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March 4, 2023

Insomnia linked to greater risk of heart attack

Sleeplessness will involve possessing issues falling asleep or remaining asleep.
Info from a modern overview located that sleeplessness and receiving only five hours of rest or a lot less at night are related with an amplified possibility for coronary heart attack.
No matter of specifics, persons can get ways to get a good night’s sleep and strengthen sleeplessness.

As study progresses, professionals are discovering more and extra good reasons for people today to prioritize slumber. One particular place of fascination is how the slumber disorder insomnia boosts the hazard for other well being problems.

A the latest critique published in Scientific Cardiology examined how sleeplessness improves the hazard of a coronary heart assault. The assessment observed that individuals with insomnia were 69{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} additional probable to practical experience coronary heart attacks. Researchers advise that sleeplessness need to be tackled as an critical heart assault possibility element.

Insomnia takes place when individuals have trouble slipping asleep or keeping asleep. Continual insomnia happens when the problem lasts for 3 months or additional. Numerous factors can enhance someone’s risk for sleeplessness, these as higher-tension ranges or long-term soreness.

When persons do not get enough snooze, it can direct contribute to a wide variety of disagreeable symptoms and enhance the chance for unique wellness difficulties. Non-review creator Dr. Harneet Walia, director of Rest Drugs and Ongoing Advancement at Baptist Overall health Miami Cardiac & Vascular Institute, spelled out to Health care Information Now:

“Insomnia is related with impairment in good quality of lifestyle ranging from exhaustion, sleepiness, temper adjustments, enhanced absenteeism, and lower interest. They may perhaps also have lessened cognitive function. There are studies to advise that insomnia is involved with cardiovascular and metabolic threat this kind of as high blood stress, heart assault and diabetes.”

Non-research writer Dr. Wafi Momin, a cardiologist with UTHealth Houston Heart & Vascular and Memorial Hermann, even further observed the following reasons for a very good night’s rest:

“Sleep is important in aiding the body maintenance alone. Having at least 7 hours of sleep each and every night time allows your body recover and makes it possible for you to operate commonly the adhering to working day. Common, dependable slumber also can help regulate blood stress, sugar levels, as very well as weight. These health and fitness complications are connected to coronary heart disorder such as heart assault and stroke, so acquiring a lot of snooze and regulating these danger components can be of a great deal help.”

This distinct systematic evaluation and meta-assessment seemed at the affiliation concerning sleeplessness and the incidence of coronary heart assault, also termed myocardial infarction (MI). It provided managed observational research about heart attacks in individuals eighteen or more mature.

Researchers provided 9 studies in their analysis and research, including 153,881 persons with insomnia and 1,030,375 people today who did not have sleeplessness. Scientific tests came from six distinct international locations, making it possible for for range in facts assortment.

The results of the examine uncovered that folks with insomnia have been at a substantially larger hazard for coronary heart assault than individuals who did not have insomnia. Persons with sleeplessness ended up 69{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} extra probable to expertise a heart attack.

In addition, getting 5 or much less hours of slumber at night was associated with a significantly bigger risk for heart attack than acquiring in between 7 and eight hrs of snooze. Folks who bought five or less several hours of snooze every single night time were 56{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} additional very likely to encounter a heart attack than all those who obtained among seven and eight hours of rest at evening.

Review author Dr. Hani Aiash, Ph.D. mentioned the vital results of the exploration to MNT:

“Our effects have shown that sleeplessness increases the possibility of MI by 69{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}, subsequently, patients need to be educated about the worth of slumber, and rest must be integrated into principal cardiovascular avoidance recommendations.”

Scientists located that the risk for coronary heart attack was bigger among ladies with sleeplessness. Nonetheless, the possibility affiliation was nevertheless current throughout important subgroups dependent on intercourse, co-comorbidities, and age. The success indicate that sleeplessness is a major danger aspect that all grown ups really should acquire significantly.

Scientists concluded that men and women should really handle sleeplessness as a different threat factor for coronary heart assault. With this in brain, individuals can consider steps to deal with insomnia and therefore lower their heart assault threat.

This particular review did have certain limits. To start with, there was sizeable variation among the experiments that researchers included in their overview. For instance, there was variation concerning sample dimensions and research length.

Second, most of the studies relied on knowledge from questionnaires, which can raise the risk of bias and glitches. Scientists only involved papers penned in English, which limitations the study’s findings.

