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21. Todays Videos

More than one third of adults have multiple health problems in midlife

University College London, July 28, 2021

More than one in three British adults are suffering from two or more chronic health conditions in middle age, such as recurrent back problems, mental ill-health, high blood pressure, diabetes, and high-risk drinking, according to UCL researchers.

The new study, published in BMC Public Health, shows that among Generation X—adults born in 1970—those who grew up in poorer families are at much greater risk of having multiple long-term health problems in their late 40s. The research also reveals an association between physical and mental health conditions in childhood and adolescence, and chronic health problems in middle age.

Lead author, Dr. Dawid Gondek (UCL Department of Epidemiology & Public Health) said: “This study provides concerning new evidence about the state of the nation’s health in midlife. It shows that a substantial proportion of the population are already suffering from multiple long-term physical and mental health problems in their late 40s, and also points to stark health inequalities which appear to begin early in childhood.”

The researchers analyzed data collected from a nationally representative group of around 8,000 British adults who have participated in the 1970 British Cohort Study (BCS70) since they were born, more than 50 years ago. At age 46-48, in 2016-18, they took part in a biomedical survey, where nurses measured their blood pressure and took a blood sample to check for diabetes. Participants were asked to report whether they had various chronic physical health conditions, such as recurrent back problems, asthma, heart problems, and arthritis. Mental health and high-risk drinking were also assessed, using separate questionnaires.

At age 46–48, 34% of adults had multiple chronic health problems, with more than a quarter (26%) engaged in high-risk drinking, more than one in five (21%) reporting recurrent back issues, and just under a fifth (19%) experiencing mental health problems. One in six (16%) had high blood pressure, more than one in 10 (12%) were suffering from asthma or bronchitis, one in 13 (8%) had arthritis and one in 20 (5%) had diabetes in midlife.

The study also revealed the most common combinations of chronic health conditions experienced by adults in middle age. More than 4% had mental ill-health and high blood pressure, 3% suffered from mental health problems and asthma, 2.5% had mental ill-health and arthritis and 2% had diabetes and high blood pressure.

The research team used the rich longitudinal data collected from study participants throughout their lives to investigate the links between family background, cognitive development and health in childhood and adolescence, and physical and mental health in midlife.

They found that adults from the poorest families were at 43% greater risk of having multiple long-term health conditions in midlife compared to those from the most privileged families. They had almost three and half times higher risk of suffering from mental ill-health and arthritis, and around three times the risk of having poor mental health and high blood pressure in their late 40s.

Lower birthweight, higher body mass index and lower cognitive ability at age 10, and worse emotional and conduct issues at age 16 were all linked with increased risk of having multiple chronic health problems in middle age.

Dr. Gondek said: “Compared to previous generations, it appears that the health of British adults in midlife is on the decline. With earlier studies finding links between poor health in adulthood and lower life satisfaction, lower earnings and early retirement, public health guidance should focus on helping the population improve their health in midlife so they can age better, stay economically active and continue to lead fulfilling lives.”

Professor George Ploubidis (UCL Center for Longitudinal Studies) added: “Thanks to longitudinal data collected from across five decades of our study participants’ lives, we can show the long-lasting links between childhood and adolescence and midlife health. We found that adults from the most disadvantaged backgrounds, those who had been overweight or obese as children and those who had experienced mental ill-health as teenagers were all at increased risk of poor health later on.

“If these links reflect causal effects, policy and practice targeting these core areas in childhood and adolescence may improve the health of future generations and alleviate potential pressures on the NHS.”

As this is an observational study, researchers did not control what the participants were exposed to. Instead, they observed what happened to the different groups of people without intervening. The authors were able to use detailed data to account for a range of factors that may have influenced the link between early life characteristics and midlife health. However, it would be impossible to rule out every influence with absolute certainty.

Millet based diet can lower risk of type 2 diabetes and help manage blood glucose levels

International Crops Research Institute, July 29, 2021

A new study has shown that eating millets can reduce the risk of developing type 2 diabetes and helps manage blood glucose levels in people with diabetes, indicating the potential to design appropriate meals with millets for diabetic and pre-diabetic people as well as for non-diabetic people as a preventive approach.

