The Heart

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What ways are there to measure body fat?

The body takes in fat from food and stores it. This stored fat protects the organs, provides energy, and helps keep the body insulated.

However, too much body fat can lead to obesity and other chronic diseases, such as type 2 diabetes and heart disease.

The conventional body mass index (BMI) only measures total body weight, without taking body fat and muscle mass into account. A very muscular person, for example, may have a low percentage of body fat but a high BMI.

Read on to discover seven methods for accurately measuring body fat.

Skinfold measurements A woman measuring Skinfold with calipers which is one way on How to measure body fat
A person can estimate their body fat percentage by measuring the thickness of skinfolds in different areas of the body.

The body stores a large amount of fat directly beneath the skin. Measuring the thickness of skinfolds in different areas of the body can help a person estimate their body fat percentage.

According to the American Council on Exercise, this method provides fairly accurate results.

It requires a person to use calipers to measure the thickness of skinfolds. Due to differences in body fat distribution, males and females need to take measurements in different areas.

Males should measure skinfolds on the chest, thigh, and abdomen. Females should measure skinfolds on the triceps, thigh, and just above the hip bone. It is important for people to take the measurements at the same sites each time.

People can then enter these measurements into an online calculator, which estimates body fat percentage.

It is important to note that skinfold measurements vary widely, and body fat distribution can differ, based on race, age, sex, and physical activity.

Circumference measurements A person can easily estimate their body fat percentage by measuring the circumference of different parts of their body. They should use a tape measure to do this. To get a more accurate estimation, measure the circumference of the neck and waist. Females should also measure the circumference of the hips. Take measurements at the widest point, and ensure that the tape measure does not compress the skin. The United States Army use an equation that incorporates a person's height and circumference measurements to estimate body fat percentage. Thank you for supporting Medical News Today Body fat scales person stepping on weighing scales
There are a number of bathroom scales available that can estimate body fat percentage. Some bathroom scales estimate body fat percentage. They use a method called bioelectrical impedance analysis (BIA). BIA involves passing a very weak electrical current through the body to measure its resistance to the current. Body fat is particularly resistant, meaning that it conducts electricity less effectively than other tissues and substances within the body. Therefore, measurements that show a greater resistance indicate a higher body fat mass. Scales can use this measurement and information about gender, age, and height to estimate body fat percentage. According to a 2016 study, BIA can give a reasonable estimate of body fat percentage. However, it is not the most accurate method available. Also, scales from different manufacturers may give different results. Dual-energy X-ray absorptiometry (DEXA) A DEXA scan uses X-rays to precisely measure body fat, lean muscle, and mineral composition in different parts of the body. The scan is similar to any X-ray and only takes a few minutes. The amount of radiation that the scan emits is low. Typically, researchers use DEXA scans to measure body fat percentage in research settings. The test is not readily available to the general public. There are no specific guidelines about who should undergo DEXA scanning for body fat analysis. However, researchers suggest that the scans may help with treatment for the following groups: people who are obese people who have had bariatric surgery people undergoing therapy for HIV people who have sarcopenia, a condition that causes loss of muscle mass and strength Hydrodensitometry Hydrodensitometry, or underwater weighing, uses a person's body mass and volume to calculate their body density. This helps with assessing body fat composition. In order to determine body density, a person must divide body weight, or mass, by body volume. The volume of an object is how much space it takes up. Hydrodensitometry involves submerging a person in water and measuring the volume of water that they displace. This displacement indicates body volume. Following hydrodensitometry, a person can use body mass and volume measurements to calculate body density with an equation. A further equation converts body density into body fat percentage. Hydrodensitometry is usually only available at medical centers and research institutions. Air displacement plethysmography Air displacement plethysmography (ADP) is another method that uses a person's body mass and volume to calculate their body fat composition. During ADP, a person sits inside an enclosed device called a Bod Pod. Scales inside the Bod Pod measure body mass, while air pressure sensors measure the amount of air displaced by the person. The volume of air displaced indicates body volume. The person's body mass and volume are used to calculate their body density, and the three measurements are used to determine the body fat percentage. The entire procedure takes around 10 minutes and gives consistent results. 3D body scanner A 3D body scanner uses lasers to create a 3D image of the body. The scanner rotates to take pictures of the body from different angles, and the scan is quick, taking only a few seconds. A computer then combines the individual pictures to form the 3D image. With this image, it is possible to determine body volume. Dividing body mass by body volume can indicate body density. Then, the computer uses a separate equation to estimate the person's body fat percentage. 3D body scanners are a portable, quick, and inexpensive way to measure body fat. Healthy ranges Below are body fat ranges for males and females, according to the American College of Sports Medicine: Male Age (years) Fitness category 20–29 30–39 40–49 50–59 60+ Essential fat 2–5 2–5 2–5 2–5 2–5 Excellent 7.1–9.3 11.3–13.8 13.6–16.2 15.3–17.8 15.3–18.3 Good 9.4–14 13.9–17.4 16.3–19.5 17.9–21.2 18.4–21.9 Average 14.1–17.5 17.5–20.4 19.6–22.4 21.3–24 22–25 Below average 17.4–22.5 20.5–24.1 22.5–26 24.1–27.4 25–28.4 Poor >22.4 >24.2 >26.1 >27.5 >28.5 Female Age (years) Fitness category 20–29 30–39 40–49 50–59 60+ Essential fat 10–13 10–13 10–13 10–13 10–13 Excellent 14.5–17 15.5–17.9 18.5–21.2 21.6–24.9 21.1–25 Good 17.1–20.5 18–21.5 21.3–24.8 25–28.4 25.1–29.2 Average 20.6–23.6 21.6–24.8 24.9–28 28.5–31.5 29.3–32.4 Below average 23.7–27.6 24.9–29.2 28.1–32 31.6–35.5 32.5–36.5 Poor >27.7 >29.3 >32.1 >35.6 >36.6 Thank you for supporting Medical News Today Summary There are various ways to accurately measure body fat percentage. Some methods are simple and inexpensive, while others are more complicated and costly. Some of these methods, including DEXA scans, hydrodensitometry, and ADP, are only available at specialized facilities. However, a person can estimate their body fat composition at home by other means. A doctor or personal trainer can offer additional advice on taking accurate body measurements.
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Daytime napping 1–2 times a week may benefit heart health

Taking a daytime nap once or twice a week may halve the risk of cardiovascular events, such as heart attacks, strokes, and heart failure.
woman napping in hammock
New research suggests that napping during the day could protect heart health, after all.

This is the main takeaway of an observational study appearing in the BMJ journal Heart.

Nadine Häusler, Ph.D., from the department of internal medicine at Lausanne University Hospital, in Switzerland, is the first author of the study.

As Häusler and colleagues explain in their paper, much controversy has surrounded the relationship between daytime napping and cardiovascular health.

Some previous studies, referenced by the authors, have found a lower risk of coronary heart disease among daytime nappers, while others have found a higher risk of cardiac events or cardiovascular mortality among those who regularly nap during the day.

To help settle the controversy, Häusler and the team set out to examine the link between napping and fatal and nonfatal cardiovascular events in a cohort of 3,462 adults in Switzerland.

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Studying naps and cardiovascular events

Häusler and colleagues had access to medical data from participants in the CoLaus cohort study.

The participants were between 35 and 75 years of age when they enrolled in the CoLaus study and did not have a history of cardiovascular problems at baseline, that is, in 2003–2006.

The researchers looked at the associations between napping frequency and napping duration, on the one hand, and the incidence of heart attacks, strokes, and heart failure, on the other.

Häusler and the team had access to self-reported sleeping patterns and continual health monitoring over an average period of 5 years, as part of the CoLaus study.

When the participants were asked about their sleeping and napping patterns, more than half reported no naps in the previous week, almost 20% said they had napped once or twice, about 12% said they had napped 3–5 times, and a similar number said they had napped 6–7 times.

Those who napped more frequently tended to be older, overweight males who smoked. These participants also tended to sleep for longer at night, have sleep apnea, and feel more sleepy during the day.

Naps tied to 48% lower cardiovascular risk

During the 5-year monitoring period, 155 cardiovascular events occurred. To assess the association between naps and cardiovascular events, the researchers accounted for potential confounders, such as age or heart disease risk factors, such as hypertension.

The researchers found that taking 1–2 weekly naps during the day was linked with 48% lower chances of having a heart attack, stroke, or heart failure, compared with those who did not nap at all.

However, the analysis revealed no link between cardiovascular events and the duration of the naps.

Häusler and colleagues conclude, "Subjects who nap once or twice per week have a lower risk of incident [cardiovascular disease] events, while no association was found for more frequent napping or napping duration."

"Nap frequency may help explain the discrepant findings regarding the association between napping and [cardiovascular disease] events."

Yue Leng, Ph.D., and Dr. Kristine Yaffe, of the University of California, San Francisco, independently comment on the findings in a linked editorial.

They say that it is "premature to conclude on the appropriateness of napping for maintaining optimal heart health," given that we lack a standard definition or measurement of naps.

However, they add, "While the exact physiological pathways linking daytime napping to [cardiovascular disease] risk is not clear, [this research] contributes to the ongoing debate on the health implications of napping and suggests that it might not only be the duration, but also the frequency that matters."

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What do code blue and other hospital codes mean?

Hospital intercoms sometimes blare unfamiliar codes and alerts that may be confusing to patients. Each hospital code refers to a specific emergency situation.

Code blue means that there is an urgent medical emergency. This is usually a patient in cardiac or respiratory arrest. Other codes denote other emergencies, such as an active shooter or hazardous waste spill.

Hospital codes are a quick way to tell hospital workers who needs to attend to an emergency situation, what they need to bring, and what they should expect.