Dr. Aiash, Ph.D. noted the pursuing places for ongoing investigation:

“I consider we must investigate the romantic relationship amongst the length of insomnia and the subsequent danger of MI. (Will staying an insomniac for extended durations final result in larger threat? What is the minimum period of condition i.e., insomnia that results in an improved danger of MI?).”

“Additionally, 96{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of our patient inhabitants did not have prior assaults of MI and the other 4{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} ended up accounted for. Would prior coronary heart assaults end result in a higher hazard of recurrence amongst insomniacs in contrast to insomniacs who did not endure from coronary heart assaults prior to?”

The study highlights the significance of controlling insomnia. Dr. Aiash, Ph.D., mentioned that it’s vital to choose insomnia very seriously. He spelled out that folks should “Consider insomnia as a modifiable possibility component for MI. [It] should be treated as Diabetic issues or Hypertension to reduce the incidence of MI. It is important that clinicians teach the sufferers about the relevance of rest in protecting a wholesome heart and persuade correct sleep cleanliness.”

To regulate sleeplessness, medical practitioners might stimulate individuals to modify specified way of life behavior, like limiting electronics in advance of mattress or limiting caffeine ingestion to particular occasions of the working day. These adjustments can be utilized in conjunction with cognitive behavioral remedy and relaxation techniques.

Dr. Walia famous a couple of vital actions in sleep cleanliness:

preserve a common rest and wake schedule each working day, which include the weekends.
avoid electronics in the evening
avoid caffeine afterwards in the day
prevent having extensive naps late in the working day
preserve a conducive slumber natural environment
actual physical action and physical exercise during the day boost slumber

She more extra that “if a person continues to battle with insomnia, they must search for medical attention, as there might be other slumber or medical or psychiatric issues leading to sleeplessness.”

March 3, 2023

500 extra steps a day may lower risk by 14{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}

A close up of a person's feet and lower legs, walking on a beach — Walking more on a daily basis can improve cardiovascular health in older adults. Raymond Forbes LLC/Stocksy

For older people, every additional 500 steps walked during a day reduces the risk of cardiovascular disease by 14{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}, according to a new study.
The health benefits from walking begin at about 3,000 daily steps, the researchers found.
Five hundred steps is roughly equal to a quarter of a mile.

Plenty of studies associate physical activity, including brisk walking, with good health. With much of them focused on young-to-middle aged adults, there have been fewer investigations into the benefits of walking for older people.

New research, however, explores the ways in which walking can help reduce the risk of cardiovascular disease (CVD).

Researchers recently found that for people aged 70 and older, each additional 500 steps of daily brisk walking lowered the risk of CVD by 14{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}.

In addition, individuals who walked roughly 4,500 steps each day lowered their risk of CVD by 77{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}.

The research was presented at the American Heart Association’s Epidemiology and Prevention Lifestyle and Cardiometabolic Health Scientific Sessions 2023.

The research involved 452 participants from the ongoing Atherosclerosis Risk in Communities study. The participants’ average age was 78, and 59{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} were women. Twenty percent self-identified as Black, 70{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of whom were women.

Researchers tracked participants’ daily step counts using an accelerometer worn at the hip, and their cardiovascular health was tracked for a period of 3.5 years.

During that period, almost 12{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of participants who walked fewer than 2,000 steps a day experienced a cardiovascular event. Just 3.5{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of those who walked around 4,500 daily steps had one.

Cardiac events include coronary heart disease, stroke, or heart failure.

Similarly, in another recently published study, researchers found that 11 minutes of moderate-intensity physical activity a day (or about 75 minutes a week)—such as brisk walking, hiking, or dancing—may be able to lower the risk of diseases such as heart disease, stroke, and some cancers.

While higher-intensity physical activity also offers health benefits, for older people, brisk walking may be a more practical option.

“Walking is a great way to get physical activity. Not only is it a low-impact, weight bearing exercise which is important for bone health in older adults, walking is associated with reducing risk factors for CVD by helping to control blood pressure and blood sugars, decrease weight, and help reduce stress.”
— Dr. Erin E. Dooley of the University of Alabama, lead researcher

Meanwhile, Dr. Amanda Paluch of the University of Massachusetts, Amherst, who was not involved in the research, touched on walking’s benefits on cardiovascular health.

“Walking provides a great physiological stimulus to improve the strength and quality of the heart muscle and vessels in older adults,” she said.