Drawing on research from 11 countries, the study published in Frontiers in Nutritionshows that diabetic people who consumed millet as part of their daily diet saw their blood glucose levels drop 12-15% (fasting and post-meal), and blood glucose levels went from diabetic to pre-diabetes levels. The HbA1c (blood glucose bound to hemoglobin) levels lowered on average 17% for pre-diabetic individuals, and the levels went from pre-diabetic to normal status. These findings affirm that eating millets can lead to a better glycemic response.

The authors reviewed 80 published studies on humans of which 65 were eligible for a meta-analysis involving about 1,000 human subjects, making this analysis the largest systematic review on the topic to date. “No one knew there were so many scientific studies undertaken on millets’ effect on diabetes and these benefits were often contested. This systematic review of the studies published in scientific journals has proven that millets can keep blood glucose levels in check and reduce the risk of diabetes. It has also shown just how well these smart foods do it,” said Dr. S Anitha, the study’s lead author and a Senior Nutrition Scientist at ICRISAT.

Millets, including sorghum, were consumed as staple cereals in many parts of the world until half a century ago. Investments in a few crops such as rice, wheat and maize, have edged nutritious and climate-smart crops like millets out of the plate.

“Awareness of this ancient grain is just starting to spread globally, and our review shows millets having a promising role in managing and preventing type 2 diabetes. In the largest review and analysis of research into different types of millet compared to other grains such as refined rice, maize and wheat we found that millets outperform their comparison crops with lower GI and lower blood glucose levels in participants,” observed Professor Ian Givens, a co-author of the study and Director at University of Reading’s Institute of Food, Nutrition and Health (IFNH) in the UK.

According to the International Diabetes Association, diabetes is increasing in all regions of the world. India, China and the USA have the highest numbers of people with diabetes. Africa has the largest forecasted increase of 143% from 2019 to 2045, the Middle East and North Africa 96% and South East Asia 74%. The authors urge the diversification of staples with millets to keep diabetes in check, especially across Asia and Africa.

Strengthening the case for reintroducing millets as staples, the study found that millets have a low average glycemic index (GI) of 52.7, about 36% lower GI than milled rice and refined wheat, and about 14-37 GI points lower compared to maize. All 11 types of millets studied could be defined as either low (<55) or medium (55-69) GI, with the GI as an indicator of how much and how soon a food increases blood sugar level. The review concluded that even after boiling, baking and steaming (most common ways of cooking grains) millets had lower GI than rice, wheat and maize.

“Millets are grown on all inhabited continents, yet they remain a ‘forgotten food’. We hope this will change from 2023, when the world observes the United Nations declared International Year of Millets, and with studies like this that show that millets outperform white rice, maize and wheat,” said Ms. Rosemary Botha, a co-author of the study who was based in Malawi at the time of the study, with the International Food Policy Research Institute (IFPRI).

“The global health crisis of undernutrition and over-nutrition coexisting is a sign that our food systems need fixing. Greater diversity both on-farm and on-plate is the key to transforming food systems. On-farm diversity is a risk mitigating strategy for farmers in the face of climate change while on-plate diversity helps counter lifestyle diseases such as diabetes. Millets are part of the solution to mitigate the challenges associated with malnutrition, human health, natural resource degradation, and climate change. Trans-disciplinary research involving multiple stakeholders is required to create resilient, sustainable and nutritious food systems,” said Dr. Jacqueline Hughes, Director General, ICRISAT.

Professor Paul Inman, Pro-Vice-Chancellor (International) of the University of Reading, stressed that “The rapidly accelerating threats of climate change and global health crises, including obesity and diabetes, require everyone to pull together in action. The partnership between ICRISAT and the University of Reading is doing exactly this, bringing together our world leading expertise in human nutrition with ICRISAT’s long established role as a leader in agricultural research for rural development.”

