of these organs, impacting blood cholesterol and the sensitivity of the body to insulin.  Visceral fat also leads to an increase in leptin, the hormone that normally functions to signal our brains that we are full.  Unfortunately, because elevated visceral fat releases an excess of leptin, the brain stops responding to leptin so that individuals do not feel full and are likely to overeat, precipitating greater weight gain around the middle.

What to do:  Measure your waist to assess your risk.  Check out our website (www.nycheartcenter.com) for detailed directions on how to measure waist size.  If yours is greater than 40 inches for men or 35 inches for women, work on losing weight.  Contrary to common perception, doing abdominal exercises will build muscle in the abdominal region but will not reduce fat around the middle. The best way to lose abdominal fat is to avoid smoking and excessive alcohol consumption, to consume a healthy calorie-controlled Mediterranean-style diet (i.e. a diet rich in plant foods and plant-based fats and low in refined carbohydrates) and to do regular, preferably vigorous, cardiovascular activity.  Fortunately, cardiovascular activity appears to preferentially mobilize visceral abdominal fat.   

Sources:

Poirier P. The many paradoxes of our modern world: Is there really an obesity paradox or is it only a matter of adiposity assessment?. Annals of Internal Medicine. 2015;163:880-881. DOI:10.7326/M15-2435

Sahakyan KR, Somers VK, Rodriguez-Escudero JP, et al.  Normal-weight central obesity: Implications for total and cardiovascular mortality. Annals of Internal Medicine. 2015;163:827-835. DOI:10.7326/M14-2525

Adapted from articles available at:

http://consumer.healthday.com/vitamins-and-nutrition-information-27/obesity-health-news-505/belly-fat-can-up-risk-of-early-death-even-in-normal-weight-folks-705093.html

http://www.theatlantic.com/health/archive/2015/11/the-health-dangers-of-a-spare-tire/415194/

https://www.washingtonpost.com/national/health-science/even-if-youre-thin-excess-belly-fat-can-raise-your-death-risk/2015/11/16/516df774-87ca-11e5-9a07-453018f9a0ec_story.html

http://health.usnews.com/health-news/articles/2015/11/09/belly-fat-is-bad-even-at-a-normal-weight

THE SKINNY ON HOLIDAY WEIGHT GAIN

From Thanksgiving to the New Year’s Eve toast, the opportunities to overindulge are nearly endless. There is a common misconception that holidays are so infrequent that eating done only on special occasions doesn't matter. But, the celebrations can add up with parties, work events and family gatherings.  And several high calorie days can significantly derail your weight management goals.  For example, on Thanksgiving, the average American consumes 4,500 calories and 229 grams of fat. That's at least 2-3 times what one needs to eat in one day.  The average holiday weight gain is 1-2 lbs.   A pound is not so much, but people tend to not lose the weight when the holidays are over so it adds up over time.  Also, while the average for the general population is just 1 pound gain, for those who are obese, average weight gain is 4-6 lbs.

Enjoying the food is a big part of enjoying the holidays, but it doesn’t have to add inches to your waistline. It is possible to eat foods traditionally associated with holiday celebrations and to stick with a weight-loss plan.  Try to maintain a clear idea about your weight goals during the holiday season and don't let small setbacks completely derail progress.  The following tips can also help to prevent holiday weight gain.

Minimize mindless munching - Nibbling before and after a big holiday meal is a sure way to add significant calories. Between the eggnog, cheese ball, homemade cookies and candy, it’s easy to top 1,000 calories before sitting down to dinner. What to do? Survey the culinary landscape and decide what you really want. Keep the portion reasonable and then leave the food table.  Also, beware the baskets, tins and trays of treats that frequently appear in the workplace around this time of year.  Try to see these foods as not yours and avoid them altogether.  Or, save one treat from the selections for the end of the day.  Be mindful of your choices and honest with yourself about your decisions.

Enjoy the turkey, but don’t gobble - Life is so full of rushing, we forget that we can slow down and enjoy our food.  Truly savor the rich pleasure of the foods you don’t get every day. Let the food linger on your tongue. You may discover a sense of satisfaction with half your typical portions when you take time to slow down and enjoy the food you’re eating.