Walking reduces both the systolic and diastolic blood pressure, so “it lowers the stress and strain on the heart muscle to pump blood throughout the body,” explained further Skidmore College’s Dr. Paul Arciero, who was also not involved in the research.

Dr. Arciero told Medical News Today that this reduction in blood pressure also makes strokes less likely since it reduces the force of blood traveling through the brain.

“Research from our lab strongly supports adding cardio exercise, such as walking, to the daily routine, performed in the morning for women and in the evening for men, to significantly reduce blood pressure and boost mood,” he said.

Participants’ steps were tracked by device, but there are other ways to count the distance walked if a person does not want to wear a step-tracker.

Epidemiologist Dr. I-Min Lee of Harvard University, a co-author of the research, said that any way one prefers to track the distance that they walk is fine.

“Step tracker or not? This depends on the individual. It is not much use going with a ‘system’ that one does not like,” he said.

Dr. Arciero recommended walking between 4,000 and 7,000 steps per day each weekday, rising to 10,000 steps, if possible, on weekends.

150 minutes per week

Current government guidelines suggest at least 150 minutes of moderate to vigorous intensity exercise, which can include brisk walking, per week.

“One easy way to accomplish this is to break your walks into smaller chunks of 10–15 minutes [t]hroughout the day. Additionally, perform your walk outside in nature, referred to as a ‘forest bath’ for an added boost to your emotional/psychological health,” said Dr. Arciero.

When measuring walking by the distance traveled, one quarter mile roughly equals about 500 steps.

“Going to a community track or map out a ¼ to ½ mile loop can be a great option as well,” Dr. Paluch said.

“I always encourage older adults to use some form of a reminder or motivation to help nudge them to get out and walk, whether it’s simply using the health app on a phone, an accelerometer they attach to their waist or wrist, or a walking buddy,” Dr. Arciero added.

Many phones nowadays come with apps that can track steps.

Dr. Dooley reported that this research concluded that health benefits begin at around 3,000 brisk steps per day.

The U.K.’s National Institutes of Health provides a simple way to confirm that walking is adequately brisk: “You can tell you’re walking briskly if you can still talk but cannot sing the words to a song.”

A limitation of the research, noted Dr. Dooley, was that there is no way to know if walking improved participants’ health or if poor health reduced the distance they could walk. However, other research supports the benefits of walking.

Dr. Lee said that other studies have found that there is no risk of mortality in walking up to 10 times the recommend amount.

“Of course, one should not ‘over-do’ steps. By this, I mean make sudden large increases beyond what one is used to. If increasing, do so gradually,” he said.

“A good rule of thumb is don’t increase [one’s walking] by more than 10{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} a week. Too-large increases can lead to musculoskeletal injuries.”
— Dr. I-Min Lee

February 21, 2023

Irregular sleeping habits may increase risk

an older woman with gray hair sleeps or naps in bed under the covers with one hand covering her eyes — A analyze uncovered a url among irregular sleeping designs and an improved possibility of atherosclerosis in more mature grownups. Milamai/Getty Images

A new review finds a backlink amongst irregular sleeping styles and subclinical indications of atherosclerosis in older individuals.
Atherosclerosis-relevant conditions are the leading cause of dying in the United States.
The research underscores the importance of setting up regularity in one’s slumber regimen.

A latest research explores a relationship in between atherosclerosis, not retaining a common bedtime, and sleeping for inconsistent durations of time.

The analyze discovered that older people who varied slumber time by an normal of two hours inside of a one 7 days and those who changed their bedtimes by an hour and a half ended up substantially a lot more most likely to exhibit subclinical symptoms of atherosclerosis.

According to a push launch, here’s what the researchers calculated to look into the presence of plaque in the arteries:

calcified fatty plaque buildup in arteries — coronary artery calcium
fatty plaque buildup in neck arteries — carotid plaque existence
thickness of the interior two levels of the neck arteries — carotid intima-media thickness
narrowed peripheral arteries — the ankle brachial index

They detected calcified plaque in arteries, the main fundamental trigger of strokes and heart attacks. When they calculated participants’ blood pressure at their arms and when compared that determine to blood pressure at their ankles, the ensuing substantial ankle brachial indexes indicated stiffness in their blood vessels. Equally signs or symptoms might be indications of producing atherosclerosis.