The study also identified information gaps and highlighted a need for collaborations to have one major diabetes study covering all types of millets and all major ways of processing with consistent testing methodologies. Structured comprehensive information will be highly valuable globally, taking the scientific knowledge in this area to the highest level.

“This study is first in a series of studies that has been worked on for the last four years as a part of the Smart Food initiative led by ICRISAT that will be progressively released in 2021. Included are systematic reviews with meta-analyses of the impacts of millets on: diabetes, anemia and iron requirements, cholesterol and cardiovascular diseases and calcium deficiencies as well as a review on zinc levels. As part of this, ICRISAT and the Institute for Food Nutrition and Health at the University of Reading have formed a strategic partnership to research and promote the Smart Food vision of making our diets healthier, more sustainable on the environment and good for those who produce it,” explained Ms. Joanna Kane-Potaka, a co-author from ICRISAT and Executive Director of the Smart Food initiative.

Higher dietary total antioxidant capacity and diversity in younger, as compared to older, adults

Hacettepe University (Turkey), July 25, 2021

According to news reporting originating in Ankara, Turkey, by NewsRx journalists, research stated, “The present study aimed to assess the dietary total antioxidant capacity and diversity among older and younger adults. In total, 38 older adults aged >= 65 years and 38 younger adults aged between 19 and 30 years were included in the study.”

The news reporters obtained a quote from the research from Hacettepe University, “The participants’ general characteristics, dietary habits, and three-day dietary intake records were assessed. The dietary total antioxidant capacity and diversity score were calculated from the dietary intake records. Moreover, the serum total antioxidant capacity and oxidant status were assessed using commercial kits. The dietary diversity was greater among the younger adults than among the older adults (p < 0.05). According to the dietary total antioxidant capacity values calculated from various databases, in males, the lipophilic and total oxygen radical absorbance capacity values were significantly lower among the older adults than among the younger adults. In females, the hydrophilic and total oxygen radical absorbance capacity, total phenol, and ferric reducing antioxidant power values were significantly lower among the older adults than among the younger adults. The serum total oxidant status and oxidative stress index of the older adults were significantly higher than those of the younger adults (p < 0.05). Furthermore, the dietary diversity score and serum total antioxidant capacity were associated with the dietary total antioxidant capacity. With aging, the dietary total antioxidant capacity and diversity decrease, while the oxidative stress index increases.”

According to the news reporters, the research concluded: “Therefore, the consumption of foods with high antioxidant capacity and dietary diversity should be encouraged among older adults.”

This research has been peer-reviewed.

Older adults are happier when their space matches their personality

University of Texas, July 29, 2021

The old saying, “Home is where the heart is,” has some new science to back it up. A study has found photos of a person’s living space can accurately point at personality traits and the mood of the people who live there, especially as a person gets older.

For the study, scientists at The University of Texas at Austin studied 286 people over the age of 65. They took photographs of the rooms where the subjects spent the most time (typically the living room) and found that certain characteristics of a person’s personality were reflected in core elements of room décor. Applying the findings could help lead to happier lives, including for older adults with frailty or cognitive impairment that has led them to be transferred from their homes to long-term care facilities.

“People who have a match between personality and living space report better well-being, and they feel better about their life and have a better mood,” said Karen Fingerman, professor of human development and family sciences at The University of Texas at Austin and director of the Texas Aging and Longevity Center. “Home is where we can express ourselves.”

The researchers analyzed participants’ personalities and took photos of the room where each person spent the most time. As part of a first-of-its-kind study, independent examiners looked at the photos and rated characteristics of the room, such as brightness, cleanliness and newness. The results were published online in the journal The Gerontologist earlier this month.

Extraversion was expressed in room décor with newness of items in the room and cheerfulness of décor. This may come from a desire to make the room appealing to visiting friends and family, researchers said.

Conscientiousness was associated with newness and comfort. Because orderliness and organization are key components of that personality trait, that may explain the association.

