Monday, February 27, 2017

Eating up to ten portions of fruit and vegetables a day may prevent 7.8 million premature deaths worldwide

A fruit and vegetable intake above five-a-day shows major benefit in reducing the chance of heart attack, stroke, cancer and early death.
This is the finding of new research, led by scientists from Imperial College London, which analysed 95 studies on fruit and vegetable intake.
The team found that although even the recommended five portions of fruit and vegetables a day reduced disease risk, the greatest benefit came from eating 800g a day (roughly equivalent to ten portions -- one portion of fruit or vegetables if defined as 80g).
The study, which was a meta-analysis of all available research in populations worldwide, included up to 2 million people, and assessed up to 43,000 cases of heart disease, 47,000 cases of stroke, 81,000 cases of cardiovascular disease, 112,000 cancer cases and 94,000 deaths.
In the research, which is published in the International Journal of Epidemiology, the team estimate approximately 7.8 million premature deaths worldwide could be potentially prevented every year if people ate 10 portions, or 800 g, of fruit and vegetables a day.
The team also analysed which types of fruit and vegetables provided the greatest protection against disease.
Dr Dagfinn Aune, lead author of the research from the School of Public Health at Imperial explained: "We wanted to investigate how much fruit and vegetables you need to eat to gain the maximum protection against disease, and premature death. Our results suggest that although five portions of fruit and vegetables is good, ten a day is even better."
The results revealed that even a daily intake of 200g was associated with a 16 per cent reduced risk of heart disease, an 18 per cent reduced risk of stroke, and a 13 per cent reduced risk of cardiovascular disease.
This amount, which is equivalent to two and a half portions, was also associated with 4 per cent reduced risk in cancer risk, and 15 per cent reduction in the risk of premature death.
Further benefits were observed with higher intakes. Eating up to 800g fruit and vegetables a day -- or 10 portions -- was associated with a 24 per cent reduced risk of heart disease, a 33 per cent reduced risk of stroke, a 28 per cent reduced risk of cardiovascular disease, a 13 per cent reduced risk of total cancer, and a 31 per cent reduction in dying prematurely. This risk was calculated in comparison to not eating any fruit and vegetables.
The current UK guidelines are to eat at least five portions or 400g per day. However fewer than one in three UK adults are thought to meet this target.
The team were not able to investigate intakes greater than 800 g a day, as this was the high end of the range across studies.
An 80g portion of fruit and vegetables equals approximately one small banana, apple, pear or large mandarin. Three heaped tablespoons of cooked vegetables such as spinach, peas, broccoli or cauliflower count as a portion.
The researchers also examined the types of fruit and vegetables that may reduce the risk of specific diseases.
They found the following fruits and vegetables may help prevent heart disease, stroke, cardiovascular disease, and early death: apples and pears, citrus fruits, salads and green leafy vegetables such as spinach, lettuce and chicory, and cruciferous vegetables such as broccoli, cabbage and cauliflower. They also found the following may reduce cancer risk: green vegetables, such as spinach or green beans, yellow vegetables, such as peppers and carrots, and cruciferous vegetables.
Similar associations were observed for raw and cooked vegetables in relation to early death, however, additional studies are needed on specific types of fruits and vegetables and preparation methods. The team say the number of studies was more limited for these analyses, and the possibility that other specific fruits and vegetables may also reduce risk cannot be excluded.
Dr Aune said that several potential mechanisms could explain why fruit and vegetables have such profound health benefits: "Fruit and vegetables have been shown to reduce cholesterol levels, blood pressure, and to boost the health of our blood vessels and immune system. This may be due to the complex network of nutrients they hold. For instance they contain many antioxidants, which may reduce DNA damage, and lead to a reduction in cancer risk."
He added that compounds called glucosinolates in cruciferous vegetables, such as broccoli, activate enzymes that may help prevent cancer. Furthermore fruit and vegetables may also have a beneficial effect on the naturally-occurring bacteria in our gut.
The vast array of beneficial compounds cannot be easily replicated in a pill, he said: "Most likely it is the whole package of beneficial nutrients you obtain by eating fruits and vegetables that is crucial is health. This is why it is important to eat whole plant foods to get the benefit, instead of taking antioxidant or vitamin supplements (which have not been shown to reduce disease risk)."
In the analysis, the team took into account other factors, such as a person's weight, smoking, physical activity levels, and overall diet, but still found that fruit and vegetables were beneficial.
Dr Aune added: "We need further research into the effects of specific types of fruits and vegetables and preparation methods of fruit and vegetables. We also need more research on the relationship between fruit and vegetable intake with causes of death other than cancer and cardiovascular disease. However, it is clear from this work that a high intake of fruit and vegetables hold tremendous health benefits, and we should try to increase their intake in our diet."