Atherosclerosis is a affliction in which cholesterol, fatty deposits, and mobile squander items in your blood kind sticky plaques on the insides of your arteries. The plaques as a result thicken artery walls and can result in them to harden. The condition inhibits blood stream, avoiding adequate oxygen from being sent to your organs.

According to the United States Countrywide Institutes of Well being (NIH), 50 {cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of Americans aged 45-84 have atherosclerosis devoid of being aware of it, and the condition joined to atherosclerosis is the top cause of loss of life in the U.S.

The analyze appears in the Journal of the American Coronary heart Association.

The analyze associated 2032 contributors in the separate community‐based MESA (Multi‐Ethnic Research of Atherosclerosis). MESA aimed to examine the qualities and possibility factors of subclinical signs of atherosclerosis across a assorted inhabitants of older folks.

To that conclusion, just over half of the participants in MESA have been gals. Thirty-8 per cent of the participants self-discovered as White, 28{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} as Black or African American, 23{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} as Hispanic, and 11{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} as Chinese. They ended up also geographically varied, recruited from St. Paul, MN Baltimore Metropolis and Baltimore County, MD Chicago, IL Forsyth County, NC Los Angeles County, CA Northern Manhattan and the Bronx, NY.

The individuals ranged from 45 to 84 yrs previous, with an normal age of 69, and all ended up absolutely free of identified cardiovascular condition.

Each and every participant wore a wrist system for seven days that tracked their durations of getting awake or asleep. They also accomplished rest diaries.

Finally, each individual individual participated in one particular night of in-house snooze monitoring that measured their breathing, rest levels, rest period, heart level, and the time they went to bed.

In the current review, people today whose slumber length various by an regular of two hours per week ended up 1.33 moments additional probably to have substantial coronary artery calcium scores than those people with far more regular slumber styles. They ended up also 1.75 situations a lot more possible to have abnormal ankle brachial indexes.

When evaluating men and women whose bedtimes varied by an common of 90 minutes above the program of a 7 days, researchers located a 1.39 moments improve in the likelihood of calcified artery plaques.

“Our success add to expanding proof from modern scientific studies that have linked irregular slumber styles to cardiovascular chance,” reported the study’s lead writer, Dr. Kelsie M. Complete of Vanderbilt College.

Other scientific studies, Dr. Complete mentioned, already join inadequate sleep to cardiovascular disorders these as hypertension, sort 2 diabetes, and heart sickness.

“Our bodies have a all-natural 24-hour internal clock, known as the circadian rhythm, that regulates quite a few physiological processes, like rest-wake cycles. When we continuously go to bed and wake up at distinctive instances, it can disrupt our circadian rhythm and guide to what is termed ‘social jet lag,’” mentioned Dr. José M. Ordovás of Tufts College, who was not included in the research.

Interventional cardiologist Dr. Hoang Nguyen, not included in the review, told Professional medical News Right now:

“The authors suggested that disturbance in rest regularity encourages cardiovascular disorder by disturbing the normal circadian rhythm of the human body, thus influencing inflammation, glucose metabolism and sympathetic neurohormal reaction. All of these components are identified to induce cardiovascular disease.”

“During sleep, the sympathetic anxious method (SNS) activity is usually reduced, permitting the entire body to relaxation and get well,” Dr. Ordovás stated.

“However, slumber disorders these kinds of as slumber apnea can direct to increased SNS exercise, which can cause hypertension and other CVD possibility aspects,” he extra.

The press release noted that owing to the limitation of sleep and atherosclerosis currently being measured concurrently, the scientists were being unable to assess “if better sleep irregularity leads to the growth of atherosclerosis.”

Dr. Whole famous that their examine tracked persons who frequently obtained fewer or more slumber than typical and observed no big difference in their atherosclerosis indicators.

The NIH recommends that older grownups, like all other grown ups, get between 7 and 9 several hours of sleep each and every working day.

It is doable to get much too much rest, in accordance to other investigation. Dr. Ordovás described that each a limited snooze period of less than 7 hours for every evening and a lengthy slumber period of additional than 9 hours per night time have both of those been related with an enhanced chance of CVD.

“What is fascinating about this examine is that the authors went beyond the quality of rest, and investigated the regularity of snooze,” reported Dr. Nguyen.

“I come across this portion intriguing, as it opens up a myriad of thoughts on the fundamental reasons for this, and has implications on attainable interventions from a health and fitness care company standpoint to increase cardiovascular overall health.”

