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Lifestyle improvement may be as influential as drug therapy for ED
March 31 2014. An article published online in The Journal of Sexual Medicinereveals that lifestyle changes may be as good as prescription medication for treating erectile dysfunction (ED) in older men.
In an investigation of 810 men aged 30 to 80 years at the beginning of the study, Gary A. Wittert, MD, and his associates at the University of Adelaide in Australia documented the presence of erectile dysfunction in 23.2% of the subjects. During the following five year period, 31.7% developed ED, yet the condition went into remission among 29%.
Predictors of the development of ED included having a lower income, the presence of significant abdominal fat, depression, diabetes, obstructive sleep apnea, voiding lower urinary tract symptoms and other factors. Predictors of its remission included employment and the absence of lower urinary tract symptoms, angina, diabetes and disordered lipids.
"Sexual relations are not only an important part of people's wellbeing,” noted Dr Wittert, who heads the Discipline of Medicine at the University of Adelaide and is Director of the University's Freemasons Foundation Centre for Men's Health. “From a clinical point of view, the inability of some men to perform sexually can also be linked to a range of other health problems, many of which can be debilitating or potentially fatal. Our study saw a large proportion of men suffering from some form of erectile dysfunction, which is a concern. The major risk factors for this are typically physical conditions.”
"The good news is, our study also found that a large proportion of men were naturally overcoming erectile dysfunction issues,” he concluded. “The remission rate of those with erectile dysfunction was 29%, which is very high. This shows that many of these factors affecting men are modifiable, offering them an opportunity to do something about their condition."
Need for choline higher in some individuals
March 28 2014. An article published in The FASEB Journal on March 27, 2014 presents the finding of University of North Carolina researchers of a variance in the requirement for choline among people of different genders and ethnic backgrounds.
Kerry-Ann da Costa, PhD, and colleagues gave 79 men and women a ten-day diet that provided 550 milligrams (mg) choline per day, which is the Institute of Medicine’s adequate intake level. This was followed by a diet containing only 50 mg choline daily for up to six weeks, during which changes associated with the development of liver or muscle dysfunction were monitored. DNA samples were evaluated for 200 variations in ten genes related to choline metabolism in order to determine their relationship with deficiency symptoms.
The researchers observed several single nucleotide polymorphisms (SNPs) associated with choline deficiency-related organ dysfunction in women, as well as variants that affect choline requirements. Other SNPs were identified with muscle damage. Variation in SNPs that affect choline requirement was observed among Europeans, Mexicans, Asian Americans and people of African descent.
"Our study shows that gender, life stage and genetic makeup influence the requirement for choline in humans," stated Dr da Costa. "We hope that it will focus attention on setting the dietary recommendations at a level that is high enough to meet the needs of those with the greatest requirements for choline."
"Getting the right amount of choline is important, and also important is this study which shows that each person has unique nutritional needs," commented Gerald Weissmann, MD, who is The FASEB Journal’sEditor-in-Chief. "Today's dietary guidelines are approximations at best, and one size does not fit all. As we move toward an age of personalized medicine, studies like this should make it possible for health care professionals to judge how much of each nutrient your particular body needs."
Increased vitamin K intake associated with lower risk of dying over 4.8 year median
March 26 2014. A study reported online on March 19, 2014 in the Journal of Nutrition links higher intake of vitamin K with a lower risk of dying from any cause over a median follow-up of 4.8 years.
The study included 7,216 participants in the PREDIMED study, which sought to evaluate the protective effect of a Mediterranean diet against the risk ofcardiovascular disease in older men and women. Annual dietary questionnaire responses completed by the participants were analyzed for the intake of phylloquinone (vitamin K1) and menaquinone (vitamin K2). Over a 4.8 year median, there were 323 deaths, including 81 deaths from cardiovascular disease and 130 cancer deaths.