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Materials provided by Imperial College London. Original written by Kate Wighton. Note: Content may be edited for style and length.

staying active help to prevent chronic pain? Physical activity affects pain modulation in older adults

Older adults with higher levels of physical activity have pain modulation patterns that might help lower their risk of developing chronic pain, reports a study in PAIN®, the official publication of the International Association for the Study of Pain (IASP). The journal is published by Wolters Kluwer.
In tests of pain processing by the central nervous system, physically active older adults have lower pain perception and are better able to block responses to painful stimuli, according to the new research by Kelly M. Naugle, PhD, and colleagues of Indiana University-Purdue University Indianapolis. "This study provides the first objective evidence suggesting that physical activity behavior is related to the functioning of the endogenous pain modulatory systems in older adults," the researchers write.
Being More Active, Less Sedentary, Affects Pain Perceptions in Older Adults
Dr. Naugle and colleagues performed a series of experiments in 51 healthy adults, aged 60 to 77. All wore an activity monitor device for one week to measure their level of physical activity. They then underwent two tests of pain modulation -- functions affecting the way pain is interpreted and perceived by the central nervous system.
One test, called "temporal summation," measured the production (facilitation) of pain responses to repeated pain stimuli. The other test, called "conditioned pain modulation," assessed the reduction (inhibition) of pain responses to competing pain stimuli.
In both tests, pain modulation was significantly related to daily physical activity level. Older adults with more frequent moderate-to-vigorous physical activity had lower pain scores on the temporal summation test -- indicating less pain facilitation. Those who did more light physical activity or had less sedentary time per day had lower pain scores on the conditioned pain modulation test -- indicating better pain inhibition.
In other words, older adults who did more moderate to vigorous physical activity perceived less facilitation of pain, while those who did at least some activity were better able to block pain perceptions. These differences may be relevant to the "central sensitization" process believed to be responsible for the transition from acute to chronic pain.
Previous studies have shown that pain modulation processes are dysregulated in patients with chronic pain syndromes -- for example, arthritis, back pain, and fibromyalgia. People with higher pain facilitation and lower pain inhibition are more likely to develop problems with chronic pain.
The results are consistent with studies in younger adults suggesting that higher levels of physical activity are related to "more efficient conditioned pain modulation." Older adults are more likely to be physically inactive, which might make them more vulnerable to chronic pain.
"Our data suggest that low levels of sedentary behavior and greater light physical activity may be critical in maintaining effective endogenous pain inhibitory function in older adults," Dr. Naugle and coauthors write. Further studies will be needed to test the implications for physical activity programs to reduce and prevent pain in older adults. For example, it might be possible to match the patient's specific dysfunctional pain modulation pattern to the type of physical activity that can best improve their pain response patterns.

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Materials provided by Wolters Kluwer HealthNote: Content may be edited for style and length.

Journal Reference:
  1. Kelly M. Naugle, Thomas Ohlman, Keith E. Naugle, Zachary A. Riley, NiCole R. Keith. Physical activity behavior predicts endogenous pain modulation in older adultsPAIN, 2017; 158 (3): 383 DOI: 10.1097/j.pain.0000000000000769

Never too late: Reaping the benefits of exercise in early postmenopause

Women recently postmenopause have similar or improved benefits from physical activity, in terms of muscle and blood vessel function, as those premenopause. Therefore, early postmenopause might be a time when women can gain increased benefit from physical activity to oppose negative effects of oestrogen loss and aging.
This research, published in the Journal of Physiology, was conducted by Professor Hellsten and her team at the University of Copenhagen.
Postmenopausal women are deprived of oestrogen, a hormone with a strong positive effect on muscle and blood vessel function. Previous research had shown that the beneficial impact of physical activity is reduced or absent in postmenopausal women.
This research suggests that the effects of different stages of menopause on physical exercise cannot be lumped together.
The participants were 36 middle-aged pre and postmenopausal women only a few years apart in age. After a 12-week training regimen of high intensity cycling, Professor Hellsten and her colleagues determined the effect of training on the women's muscles and blood vessels using a series of physiological tests. To look at molecular changes, they took tissue samples from thigh muscles.
Less invasive tests in larger and more diverse populations will be important in order to confirm these findings.
Elaborating on the findings, first author Michael Nyberg said,
'The present study pinpoints a possible signalling pathway at the cellular level that may underlie the higher sensitivity to physical activity in recent postmenopausal women. Future studies should, therefore, further explore this pathway in both animal and human models.'

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Materials provided by The Physiological SocietyNote: Content may be edited for style and length.