Hospital staff should consult their manual for details about their hospital's codes, since practices can vary from facility to facility.

In this article, learn all about the meanings of different hospital codes and their benefits.

Code blue some medical professionals responding to a Code blue in a hospital
A code blue is a quick way to tell staff that someone is experiencing a life threatening medical emergency.

Code blue means that someone is experiencing a life threatening medical emergency. Usually, this means cardiac arrest (when the heart stops) or respiratory arrest (when breathing stops).

All staff members near the location of the code may need to go to the patient.

In most cases, each medical provider will have a preassigned role in the event of a code blue during their shift.

Code white In previous years, code white had the same meaning as code blue, but it specifically referred to medical emergencies in children and babies. Some hospitals may still use code white instead of code blue for pediatric medical emergencies. For example, some hospitals may still use code white to alert staff that a child or baby is in respiratory or cardiac arrest, or to signal that they are experiencing another serious medical emergency. Treating children sometimes requires smaller or specialized equipment, or even different medical procedures. Having a different code for a pediatric emergency alerts staff to these unique needs. Other hospitals now use code white to indicate a mandatory evacuation. This could involve the entire hospital, or it may involve just one or two areas of the hospital. Thank you for supporting Medical News Today Code red Code red alerts staff to a fire or probable fire. To respond to this code, staff must follow the hospital's fire protocols, which typically require evacuation. Patients near the fire who cannot move on their own will need assistance to escape the fire. The code will often come with information about the fire's location. Code purple or pink Code purple alerts hospital staff to a missing child or child abduction. Some hospitals use a separate code, code pink, to denote an infant abduction. The code should also include clear details about the child, what they were wearing, where they were last seen, and, if applicable, clear details of who they were last seen with. In most cases, the hospital will go on lockdown during the search for the child. This is to ensure that nobody leaves the building with them. Code gray At some hospitals, code gray is a call for security personnel. It might indicate that there is a dangerous person in a public area, that a person is missing, or that there is criminal activity somewhere in the hospital. A hospital may use code gray if someone, including a patient, is being aggressive, abusive, violent, or displaying threatening behavior. Security personal can assist other hospital staff to resolve the situation or remove the person from the premise if necessary. Code gray may also include a description of the dangerous person and their current location. Code green Paramedics taking patient on stretcher from ambulance to hospital
A code green may indicate the arrival of patients from a mass casualty event. Hospitals tend to use code green along with other codes, as it indicates that the hospital is activating an emergency operations plan. Some hospitals also use a code green to denote a mass casualty event, such as groups of survivors of a mass shooting arriving at the hospital for treatment. The code may include a description of the mass casualty scenario, as well as information about which emergency operations plan that code activates. Code orange Code orange is a call for medical decontamination, usually due to a hazardous fluids spill. For example, a hospital may call a code orange if toxic chemicals spill in an emergency room, or if a bag of patient blood spills on the floor. However, some hospitals use code orange to call for help with a violent or combative patient. Code silver Code silver alerts hospital staff to an active shooter in the hospital. The code alert will likely include information about the appearance and current location of the shooter. Hospital personnel should follow the hospital's active shooter protocols, which may include locking doors or evacuating to a specific location. Some hospitals use code silver and code gray interchangeably. However, the Joint Commission — whose recommendations the United States Department of Health and Human Services and the U.S. Department of Homeland Security support — updated its standards in 2010 to recommend the use of code silver as a distinct code from code gray. However, in 2014, the Recommendations for Hospital Overhead Emergency Codes — by the Florida Hospital Association — advised using plain language instead of a code for an active shooter situation and using code gray specifically to announce the need for security personnel. This is because announcing the presence and location of an active shooter in the building, rather than using an emergency code, can help ensure that more people understand the situation and can take the relevant safety precautions. Thank you for supporting Medical News Today Code black Code black indicates a bomb threat. The code tends to include relevant information, such as the specific location of the threat. If there is a person in the hospital threatening to bomb the building, the code may also include a description of the person. More specific threats are more credible. So, people who receive bomb threats over the phone should remain calm and gather as much information regarding the purported bomber as possible. Each hospital will have an evacuation protocol in the event of a bomb threat. Benefits and drawbacks The inside of a hospital.
Hospital codes can quickly and succinctly provide key information to medical staff. Hospital overhead codes standardize a hospital's response to various emergencies. This allows them to quickly get the attention of staff and others. Some other benefits of hospital codes include: succinctly providing key information about an emergency without wasting time the ability to devise a specific plan for each code a uniform and preplanned response to various emergencies in some cases, the ability to alert staff to a serious problem without triggering panic in patients Every hospital adopts a slightly different approach to codes, however, which can be a problem when a staff member works at multiple facilities or moves from one facility to another. Many hospitals and healthcare facilities in the same area try to standardize their codes. Some other drawbacks of hospital codes include: a reduced ability to alert patients to an emergency that requires their response difficulty coordinating an emergency response across teams the risk that staff may panic when they hear a code Summary Hospital codes are a simple way to alert staff to an actual or potential emergency. Codes help healthcare providers effectively respond to their patients' needs. Patients may find these codes confusing, but they should feel assured that each staff member knows what to do during each situation. It is important to note that some hospitals use different codes than others. Codes will likely remain a part of hospital culture because of their ease of use. Patients and hospital staff who want to better understand the codes in use at their hospital should consult a manual or ask about the hospital's emergency management plan.
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What are the best breakfasts for losing weight?

Some people believe that breakfast is the most important meal of the day and that eating breakfast increases weight loss. But is this true? And, if so, which are the best breakfast foods for weight loss?

There is little evidence to support the idea that eating breakfast can increase weight loss. Breakfast is just another meal. That said, eating breakfast can give a person energy for the day. This may reduce the risk of overeating and, in this way, support weight loss efforts.

This article explores the best breakfast foods to eat to aid weight loss. It also discusses breakfast options to suit vegetarian, vegan, and restricted diets. Read on to learn all there is to know about eating breakfast and losing weight.

Breakfast food tips To get the most out of breakfast, it is best to eat nutrient dense foods. These foods offer more nutritional value per calorie, which may help a person feel fuller longer. Here are some breakfast food tips that may support weight loss: Eat fiber-rich foods a bowl of oatmeal which one of the Best breakfast foods for weight loss
People who regularly eat fiber-rich breakfasts may have less visceral fat and inflammation.

People trying to lose weight may benefit from eating fiber-rich foods for breakfast and throughout the day.

A 2015 study found that diets rich in fiber helped people lose more weight and improved symptoms of metabolic syndrome. Metabolic syndrome is a risk factor for diabetes.

Other studies link fiber to better health and more weight loss. For example, a 2012 study found that adolescents who ate more fiber had less visceral fat and less inflammation.

Eat more protein

Eating more protein for breakfast or at any other time of day may support weight loss.

Numerous studies link higher protein diets to more weight loss. A 2014 analysis suggests that protein may help people feel fuller, reducing overeating. People may also burn more calories when they eat protein.

Protein-rich foods are generally rich in other nutrients, allowing a person to get a wide range of nutrients without consuming lots of calories.

Avoid high calorie options

Try to avoid foods that are high in calories and low in nutrients. Reducing calorie intake at breakfast time and throughout the day may help a person lose weight.

To cut down on calories, avoid adding sugar to breakfast foods. A healthy oatmeal breakfast can become a sugar-laden, high calorie meal when a person adds lots of brown sugar. Select cereals that contain less sugar and avoid pancakes and pastries that contain lots of sugar.

Avoid sugary drinks

Be mindful of the role of drinks in calorie content. A glass of orange juice typically contains more than 100 calories but offers little nutritional value. Opt for eating the whole fruit rather than drinking juices.

Eat whole foods

Eating whole foods instead of processed foods may help a person lose weight. Try replacing white bread, pasta, and bagels with whole grain options.

Whole grain offers more nutritional value and may reduce the risk of some types of heart disease. Because whole grains are rich in fiber, they may support weight loss and reduce constipation.