Adjusted analysis uncovered a 36% lower risk of dying from any cause and a 46% lower risk of dying from cancer over follow-up among those whose vitamin K1 intake was among the top 25% of participants in comparison with the lowest 25%. For those who increased their intake of vitamin K1 over follow-up, the risk of death was 43% lower and for vitamin K2, the risk was 45% less than subjects whose intake was reduced or unchanged. Improvement of vitamin K1 and K2 intake was also associated with a 36% and 59% lower risk of dying from cancer during the follow-up period.
"To our knowledge, this is the first study to evaluate the specific association of both active forms of vitamin K (vitamins K-1 and K-2), and their changes during the follow-up, with cancer mortality, cardiovascular mortality, or all-cause mortality in a prospective longitudinal study of Mediterranean individuals at high cardiovascular disease risk and using repeated measurements of dietary intake," the authors announce. "The results of the present study show, for the first time, an inverse association between an increased intake of both dietary phylloquinone and menaquinone, and cancer mortality or all-cause mortality."
Nutritious meals reduce health care expenditures in chronically ill population
March 24 2014. The October 4, 2013 issue of the Journal of Primary Care & Community Health published an article by researchers affiliated with Philadelphia’s Metropolitan Area Neighborhood Nutrition Alliance (MANNA) and Drexel University School of Public Health which reports a health savings benefit for nutritious meal delivery to men and women with chronic ailments.
The study compared 65 MANNA clients with 633 Medicaid patients with chronic illnesses who did not receive the services. Chronic conditions included AIDS/HIV, cancer, diabetes, congestive heart failure, dementia and more. Subjects in the MANNA group received three nutritionally balanced meals per day that employed Medical Nutrition Therapy (MNT) to improve nutritional status, disease-fighting ability and quality of life. Health care costs for all participants were assessed for the six months prior to and twelve months following the beginning of the meal deliveries.
Average monthly health care costs and other factors including inpatient costs and hospital admissions decreased among the MANNA clients during the three months after the meal service was initiated. In the months after receiving the meals, the group’s monthly healthcare costs were an average of 31% lower than costs incurred by participants who did not receive the meals. In addition, inpatient stays among the meal recipients were half as frequent and averaged six days fewer than those of the comparison group.
“The findings of this study are consistent with prior research showing that nutrition is an integral part of disease management,” authors Jill Gurvey and colleagues write. “Chronically ill patients with several comorbid conditions have complicated nutritional needs that may be challenging for patients or their caretakers to adhere to without additional support.”
“We believe that investigating the importance of programs that address optimizing nutrient needs for chronically ill patients should be acknowledged as an essential cost-effective intervention for improving health,” they conclude.
Greater vitamin C intake linked with reduced risk of breast cancer mortality
March 21 2014. The results of a meta-analysis conducted by researchers at Sweden’s Karolinska Institutet indicate improved survival among women with breast cancer who had a higher intake of vitamin C from supplements or food sources. The findings were reported online on March 7, 2014 in the European Journal of Cancer.
For their analysis, Holly R. Harris and her colleagues selected nine reports describing ten observational studies that included a total of 17,696 women diagnosed with breast cancer, among whom there were 1,558 deaths attributable to the disease and 2,791 total deaths. Studies examined the effect of supplementing with vitamin C following breast cancer diagnosis and/or the effect of vitamin C obtained in the diet.
When the studies that reported the effects of vitamin C supplements were evaluated, their use was associated with a 19% lower risk of total mortality and a 15% lower risk of dying from breast cancer in comparison with no use. Analysis of vitamin C from food sources uncovered a 27% lower risk of mortality and a 22% lower risk of breast cancer death in association with each 100 milligram per day increase. Comparison of high versus low dietary intake resulted in a 20% lower risk of dying and a 23% reduction in the risk of breast cancer mortality among women whose intake was categorized as high.