Agreeableness, openness and neuroticism were not associated with room décor for everyone, scientists found. But openness was evident in the décor for older adults who live alone, suggesting that people who live with others may not have as much latitude to express their personalities in their room décor.

Importantly, when a living space matches the personality and preferences of the person who lives there, older adults reported enhanced well-being.

The goal for many older adults is to grow older in their own homes, but as they encountered functional limitations, such as not being able to walk or climb stairs, their homes became out-of-date, uncomfortable, dim and cluttered. Scientists said this may be because those adults have less energy to maintain their spaces.

Surprisingly, for adults with functional limitations, clutter was associated with fewer symptoms of depression.

“Clutter may represent an effort to exert control over the environment,” Fingerman said. “They may also wish to keep items close at hand to compensate for mobility issues.”

Researchers said this study suggests that older adults with functional limitationsmay benefit from a little help around the house, but cleaning and maintenance should be done in collaboration. What looks like clutter to one person may be an arrangement that makes an older adult more comfortable.

Long-term care facilities that allow for greater latitude in room décor to improve the mood of residents also may see benefits.

“There is no one ideal way to create a living space,” Fingerman said. “It has to match the person.”

Yijung K. Kim, Shiyang Zhang and Yee To Ng at UT Austin and Kira S. Birditt of the University of Michigan also contributed to the research. The research was funded by the National Institute on Aging and the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Study: Adding color to your plate may lower risk of cognitive decline

Harvard University, July 29, 2021

A new study shows that people who eat a diet that includes at least half a serving per day of foods high in flavonoids like strawberries, oranges, peppers and apples may have a 20% lower risk of cognitive decline. The research is published in the July 28, 2021, online issue of Neurology. The study looked at several types of flavonoids, and found that flavones and anthocyanins may have the most protective effect.

Flavonoids are naturally occurring compounds found in plants and are considered powerful antioxidants. It is thought that having too few antioxidants may play a role in cognitive decline as you age.

“There is mounting evidence suggesting flavonoids are powerhouses when it comes to preventing your thinking skills from declining as you get older,” said study author Walter Willett, MD, DrPH, of Harvard University in Boston, Mass. “Our results are exciting because they show that making simple changes to your diet could help prevent cognitive decline.”

The study looked at 49,493 women with an average age of 48 and 27,842 men with an average age of 51 at the start of the study. Over 20 years of follow up, people completed several questionnaires about how often they ate various foods. Their intake of different types of flavonoids was calculated by multiplying the flavonoidcontent of each food by its frequency. Study participants evaluated their own cognitive abilities twice during the study, using questions like, “Do you have more trouble than usual remembering recent events?” and “Do you have more trouble than usual remembering a short list of items?” This assessment captures early memory problems when people’s memory has worsened enough for them to notice, but not necessarily enough to be detected on a screening test.

The people in the group that represented the highest 20% of flavonoid consumers, on average, had about 600 milligrams (mg) in their diets each day, compared to the people in the lowest 20% of flavonoid consumers, who had about 150 mg in their diets each day. Strawberries, for example, have about 180 mg of flavonoids per 100 gram serving, while apples have about 113.

After adjusting for factors like age and total caloric intake, people who consumed more flavonoids in their diets reported lower risk of cognitive decline. The group of highest flavonoid consumers had 20% less risk of self-reported cognitive decline than the people in the lowest group.

Researchers also looked at individual flavonoids. Flavones, found in some spices and yellow or orange fruits and vegetables, had the strongest protective qualities, and were associated with a 38% reduction in risk of cognitive decline, which is the equivalent of being three to four years younger in age. Peppers have about 5 mg of flavones per 100 gram serving. Anthocyanins, found in blueberries, blackberries and cherries, were associated with a 24% reduced risk of cognitive decline. Blueberries have about 164 mg of anthocyanins per 100 gram serving.