Thank you for supporting Medical News Today Should you eat breakfast? With interest in intermittent fasting increasing, some people are now opting to skip breakfast altogether. But does skipping breakfast support weight loss? Not eating breakfast may support weight loss because it means a person goes longer without consuming calories, which may lead to a lower total calorie intake throughout the day. However, skipping breakfast may not support weight loss for everyone. For some people, skipping breakfast leads to overeating at lunchtime. In this way, skipping breakfast may lead to higher overall calorie consumption, undermining weight loss. Research around breakfast and weight loss is inconclusive. A 2019 BMJ meta-analysis and systematic review suggests that skipping breakfast may support weight loss. Examining 13 trials, researchers found that not eating breakfast offered modest decreases in weight. However, the study's authors also note that the data is not strong. Other factors might account for the difference. Scientists need to do more research to fully understand whether avoiding breakfast is an effective weight loss strategy. Breakfast foods for vegans peanut butter on toast.
Peanut butter on toast is a healthful breakfast choice for vegans trying to lose weight. As for all people, it is essential for people who follow a vegan diet to consume sufficient protein. Consuming protein helps people to feel full, which may support weight loss. Vegan breakfast foods may be a healthful option for anyone wanting to limit meat consumption or add variety to their diet. Also, eating more vegetables increases a person's fiber and nutrient intake. Many vegan breakfast options are rich in protein, fiber, and other nutrients. Here are some vegan breakfast foods to try: vegan scramble (using tofu instead of eggs) and kale, broccoli, or spinach peanut or almond butter on whole grain toast oatmeal with blueberries, strawberries, or raspberries and an optional teaspoon of honey whole grain cereal with soy or almond milk avocado toast on whole wheat bread, seasoned with lemon juice and sea salt tofu omelet vegan BLT made from soy bacon, lettuce, tomato, and whole grain buns mixed nuts rolled oats with peanut butter smoothie with avocado, banana, frozen berries, and a teaspoon of honey Learn more about following a plant based diet. Breakfast foods for vegetarians Vegetarians can choose from a wide variety of delicious breakfast foods. Adding dairy products makes it easy to get plenty of protein to support weight loss. A 2011 study compared the diet of vegetarians to nonvegetarians. Researchers found that vegetarian diets were more nutritionally dense. This may be because vegetarians eat more fruits and vegetables than meat eaters. The study's authors also suggest that a vegetarian diet may support weight loss. Here are some vegetarian breakfast ideas: whole grain cereal with 1% milk Greek yogurt with berries plain vanilla yogurt with bananas two slices of white cheddar cheese with a handful of mixed nuts hard boiled egg sprinkled with salt avocado with cottage cheese and hot sauce poached eggs on whole grain toast scrambled eggs with hot sauce instead of cheese or salt Learn more about vegetarian eating. Breakfast foods for meat eaters While meat is high in many nutrients, it is also a high calorie food due to its fat content. Lean meats and poultry contain less fat and calories than red meats, so choosing these types of meat is a good option for meat eaters hoping to lose weight. Reducing the amount of meat in each meal and replacing it with nutrient-rich, high fiber vegetables may also help. The following meals can support healthy weight loss: grilled chicken sandwich with lettuce on whole grain bread Canadian bacon with yogurt or eggs turkey sausage scramble with lots of vegetables Thank you for supporting Medical News Today Breakfast for people with dietary restrictions Having allergies or an underlying health condition need not affect a person's enjoyment of breakfast. There are plenty of alternatives available. Here are some breakfast options for people with dietary restrictions: Food allergies Many people have food allergies or sensitivities to lactose, nuts, and eggs, which many breakfast foods contain. Fortunately, there are many substitute options available: Lactose intolerance: Lactose free milk and milk substitutes, such as almond milk, can be good options for people with lactose intolerance. Nut allergies: Lentils, chia seeds, and quinoa can be healthful options for people with nut allergies. Egg allergies: People who cannot eat eggs should consider lean meats, nut butter, and nuts instead. Celiac disease For people with celiac disease or a gluten intolerance, finding breakfast options that do not contain gluten is essential. Many food stores sell gluten free versions of common breakfast items, including: Another gluten free breakfast idea involves serving high protein foods, such as eggs or lean meats, with wilted spinach and cooked tomatoes. Learn more about gluten free diets and whether they are healthful. Diabetes hard boiled eggs
People with diabetes can eat hard boiled eggs for breakfast to manage their blood sugar levels. People with diabetes must keep their blood sugar levels consistent. Skipping breakfast may not be healthful for people with diabetes, particularly if they take medication for their condition. People who take medication for their diabetes typically need to consume some carbohydrate to manage their blood sugar levels. Here are some breakfast options for people with diabetes: scrambled eggs with wilted spinach hard boiled eggs a handful of nuts lean meats with spinach or kale Learn more about the best foods for people with diabetes to eat. Summary Breakfast habits can support weight loss but how this works varies from person to person. Eating breakfast may aid weight loss for some people as they stay fuller for longer, which prevents snacking during the day. For others, skipping breakfast supports weight loss because it leads them to consume fewer calories overall. Losing weight requires a person to burn fewer calories than they eat. To sustain weight loss, a person must stick to a reduced calorie diet and pair this diet with more activity. To make sustainable dietary changes, it is vital that a person finds healthful foods they enjoy eating. Highly restrictive diets are often difficult to follow. Instead, incorporate a few treats and find nourishing, low calorie foods that taste good. A dietitian or doctor can help a person develop the right meal plan for their needs.
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Vegetarian heart health: Study identifies benefits and risks

The authors of a large, long term study conclude that pescatarianism and vegetarianism have an association with a reduced risk of ischemic heart disease, but they note that vegetarians have a slightly higher risk of stroke.
Cutting vegetables
A new, large scale study places the health effects of vegetarianism under the microscope once again.

Over recent years, increasing numbers of people have decided to reduce the amount of meat in their diet.

Vegetarians, vegans, and pescatarians (people who eat fish but not meat) are a growing demographic.

Following any one of these meat-free diets is nothing new, but due to the spike in popularity, researchers are keen to understand the possible health implications.

A recent study, which features in BMJ, looks specifically at plant based diets and their effect on the risk of stroke and ischemic heart disease (IHD).

IHD refers to any problems that occur due to a narrowing of the arteries to the heart. Without treatment, it can lead to a heart attack.

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What do we already know?

Earlier studies have concluded that vegetarians have a lower risk of obesity and IHD, but as a review of relevant research explains, there is a need for more long term studies involving larger numbers of people.

As for stroke risk, only a few studies have looked into the relationship between a plant based diet and stroke risk. According to the authors of the current study, these "found no significant differences in risk of total stroke deaths between vegetarians and nonvegetarians."

The latest study aimed to fill in some of these gaps. In all, the scientists took data from 48,188 people whom they followed for an average of 18.1 years.

The participants, who had an average age of 45 years at the start of the study, had no history of IHD or stroke.

The researchers assigned each participant to one of three groups:

Meat eaters: people who reported eating meat Fish eaters: those who ate fish but no meat Vegetarians and vegans: people who did not eat meat or fish

The team combined vegans with vegetarians for the main analysis due to the small number of vegans in the dataset.

Using food questionnaires, the researchers could also assess overall food intake and nutrient levels. Aside from dietary information, they collected information about factors such as body mass index (BMI), height, and blood pressure.

A double edged sword

During the 18.1 years of follow-up, there were 2,820 cases of IHD and 1,072 cases of stroke.

After adjusting for sociodemographic and lifestyle factors, the analysis revealed both positive and negative relationships between cardiovascular health and reduced meat intake.

The rate of IHD among pescatarians was 13% lower than that of meat eaters, while vegetarians had a rate that was 22% lower. To put these numbers into perspective, the authors explain:

"This difference was equivalent to 10 fewer cases of ischemic heart disease [...] in vegetarians than in meat eaters per 1,000 population over 10 years."

According to the authors, this positive association appears to be, at least partly, due to lower rates of hypertension and diabetes, as well as lower BMI and cholesterol levels. However, even after the scientists had adjusted the data to account for these factors, the effect was still "marginally significant."

Conversely, vegetarians had 20% higher rates of stroke than meat eaters. This difference is equivalent to three more cases of stroke per 1,000 people over 10 years. This association was mostly due to hemorrhagic stroke rather than ischemic stroke.

No previous studies have shown this type of relationship between vegetarianism and stroke risk. The authors believe that this might be because earlier work reported stroke mortality rather than incidence. Strokes are only fatal in 10–20% of cases, so many cases would not count toward the reported total.

Why the scientists saw this increase in stroke risk is up for debate. The authors believe that it might be due to lower levels of other circulating nutrients in the blood of vegetarians. These might include essential amino acids and vitamins B-12 and D.

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Strengths, limitations, and further work

The study has a number of strengths; first and foremost, the researchers used a large sample size and a long follow-up period. They also linked participants to their medical records to ensure the accurate collection of health outcomes.

In addition, the researchers checked the participants' eating habits at two time points that were years apart, finding that adherence was good overall.

However, there were certain limitations. For instance, the participants self-reported their diet, which leaves room for error and misreporting. Diet can also fluctuate over days, weeks, and years.

Also, researchers did not have access to the use of drugs, including statins, among participants.

As the study is observational, it is not possible to conclude that the effect is causal. In other words, the changes in risk could be due to other factors that the scientists did not measure.

Lastly, because the participants were predominantly European and white, the findings may not be widely applicable.

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An editorial by Prof. Mark A. Lawrence and Prof. Sarah A. McNaughton from Deakin University in Australia accompanies the paper.

In it, the authors call for caution, explaining how the conclusions are "based on results from just one study, and the increase is modest relative to meat eaters."

They also explain that studies "have reported mostly protective associations between vegetarian diets and chronic disease risk factors."

These results are sure to open debate and spark more research. That vegetarianism protects against IHD is not surprising given past findings. However, the fact that giving up meat might slightly increase stroke risk is unexpected. More work is sure to follow.

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Causes and treatments for a burning chest

Chest burning can be frightening, especially for people concerned about heart health or having a heart attack. However, there are many potential causes of chest pain. There are also many treatment options available.

Many causes of a burning feeling in the chest are not harmful. In fact, just 15–25% of people who visit the emergency room with chest pain have an acute heart problem.

In this article, learn more about what causes a burning chest. We also cover some treatments and home remedies.

Causes Numerous conditions can cause chest burning, including: Heartburn Woman holding her chest due to chest burning
A common cause of chest burning is heartburn.

Heartburn, or acid reflux, is one of the most common causes of painful burning in the chest.

The sensation ranges from mild discomfort to intense pain.

Heartburn occurs when acid from the stomach travels back up the esophagus. It is more common in pregnant women, people with gastroesophageal reflux disease, and those with a hiatal hernia.

Consuming acidic foods and drinks, such as tomatoes and alcohol, may increase the risk of heartburn. Smoking tobacco can also increase the risk.

Some other symptoms of heartburn include:

burping burning in the throat pain that begins shortly after a meal pain that gets worse when lying down

Other gastrointestinal problems

Other gastrointestinal problems may also cause burning chest pain. Some may cause symptoms that mimic those of heartburn.

For example, people with gallstones or liver health problems may experience intense heartburn.

If the pain does not get better after taking an antacid or other heartburn medication, the problem might be due to something else, such as gallstones, liver disease, or pancreatitis.