“To our knowledge this is the first meta-analysis to combine the limited number of published studies available on vitamin C supplement intake and dietary vitamin C intake and survival following breast cancer diagnosis,” the authors announce. “More studies of post-diagnosis supplement use, including vitamin C, are warranted to further our understanding of how their intake during chemotherapy or radiation therapy may influence breast cancer outcomes.”
Genes reflecting increased vitamin E status associated with lower prostate cancer risk
March 17 2014. An article appearing ahead of print on March 12, 2014 in theJournal of Nutrition reveals a lower risk of prostate cancer in men with genetic variants indicative of higher vitamin E status. “Genetic variants in genes involved in vitamin E transport or metabolism may be important determinants of potential beneficial effects of vitamin E supplementation on prostate cancer risk,” Jacqueline M. Major and her associates at the National Cancer Institute note in their introduction to the report.
The study included participants in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, which enrolled over 155,000 men and women between 1993 and 2001. The current investigation compared 483 men diagnosed with prostate cancer and 542 matched control subjects who had genotype data on three vitamin E-related variants available.
The researchers found that the presence a specific single nucleotide polymorphism was associated with a 25% lower risk of prostate cancer in comparison with the more common genotype, and that another variant conferred a reduction in risk that approached statistical significance. As potential mechanisms for vitamin E against prostate cancer, the authors emphasize its antioxidant properties that can protect against oxidative damage or inhibit lipid peroxidation within the cells. They also discuss the vitamin’s modifying effect on inflammation.
“To our knowledge, no previous study has examined the association between these genome-wide association study (GWAS) identified vitamin E–associated genetic variants and prostate cancer risk,” Dr Major and her colleagues announce. “These findings support the hypothesis that the variant allele may enhance antioxidant enzyme activity or other functions; however, more research is needed to substantiate this finding.”
“Prehypertension” associated with greater stroke risk
March 12 2014. The results of a meta-analysis published online on March 12, 2014 in the journal Neurology® reveal that any blood pressure reading above what is currently considered normal is associated with an increased risk of stroke. Blood pressure is classified as normal if the systolic reading is 120 and the diastolic is 80 mmHg, however, many authorities believe that a blood pressure that is lower than 120/80 is optimal.
Dingli Xu, MD, of Southern Medical University in Guangzhou, China and colleagues selected 19 cohort studies including a total of over 760,000 men and women for their analysis. They compared individuals who had normal blood pressure with those considered to have prehypertension, defined as a reading between 120/80 and 140/90 mmHg. The prehypertension group, who comprised up to 54% of the studies’ participants, was subdivided into those with blood pressure higher and lower than 130/85 mmHg.
The team found that subjects in the high range of prehypertension had a 95% greater risk of developing a stroke over follow-up periods ranging from four to 36 years in comparison with those who had normal blood pressure, and that those in the low prehypertension group had a 44% greater risk. "These findings, if confirmed, have important takeaways for the public," Dr Xu stated. "Considering the high proportion of the population who have higher than normal blood pressure, successful treatment of this condition could prevent many strokes and make a major difference in public health."
"Prehypertension should be managed with changes in diet and exercise to help reduce the risk of stroke," he recommended. "More research should be done on using blood pressure drugs for people with prehypertension."
DHA improves children’s sleep
March 10 2014. The results of a study described in an article published in theJournal of Sleep Research reveal an association between higher levels of the omega-3 polyunsaturated fatty acid docosahexaenoic acid (DHA) and bettersleep in children.
In a pilot study of 362 primary school students aged seven to nine years, Professor Paul Montgomery of Oxford University and his colleagues found that supplementation with 600 milligrams DHA per day for 16 weeks improved sleep in a sampling of participants who were rated by their parents as sleeping poorly. Those who received DHA experienced seven fewer waking episodes and nearly an hour more sleep than those who received placebos.
When blood fatty acid levels were evaluated, the researchers found an association with higher levels of DHA and less bedtime resistance, parasomnias and total sleep disturbances. Having a higher ratio of DHA to arachidonic acid was also associated with better sleep.