“The people in our study who did the best over time ate an average of at least half a serving per day of foods like orange juice, oranges, peppers, celery, grapefruits, grapefruit juice, apples and pears,” Willett said. “While it is possible other phytochemicals are at work here, a colorful diet rich in flavonoids—and specifically flavones and anthocyanins—seems to be a good bet for promoting long-term brain health. And it’s never too late to start, because we saw those protective relationships whether people were consuming the flavonoids in their diet 20 years ago, or if they started incorporating them more recently.”

A limitation of the study is that participants reported on their diets and may not recall perfectly what they ate or how much.

Carotenoids lower lipid oxidation and DNA damage in middle-aged men

Federal University of Viçosa (Brazil), July 18, 2021

Daily carotenoid intake lowers lipid and oxidative stress markers in middle-aged men, say researchers.

The study looked at 296 healthy middle-aged men with an average age of 50.5 years and body mass index (BMI) of 25.8 kg/m2.

The researchers from the Federal University of Viçosa and the Federal University of São João del-Rei in Brazil looked at various biomarkers to assess the potential relationship between carotenoid intake and lipid and oxidative stress markers.

 They looked at five carotenoid types: b-cryptoxanthin, lycopene, lutein plus zeaxanthin, b-carotene and a-carotene. All carotenoids, particularly b-carotene, impacted the lipid and oxidative stress markers.

The results suggested a significant inverse association between non-esterified fatty acids (NEFA) and the consumption of lutein plus zeaxanthin, b-carotene, a-carotene and total carotenoid. While the other lipid marker used, the Castelli index, decreased as the daily intake of lycopene, b-carotene and total carotenoids increased.

The intakes were based on the results of a food frequency questionnaire on the participant’s habitual intakes from the previous six months.

The 105-items questionnaire included the food groups: milk and dairy products, fats, breads and bread substitutes, cereals, fruits, legumes, vegetables, meats, eggs, beverages and sweets.

Individuals using vitamin supplements were excluded.

Improved Natural Killer Cell Function with Seaweed Extract

New findings on how nori seaweed may enhance the immune system

Chonbuk National University Hospital (South Korea), June 19, 2021

Randomized, double-blind, placebo-controlled trial of 8-weeks duration. To determine if an extract of the seaweed Porphyra tenera (commonly known as nori or laver, and also referred to as Pyropia tenera) has measurable immune-enhancing effects and is safe in humansResults

NK-cell activity level in the PTE group increased at every dilution level versus baseline (E:T=12.5:1 P=0.0004; E:T=25:1 P=0.0034; and E:T=50:1 P=0.0055). There was no increase in NK-cell activity in the placebo group.

While there was a tendency for improved NK-cell activity in the intervention versus placebo group, this did not reach statistical significance.

There were no differences in the secondary outcome measure of cytokine concentrations after 8 weeks between the 2 groups.

Safety indicators showed there was no significant difference between the 2 groups in laboratory tests, electrocardiograms, or vital signs.

Adverse reactions: abdominal discomfort=1, heartburn=4, contact dermatitis=1, left knee pain=1, chronic dermatitis=1, trigger finger=1, increased liver enzyme function tests=1, burn on back of hand=1. Of all the adverse reactions reported, the researchers deemed 6 cases as possibly caused by the intervention.

Key Findings

The primary outcome measure, NK-cell activity, showed there was improvement in the intervention group versus their baseline but no significant difference between the intervention and placebo groups.

Of the evaluable 111 participants, the incidence of URI at week 8 was 10 cases. There was no difference in cases between the 2 groups.

This 8-week study of Porphyra tenera extract showed overall safety of the preparation.

Commentary

In this short study, the effects of the Porphyra tenera extract (PTE) suggest that it increases NK-cell function activity. There was, however, no increase in cytokines and, thus, no systemic immune augmentation. This may be due to the short time course or due to a true lack of stimulation of cytokines from PTE. The low incidence of URIs over the 8-week study is not surprising given that the researchers recruited healthy volunteers who met stringent criteria.