Some other signs of serious gastrointestinal problems include:

very dark urine very light or infrequent bowel movements intense pain anywhere in the abdomen, but especially in the upper right side, under or near the ribs

Muscle or bone injuries

Muscle injuries can cause intense burning in the chest, especially when using the injured muscle to lift heavy objects. Injuries to cartilage or bone may also cause pain and burning in the chest.

Burning chest pain may be a sign of an injured muscle or a problem with bone or cartilage if:

the pain appears only in certain positions or while lifting heavy objects the pain changes with massage or pressure on the area there is swelling in the painful area of the chest

Panic attack

A panic attack can occur when a person feels overwhelmed with anxiety or panic. The heart may race and cause pain or discomfort in the chest. As the panic worsens, so too can the pain.

A panic attack will not cause a heart attack, but the two can feel similar. When the symptoms occur following a trauma, or in a person with a history of anxiety or panic, a panic attack is more likely than a heart attack. When in doubt, a person should go to the emergency room.

Learn more about the differences between panic attacks and heart attacks here.

Breastfeeding

mother breastfeeding her baby
Breastfeeding may cause burning pain in the breasts and chest.

Breastfeeding can cause a range of new and unfamiliar sensations in the chest as the breasts expand, contract, and adjust to feeding an infant.

Some women experience sharp, deep, shooting, or burning pains as part of their milk letdown. Others develop an infection called mastitis, which can cause a burning feeling in the skin and breast tissue.

Some people have a brief spasm in the blood vessels of their nipples after breastfeeding. The pain can be sharp, burning, and intensely painful, but it usually only lasts a few minutes.

Breastfeeding could be the cause of burning chest pain if:

a woman currently breastfeeds, has recently given birth, or has recently stopped breastfeeding the pain is primarily on one or both sides of the chest, not in the middle of the chest other changes to the breasts — such as pain in the nipples, an increase in breast size, or skin changes — occur alongside the pain

Heart disease

Although many types of chest pain, including some burning pain, can indicate a problem with the heart, they do not always mean that a person is having a heart attack.

Angina is a term that doctors use to refer to chest pain when the heart does not get enough oxygen. The most common cause of angina is coronary heart disease, which is a condition that blocks blood flow when plaque builds up in the blood vessels.

A doctor may treat angina as a warning sign that a person is at risk of having a heart attack.

It can be difficult to distinguish the pain of angina from that of a heart attack. Even doctors cannot usually tell the difference based on symptoms alone.

For this reason, a person should go to the emergency room for any angina that does not go away or that gets worse over time. A person who has previously had angina but whose angina pattern changes (unstable angina) should also seek emergency care.

Some symptoms of angina include:

pain, pressure, or burning in the chest nausea pain that comes and goes feeling winded or breathless pain that radiates to the jaw or shoulder

Other vascular health problems

Problems with the blood vessels that carry blood to and away from the heart and lungs may cause chest pain.

For example, an aortic dissection occurs when the aorta, which is a large blood vessel, tears. Without prompt treatment, it can be fatal.

A pulmonary embolism is another blood vessel issue. It occurs when a blood clot breaks loose and travels to the lungs. This can damage the lungs and heart, and it may also be fatal.

Some signs of a blood vessel problem include:

a sudden ripping, tearing, burning pain in the chest, which may indicate an aortic dissection chest pressure or burning that gets worse with exercise sudden pain accompanied by difficulty breathing or dizziness

People should always seek emergency medical attention for these symptoms.

Lung health issues

Problems with the lungs can also cause burning in the chest.

For example, lung infections and pneumonia can cause burning pain in the chest or lungs, especially when breathing or during movement or exercise.

People who experience burning pain that makes breathing difficult should see a doctor, as it can be difficult to tell these symptoms from those of a heart attack.

Doctors can also help diagnose and treat other lung health issues, such as pneumonia.

Thank you for supporting Medical News Today Diagnosis To diagnose the cause of burning in the chest, a doctor will typically perform several tests. These may include: a complete medical history a physical exam to check heart rate and pulse, look for swelling, and assess muscle and organ health blood work to check for infections or changes that may indicate a heart attack or other heart problem an electrocardiogram, which measures electrical activity in the heart chest X-rays CT scans Treatment The treatment options for burning chest pain vary depending on the cause. For example, heartburn may require a person to take an antacid or make dietary changes, whereas more serious heart or lung conditions often demand comprehensive lifestyle changes. A person having a heart attack may need blood thinners or surgery, such as bypass surgery. People should not try to treat chronic chest pain at home, especially if they do not know the underlying cause. Even chronic heartburn can cause long term health problems. Only a doctor can diagnose the cause and recommend appropriate treatment. Home remedies woman lying on the sofa and deep breathing to help with chest burning
Lying down and taking slow, deep breaths can help with minor chest burning. Some home management strategies can help soothe minor chest burning and determine whether a person needs emergency care. However, if the pain does not get better, is severe, or indicates a heart attack, they should seek immediate medical attention. Home remedies for minor causes of chest burning include: lying down and taking slow, deep breaths taking an antacid gently massaging the painful area drinking a glass of water changing positions applying a hot or warm compress to painful or tender breasts Prevention It is not always possible to prevent serious heart, lung, and vascular conditions, but people can reduce their risk by maintaining a healthy body weight and exercising as regularly as possible. Seeking care for any chronic medical conditions, such as diabetes or coronary artery disease, can also reduce the risk of developing complications. Eating a balanced, nutrient-rich diet that is low in trans fats and sodium can also help. People with chronic heartburn often find relief from eating fewer acidic foods. Eating smaller, more frequent meals may also help relieve symptoms. Thank you for supporting Medical News Today When to see a doctor Some people avoid seeking medical care for burning chest pain because they fear a particular diagnosis or worry that they are overreacting. However, burning in the chest can be serious, and prompt medical care can be life saving — especially for heart, vascular, and lung problems. People who are uncertain of the reason for their pain should seek immediate care. Go to the emergency room for: sudden, intense burning pain in the chest chest pain that occurs with other symptoms, such as confusion, loss of consciousness, or difficulty breathing intense pressure or pain in the center of the chest angina that is different from the person's usual angina pattern chest burning that gets steadily worse or does not improve with home treatment Summary Burning chest pain can occur for many reasons. It is usually due to heartburn or other gastrointestinal issues, but injuries and panic attacks can also cause a burning chest. More serious conditions, such as a heart attack or aortic dissection, can also cause a burning chest. Anyone experiencing symptoms of these issues should seek medical attention. A doctor can help diagnose and treat the issue.
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Is dairy good or bad for your health?

Although people tend to accept that fruits and vegetables are healthful options, other food groups, such as dairy, spark more discussion and seem to have conflicting recommendations.

The United States Department of Agriculture (USDA) Choose My Plate recommendations state that adults should consume 3 servings of dairy products per day. Children should consume around 2 or 2.5 servings per day, depending on their age.

Examples of typical servings of dairy include:

1 cup of milk 1 cup of yogurt 1 ounce of hard cheese, such as cheddar or Monterey Jack half a cup of cottage cheese

For decades, the USDA have advised people to consume milk every day. However, some health advocates believe that people do not need to eat dairy to be healthy. Others believe that dairy may even be bad for health if people consume too much of it.

These mixed messages can be confusing. In this article, we break down what the evidence says.

Milk and bone health Couple buying milk and wondering if dairy is bad for you
Dairy contains nutrients such as phosphorus, magnesium, vitamin D, and protein.

Calcium is a necessary mineral. It helps build strong bones and is necessary for other functions, such as muscle contraction and nerve transmission.

Dairy products are a good source of calcium, and this is one of the main reasons that the USDA and the National Institutes of Health (NIH) recommend that people consume dairy.

Dairy also contains other important nutrients for bone health, such as phosphorus, magnesium, vitamin D, and protein.

Without enough calcium, a person may be at risk of osteoporosis. This condition causes bones to weaken and leaves them prone to breaking. The National Osteoporosis Foundation explain that people need adequate calcium and vitamin D to prevent bone loss and osteoporosis.

Although dairy products may contain more calcium than many other foods, evidence suggesting that consuming dairy can prevent bone fractures seems conflicting.

For example, one systematic review and meta-analysis suggests that as dairy intake increases, the risk of osteoporosis and hip fracture decreases in some studies. However, this was not the case in all the studies included in the analysis.

It is also important to explain that many other factors can affect bone health, including exercise, smoking status, alcohol use, and changes in hormone levels during aging.

One long term Swedish study that involved more than 61,000 women and 45,000 men found a potential link between higher milk intake and higher mortality and higher incidence of bone fractures.

However, this association does not indicate a "cause and effect" relationship. For example, the women who had hip fractures and higher milk intake may have been drinking more milk because they were at risk of hip fractures.

The study authors caution that the results do not take into consideration other lifestyle factors and health conditions.

Another long term study of 94,980 Japanese people found the opposite association, with a lower risk of mortality tied to increased milk consumption.

Overall, the majority of research on dairy suggests that milk is beneficial for bone health and cardiovascular health.

One thing that is clear is that calcium and the other nutrients that milk provides are necessary for bone health.

Those who cannot or choose not to consume dairy should consume other calcium-rich foods or speak to a doctor about whether they need a calcium supplement.

Learn more about 18 nondairy calcium-rich foods here.