“Addressing snooze issues,” mentioned Dr. Ordovás, “and promoting healthful slumber practices might help to minimize the possibility of CVD by cutting down irritation, oxidative strain, and other threat components related with rest disturbances.”

February 16, 2023

How does diet affect mortality risk?

two women in orange jumpers chatting in the kitchen while mixing bowls of greens — A healthy diet can help lower a person’s risk of early death. Image credit: MaaHoo/Stocksy.

Unhealthy eating habits are among the leading causes of early death around the world.
Harvard researchers have recently found that a variety of healthy diets may help lower the risk of premature mortality.
In their extensive study, participants who consistently maintained healthy eating patterns were less likely to die from noncommunicable diseases, compared with people who did not.
The results support the current Dietary Guidelines for Americans, which recommend adapting healthy dietary regimens according to personal traditions and preferences.

Growing evidence confirms that dietary choices are key to maintaining health. Research increasingly indicates that unhealthy eating habits can lead to early, preventable deaths.

Until now, though, studies have generally focused on the life-promoting benefits of individual foods or food components.

Researchers at the Harvard T.H. Chan School of Public Health in Boston, MA, recently led a study to see how long-term eating patterns affect mortality risks.

These experts assessed adherence to diets that align with the current Dietary Guidelines for Americans, 2020-2025 (DGAs). They then compared the results with other health data collected over 36 years from more than 100,000 people in two long-term national studies.

Corresponding author Dr. Frank Hu, Fredrick J. Stare professor of nutrition and epidemiology, and chair of the Department of Nutrition notes that “[t]he Dietary Guidelines for Americans are intended to provide science-based dietary advice that promotes good health and reduces major chronic diseases.”

“Thus, it is critical to examine the associations between DGAs-recommended dietary patterns and long-term health outcomes, especially mortality,” he adds.

The study findings appear in JAMA Internal Medicine.

The Harvard researchers analyzed and combined results from the Nurses’ Health Study (NHS) and the Health Professionals Follow-up Study (HPFS).

The NHS, which began in 1976, tracked the health data of female nurses aged 30 to 55 years at baseline. The HPFS, which began in 1986, followed male health professionals aged 40-75.

Dr. Hu and his colleagues defined the baselines as 1984 for the NHS and 1986 for the HPFS, when questionnaires provided enough information to form dietary indices.

Their current work used data compiled from 75,230 NHS participants and 44,085 HPFS participants. All the individuals were free of cardiovascular disease or cancer when the study began.

At the baseline and every 2 to 4 years, the participants completed food frequency questionnaires (FFQs) covering over 130 food items every 2 to 4 years.

They also updated information regarding age, weight, body mass index (BMI), physical activity, smoking status, multivitamin use, menopausal status, and diagnosis of chronic diseases.

In the NHS, participants identified as Hispanic, non-Hispanic Black, non-Hispanic white, and “other.” The HPFS did not collect this information.

Higher scores on at least one of the indexes also correlated with a reduced risk of premature death from all causes, and from cancer, cardiovascular disease, and respiratory diseases.

In the NHS and HPFS study populations, people with higher dietary scores were more likely to be older, nonsmokers, and more physically active. They also had a lower BMI.

Food choices and cancer

Kate Cohen, who was not involved in the present research, is a registered dietitian at the Ellison Clinic at St. John’s Health Center in Santa Monica, CA.

In an interview with Medical News Today, Cohen explained how diet can impact cancer development, saying: “We know that about half to two-thirds of cancers can be avoided through diet and lifestyle changes including staying at a healthy weight, increasing fruits and vegetables, limiting alcohol, and increasing dietary fiber.”

MNT also spoke about these findings with Dr. Monique Gary, a breast surgeon and the Medical Director of the Grand View Health/Penn Cancer Network cancer program. Dr. Gary was not involved in the study.

The oncologist shared that “[t]hese findings reinforce what we tell patients in oncology: that diet and lifestyle modification support all phases of cancer care and decrease [the] risk of recurrence and mortality.”

Diets and neurodegenerative diseases

The study also found that the AMED score and AHEI “were associated with lower risk of mortality from neurodegenerative disease.”

Cohen shared how these diets feature components that contribute to brain health:

“Both AMED and AHEI emphasize healthy fats more so than the other two patterns, which may provide an anti-inflammatory benefit and contribute to a healthy brain. They also both share some similarities to the MIND diet, which was developed at Rush Hospital to prevent dementia and slow down cognitive decline. Similar to MIND, AMED and AHEI limit red meat, sugar, and saturated fat, which may help tip the scales in favor of these diets when it comes to brain health.”