Journal Reference:
  1. Michael Nyberg et al. Leg v ascular and skeletal muscle mitochondrial adaptations to aerobic high - intensity exercise training are enhanced in the early postmenopausal phaseJournal of Physiology, Accepted Article, 2017 DOI: 10.1113/JP273871

Involuntary urinary incontinence can discourage sufferers from exercise

According to a study published in the distinguished journal PLOS ONE, urinary incontinence symptoms in middle-aged woman are linked to lower levels of exercise. Involuntary urinary incontinence symptoms can discourage sufferers from partaking in exercise. However, exercise can ease symptoms by, for example, reducing obesity -- as obesity increases pressure on the urethra -- and strengthening pelvic floor muscles.
Urinary incontinence is a fairly common symptom in women, affecting approximately half of all women at some point. However, talking about the topic can be seen as embarrassing. Regular, problematic urinary incontinence increases with age, and in particular after menopause. According to the results of this recently published study, urinary incontinence symptoms are more common in women who lead a more sedentary lifestyle and whose weekly physical activity is below the recommended 2.5 hours of endurance exercise.
"The study does not answer the question of whether exercise is being avoided because of the urinary incontinence or whether more abundant exercise helped to keep symptoms in check," says Assistant Professor Eija Laakkonen from the University of Jyväskylä's Gerontology Research Center.
"However, the study does demonstrate that urinary incontinence symptoms are linked to physical activity levels in middle-aged women. A connection between reproductive health factors and objectively measured exercise had not been studied at all prior to this."
A total of 647 women aged 48-55 years old and living in central Finland partook in the study, which looked into the reproductive health of middle-aged women. Just over half of the participants had experienced pelvic floor related symptoms, the most common of which was exertion-related urinary incontinence, which 39 per cent of the study participants had experienced.
Exercise to ease symptoms
"Health care professionals should be asking openly whether urinary incontinence is a barrier to exercise," urges Urogynaecologist Pauliina Aukee, an obstetrics and gynaecology specialist who was a member of the research team.
"If a patient is suffering from urinary incontinence symptoms, the forms of exercise they undertake should include exercises that support core and pelvic floor management without intense bouncing movements. This should also be taken into account in exercise guidance."
"Managing symptoms and taking them into account can help people find a form of exercise that suits them, and that does not place too much of a burden on the pelvic floor. This will allow people to continue exercise in an enjoyable way even after going through menopause."

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Materials provided by University of JyväskyläNote: Content may be edited for style and length.

Journal Reference:
  1. Eija K. Laakkonen, Janne Kulmala, Pauliina Aukee, Harto Hakonen, Urho M. Kujala, Dawn A. Lowe, Vuokko Kovanen, Tuija Tammelin, Sarianna Sipil . Female reproductive factors are associated with objectively measured physical activity in middle-aged womenPLOS ONE, 2017; 12 (2): e0172054 DOI: 10.1371/journal.pone.0172054

Friday, February 24, 2017

Eat Lean

The caveman diet, alkaline water, gluten-free foods, intermittent fasting — proponents of each of these nutritional trends believe theirs is hands down the best way to achieve optimal health and ensure physique bliss. And while each of these styles has its merits, with all the rules and restrictions involved it’s often difficult to adopt such a trend as a lifestyle. 
Thankfully, new research has pinpointed several effective fat-loss tricks that don’t require wooden cudgels, expensive filters, hard-to-find ingredients or starvation. Implement these science-proven maneuvers into your daily life and you can say sayonara to that pesky layer of winter blubber.

Be Sodium Smart

Most Americans consume way more than the recommended daily amount of sodium (2,300 milligrams), and much of this comes from processed, packaged foods. Excessive sodium intake can lead to a number of conditions including high blood pressure, atherosclerosis, even heart disease and stroke, and new research indicates it could also give you a gut: Subjects who were presented with pasta doused in a salty sauce ingested 11 percent more calories than those who ate the same meal with a less-salty sauce. Researchers theorize that the added salt enhanced the taste of the food to the point that it overrode a natural feeling of fullness. Another study from the University of South Carolina discovered that among 407 adults analyzed, those with lofty sodium intakes were more likely to be pudgy.
Take Action: First and foremost don’t use the salt shaker like a hammer: A single teaspoon of salt has 2,325 milligrams of sodium, so dust food lightly with salt, or better yet use a salt-free, herb-based seasoning. Also, avoid the gut-bomb of highly salted restaurant fare by preparing more meals at home, and carefully read nutrition labels on any packaged grocery items, especially in sneaky sources like bread, cottage cheese, sauces and condiments.

Texturize It

When you’re hungry, you eat, but new research reveals that the textures of foods you eat could make or break your forward fat-loss progress. According to a study published in the journal Appetite, volunteers were provided either with test food that had a high textural complexity — such as crunchy, chewy and smooth together — or a food that was more of a one-note wonder — smooth only — before being offered an eat-as-much-as-you-please meal consisting of pasta and chocolate cake. Overall, the appetizer with greater textural variation resulted in people consuming about 400 fewer calories in the follow-up meal, and left them feeling just as satisfied despite having eaten fewer calories. Researchers believe that increasing the number of textures felt during chewing can stimulate your senses, making food more interesting to eat and, in turn, trigger the satiation response sooner.
Take Action: Work the opposites when preparing meals and snacks — toss crunchy nuts into smooth yogurt, add creamy dressing to crispy salad, or top grilled meat with chunky salsa. Also, when blending your postworkout shake, do it up thick. Dutch researchers determined that viscous drinks are more filling than thinner ones, even when they contain the same number of calories.