Portion control, portion control, portion control - Make those special, holiday-only foods manageable by savoring them slowly in limited portion sizes.  Skip the items that you do not really care about.  It can also be helpful to plan ahead for a dinnertime celebration by having a lighter breakfast and lunch that day, but do not skip meals as that often leads to overeating later.  To control daily calories in the face of frequent celebrations, some people find it helpful to substitute a calorie-controlled meal replacement for 1-2 meals per day during the holiday season.

Plan ahead & make wise choices - Plan ahead before heading to a holiday gathering or party.  Know what will be served and figure out what it is you really want and if it’s worth the calories.  If you can live without your mother’s pumpkin pie but not her sausage stuffing, then have some stuffing.  The same goes for a holiday buffet: scan the table first before filling your plate and decide which foods you can live without. Choose small portions of the foods you want to enjoy, filling your plate once.  If you’re asked to bring something to a gathering, try bringing something healthy, like veggies and low-fat dip, instead of cookies.  That way, if there are leftovers, you will go home with a healthy option rather than problem treat.

Use high-protein and high-fiber foods to your advantage - Lean meats, poultry, fish and green vegetables can help you feel full when you’re hungry without adding a burdensome load of calories. To avoid going to a holiday party too hungry — eat something high in fiber and/or protein before heading out.  Have ready-to-eat veggies with hummus, a cheese stick with fruit, a Greek yogurt cup, or a small portion of fiber rich cereal to help curb your hunger. 

Beware of liquid calories - Being aware of the calories you’re drinking during the holiday season is also important to maintain a healthy weight. A cup of regular eggnog can have up to 500 calories and that Starbucks white hot chocolate with whipped cream will cost you even more. Factor in alcohol, sugar-loaded punch drinks, hot cider and more and see how liquid calories add up. What to do? Choose “light” or “diet” drinks and drink lots of water. Choose hot tea or coffee in place of hot chocolate or cider.  Alcohol not only provides empty calories but it decreases one's resolve to stick to an eating plan, so use moderation when it comes to drinking. Diluting wine with club soda can make a tasty wine spritzer that has less alcohol and less calories. 

Channel your inner-Santa in non-food ways - It can also be helpful to channel your holiday spirit in ways that are not focused on food.  For example, to add activity, consider celebrating the season by going skating or going for a holiday lights walk.  Decorating, crafts, and gift giving can also satisfy the homemaker in you without running the risk of exposing you to more homemade treats. And, if you are determined to bake consider giving friends with dogs homemade pet biscuits rather than items you might be tempted to sample.  

Keep moving - Don't slow down or stop physical activity during the busy holiday months. Instead, try to maintain or even increase activity and exercise levels to compensate for additional caloric intake.  On holidays with big meals, try to get active in the morning.  Go outside with the kids to toss the football around, grab your music and take a brisk walk, or prepare for your mall shopping by doing some determined walking laps around the space first. Simply moving more can help burn off extra calories, moderate some of the negative metabolic effects of overeating, tone your muscles, and work off some of the holiday stress.

TREATING INSULIN RESISTANCE MAY IMPROVE DEPRESSION

In a new small experimental trial, researchers found that the diabetes drug pioglitazone (Actos), which makes the body more sensitive to insulin, helped relieve symptoms of chronic depression in people with insulin resistance.  These results add to growing evidence of a connection between insulin resistance — the body’s inability to efficiently process glucose, even with adequate insulin production in the pancreas — and mood disorders.  Insulin’s important role in brain function is well-documented.  Brain cells, unlike many other cells, can only use glucose for fuel and the brain accounts for one-fifth of all glucose use in an active human being.   So, it makes sense that impaired glucose uptake due to insulin resistance would affect many pivotal processes in the brain.

Insulin resistance is often a precursor to type 2 diabetes.  Normally, when food is consumed, blood sugar levels in the body increase, and, in response, insulin is released by the pancreas, signaling the cells to take up the glucose and use it for food.  However, the cells of people with insulin resistance fail to take up glucose adequately, causing blood sugar to stay elevated longer than normal.  This increases inflammation in the body and, if unchecked, leads to type 2 diabetes. 