Smoking and sex-based differences

The Harvard scientists reported that “[s]ignificant interactions were detected between 4 dietary scores and total mortality by sex and smoking status.”

Female participants had a greater risk of death than male participants. Likewise, people who currently or had ever smoked had a greater risk of mortality than those who had never smoked.

Cohen believes that the sex-based difference might be due to “the potential role of estrogen and chronic pulmonary inflammation, which may be contributing to the dramatic rise of COPD and lung cancer among women.”

The study results do not suggest that plant-based or animal-based diets offer greater health advantages. The HPDI discourages all animal products, while the AMED score recommends fish.

MNT asked Cohen whether removing meats from the diet is necessary.

She replied that “[w]e have seen in other research […] that diets highest in red and processed meat are associated with several cancers, so it’s likely a good idea to limit red meat and consider eliminating processed meats.”

However, she admitted, “[b]eyond that, we have yet to see a convincing study that shows that including lean animal proteins in the diet increases mortality.”

The Harvard study entails a direct large-scale comparison of healthy dietary patterns over three decades. It steps beyond most current literature that focuses on single foods.

Dr. Gary pointed out that this analysis “highlights the fact that when normalized for race, and irrespective of the particular nuances of the healthy diet, adherence to a healthy diet may decrease mortality among all individuals with chronic illness.”

They did acknowledge certain limitations, though.

Due to dependence on self-reported data, the team felt that some measurement errors were unavoidable. Additionally, as an observational study, the possibility of confounding persists as well.

Moreover, the sample population consisted exclusively of health professionals, limiting the study’s generalizability.

Dr. Gary noted that “[f]urther studies will be helpful to better elucidate the benefits of particular dietary and lifestyle changes that result in a greater advantage for those facing chronic illnesses, including cancer.”

February 14, 2023

Phthalate exposure may increase risk in some women

shelves of foods packed in plastic containers at the supermarket — New research indicates that some women may be at an increased risk of diabetes due to phthalates, chemicals often used in food packaging. Image credit: Julien McRoberts/Getty Images.

Phthalates are chemicals widely used in food packaging, cosmetics, and children’s toys.
Research suggests they can interfere with hormone function, and that they are associated with obesity, allergies, and other health concerns in both children and adults.
Phthalates may also increase insulin resistance, raising the risk of diabetes.
Now, a study in women has shown that increased exposure to phthalates over a prolonged period may contribute to a higher risk of diabetes.

Plastics are everywhere, and they are extremely useful. They package our food and drink, they are in many of our clothes, and are also in our personal care products. They are even in the water we drink and the air we breathe in the form of microplastics.

While they may be useful, increasing scientific evidence is suggesting that some components of plastics may be harmful to human health.

Top of the potentially harmful list are phthalates, chemicals added to many plastics to make them flexible. Phthalates have been implicated in many health concerns, including endocrine disruption, obesity, allergies, and reproductive issues.

One hormone likely to be affected by phthalates is insulin, which controls blood glucose (sugar) levels and makes glucose available to cells. A study in adolescents found that increased urinary phthalate levels were associated with increased insulin resistance, which is often a precursor to type 2 diabetes.

Another study made similar observations in older adults, finding that exposure to one particular group of phthalates, diethylhexyl phthalates (DEHP), increased oxidative stress and insulin resistance.

Now, a longitudinal study published in The Journal of Clinical Endocrinology & Metabolism has found that women exposed to high levels of phthalates have an up to 63{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} increased risk of developing diabetes.

“The study subjects were chosen from a larger longitudinal study of midlife women to evaluate an association between phthalates in the urine and [the] development of diabetes. The study found an association between higher levels of certain phthalates and development of diabetes in white women, but not the other races studied — Black and Asian.”

– Dr. Ishita Prakash Patel, board-certified endocrinologist, Texas Diabetes and Endocrinology, not involved in the study

Researchers from the University of Michigan School of Public Health studied 1,308 women from the Study of Women’s Health Across the Nation (SWAN) for 6 years.

All the women were aged between 42 and 52 years (median age 49.4 years), and not taking any exogenous reproductive hormones for the last 3 months — such as the birth-control pill or hormone replacement therapy (HRT) — when they enrolled in the study in 1996–’97.