Practice Predictability

Meal-to-meal caloric consistency — rather than day-to-day — could help you hold onto your abs, according to a 2016 British Journal of Nutrition investigation. People who were inconsistent with their calorie intake at the same meal each day tended to have larger waistlines and were more likely to suffer from metabolic syndrome (a cluster of conditions such as high blood pressure and cholesterol associated with heart disease) than those who were more consistent. In other words, eating a breakfast that contains roughly the same number of calories each day is better metabolically than hitting the all-you-can eat pancake buffet on Monday, then skipping breakfast on Tuesday. Researchers suspect that this inconsistency affects your internal body clock, or circadian rhythm, negatively impacting appetite, digestion and metabolism.
Take Action: When outlining your eating plan, break your calories up consistently between meals and snacks all week long. Also consider frontloading your calorie intake at breakfast and paring it down as the day progresses. Research shows that eating more calories in the morning could help with weight loss by taking advantage of your higher metabolism early in the day while also promoting early satiety to lessen the risk for overeating as the day wears on.

Open Up & Say “Agua”

Water is good for more than just hydration — it could also help with fat loss. A study in the journal Obesity reported that individuals who sipped two cups of tap water 30 minutes before their main meal of the day lost on average three pounds more over a 12-week period than those who did without the water. Drinking water before noshing expands your stomach, making you feel satisfied with fewer calories while preventing low-grade dehydration that is often confused with hunger. Another study found that people who simply increased their daily water consumption by one to three cups consumed up to 205 fewer calories during the course of the day than those who did not.
Take Action: Aside from hydrating pre- and postworkout, make a habit of drinking a full glass or two of plain water or seltzer before meals to silence the hunger monster and help with portion control.

Do the Munching Math

Monitoring the number of bites of food you take can help you become mindful of your overall intake and work to reduce your waistline. Researchers at Clemson University determined that volunteers who wore technology designed to provide bite-count feedback consumed less food and took fewer overall bites per meal. In another study, this one from Brigham Young University, subjects were encouraged to count bites of food taken each day for a week to obtain a baseline. Afterward, the researchers instructed their charges to reduce the number of bites by 20 to 30 percent for the next four weeks without altering anything else in their diet or lifestyle. On average, they lost four pounds of bodyweight.
Take Action: Keep track of how many bites of food you take every day for a week, then reduce the number by 10 to 15 percent to slash a few calories from your daily intake. Also, consider taking smaller bites of food to slow down your pace and further cut calories.

Slow Down

Yes, you’re starving after finishing Murph, but bolting your food could actually be slowing your weight-loss results: Research suggests that chewing your food more thoroughly can slow down the pace of food consumption, giving your body a better chance of sensing fullness and reducing overall calorie intake.
Take Action: Use the water trick from above and either drink a full glass before eating a postworkout meal or have a shake made with water to quell the hole in your gut. Then 30 to 60 minutes later eat your meal when you’re not famished and are more likely to take your time. Still can’t put on the brakes? Place your utensils down between bites to reduce meal pace or, better yet, trade your fork for chopsticks for guaranteed slowdown.

Sound Effects

According to many, snacking and watching Sunday Night Football at full volume is constitutional right, but according to a 2016 Colorado State University study, listening to electronics at high volume could actually cause you to eat more. The reasoning? If you can’t hear yourself chewing, you’re more likely to eat thoughtlessly.
Take Action: Reduce the volume to less-than-airline-jet decibels; otherwise, surround yourself with piles of carrots, celery sticks and other low-calorie fare to prevent overeating.

Dirty Up Your Meals

Continual clean eating is awesome — most of the time. However, long-term dieting could lead to feelings of deprivation and propel you headfirst into the cookie jar. A cheat day might help with those cravings in the short term, but it could also lead to a calorie binge that’s impossible to undo in any reasonable time frame. The solution, therefore, is moderation, with a twist. A study in the journal Management Science found that consuming a small amount of your vice food alongside your clean and nutritious meal tricks your brain into thinking that the overall healthy meal is just as delicious as a meal dominated by indulgent items like a cheeseburger and onion rings.
Take Action: Rather than giving them their own day or time slot, combine your “cheats” with your clean eating in the same meal to stave off cravings and stay the course. Serve yourself a sliver of chocolate cake after your grilled chicken and steamed vegetables or have some fries with your lean beef patty and salad. The double helping of fulfillment (clean eating and tasty treat) can be enough to keep your physique-friendly diet on track.