The 12-week study involved both insulin sensitive and insulin resistant patients whose symptoms of depression had failed to improve substantially, despite treatment.  Half the participants were randomly selected to receive treatment with pioglitazone while the other half received a placebo.  Throughout the study, patients’ levels of depression and insulin resistance were monitored. Researchers found the insulin resistant patients on pioglitazone showed significantly improved depressive symptoms while those on the placebo did not.  Also, the more insulin resistant a participant was at the beginning of the study, the better the drug’s antidepressant effect.

What to do:  Excess weight and inactivity are potent risk factors for insulin resistance.  Even though your fasting glucose may be normal you may still have insulin resistance.  Discuss being screened for insulin resistance with your healthcare provider.  Checking hemoglobin A1C in bloodwork is one way to screen for the presence of insulin resistance.  Whether drugs for insulin resistance are a safe, effective way to treat depression in insulin resistant individuals remains to be seen but, in the meantime, weight loss and regular cardiovascular activity are two sure fire means of reducing insulin resistance.  And, there is also plenty of evidence that healthier weight and activity are both supportive of mood.   

Source:

Lin KW, Wroolie TE, Robakis T, & Rasgon NL.  Adjuvant pioglitazone for unremitted depression: Clinical correlates of treatment response.  Psychiatry Research. Published online ahead of print October 12, 2015. DOI: http://dx.doi.org/10.1016/j.psychres.2015.10.013

Adapted from articles available at:

http://med.stanford.edu/news/all-news/2015/11/insulin-sensitizing-drug-relieves-symptoms-of-chronic-depression.html

http://www.medscape.com/viewarticle/854618

https://www.nlm.nih.gov/medlineplus/news/fullstory_155792.html

DIET RICH IN ORANGE & DARK GREEN VEGGIES DECREASES RISK OF MACULAR DEGENERATION

A recent analysis tracking more than 100,000 individuals for over 20 years has found that persons who consume a diet rich in orange and dark green vegetables have lower rates of severe age-related macular degeneration (AMD).  AMD, in which the center part of the retina fails, is one of the most common causes of vision loss.  In previous studies, carotenoids, the pigments responsible for the bright orange and dark green colors of vegetables and fruits have been linked to fewer age-related vision problems.

In this recent analysis researchers tracked the dietary patterns and health outcomes of adults age 50 and older.  They found  people who consumed vegetables rich in phyto-pigments lutein and zeaxanthin most frequently, had a 40% lower risk of advanced AMD compared to those who consumed these foods least frequently.  Those consuming a diet highest in pigments cryptoxanthin, alpha carotene, and beta carotene had a 35% decreased risk of advanced AMD.  The researchers noted that carotenoids such as lutein, zeaxanthin, and others concentrate in the macula, where they are thought to help protect it from the harmful effects of oxygen and sunlight.

What to do:  Consume a diet rich in a variety of fruits and vegetables.  The foods highest in lutein and zeaxanthin  include  winter and summer squash, peas, corn, beet greens, pumpkin, Brussels sprouts, broccoli, spinach, romaine, kale, asparagus, goji berries, and carrots.  Rich food sources of cryptoxanthin and alpha- and beta-carotene are generally orange including carrots, orange & red peppers, sweet potatoes, pumpkins, winter squash, papayas, and tangerines.

Adapted from article available at:

https://www.nlm.nih.gov/medlineplus/news/fullstory_155057.html

Source:

Wu J, Cho E, Willett WC, Sastry SM, & Schaumberg DA. Intakes of lutein, zeaxanthin, and other carotenoids and age-related macular degeneration during 2 decades of prospective follow-up.  JAMA Ophthalmology. Published online ahead of print October 08, 2015. DOI:10.1001/jamaophthalmol.2015.3590.

HIGH FIBER MEDITERRANEAN DIET PROMOTES HEALTHY GUT BACTERIA & BETTER HEART HEALTH

Numerous studies have found the Mediterranean diet and other plant-rich dietary patterns are beneficial to heart health.  The Mediterranean diet is plentiful in fruits, vegetables, legumes, nuts and whole grains; moderately high in olive oil and fish; and low in red meat, sweets, and dairy products.  An interesting recent study reveals one way that Mediterranean-style diet is beneficial is that it boosts gut bacteria production of short-chain fatty acids (SCFA’s).  These are the preferred fuel of our intestinal cells and higher levels have been found to decrease systemic inflammation and improve immune function.  SCFA’s are associated with better cardiovascular and metabolic health, lower rates of insulin resistance and diabetes, decreases in the risk for autoimmune diseases, and decreases in the risk of colon cancer.