The study looked at phthalate exposure and incident diabetes in these women in the 6 years between 1999–2000 and 2005–2006.

At the start, and in 2002–2003, all the women gave urine samples in PET (polyethylene terephthalate) tubes. PET is a plastic that does not release phthalates when stored at cool temperatures. The researchers froze the urine samples at -80 degrees Celsius until analysis in 2017–’18.

Using mass spectroscopy (HPLC-MS), the researchers measured the concentration of 12 different phthalates and phthalate metabolites in the urine samples.

The women attended nine follow-up visits during the study. Researchers classified diabetes if a woman reported using antidiabetic medications, had a doctor’s diagnosis of diabetes, and/ or had fasting blood glucose greater than 126 milligrams per deciliter (mg/dL) for two consecutive visits.

In the 6 years of the study, 61 women (4.7{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}) developed diabetes. These women had significantly higher concentrations of all except two phthalate metabolites than women who did not develop diabetes.

“Our research is a step in the right direction towards better understanding phthalates’ effect on metabolic diseases, but further investigation is needed,” says co-author Dr. Sung Kyun Park, of the University of Michigan School of Public Health in Ann Arbor, MI.

When the researchers stratified their results by race/ethnicity, they found a positive association between phthalate metabolites and incident diabetes in white, but not Black or Asian women. The authors state that it is “unclear what might explain such racial/ethnic differences”.

Dr. Patel agreed that the reasons for this finding were unclear, telling Medical News Today that “[t]he findings could have been skewed by a selection bias — for example, missing many cases of earlier onset diabetes.”

“Another possible reason could be that products were administered differently, leading to some forms causing more harm than others,” she hypothesized.

The researchers note that those who were younger, Black, current smokers, or obese generally had higher concentrations of phthalate metabolites. They also note that of the women who developed diabetes, 89.9{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} had overweight or obesity at the start of the study.

Because it was a longitudinal study, the researchers could demonstrate that phthalate exposure occurred before diabetes diagnosis, suggesting a causative effect.

Also, the population of women in the study was diverse, with white, Black, Chinese, Japanese, and Hispanic women participating. However, the researchers noted that “given inconsistent associations across racial/ethnic groups and phthalate metabolites, a causal relationship between phthalates and diabetes remains uncertain.”

The researchers note several limitations of their study. First, phthalate concentrations in single urine samples may not reflect habitual exposure to phthalates.

Secondly, they relied on fasting glucose to diagnose diabetes. Thirdly, the follow-up time was relatively short, and the sample was relatively small. And fourthly, other environmental factors may have affected the results.

Mindful of these limitations, they call for more research into the impact of phthalates on glucose homeostasis and diabetes, saying that, “[g]iven widespread exposure to phthalates and the enormous costs of diabetes to individuals and societies, ongoing investments in the research on phthalates’ metabolic effects are warranted.”

Although this study cannot prove that phthalates cause diabetes, it does raise the possibility, and phthalates are known to have other health effects. The European Chemicals Agency states that they can “interfere with our hormonal systems and cause allergies.”

But avoiding phthalates is not always easy, as they are found in many plastics. However, some steps are being taken to reduce people’s exposure to phthalates.

Many countries have limited the use of phthalates in children’s toys and other products, as there is evidence that exposure in childhood may adversely affect normal development.

Recently, the Food and Drug Administration (FDA) limited the use of phthalates in food packaging, reducing the risk of these chemicals being absorbed into foods

And some cosmetic manufacturers are now using other ingredients in place of phthalates. People can check whether plastics contain phthalates by looking at the recycling information.

So perhaps, to be on the safe side, we should follow the advice of Dr. Patel:

“It is probably best to limit exposure to chemicals like phthalates, which can be absorbed through the skin or digestive system, as much as reasonably possible.”

February 13, 2023

High coffee consumption may triple kidney disease risk in some people

Three coffee beans in a line, standing vertically. — The amount of coffee and caffeine someone consumes can affect their kidney health. Antonia Gros/EyeEm/Getty Images

A new study finds that people who metabolize caffeine slowly are three times more likely to develop kidney dysfunction.
Other research has suggested that coffee promotes health, including kidney health.
The slow metabolism, says the new study, is the result of a gene variant present in half the population at large. They propose that this may account for the conflicting conclusions of previous studies.