Take an Adventure

If your diet is as stale as week-old bread, it’s time to think outside your plate. Two separate studies published in the Journal of Nutrition discovered that people who ate a greater variety of healthy foods tended to have less body fat and were less likely to suffer from metabolic syndrome. Eating a greater range of nutritious edibles can also make it easier to stick with a healthy eating plan by adding some much-needed excitement to your meals.
Take Action: Continue to buy standard ab-carving foods such as salmon and broccoli, but live on the edge and serve it with some freekeh (young green wheat that has been toasted) and rocket (arugula) salad. Bonus: The more healthful foods you introduce the less room there is for nutritional dreck.

Take Counter Measures

Out of sight, out of mind has never been so true. Scientists at Cornell University showed that those who left snack-style foods, such as boxed cereal and soda, out on the kitchen countertop were up to 26 pounds heavier than those who stashed these items out of sight. Additionally, those same study subjects who kept a bowl of fruit on the counter weighed on average 13 pounds less than those who didn’t. It all comes down to eating what is easiest to get at when you’re hungry, and if that happens to be cookies it’s likely to have waistline repercussions.
Take Action: Sequester vice foods in your cupboards or replace them with options like apples or baby carrots. Alternately make the treat foods harder to get to. Research in the journal Appetite reported that volunteers who had to walk six feet to get some candy ate about half as much as those who had them within arm’s reach

Long-term stress linked to higher levels of obesity, hair samples show

People who suffer long-term stress may also be more prone to obesity, according to research by scientists at UCL which involved examining hair samples for levels of cortisol, a hormone which regulates the body's response to stress.
The paper, published in the journal Obesity, showed that exposure to higher levels of cortisol over several months is associated with people being more heavily, and more persistently, overweight.
Chronic stress has long been hypothesised to be implicated in obesity -- people tend to report overeating and 'comfort eating' foods high in fat, sugar and calories in times of stress, and the stress hormone cortisol plays an important role in metabolism and determining where fat is stored.
Previous studies looking at the link between cortisol and obesity relied mainly on measurements of the hormone in blood, saliva or urine which may vary according to the time of day and other situational factors. These studies failed to capture long-term cortisol levels.
This research involved 2,527 men and women aged 54 and older taking part in the English Longitudinal Study of Ageing, taking data over a four-year period.
In the research, the scientists took a lock of hair 2cm long from each participant which was cut as close possible to a person's scalp -- this represented approximately two months' hair growth with associated accumulated levels of cortisol. They also examined the participants' weight, body mass index and waist circumference and how hair cortisol related to the persistence of obesity over time.
They found that people who had higher levels of cortisol present in their hair tended to have larger waist circumference measurements, were heavier, and had a higher body mass index (BMI). Individuals classified as obese on the basis of their BMI (greater than or equal to 30) or waist circumference (greater than or equal to 102cm in men, 88cm in women) had particularly high levels of hair cortisol.
"These results provide consistent evidence that chronic stress is associated with higher levels of obesity," said Dr Sarah Jackson (UCL Epidemiology and Public Health) who led the research. "People who had higher hair cortisol levels also tended to have larger waist measurements, which is important because carrying excess fat around the abdomen is a risk factor for heart disease, diabetes, and premature death."
"Hair cortisol is a relatively new measure which offers a suitable and easily obtainable method for assessing chronically high levels of cortisol concentrations in weight research and may therefore aid in further advancing understanding in this area."
There were limitations to the study, which included the fact the data was from an older population in which levels of cortisol may differ relative to younger adults and the sample was almost exclusively white. It is not currently known whether chronically elevated cortisol levels are a cause or a consequence of obesity.
More research is needed and if causation is proved, then targeting cortisol levels may offer a new method for treating obesity.

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Materials provided by University College LondonNote: Content may be edited for style and length.

Raising dietary potassium to sodium ratio helps reduce heart, kidney disease

Reducing sodium (salt) in the diet has been recommended to lower blood pressure and the risk of heart disease. However, in a new review article, University of Southern California researchers found that increasing dietary potassium is as important to improving the risk factors for cardiovascular and kidney disease as limiting dietary sodium. The article is published ahead of print in the American Journal of Physiology -- Endocrinology and Metabolism.
The research team reviewed more than 70 studies related to dietary approaches to regulating high blood pressure and found that the interaction of sodium and potassium is integral to maintaining healthy blood pressure levels. The ratio of sodium to potassium excreted as urine is an indication of how much of these minerals is consumed. When dietary potassium intake is elevated, the kidneys -- composed of millions of small tubes working together -- shift fluid to the area near the end of the tubes where potassium secretes into the urine. This shift reduces the amount of sodium and water that's reabsorbed into the body. In this way, high potassium diet signals the body to reduce the amount of sodium that is retained. This circular pattern regulates the levels of both minerals in the body, which in turn helps lower blood pressure. Higher intake and excretion of potassium has also been found to slow the progression of kidney and heart disease.
In addition to analyzing data about the sodium-potassium ratio and its relationship to chronic disease, the research team explored strategies to educate the public about the importance of potassium for blood pressure control and heart health. Suggested policies include:
  • Requiring manufacturers to print potassium content on Nutrition Facts labels,
  • Promoting low-cost and easily available sources of potassium (milk, dried beans, potatoes, bananas) and
  • Encouraging families to cook healthy, plant-based meals together.
"Consuming [an abundance] of [potassium] is a good strategy since our physiology evolved and was optimized to deal with high [potassium] low [sodium] intake, often referred to a Paleolithic diet," wrote the research team. In other words, the human body functions best with a balance of the two nutrients.

