Tuesday, February 25, 2014

Live Long and Prosper Newsletter #2

This newsletter was compiled from the latest research on health and longevity, by David Donohue, MD, FACP.
Nutrition
1.   Effects of dark chocolate in a population of Normal Weight Obese women: a pilot study.
15 women with normal weight but excess body fat ate 100gm dark chocolate (70% cacao) for just 7 days, and surprisingly had improvement in waist circumference and cholesterol levels.

2.   Frequency of nut consumption and mortality risk in the PREDIMED nutrition intervention trial.
Eating nuts (mostly walnuts and almonds) reduced mortality by 39%. This confirms other trials attesting to the life-extending properties of nuts (in moderation). I have often wondered how much of a favor we are doing our children by aggressively branding them lifelong nut-allergics.

3.   IOM report: Evidence fails to support guidelines for dietary salt reduction.
Institute of Medicine does not find dietary salt to be a risk.

4.   Subclinical hypothyroidism and survival: the effects of heart failure and race.
Having an underactive thyroid increases your risk of death if you are black or if you have congestive heart failure.

5.   Joint associations of alcohol consumption and physical activity with all-cause and cardiovascular mortality.
Being sedentary seems to be a bigger risk of death, than being a heavy drinker (>35 per week for men or >21 per week for women).

Exercise
1.   Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes.
"CONCLUSIONS: An intensive lifestyle intervention focusing on weight loss did not reduce the rate of cardiovascular events in overweight or obese adults with type 2 diabetes." This large study was stopped early because they failed to reduce heart attacks, strokes, and the like. What was the intervention? Low calorie diet and exercise. Why did they fail, when so many other studies have shown a positive benefit? We could argue that by focusing on calorie counting they did not stress enough the importance of switching to entirely different classes of foods. Look for example at the recent large prospective trial on the Mediterranean Diet, which did just that. This trial had to be halted early because it showed so much benefit (in reducing these same cardiovascular events) than this trial. That is instead of advising 'Eat only half a sandwich for lunch', we should instead advise 'Eat a large salad with nuts and other whole foods at lunch and stop eating sandwiches and other highly refined western foods'.

2.   Scientific overview of hormone treatment used for rejuvenation.
Want to rejuvenate? Hormones don't seem to work much. Vitamin D or sunlight might help, and perhaps testosterone in men who are deficient. From the scientific literature, your best bets are exercise, sunlight, a plant-based diet, protein. And let's see what materializes with resveratrol.

3.   Vehicle submersion: a review of the problem, associated risks, and survival information.
Take homes: If you drive your car into a lake, get out first and call 911 later. Don't forget to unbuckle the little ones.

4.   Cardiorespiratory fitness predicts mortality and hospital length of stay after major elective surgery in older people.
Elderly folks undergoing major elective surgery (like a joint replacement) had almost 50% reduction in risk of perioperative death, and a shorter hospital stay, than those who are not fit.

5.   Statin and exercise prescription.
In veterans with elevated blood lipids or cholesterol, the combination of a statin (like pravastatin or simvastatin) plus physical exercise achieved the greatest reduction in mortality (70% reduction over 10 years). Either a statin or exercise alone also reduced mortality, but not as much as the combination.



Lifestyle
1.   Physical activity and mortality in a prospective cohort of middle-aged and elderly men -- a time perspective.
More in favor of physical activity: "physically active lifestyle is associated with a substantial improvement in survival time, up to 2.5 years over 13 years of follow-up"

2.   Mortality in depressed and non-depressed primary care Swedish patients: a 12-year follow-up cohort study.
This 12 year study found depressed Swedes were 3.3 times as likely to die during the 12 years then non-depressed Swedes.

3.   [Psychosis, cardiovascular risk and associated mortality: Are we on the right track?]
Beware antipsychotic medicines. They are often prescribed off-label, and there is considerable evidence that they make you die younger.

4.   Adverse childhood experiences and premature all-cause mortality.
The more adverse childhood experiences you have, the greater the shorter the lifespan on average. Maybe the helicopter moms have a point. The Longevity Project similarly found childhood divorce had an impact on the child's lifespan.

5.   Leisure time physical activity and mortality.
Physical activity or many kinds correlated with lower death rate. "We found lower mortality with participation in sports (for women, mortality rate ratio = 0.75, 95% confidence interval = 0.69-0.81; for men, 0.78, 0.73-0.84), cycling (for women, 0.77, 0.71-0.84; for men, 0.90, 0.84-0.96), or gardening (for women, 0.84, 0.78-0.91; for men, 0.73, 0.68-0.79) and in men participating in do-it-yourself activity (0.77, 0.71-0.84)"

Prevention
1.   Durability of effect of massage therapy on blood pressure.
Swedish massage 10-15 min, 3 times a week for 10 sessions experienced lowered blood pressure. Those receiving massage continued to have blood pressures lower by 11/5 points, 72 hours after the massage.

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