Thank you for supporting Medical News Today Dairy, saturated fat, and heart health Saturated fats are present in full fat dairy products such as whole milk, butter, and cream, and to a lesser extent, in reduced fat dairy products such as 1% milk. Saturated fats are also present in meat, some processed foods, coconut oil, and palm oil. The American Heart Association (AHA) say that saturated fats can lead to high cholesterol and heart disease. As a result, many full fat dairy products do not appear in heart-healthy diet recommendations. The AHA advise people to choose fat free or low fat dairy products to obtain calcium without the saturated fat. The National Heart, Lung, and Blood Institute also recommend that people choose low fat or fat free dairy products as part of a healthful diet. However, recent evidence suggests that the link between saturated fat and heart disease is not as strong as people once believed. One review states that some people have exaggerated the role of saturated fat in heart disease. Again, many other lifestyle factors are important when it comes to evaluating heart disease risk. A team of cardiologists wrote an article stating that eating foods with saturated fat does not clog the arteries, as people once believed. They contend that the "fat free" movement caused higher intakes of carbohydrate foods, including sugars. This might explain why rates of heart disease have increased. Another article states that numerous analyses and reviews do not support the belief that eating saturated fat is linked to heart disease. The article also mentions that saturated fat could lower the risk of obesity-related diabetes in some cases. Although the links between full fat dairy and heart disease are no longer clear, there are other things a person can do to adopt a heart-healthy lifestyle, including: eating plenty of fruits and vegetables exercising regularly not smoking limiting alcohol consumption getting adequate amounts of sleep controlling blood sugar levels, if they have diabetes People should also speak with a health professional about how often they need blood pressure checks, cholesterol and glucose tests, and other measures that can predict heart disease risk. Learn more about cardiovascular disease and the lifestyle changes that reduce its risk here. Diabetes and dairy foods from a mediterranean diet
A person can try the Mediterranean diet to reduce the risk of type 2 diabetes. Diabetes is a common health condition, with diabetes and prediabetes affecting more than 100 million people in the U.S. Although many factors influence whether or not a person will develop diabetes, diet is one important aspect. The American Diabetes Association recommend a Mediterranean diet for a reduced risk of type 2 diabetes and for lowering A1C levels, which are an important indicator of blood sugar control. The Mediterranean diet emphasizes the consumption of healthful fats from olive oil and fish, as well as fruits, vegetables, whole grains, and moderate amounts of dairy. A meta-analysis found that consuming dairy, particularly yogurt, could have a protective effect against type 2 diabetes. Another study found that the people who consumed the most high fat dairy products had a 23% lower risk of developing type 2 diabetes than those who consumed the least amount of high fat dairy. Dairy may fit into a healthful diet for many people who have type 2 diabetes. As each person is different, it is best to speak with a doctor or nutritionist about diet recommendations for good blood glucose control and management of diabetes. Learn more about the best milk for people with diabetes here. Nutrients in milk Milk contains a number of nutrients that are beneficial to health. It contains a complete protein, which means that it contains all the amino acids that are essential for health. It also contains other vitamins and minerals that other foods provide limited amounts of. One cup of fortified whole milk contains: Calories: 149 Protein: 7.69 grams (g) Carbohydrate: 11.7 g Fat: 7.93 g Calcium: 276 milligrams (mg) Vitamin D: 3.7 international units (IU) Vitamin B-12: 1.1 mcg Vitamin A: 112 IU Magnesium: 24.4 mg Potassium: 322 mg Folate: 12.2 IU Phosphorus: 205 mg Most milk manufacturers fortify their products with vitamins A and D. A person can see whether milk is fortified by reading the ingredients label. The label will list the added vitamins, such as vitamin A palmitate and vitamin D-3, as ingredients. Milk is a nutrient-rich drink, offering many nutrients that other beverages such as sports drinks, sodas, and other nondairy milk substitutes are lacking. Learn more about how cow's milk compares with almond, hemp, oat, and soy milk. Lactose intolerance Dairy products contain a sugar called lactose. To digest lactose, a person's small intestine must produce an enzyme called lactase. Without enough lactase, a person will not be able to digest dairy products that contain lactose. This leads to symptoms of lactose intolerance, which may include: Lactose is also present in human breast milk. Most babies are able to digest it without issues. In fact, lactose intolerance in infancy is a rare disorder. However, many people become lactose intolerant as their body slows down its production of lactase. About 65% of the world's population have a "reduced ability to digest lactose after infancy." Some dairy products that are fermented, such as yogurt and certain hard cheeses, contain lower amounts of lactose than a glass of milk. These types of fermented products may be suitable choices for some people who are sensitive to lactose. Other people find that almost any amount of dairy causes symptoms. People who cannot digest dairy may wish to consume lactose reduced dairy milk or fortified soy milk alternatives. Other nondairy milk alternatives do not provide similar nutrition. Learn more about lactose intolerance here. Thank you for supporting Medical News Today Summary The majority of reliable evidence suggests that dairy can be an important nutrient-rich choice for a healthful diet. However, it is up to each individual to decide whether or not to consume it. People who do not or cannot consume dairy should obtain calcium from other sources, such as fortified nondairy soy milk, leafy green vegetables, and other calcium-rich foods. People may wish to speak with a health professional about their dietary needs based on their health history and lifestyle.
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Differences in gut bacteria may predispose to heart attacks

A small study has recently made two breakthrough discoveries. First, that the bacteria present in coronary (heart) plaques are pro-inflammatory, and second, that some people with heart disease harbor different sets of gut bacteria that may contribute to their risk of a heart attack.
doctor advising patient in hospital
Some researchers believe that gut bacteria may hold clues about who is more at risk of experiencing a heart attack.

According to data from the Centers for Disease Control and Prevention (CDC), approximately 735,000 individuals in the United States experience a heart attack each year.

Heart attacks can occur when a person has developed heart disease. A key feature of heart disease is the buildup of plaque in the arteries. Plaque is made up of fat, calcium, and other substances.

However, some people are more predisposed to heart attacks than others, even within a cohort whose members all have heart disease. So, researchers have been trying to understand why this happens.

Last week, Eugenia Pisano from the Catholic University of the Sacred Heart in Rome, Italy, and her colleagues presented their findings on this topic at the European Society of Cardiology Congress. This year, the congress took place in Paris, France.

In a small study, Pisano and team investigated how bacteria might influence the stability of coronary plaques. Coronary plaques form in the heart's arteries, and when they become unstable, a heart attack can follow.

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For the study, the researchers worked with 30 individuals who had acute coronary syndrome. Coronary syndrome refers to a multitude of conditions and events characterized by reduced blood flow to the heart. These conditions and health events include unstable angina and myocardial infarction (heart attack).

Additionally, the researchers also recruited 10 participants with stable angina, which is a heart condition characterized by chest pain and discomfort.

The team collected fecal samples from all the participants so that they could isolate gut bacteria. They also extracted and analyzed coronary plaque bacteria from angioplasty balloons. Doctors use angioplasty balloons to widen coronary arteries to improve blood flow.

First of all, the researchers found that the bacteria present in coronary plaques were pro-inflammatory, primarily belonging to species, such as Proteobacteria and Actinobacteria.

"This suggests a selective retention of pro-inflammatory bacteria in atherosclerotic plaques, which could provoke an inflammatory response and plaque rupture," says Pisano.

In comparison, fecal samples had a heterogeneous bacterial composition, featuring mainly bacterial strains, such as Bacteroidetes and Firmicutes.

The researchers also discovered that the gut bacteria populations differed between the two groups of participants. Individuals with acute coronary syndrome had a higher proportion of Firmicutes, Fusobacteria, and Actinobacteria in their guts, whereas people with stable angina had a stronger Bacteroidetes and Proteobacteria presence.

"We found a different make-up of the gut microbiome in acute and stable patients," notes Pisano. This suggests that "[t]he varying chemicals emitted by these bacteria might affect plaque destabilisation and consequent heart attack."

"Studies are needed to examine whether these metabolites do influence plaque instability," the researcher advises, since, so far, it remains unclear to what extent bacteria present in the gut or on coronary plaques influence the development of a heart attack.

However, Pisano, adds: "While this [current] study is a small study, the results are important because they regenerate the notion that at least in a subset of patients, infectious triggers might play a direct role in plaque destabilization."

"Further research will tell us if antibiotics can prevent cardiovascular events in certain patients. Microbiota in the gut and coronary plaque could have a pathogenetic function in the process of plaque destabilization and might become a potential therapeutic target."

Eugenia Pisano

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Heart attack risk higher in those who sleep too little or too much

The right amount of sleep is protective of heart health. This was the conclusion of new research that found sleep duration can influence a person's risk of heart attack, regardless of other heart risk factors, including genetic ones.
man sleeping
New research tracks sleep duration and a person's risk of a heart attack.

In a recent Journal of the American College of Cardiology paper, scientists from the United States and the United Kingdom describe how they analyzed sleep habits and medical records of 461,347 people aged 40–69 years living in the U.K.

The data, which came from the UK Biobank, included self-reports of how many hours participants habitually slept per night and health records covering 7 years. It also included results of tests for risk genes.

The analysis revealed that those who slept less than 6 hours per night had a 20% higher risk of a first heart attack in comparison to those who slept 6–9 hours. Those who slept more than 9 hours had a 34% higher risk.

The researchers also found that keeping sleep duration to 6–9 hours per night can reduce the risk of a first heart attack by 18% in those people with a "high genetic liability" for developing heart disease.

"This [study]," says senior study author Celine Vetter, Ph.D., an assistant professor of integrative physiology at the University of Colorado at Boulder, "provides some of the strongest proof yet that sleep duration is a key factor when it comes to heart health — and this holds true for everyone."

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Sleep duration is an independent risk factor

Studies have been finding links between sleep habits and heart health for some time now. However, most of those findings have come from observational studies: these studies that can only confirm links but cannot establish the direction of cause and effect.