The study of 153 adults tracked dietary intake and levels of gut bacteria and their metabolites in stool and urine.  Researchers found a clear pattern of higher SCFA levels in those who consumed more fiber-rich foods, especially those consuming plenty of beans. Participants whose diet most closely resembled the Mediterranean diet, whether vegan, vegetarian, or omnivore, had the highest levels of SCFA production.  Interestingly, vegan diets were the diet that most frequently resembled the Mediterranean diet.   

The study also showed that vegans or vegetarians had the lowest levels of a gut bacterial metabolite called trimethylamine oxide (TMAO).  Eggs, beef, pork and fish are the primary sources of carnitine and choline--compounds that are converted by gut microbes into trimethylamine, which is then processed by the liver and released into the circulation as TMAO.  TMAO levels appear to increase heart disease risk.  Among non-vegetarians, people who adhered to the Mediterranean diet also had relatively low TMAO levels.  

What to do:  Eat more fiber rich foods.  Fruits, vegetables, whole grains, nuts, and beans are all fantastic sources of dietary fiber.  Typically, our first consideration when planning a meal is the protein option (usually fish, chicken, or meat).  Instead, try meal planning by first considering the vegetable component.  Aim to make half your plate vegetables.  Also, beans and nuts are easily added to a variety of dishes, so mix things up a bit and add them in your favorite dishes to give your fiber intake a healthy boost.

Sources:

Filippis F, Pellegrini N, Vannini L, et al.  High-level adherence to a Mediterranean diet beneficially impacts the gut microbiota and associated metabolome. Gut.  2015, published online ahead of print September 28, 2015. DOI: 10.1136/gutjnl-2015-309957

Den Besten G, Van Eunen K, Groen AK, et al.  The role of short-chain fatty acids in the interplay between diet, gut microbiota, and host energy metabolism.  Journal of Lipid Research. 2013;54(9):2325-2340. DOI:10.1194/jlr.R036012.

Adapted from articles available at:

http://www.sciencedaily.com/releases/2015/09/150929070122.ht

http://consumer.healthday.com/vitamins-and-nutrition-information-27/dietary-fiber-health-news-308/high-fiber-foods-gut-release-batch-1955-703617.html

ANOTHER REASON TO QUIT: SMOKING AND SECOND-HAND SMOKE INCREASE DIABETES RISK

The links between smoking and increased risk for cancer and respiratory and cardiovascular disease are well-known, but the association between smoking and diabetes has received less attention.  A new analysis of 88 existing studies that included almost six million people has found that current smokers and people exposed to secondhand smoke have a significantly increased risk of developing type 2 diabetes.  The good news is that after quitting, over time the risk for diabetes decreases. 

The study found a dose-response relationship between smoking and diabetes risk. Compared with those who have never smoked, light smokers have a 21% increased risk of type 2 diabetes, moderate smokers have a 34% increased risk, and heavy smokers have a 57% increased risk.  Those who do not smoke but are regularly exposed to second hand smoke have a 22% increased risk of type 2 diabetes.  Diabetes risk among quitters does substantially decline over time.  Among those who quit within the past 5 to 9 years their increased risk falls to 18% and among those who have quit a decade ago or more saw their smoking related diabetes risk fall to 11%.   

What to do:  If you smoke, try to quit.  Previous unsuccessful efforts to quit do not mean that you cannot succeed.  Keep trying.  Discuss smoking cessation treatment options with your healthcare provider.  Check out www.nyc.gov/nycquits or call x311 to learn about the many free resources available including local tobacco cessation programs & support groups, and free nicotine patches.

Adapted from articles available at:

https://www.nlm.nih.gov/medlineplus/news/fullstory_154711.html

http://www.medscape.com/viewarticle/851298

Sources:

Pan A, Wang Y, Talaei M.  Relation of active, passive, and quitting smoking with incident type 2 diabetes: a systematic review and meta-analysis. The Lancet:  Diabetes & Endocrinology.  Published online ahead of print Sept. 17, 2015. DOI: http://dx.doi.org/10.1016/S2213-8587(15)00316-2.