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Materials provided by American Physiological Society (APS)Note: Content may be edited for style and length.

tips to better recognize and prevent common workout injuries

For many, the start of a new year means the start of a new workout regimen. It is difficult enough to make the time commitment, but nothing throws off a resolution like an injury. Martin Mufich, MSN, RN, sports massage therapist and clinical assistant professor at the Texas A&M College of Nursing, offered some tips to better recognize and prevent common workout injuries. Still, he warned that you should not self-diagnose. "See a health care provider to be sure about the type of harm that may have occurred, especially if improvements are not seen within 24 hours," Mufich recommended.
Sprain: Ligament injury
Have you ever been running through the grass then all of a sudden your foot lands on uneven ground, and you feel your ankle wrench followed by a jolt of pain? It is likely that your ankle is sprained, or twisted.
A sprain involves the overstretching or tearing of the ligaments, which are the fibrous connective tissues that connect bones to each other and stabilize them. "Sprains occur when the joint is forced into an unnatural position," Mufich said. "They happen most often in the ankle but can occur at any joint, such as the wrist or knee." Ligament injuries on the outside ankle occur when the ankle turns outward and the foot twists inward. On the other hand, inner-ankle sprains, which are less common than those on the outside of the ankle, result from the ankle rocking inward and the foot turning outward.
Joint or muscle pain, inflammation, hampered movement, tenderness and bruising are symptoms of a sprain. The severity of the sprain can range from mild to serious. A tweak of the ankle could result in an overstretched ligament that becomes tender, swollen and stiff, but the ankle should still be stable enough to support the weight of walking. "A mild sprain should take approximately seven to 10 days to heal," Mufich said. "A torn ligament is considered a severe sprain that will cause pain, inflammation, bruising and result in ankle instability, often making it difficult and painful to walk. Recovery from a torn ligament may take several weeks, and should be done under the supervision of a health care provider."
Strain: Muscle or tendon injury
A strain is the overstretching or tearing of a muscle or tendon, which are the fibers that connect the muscles to the bones. They can occur from a single incident or from repetitive movements over the long term. "An acute strain is an instantaneous stretch or tear of the muscle or tendon;" Mufich said, "whereas, a chronic strain stems from repetitive motions over time that place stress on the muscle or tendon."
Muscle spasms, weakness, cramping and immobility, as well as pain, bruising and swelling are symptomatic of a strain. Like sprains, strains vary in severity. It could take a few weeks for the symptoms of a mild-to-moderate strain to subside.
Tear: Ligament, muscle or tendon injury
Tears are the ripping of fibrous tissue that can occur in the ligaments, muscles or tendons from similar activities that cause fibers to overstretch, but the diagnosis is more serious and muscle and tendon tears could take multiple months to heal. "Typically, the worse a tear, the more inflammation and pain a person will experience, and the longer it will take for the injury to heal," Mufich said. Non-surgical rehabilitation is often sufficient. However, some tears may require surgery to repair, such as those to the anterior cruciate ligament, or ACL.
Treatment and Prevention
Treating sprains, strains and tears consists of taking steps to reduce the swelling and pain from the injury. Swelling is often the body's first reaction for healing an injury. As fluid and white blood cells rush to the damaged tissue, it becomes inflamed in an effort to repair the tissue and protect it from further damage. However, the fluid can compress the nerves in the injured area and cause pain. Excessive swelling can also potentially lessen the ligaments', tendons' and muscles' flexibility, making the area more susceptible to future injuries. Mufich said these injuries are generally treated by following the plan "RICES."
Rest: Unpainful movement of the area is important, but avoid putting weight on the injury for a prolonged time, perhaps by using crutches, until it is less painful to use
Ice: Apply ice, not heat, to the affected area for 10 to 20 minutes every hour or two throughout the first 24 to 72 hours or until the swelling subsides
Compression: Wear an elastic compression wrap for the first 24 to 36 hours to help minimize any swelling
Elevation: Rest the injury above heart level for two to three hours per day to reduce the amount of swelling that collects in the body's extremities
Stabilization: Especially if medical care is not readily available, like in the wilderness, stabilize the injured area until care becomes available
"Particularly for muscle injuries, the blood works to lay collagen layers on the injury to heal it by forming an internal scab," Mufich said, "and hopefully overtime, as the muscles fibers heal, that collagen will break down." Ligaments and tendons do not receive as much blood flow, so they tend to take longer to heal.
It is important to ease back into mobilizing the area and remain patient throughout the recovery process until your body is ready to return to pre-injury activities. Some discomfort throughout the healing process is normal. However, there should not be any sharp pain. A health care provider can recommend proper rehabilitation practices and exercise.
Sprain, strains and tears can generally be prevented by adequately warming up and stretching prior to rigorous activity, wearing protective equipment, wearing proper fitting shoes that provide stability and building and maintaining muscle and joint strength by exercising regularly.
"While it is great to push your limits, know your limits," Mufich said. "If you are not seeing improvements within 24 hours or it is getting worse, contact a health care provider."