Because many factors affect both sleep and heart health, it is not easy to determine whether poor sleep makes for poor heart health or poor heart health leads to poor sleep.

Vetter and her colleagues sought to meet this challenge by using data from a vast number of individuals, combining it with genetic research, and ruling out dozens of potential influencing factors.

Altogether, they adjusted the results to remove the potential effect of 30 factors that can influence both heart health and sleep. These factors include physical activity, mental health, income, education, smoking, and body composition.

The researchers' results showed that sleep duration was an independent risk factor for heart attack.

The researchers found that the risk of heart attack increased the further that people's habitual night sleep diverged from 6–9 hours.

Individuals who slept 5 hours each night, for example, had a 52% higher risk of a first heart attack than those who slept 7–8 hours. Individuals who slept 10 hours per night had double the risk.

Analysis using gene variants for short sleep

The team then used a method called Mendelian randomization (MR) to confirm that short sleep duration was an independent risk factor for heart attack.

The MR analysis showed that individuals with gene variants that predisposed them to short sleep had a higher risk of heart attack.

Previous studies have uncovered more than 2 dozen variants associated with short sleep duration.

By using genetic variants, MR can determine whether an observational link between a risk factor and a disease is consistent with a causal effect.

"This gives us even more confidence that there is a causal relationship here – that it is sleep duration, not something else, influencing heart health," Vetter argues.

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Sleep is key to heart health

According to the Centers for Disease Control and Prevention (CDC), more than one-third of adults in the U.S. sleep less than the recommended 7 hours per night.

The CDC recommend the following tips for good sleep:

Go to bed and rise at the same time every day, even at the weekend. Get enough natural light — especially earlier in the day. Avoid exposure to artificial light, particularly in the hours up to bedtime. Get enough daily exercise and avoid exercising near bedtime. Avoid eating and drinking in the hours before bedtime — especially alcohol and high fat and sugar-rich foods. If difficulties persist, seek medical advice to help identify obstacles to sleep, including other health conditions.

The latest research team hopes that its findings will raise awareness among doctors, the public, and policymakers about the impact of sleep on heart health.

"It's kind of a hopeful message," says first study author Iyas Daghlas, who is studying medicine at Harvard Medical School in Boston, MA, "that regardless of what your inherited risk for heart attack is, sleeping a healthy amount may cut that risk just like eating a health[ful] diet, not smoking, and other lifestyle approaches can."

"Just as working out and eating health[fully] can reduce your risk of heart disease, sleep can too."

Celine Vetter, Ph.D.

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Exercise may help people with cardiovascular disease the most

New research comparing the benefits of exercise for healthy people versus people with cardiovascular disease found that the latter may benefit the most from being physically active.
person running on country road
A study shows, for the first time, that people with cardiovascular disease benefit more from exercise than healthy people.

Existing evidence shows that staying physically active can help a person live longer and that regular exercise can help prevent many chronic conditions, including cardiovascular disease.

However, no studies had looked at how exercise really benefits individuals who already have cardiovascular disease.

Now, for the first time, researchers — many from Seoul National University, in South Korea — have compared the effects of exercise on the risk of death in a cohort of healthy participants and a cohort of participants with preexisting cardiovascular disease.

The study revealed that individuals with cardiovascular disease seemed to benefit more from exercise than healthy individuals — and the more they exercised, the better.

The team, led by Dr. Sang-Woo Jeong, published the findings in the European Heart Journal last week and also presented them at the European Society of Cardiology (ESC) Congress 2019, held in Paris, France.

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14% death risk reduction over 6 years

Dr. Jeong and colleagues analyzed the data of 441,798 participants, who were part of the Korean National Health Insurance Services Health Screening Cohort.

Of these, 131,558 participants had preexisting cardiovascular disease, while 310,240 were healthy. All of the participants were aged 40 or over, with an average age of 60. All had taken part in a health screening program between 2009 and 2015 and had provided information about their levels of physical activity.

In their analysis, the researchers also had access to follow-up data for nearly 6 years, as well as information regarding death and its cause, accessed through the Korean National Death Index.

The participants provided information on their levels of physical activity via surveys that asked them to report how often they had been physically active in the past week. In this case, physical activity referred mainly to instances of aerobic exercise and did not include daily activities, such as housework.

The researchers converted these data into units of metabolic equivalent task minutes per week (MET-mins/week), which allowed them to quantify levels of activity.

Dr. Jeong and the team found that, after the 6-year follow-up period, the participants with cardiovascular disease had benefitted more from physical activity than the healthy participants.

More specifically, for every 500 MET-mins/week, healthy individuals saw a 7% reduction in premature death risk, while those with cardiovascular disease saw a 14% death risk reduction.

Among healthy individuals, those who saw the most benefits were those who undertook 0–499 MET-mins/week of exercise. The benefits were less significant for healthy people who undertook 500–1,000 MET-mins/week, only increasing again after the 1,000 MET-mins/week landmark.

As for participants with cardiovascular disease, once more, individuals who undertook 0–499 MET-mins/week of exercise saw the most significant benefits. However, in this cohort's case, risk reduction continued to rise beyond the 500 MET-mins/week point.

Yet, at the same time, the researchers noted that almost 50% of all participants exercised very little, and about 25% of participants reported no physical activity.

"We found that approximately half of the people in the study did not reach the recommended level of leisure-time physical activity, and a quarter had a totally sedentary lifestyle," says Dr. Jeong.

"People with cardiovascular disease had lower levels of physical activity than those without, but the more exercise people did, the lower their risk of death during the 6 years of follow-up. The main new finding of this study is that people with cardiovascular disease benefit from a physically active lifestyle to a greater extent than healthy people without cardiovascular disease," Dr. Jeong explains.

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How to reach desired activity levels

As to why individuals with cardiovascular disease derive greater benefits from exercise than healthy individuals, the researchers can only make conjectures.

"There may be several plausible explanations for why people with [cardiovascular disease] benefited the most from exercise. First, sedentary lifestyle is a well-known risk factor for [cardiovascular disease]. Patients with [cardiovascular disease] may have had sedentary lifestyles, and thus, changing their lifestyle to become more physically active may be more beneficial," notes study co-author Dr. Si-Hyuck Kang.

"Secondly," he adds, "a number of previous studies have shown that physical activity helps control cardiovascular risk factors such as blood pressure, cholesterol, and blood glucose. The benefit of physical activity in secondary prevention may come by better controlling such risk factors."

"Lastly, patients with [cardiovascular disease] usually have higher levels of systemic inflammation than those without [this condition], and there is evidence that physical activity lowers systemic inflammatory levels," Dr. Kang explains.

The researcher also goes on to advise that doctors encourage individuals with cardiovascular problems not to give up on exercise and explain just how physical activity can benefit health.

"The 2016 ESC guideline for primary prevention recommends healthy adults of all ages should perform at least 150 minutes a week of moderate intensity or 75 minutes a week of vigorous intensity aerobic physical activity, or an equivalent combination," Dr. Kang notes.

"One way you can achieve 500 MET-minutes a week is to do brisk walking for 30 minutes, five times a week. If you are very busy [...], the other way to achieve approximately 500 MET-minutes a week is to do vigorous physical activity, such as climbing hills with no loads, for 75 minutes, once a week."

Dr. Si-Hyuck Kang

"You can achieve 1,500 MET-minutes a week by doing brisk walking for 30 minutes, five times a week, plus climbing hills for 2.5 hours, once a week," Dr. Kang also suggests.

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Heart health: Focus on healthful foods rather than diet type

New research finds that the type of diet a person follows is not as important as simply making sure it includes healthful foods.
close up of man chopping vegetables
When it comes to cardiovascular health, the type of diet is less important than 'simply eating healthful foods,' researchers say.

Most people know that eating a healthful diet is crucial for keeping our heart and our cardiovascular system healthy. But which diet is best?

Researchers at Beth Israel Deaconess Medical Center (BIDMC) in Boston, MA, set out to compare the effects of three diets on heart disease risks.

Each of the three diets followed the DASH pattern while focusing on one main macronutrient: carbohydrates, proteins, or unsaturated fats.

In the carbohydrates-rich diet, around 58% of kilocalories came from carbs; the protein-rich diet replaced 10% of kilocalories from carbs with protein; and the unsaturated fat diet replaced 10% of kilocalories from carbs with unsaturated fats, for example, from avocados, nuts, and fish.

Dr. Stephen Juraschek, Ph.D., an assistant professor of medicine at BIDMC and Harvard Medical School, is the corresponding author of the study.

Dr. Juraschek and team examined the effect of the three diets on cardiovascular risk factors, such as systolic blood pressure, low density lipoprotein (LDL) cholesterol, C-reactive protein levels — a marker of inflammation — and high-sensitivity troponin, which is "a marker of subclinical cardiac injury."

The researchers published their findings in the International Journal of Cardiology.

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Juraschek and team obtained their data from the so-called OmniHeart trial, a randomized intervention that followed 150 participants over 6 weeks. The average age of the participants was 54 years, 45% were women, and 55% were African American.

The researchers measured the cardiovascular risk factors at the beginning and end of each diet and compared the effects between the diets.

All three diets used the DASH dietary model, which emphasizes the consumption of vegetables, fruits, whole grains, fish, poultry, and beans.

In comparison with the baseline, the analysis revealed that all three diets had positive and prompt effects on heart health, as they all lowered the markers of inflammation and cardiac injury.

However, changing the composition of the macronutrients did not make a difference, suggesting that it does not matter whether the diet is high or low in healthful fats or carbs, but that the most important factor for improving heart injury is the general healthfulness of the diet.

"[T]hese findings suggest that a health[ful] diet, regardless of macronutrient profile, can directly mitigate subclinical cardiac damage and inflammation beyond traditional risk factors," write the researchers.