While some research has linked the consumption of coffee to kidney damage, other research has reported no association between caffeine intake and the development of chronic kidney disease. A new study from researchers at the universities of Toronto, Canada, and Padova, Italy may offer an explanation for the differing conclusions.

It also finds that for some people, coffee can indeed be damaging to one’s kidneys.

The new study finds that the presence of a particular gene variant can result in coffee being three times more likely to cause kidney dysfunction.

The researchers say it is all about the speed at which a person metabolizes caffeine. In the study, about half of the participants had the rs762551 variant of the CYP1A2 gene, a variant that caused them to metabolize caffeine more slowly. This group was determined to be at a higher risk of kidney damage.

The authors say that this is about the same percentage of slow caffeine metabolizers in the general population.

The study assessed kidney health by tracking three accepted markers of kidney dysfunction: albuminuria, hyperfiltration, and hypertension.

The study is published in JAMA Network Open.

The observational study spanned about 16 years. It involved a population of 1,180 participants ages 18 to 45 years, with each regularly being assessed over a 7.5-year follow-up period. All participants had untreated stage 1 hypertension and had been recruited as part of the separate Hypertension and Ambulatory Recording Venetia Study.

Dr. Sara Mahdavi, was the lead author of the study as a researcher with the Department of Community and Family Medicine at the University of Toronto.

After identifying those with the problematic CYP1A2 variant, Dr. Mahdavi said:

“It was remarkable to see just how striking the effects of coffee were in the group that had this genetic variant, yet no effect whatsoever in those who did not.”

People who metabolized caffeine slower and who drank three or more cups of coffee each day were 2.7 times more likely to develop kidney dysfunction.

They were also 2.8 times more likely to develop hypertension.

Medical News Today reached out to nephrologist Dr. Francis Perry Wilson, associate professor at Yale School of Medicine, who was not involved in the study. He expressed concern about the accuracy of the authors’ conclusions:

“While the study shows an interesting association between coffee intake and the risk of kidney disease in a subgroup of the population, I have some concerns about the statistical analysis that make the conclusions difficult to interpret.”

“Particularly, the fact that the event curves go to 0 implies that every participant is assumed to experience the event over time, when in fact, that is biologically not possible. This can sometimes arise when individuals followed for longer in a study are significantly different from those followed for a shorter time,” he elaborated.

“Caffeine is the most widely studied substance in coffee and can be found in other beverages like tea, cola, and energy drinks. Coffee contains many substances that can have various effects on the body, both beneficial as well as harmful,” noted Dr. Mahdavi.

The study suggests that it is only harmful in people whose ability to quickly detoxify caffeine out of their system is impaired.

“This implicates caffeine, specifically, as the component in coffee that can damage the kidneys. It also suggests that caffeine from any source can be harmful in those individuals who have this genetic variant that impairs their ability to eliminate caffeine from their system,” she explained.

The authors hope the study’s findings will prompt a re-examination of the current guidelines approving up to 400 milligrams, or four or five cups, of brewed coffee per day.

“[D]ecaffeinated coffee is virtually devoid of caffeine, those who consume decaf would not have a higher risk of kidney dysfunction, regardless of their genetics.”
— Dr. Sara Mahdavi, lead author

There are general guidelines as to the relative amounts of caffeine one can expect to find in different caffeinated beverages such as coffee, espresso, and tea.

However, there are a surprising number of factors that determine a specific cup’s caffeine content. These include the species of bean, brewing time, the temperature of the water, pressure, the extent of roasting and grinding, the type of water, and the coffee/water balance.

According to the study’s senior investigator, the University of Toronto’s Dr. Ahmed El-Sohemy, the CYP1A2 enzyme metabolizes certain compounds such as caffeine, some medications, and several dietary substances.

“Although the enzyme detoxifies caffeine, it can actually activate some pro-carcinogens that are found on the surface of barbecued meat,” Dr. El-Sohemy noted.

In addition to the rs762551 variant, he said, there were a “number of factors that can either increase or decrease the activity of CYP1A2, regardless of whether a person is a fast or slow metabolizer.”

Dr. El-Sohemy said that hormonal contraceptives may decrease the activity of CYP1A2, “and effectively turn fast metabolizers into slow metabolizers.”

Cruciferous vegetables, he added, can speed up CYP1A2 activity.

The rs762551 CYP1A2 variant has also been implicated in the development of cancer. There are genetic companies that can test a person for the presence of this variant.