Wednesday, February 22, 2017

Obesity reprograms muscle stem cells

Obesity is associated with reduced muscle mass and impaired metabolism. Epigenetic changes that affect the formation of new muscle cells may be a contributing factor, according to new research from Lund University, Sweden.
In a new study, doctoral student Cajsa Davegårdh has studied so-called DNA methylation in muscle stem cells in both obese and non-obese individuals. DNA methylation is an epigenetic process in which small molecules -- methyl groups -are added to genes and fine-tune the gene's activity, like a dimmer switch.
By comparing the DNA methylation in immature and mature muscle cells from healthy individuals, Cajsa Davegårdh discovered that the actual degree of methylation had a major impact on the maturation process.
"Many genes that had changed their genetic expression also changed their degree of methylation during the development to mature muscle cells, which indicates a connection," she says.
A pro-inflammatory gene, IL-32, turned out to be particularly important with regard to the maturation process and the insulin sensitivity of the fully developed muscle cell. Impaired insulin sensitivity is common in obesity and is a risk factor for type 2 diabetes.
"By reducing the gene expression, the muscle's insulin sensitivity was increased," says Cajsa Davegårdh.
These findings were confirmed by experiments on mice.
Difference between slim and obese individuals
Cajsa Davegårdh then compared the differences in DNA methylation in muscle stem cells from obese individuals (BMI over 30) and individuals of normal weight. She discovered that partly different genes were regulated during the maturation process and that methylation changes were significantly more common in subjects who were obese compared to those who were non-obese.
"We believe that in obese individuals the muscle stem cells have been reprogrammed, and that this may partly explain why muscle cells in obese people have decreased insulin sensitivity and lower metabolism after they have matured," says Cajsa Davegårdh.
However, the cause and effect -- i.e. whether the methylations are caused by obesity or the methylations increase the risk of becoming obese -- can so far not be explained.
"They may also have a protective function. Furthermore, we don't know what happens when you lose weight -- whether the methylations are restored. This would be interesting to follow up."

Story Source:
Materials provided by Lund UniversityNote: Content may be edited for style and length.

Journal Reference:
  1. Cajsa Davegårdh, Christa Broholm, Alexander Perfilyev, Tora Henriksen, Sonia García-Calzón, Lone Peijs, Ninna Schiøler Hansen, Petr Volkov, Rasmus Kjøbsted, Jørgen F. P. Wojtaszewski, Maria Pedersen, Bente Klarlund Pedersen, Dov B. Ballak, Charles A. Dinarello, Bas Heinhuis, Leo A. B. Joosten, Emma Nilsson, Allan Vaag, Camilla Scheele, Charlotte Ling. Abnormal epigenetic changes during differentiation of human skeletal muscle stem cells from obese subjectsBMC Medicine, 2017; 15 (1) DOI: 10.1186/s12916-017-0792-x