The seaweed Porphyra tenera is a red algae and 1 of 133 Porphyra species (Porphyra spp). Out of the 133 species, 6 of them are largely cultivated: Porphyra yezoensis, Porphyra tenera, Porphyra haitanensis, Porphyra pseudolinearis, Porphyra dentata, and Porphyra angusta. Referred to as “nori” in Japan, “gim” or “kim” in Korea, and “zicai” in China, Porphyra spp are commonly consumed across the Asia-Pacific region in various forms.1 In English-speaking countries around the world and in many research papers, Porphyra spp is referred to as “laver.” In the United States and Canada, any of these terms may be used depending on the regional derivation of a given recipe. Nori sheets and snacks dominant the seaweed market in the United States, encompassing one-third of all sales, and growing.

Various seaweeds the world over have been used as food due to their macronutrients, micronutrients, and ease of obtaining them along shorelines.3 Porphyra spp have readily extractable pigments, lipids, minerals, vitamins, amino acids, and polysaccharides, making it an intriguing candidate for commercial production of these nutrients.4 There are so many nutrients densely packed into this foodstuff, that it has been proposed as a feasible and sustainable functional food.5

Porphyran, an indigestible polysaccharide unique to Porphyra spp, is thought to be responsible for its immunomodulatory effects. Chemically, porphyran is a sulfated polysaccharide whose structure varies slightly among species.6 Immune-modulating action of polysaccharides is not surprising. They are often a constituent that provides immune-modulatory properties in plants, fungi, and bacteria commonly used for immune support (eg, 1-3 beta glucan).7

In a 2021 review of the compound porphyran, the authors summarize its effects as “antioxidation, anticancer, antiaging, antiallergic, immunomodulatory, hypoglycaemic, and hypolipidemic.”6 How porphyran influences immune function is paradoxical and appears to be context dependent, with both immune-suppressive and immune-augmentative effects suggested in rodent studies.8 The effects may depend on the physiological differences between acute and chronic inflammation and, more specifically, the immune requirements or aberrations involved in each.9 The net immune homeostatic effect of porphyran is suggested in animal studies showing benefits in conditions such as allergies and autoimmunity as well as infections and cancer.10-12

Another possible mechanism that can explain immune homeostasis is possible effects on the gut microbiota. The indigestible polysaccharide is a prebiotic and may alter the microbiota, thus affecting nearly every system in the body.13 In one study of mice with colitis induced by dextran sodium sulfate (DSS), Porphyra tenera extracts shifted the composition of the microbiome found in the mouse gut and ameliorated the colitis.14 In another rodent study, Porphyra yezoensis led to a 2-fold increase in secretory immunoglobulin A (IgA) in the cecum and synergized with another saccharide from the seaweed called glycerol galactoside, favorably shifting the microbiota and its metabolites.15

The study currently under review standardized the porphyran content to 68.45 (±20%) mg/g of porphyran334, the specific porphyrin found in this species of Porphyra. Whether this is ideal, whether the ethanol or 1-µm filter separated out other synergistic constituents, and how this extract compares to consuming the whole food are all lingering questions. While extraction may lead us to answer the question regarding which constituent is responsible for a given action, ethnobotanical use involves the whole seaweed prepared through roasting, boiling, frying, keeping raw, fermenting, etc. Arguably, when we are querying the action of a plant in its traditional use, we should also use traditional means of preparation to test physiological effects.

There is 1 caveat to any sourcing of food from seawater, and that is contamination. Seaweed generally contains alginate or other absorptive compounds that can bind pollutants, including microplastics, in open waters. Integration of smaller molecules such as petroleum distillates and nanoplastics are also a concern. The uptake of heavy metals into Porphyra spp is being studied as a means of bioremediation of contaminated waters, so the extent of their ability to take up pollutants should be top of mind. Fortunately, most of the nori snacks sold in the US are from cultivated sources, usually in Japan. It is important to make sure this detail is somewhere on the label.

Red algae, or Porphyra spp, will continue to be studied for the precise constituents that can someday be used as drug-like compounds in medicine. The presence of diverse nutrients and complex polysaccharides makes this seaweed an appealing whole food to recommend for our patients.