Juraschek sums up the significance of the findings, saying, "It's possible that macronutrients matter less than simply eating health[ful] foods."

"Our findings support flexibility in food selection for people attempting to eat a healthier diet and should make it easier," he continues.

"With the average American eating fewer than 2 servings of fruit and vegetables a day, the typical American diet is quite different from any of these diets, which all included at least 4 to 6 servings of fruits and vegetables a day."

"There are multiple debates about dietary carbs and fat, but the message from our data is clear: Eating a balanced diet rich in fruits and vegetables, lean meats, and high in fiber that is restricted in red meats, sugary beverages, and sweets, will not only improve cardiovascular risk factors but also reduce direct injury to the heart."

Dr. Stephen Juraschek

"Hopefully, these findings will resonate with adults as they shop in grocery stores and with health practitioners providing counsel in clinics throughout the country."

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Could bone-like particles in blood contribute to artery clogging?

Scientists have discovered that blood circulating around the body contains bone-like particles. They found the particles in blood samples from healthy humans and rats.
illustration of blood vessels
New research finds bone-like particles in the blood vessels.

They suggest that the bone-like particles could be evidence of ossification in bone marrow vessels.

The team also proposes that the particles may contribute to conditions such as atherosclerosis, a process that causes plaques, or deposits of fats and other substances, to build up inside arteries.

A recent paper in the journal Microcirculation gives a detailed account of the study.

Although most of the bone-like particles were very small, a significant proportion were large enough "to block small blood vessels throughout the vascular tree," write the authors.

The study follows previous research that uncovered a process in bone marrow whereby blood vessels "progressively and theoretically convert into bone tissue with advancing age."

That finding was the work of Rhonda D. Prisby, Ph.D., an associate professor of kinesiology at the University of Texas at Arlington, who is also the lead and corresponding author of the new study.

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Bone-like particles and vascular calcification

Prisby wondered if the processes of ossification in bone marrow blood vessels could give rise to bone-like particles that are capable of entering the bloodstream.

"By examining seemingly unrelated images and linking the details of them together," says Prisby, "I was able to posit the presence of bone-like particles in the blood."

Therefore, for the new investigation, she and colleagues used ultra-high microscopy to examine ossified bone marrow blood vessels in more detail.

They also "sought to confirm, characterize, and quantify the presence of [bone-like particles] in peripheral whole blood samples from humans and rats."

Cardiovascular diseases are the leading cause of death worldwide and were responsible for around 31% of all global deaths in 2016, according to the World Health Organization (WHO).

The WHO also estimate that, in 2016, 17.9 million people died of cardiovascular diseases, the majority of them from heart attack and stroke.

Vascular calcification is a complex and dynamic process — involving several mechanisms — that deposits calcium in the walls of blood vessels.

The process hardens the vessels, reduces their elasticity, and raises the risk of cardiovascular diseases and deaths from such diseases.

Probing the process of vascular calcification

In their study paper, Prisby and colleagues explain that the processes of vascular calcification are unclear. However, scientists suspect that the processes involve several types of cell in the vessel wall and the tissue that surrounds it.

The authors give an example involving smooth muscle cells. These cells in the vessel wall can transition from a contractile type to a bone-generating type and thence to a form that is "noncontractile, migratory, and proliferative."

This and other examples suggest that vascular calcification can start inside blood vessels.

Given that bone marrow vessels also undergo calcification, but most of the research literature on vascular calcification describes that which occurs outside the skeleton, the team decided to investigate further.

The purpose of the new study was to describe the features of bone marrow blood vessels that had become bone-like and to confirm what the team suspected — that the bloodstream contains bone-like particles, likely as a result.

The researchers used advanced microscopy techniques to examine human bone marrow blood vessels. These methods revealed two types of bone-like vessels: "transitioning" and "ossified."

They observed how transitioning vessels had bone-like particles stuck to their surfaces, meaning that, in theory, the particles could "gain access to and circulate within the blood."

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'Sharp tips and edges'

As well as examining human bone marrow vessels, the researchers examined blood samples from younger and older healthy human volunteers and rats.

They found bone-like particles in samples from both species. In neither species did age appear to make a difference to the percentage of bone-like particles.

Although most of the bone-like particles had a diameter no bigger than 15 micrometers, some were bigger and "of sufficient size to serve as emboli."

Prisby suggests that scientists should consider the potential role of bone-like particles when studying the processes of vascular calcification, heart attack, and stroke.

"Some of the ossified particles have sharp tips and edges that could damage the lining of blood vessels. This damage could initiate events leading to atherosclerosis [...] which can restrict blood flow over time."

Rhonda D. Prisby, Ph.D.

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Deaths to heart related conditions rising in the US

Progress against cardiovascular disease appears to be slipping in the United States as a new study reveals total related deaths rising since 2011.
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Being easily fatigued may signal future heart problems

People who are easily winded by very light exercise could be at more of a risk for heart disease than others who do not experience the same level of tiredness, recent research finds.
senior woman walking her dog
Finding light physical exercise exhausting may be a sign of future heart disease, says a new study.

The study, appearing in the Journal of the American Heart Association, looked at a participant pool of 625 individuals with an average age of 68 years.

The study team found that those who tired easily had an overall higher chance of developing cardiovascular disease.

First, the researchers calculated each person's 10-year risk of heart disease or stroke, using two different formulas.

Then, 4.5 years later, they assessed each participant with a test that consisted of "an extremely slow walk." Each person had to walk for 5 minutes on a treadmill set at a pace of 1.5 miles per hour. This exercise test was to examine their "fatigability."

After studied all the data, the researchers found that those who had higher cardiovascular risk scores from years ago were more likely to report that this simple physical task was exhausting.

"Even if you're exhausted because you have a newborn at home, this would be considered a very easy task," says study author Jennifer Schrack, an associate professor in the epidemiology department at Johns Hopkins Bloomberg School of Public Health in Baltimore, MD.

"It should be very light exertion. When people think the effort is more than very light, that's informative."

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Risks of cardiovascular disease on the rise

Cardiovascular disease (CVD) is the leading cause of death worldwide, according to the World Health Organisation (WHO). While the current numbers of deaths due to CVD are high, experts believe they will increase over the next 15 years from 17.9 million in 2016 to over 23.6 million in 2030 around the world.

The American Heart Association (AHA) estimate there are 85.6 millions of people in the United States with more than one type of CVD, and approaching half of these adults are 60 years old or above.

CVD is a broad term that can refer to several different conditions. There are several ways to reduce the chances of developing CVD.

Eating well is a significant part of having a healthy cardiovascular system. This means consuming foods that are low in saturated fat, trans fats, and sodium. It is also vital to include fruits and vegetables, whole grains, fatty fish if not vegetarian or vegan, nuts, legumes, and seeds.

Also, it is crucial to be physically active. The WHO goal for maintaining a healthy heart is to do at least 150 minutes each week of moderate anerobic exercise, such as brisk walking.

Many people break this up into five 30-minute sessions each week. Alternatively, they can swap this regime for 75 minutes of high-intensity aerobic exercise, such as jogging or running.

Implications of the study

Dr. Salim Virani, a cardiologist at Michael E. DeBakey VA Medical Center and a professor of cardiology at Baylor College of Medicine in Houston, who did not participate in the study, voiced one criticism of this latest investigation.

He notes that the researchers did not measure "fatigability" at the beginning of the study, which would have allowed them to compare the two tests 4.5 years later.

However, Schrack says that people can use this symptom as a sign that they should pay more attention to their cardiovascular health and possibly make changes that could reduce their risk of CVD.

"People don't like to hear, 'Eat right and exercise.' These are two of the biggest pieces of public health advice, and we say it relat[ing] to almost every condition. But it's so true."

Jennifer Schrack

"People who are able to maintain their weight, maintain their activity level, tend to have [fewer] effects of fatigue and certainly less cardiovascular risk over time," concludes Schrack.

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Blood pressure in our 30s and 40s has lasting impact on brain health

A new study followed adults from their mid-30s into their early 70s. It shows an association between blood pressure changes in early adulthood and midlife and brain changes at the endpoint of the study.
Blood pressure linked to brain health
At what age should we start monitoring people's blood pressure?

High blood pressure, or hypertension, is a risk factor for cardiovascular disease, stroke, and kidney disease.

With around 15–20% of our blood going to the brain, the National Institute of Aging (NIA), part of the National Institutes of Health (NIH), explain that "the blood flow that keeps the brain healthy can, if reduced or blocked, harm this essential organ."

A recent study, which Medical News Today featured earlier this month, indicates that intensive blood pressure treatment in mid-life — or lowering of systolic blood pressure to below 120 millimeters of mercury (mm Hg) — is linked to fewer white matter lesions in the brain in later life.

White matter lesions are a sign of blood vessel damage in the brain and are a hallmark sign of aging and a risk factor for cognitive decline.

In the United Kingdom, routine blood pressure monitoring starts around 40 years of age.

Yet, researchers from University College London in the U.K., and colleagues, suggest this should start earlier. They are basing this view on the findings of their latest study on the long term effects of blood pressure on brain health.

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Changes in blood pressure

Dr. Jonathan M. Schott, a professor in clinical neurology and a consultant neurologist, is the senior's study author. The team published their findings in The Lancet Neurology.

Dr. Schott and his colleagues used data from 502 individuals from the Insight 46 dataset, a neuroscience study that is part of the U.K.'s Medical Research Council National Survey of Health and Development, a large birth cohort study of people born in the U.K. in 1946.

The team had blood pressure measurements from all participants when they were 36, 43, 53, 60–64, and 69 years old. None of the volunteers had dementia when they had their brains scanned using PET-MRI imaging around 70 years of age.