Popular heartburn drugs linked to gradual yet 'silent' kidney damage

Taking popular heartburn drugs for prolonged periods has been linked to serious kidney problems, including kidney failure. The sudden onset of kidney problems often serves as a red flag for doctors to discontinue their patients' use of so-called proton pump inhibitors (PPIs), which are sold under the brand names Prevacid, Prilosec, Nexium and Protonix, among others.
But a new study evaluating the use of PPIs in 125,000 patients indicates that more than half of patients who develop chronic kidney damage while taking the drugs don't experience acute kidney problems beforehand, meaning patients may not be aware of a decline in kidney function, according to researchers at Washington University School of Medicine in St. Louis and the Veterans Affairs St. Louis Health Care System. Therefore, people who take PPIs, and their doctors, should be more vigilant in monitoring use of these medications.
The study is published Feb. 22 in Kidney International.
The onset of acute kidney problems is not a reliable warning sign for clinicians to detect a decline in kidney function among patients taking proton pump inhibitors, said Ziyad Al-Aly, MD, the study's senior author and an assistant professor of medicine at Washington University School of Medicine. "Our results indicate kidney problems can develop silently and gradually over time, eroding kidney function and leading to long-term kidney damage or even renal failure. Patients should be cautioned to tell their doctors if they're taking PPIs and only use the drugs when necessary."
More than 15 million Americans suffering from heartburn, ulcers and acid reflux have prescriptions for PPIs, which bring relief by reducing gastric acid. Many millions more purchase the drugs over-the-counter and take them without being under a doctor's care.
The researchers -- including first author Yan Xie, a biostatistician at the St. Louis VA -- analyzed data from the Department of Veterans Affairs databases on 125,596 new users of PPIs and 18,436 new users of other heartburn drugs referred to as H2 blockers. The latter are much less likely to cause kidney problems but often aren't as effective.
Over five years of follow up, the researchers found that more than 80 percent of PPI users did not develop acute kidney problems, which often are reversible and are characterized by too little urine leaving the body, fatigue and swelling in the legs and ankles.
However, more than half of the cases of chronic kidney damage and end-stage renal disease associated with PPI use occurred in people without acute kidney problems.
In contrast, among new users of H2 blockers, 7.67 percent developed chronic kidney disease in the absence of acute kidney problems, and 1.27 percent developed end-stage renal disease.
End-stage renal disease occurs when the kidneys can no longer effectively remove waste from the body. In such cases, dialysis or a kidney transplant is needed to keep patients alive.
"Doctors must pay careful attention to kidney function in their patients who use PPIs, even when there are no signs of problems," cautioned Al-Aly, who also is the VA's associate chief of staff for research and education and co-director of the VA's Clinical Epidemiology Center. "In general, we always advise clinicians to evaluate whether PPI use is medically necessary in the first place because the drugs carry significant risks, including a deterioration of kidney function."

Story Source:
Materials provided by Washington University in St. LouisNote: Content may be edited for style and length.

Journal Reference:
  1. Yan Xie, Benjamin Bowe, Tingting Li, Hong Xian, Yan Yan, Ziyad Al-Aly. Long-term kidney outcomes among users of proton pump inhibitors without intervening acute kidney injuryKidney International, February 2017 DOI: 10.1016/j.kint.2016.12.021

Fifth of world's food lost to over-eating and waste, study finds

Almost 20 per cent of the food made available to consumers is lost through over-eating or waste, a study suggests.
The world population consumes around 10 per cent more food than it needs, while almost nine per cent is thrown away or left to spoil, researchers say.
Efforts to reduce the billions of tonnes lost could improve global food security -- ensuring everyone has access to a safe, affordable, nutritious diet -- and help prevent damage to the environment, the team says.
Scientists at the University of Edinburgh examined ten key stages in the global food system -- including food consumption and the growing and harvesting of crops -- to quantify the extent of losses.
Using data collected primarily by the UN's Food and Agriculture Organization, the team found that more food is lost from the system than was previously thought.
Almost half of harvested crops -- or 2.1 billion tonnes -- are lost through over-consumption, consumer waste and inefficiencies in production processes, researchers say.
Livestock production is the least efficient process, with losses of 78 per cent or 840 million tonnes, the team found. Some 1.08 billion tonnes of harvested crops are used to produce 240 million tonnes of edible animal products including meat, milk and eggs.
This stage alone accounts for 40 per cent of all losses of harvested crops, researchers say.
Increased demand for some foods, particularly meat and dairy products, would decrease the efficiency of the food system and could make it difficult to feed the world's expanding population in sustainable ways, researchers say.
Meeting this demand could cause environmental harm by increasing greenhouse gas emissions, depleting water supplies and causing loss of biodiversity.
Encouraging people to eat fewer animal products, reduce waste and not exceed their nutritional needs could help to reverse these trends, the team says.
The study is published in the journal Agricultural Systems. It was carried out in collaboration with Scotland's Rural College, University of York, Karlsruhe Institute of Technology and the Centre for Australian Weather and Climate Research.
The research was funded through a Global Food Security Programme supported by the Biotechnology and Biological Sciences Research Council, Economic and Social Research Council, Natural Environment Research Council and the Scottish Government.
Dr. Peter Alexander, of the University of Edinburgh's School of GeoSciences and Scotland's Rural College, who led the study, said: "Reducing losses from the global food system would improve food security and help prevent environmental harm. Until now, it was not known how over-eating impacts on the system. Not only is it harmful to health, we found that over-eating is bad for the environment and impairs food security."
Professor Dominic Moran, of the University of York, who was involved in the study, said: "This study highlights that food security has production and consumption dimensions that need to be considered when designing sustainable food systems. It also highlights that the definition of waste can mean different things to different people."

Story Source:
Materials provided by University of EdinburghNote: Content may be edited for style and length.

Journal Reference:
  1. Peter Alexander, Calum Brown, Almut Arneth, John Finnigan, Dominic Moran, Mark D.A. Rounsevell. Losses, inefficiencies and waste in the global food systemAgricultural Systems, 2017; 153: 190 DOI: 10.1016/j.agsy.2017.01.014