“Various substances made within the body from omega-3 and omega-6 fatty acids have long been known to play key roles in the regulation of sleep,” Dr Montgomery explained. “For example, lower ratios of DHA have been linked with lower levels of melatonin, and that would fit with our finding that sleep problems are greater in children with lower levels of DHA in their blood.”
“Previous studies we have published showed that blood levels of omega-3 DHA in this general population sample of 7-9 year olds were alarmingly low overall, and this could be directly related to the children's behavior and learning,” noted study coauthor Dr Alex Richardson. “Poor sleep could well help to explain some of those associations.”
“This randomized controlled trial does suggest that children's sleep can be improved by DHA supplements and indicates yet another benefit of higher levels of omega-3 in the diet,” he concluded.
Calcium, vitamin D supplementation associated with improved lipid levels
March 7 2014. An article scheduled to be published in the August 2014 issue ofMenopause, the journal of The North American Menopause Society, will report findings gleaned from the Women’s Health Initiative CaD trial of improved lipid levels among participants supplemented with calcium and vitamin D.
North American Menopause Society Board of Trustees member Peter F. Schnatz, DO, NCMP, and his colleagues compared serum lipid levels of over 600 participants who received a placebo or 1,000 milligrams calcium plus 400 international units (IU) vitamin D3 over the course of the trial. In addition to being twice as likely to have vitamin D levels of 30 nanograms per milliliter (ng/mL) or more, women who received calcium and vitamin D had levels of low-density lipoprotein (LDL) that averaged 4 to 5 milligrams per deciliter (mg/dL) lower than those who received a placebo. Subjects who received calcium plus vitamin D also had greater levels of beneficial high-density lipoprotein (HDL) cholesterol levels than the placebo group. Older age, having a low intake of the nutrients prior to the study, not smoking and consuming less alcohol in comparison with the remainder of the participants were associated with a greater increase in serum vitamin D.
Furthermore, among those whose vitamin D levels were 15 ng/mL or higher, calcium and vitamin D supplementation was associated with lower levels of triglycerides.
“The results of this study should inspire even more women to be conscientious about their calcium and vitamin D intake—a simple and safe way to improve health," noted North American Menopause Society Executive Director Margery Gass, MD. "One action can lead to multiple benefits!”
High fiber diet associated with lower risk of prostate cancer
March 3 2014. An article published online on February 19, 2014 in the Journal of Nutrition reveals the finding of French researchers of a reduction in the risk ofprostate cancer over a 12.6 year median among men with a high intake of insoluble fiber.
The analysis included 3,313 men who enrolled in the Supplémentation en Vitamines et Minéraux Antioxydants (SU.VI.MAX) study in 1994. Dietary records completed on at least three occasions from 1994 to 2002 were analyzed for the quantity, source and type of fiber consumed. The subjects were followed until 2007, during which 139 men developed a first primary prostate cancer.
Among participants whose intake of fiber was among the top 25% of participants, there was a 53% lower risk of developing prostate cancer in comparison with those in the lowest 25%. When fiber was analyzed by type, insoluble fiber emerged as protective, and when analyzed by source, fiber from legumes had a significant protective effect. The associations tended to be slightly stronger in men with alcohol intake greater than the median of the population.
Authors Mélanie Deschasaux and colleagues list reductions in inflammation, insulin resistance and hyperinsulinemia, and androgenic or estrogenic hormones as potential protective mechanisms for increased dietary fiber against prostate carcinogenesis. “Dietary fiber may reduce concentrations of circulating estrogens and androgens, notably through increased serum hormone binding globulin concentration, modified enterohepatic circulation of steroid hormones, and increased fecal excretion of these hormones, resulting from binding to insoluble fibers,” they write.
“These results suggest a potentially protective involvement of dietary fiber intake in prostate carcinogenesis,” they conclude. “This must be confirmed by additional mechanistic and prospective epidemiologic studies, especially taking into account the grade of prostate cancers.”
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