The results showed that between ages 36 and 43, as well as from 43 to 53, there was an association between greater than normal increases in blood pressure and a smaller brain volume later in life.

In those with higher blood pressure changes between ages 36 and 43, there was also evidence of a smaller volume of the hippocampus at age 70.

Dr. Schott also found an association between having high blood pressure at 53 years of age and a 7% increase in white matter lesions in the brain at the time of the brain scans.

Similarly, he was able to link a greater than expected increase in blood pressure between the ages of 43 and 53 to a 15% increase in the same lesions.

However, the team found no effect of blood pressure on cognitive ability or beta-amyloid, both hallmarks of Alzheimer's Disease.

Monitor blood pressure 'even before mid-life'

"Our research builds on existing evidence around the role of blood pressure and subsequent brain pathology," Dr. Schott comments on the findings.

"We found that higher and rising blood pressure between the ages of 36 and 53 had the strongest associations with smaller brain volume and increases in white matter brain lesions in later life," he continues. "We speculate that these changes may, over time, result in a decline in brain function, for example, impairments in thinking and behavior, so making the case for targeting blood pressure in mid-life, if not earlier."

In an accompanying comment, Lenore J Launer, a senior investigator in the Laboratory of Epidemiology and Population Science at NIA, writes:

"Although there are several major translational efforts to more completely understand the complexity of blood pressure–cognitive-related outcomes, the association between blood pressure and vascular brain pathology is unlikely to be a chance finding."

"Millions of individuals have unhealthy blood pressure. Immediate attention should be given to efforts to control blood pressure through clinical services and public health interventions, and to alleviate the barriers to delivery and uptake of these public-health messages."

Lenore J Launer

"As increases in blood pressure and higher blood pressure between the ages of 36 and 53 seem to have a detrimental effect on brain health in later life, these findings reinforce the need for monitoring blood pressure even before mid-life," concludes study co-author Josephine Barnes.

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Study links insomnia genes to heart disease, stroke risk

Scientists used data from more than 1.6 million people to link insomnia genes to a higher risk of heart disease and stroke but not atrial fibrillation.
Insomnia link to heart disease
Does insomnia contribute to heart disease, or is heart disease a contributing factor for insomnia?

Heart disease is the leading cause of death in the United States, with stroke coming in at number five.

Maintaining a healthy heart is central to preventing heart or cardiovascular disease (CVD), and our sleep is part of this strategy.

The Centers for Disease Control and Prevention (CDC) advise that "most adults need at least 7 hours of sleep each night."

But what links sleep to our hearts?

Experts have previously identified associations between poor sleep and heart disease.

Earlier this year, Medical News Today featured a study that identified a significantly greater risk of death from heart disease in people who had high blood pressure together with insomnia and stress.

So, what can another study add to the picture?

Most population studies look for associations, but they cannot pinpoint cause and effect. While it may make sense to many people that poor sleep causes poor heart health, there is little data to confirm which is the chicken and which is the egg.

A new study aims to do just that.

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Using Mendelian randomization

Susanna Larsson, an associate professor of cardiovascular and nutritional epidemiology at the Karolinska Institute in Stockholm in Sweden, and Dr. Hugh Markus, a professor of stroke medicine at the University of Cambridge in the United Kingdom, published their analysis this week in the journal Circulation.

What sets this study apart from others is the use of Mendelian randomization (MR). This method uses genetic markers to investigate whether a risk factor can cause a particular disease.

A person inherits genetic markers, which will not change during their lifetime. Therefore, the technique works under the assumption that a disease cannot modify these markers. This allows scientists to look at causation.

Earlier this year, a large scale genetic analysis using data from 1.3 million people identified 956 genes across 202 locations in our genome that have a link to insomnia.

Larsson looked at a group of genetic variants called single nucleotide polymorphisms (SNPs) from this dataset and any potential ties to heart health. SNPs are mutations that only change one base in a particular genetic sequence.

This analysis allowed her to measure the odds of cardiovascular disease risk associated with an individual's genetic propensity toward insomnia.

Larsson used publicly available data from large association studies of people with various forms of heart disease.

Specifically, her analysis included 184,305 individuals from a coronary artery disease study, 394,156 from a heart failure study, 588,190 from an atrial fibrillation study, and 438,847 from a stroke study. The majority of the study participants were of European ancestry.

In those individuals with the insomnia genetic variants, the odds of developing coronary artery disease were 12% higher than in those without the SNPs. For heart failure, the odds were 16% higher, and for all types of stroke combined, they were 7% higher.

There was no change in the odds of developing atrial fibrillation in people with the insomnia SNPs.

"In conclusion, this MR study indicates that liability to insomnia is associated with a modest increased risk of CVD," Larsson and Dr. Markus write in the paper.

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Strengths and weaknesses

Larsson and Dr. Markus explain in the paper that one of the strengths of their analysis lies in the large dataset that they used.

On the other hand, one of the shortcomings is that while MR can help identify cause and effect, in this case, the data do not prove that insomnia itself is the cause of CVD.

"Thus, our findings may not necessarily mean that insomnia itself is a cause of CVD. We cannot rule out that there are other causal pathways leading to insomnia that cause CVD," they explain.

Another weakness is that the SNPs that the researchers used in this analysis only account for 2.6% of the genetic variance that occurs in insomnia, meaning that they only contribute a small amount to the likelihood of a person developing insomnia.

In fact, Larsson did not know which of the study participants who had heart disease also experienced insomnia.

Nevertheless, this study adds to the wider picture linking sleep habits to heart health.

"It's important to identify the underlying reason for insomnia and treat it."

Susanna Larsson

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Intense light may boost heart health

A novel use of intense light therapy may help decrease the tissue damage experienced during heart attacks, reveals new research in mice.
woman holding her chest
New research introduces a potential novel therapy for heart attacks.

The study, out of the University of Colorado and appearing in the journal Cell Reports, shows that exposing lab mice to intense light for a week improved their outcomes after heart attacks.

The research also suggests that this procedure could benefit humans, and the researchers outline the reason why.

"We already knew that intense light can protect against heart attacks, but now we have found the mechanism behind it," says the study's senior author Dr. Tobias Eckle, professor of anesthesiology at the University of Colorado School of Medicine in Aurora.

Boosting specific gene protects heart

In the study, the researchers discovered that intense light influences the functions of the PER2 gene, which is expressed by a part of the brain that controls circadian rhythms.

By boosting this gene through intense light therapy, the researchers discovered that the mice's heart tissue received extra protection when it experienced issues with oxygen, such as during a heart attack.

Additionally, this intense light also heightened cardiac adenosine, which is a specialized chemical that helps with blood flow regulation. In concert, both benefits helped protect heart health.

Also, when they studied the mice, the researchers found that being able to physically perceive light was vital, as blind mice experienced no benefits from the intense light.

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Humans had similar benefits

The next step was to see if humans could benefit from light therapy. The researchers worked with healthy human volunteers and exposed them to 30 minutes of intense light.

On five consecutive mornings, the researchers exposed the participants to 10,000 lumens of light and drew blood several times.

The researchers found that PER2 levels increased in response to light therapy in the human participants as it did in the mice. They also reported that the human volunteers saw a decreased level of plasma triglycerides and improved metabolism.

Dr. Eckle explained that light plays an essential part in human health, not only in regulating the circadian rhythm but in cardiovascular health as well.

He adds that according to prior studies, more people throughout the U.S. experience heart attacks during the darker months of winter, even in states that traditionally get more sunshine, such as Hawaii and Arizona.

Heart disease and its impact on U.S. adults

Heart disease is widespread throughout the United States. Around 610,000 people die from heart disease every year, which accounts for 1 out of every 4 deaths.

Coronary heart disease is the most common form of heart disease, and around 735,000 people in the U.S. experience a heart attack annually.

While most people know that chest pain is a sign of a heart attack, other less obvious signs include shortness of breath, upper body pain, nausea, cold sweats, lightheadedness, and discomfort in the arms, back, neck, jaw, or upper stomach.

There are many ways that people can reduce their risk of developing heart disease, such as eating better and exercising more. However, it is vital that research to discover new ways to protect the cardiovascular system continues.

This study using intense light highlights how something seemingly unrelated to heart health can have such protective benefits.

This study could have a significant impact on the treatment of heart patients in the future. Eckle says that "if the therapy is given before high risk cardiac and non-cardiac surgery, it could offer protection against injury to the heart muscle which can be fatal."

Eckle believes there are other possibilities, too, adding that "drugs could also be developed that offer similar protections based on these findings."

"However, future studies in humans will be necessary to understand the impact of intense light therapy and its potential for cardio protection."

Dr. Tobias Eckle

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Apple cider vinegar pills: Health claims and evidence

Apple cider vinegar is a type of fermented vinegar made from apples. Pills made from apple cider vinegar make this sour liquid easier to consume. People who promote natural health products claim that this vinegar offers numerous health benefits.

Apple cider vinegar (ACV) pills contain a dehydrated form of the vinegar. Some brands of ACV pills may include other ingredients, such as cayenne pepper or ginger.

This article outlines the scientific research on apple cider vinegar (ACV) for a range of different ailments. We also discuss the risks and potential side effects of ACV.

Claimed benefits a woman about to swallow some Apple cider vinegar pills
There is little research into the health benefits of ACV pills.

Proponents of ACV claim that it offers numerous health benefits. We list some of the most popular claims below.

However, people should note that most research into ACV involves the vinegar in liquid form.

Very little information is available about ACV in pill form, and any findings relating to liquid ACV may not translate to ACV pills.

Controlling yeast and other fungi

People who promote ACV claim that it may help treat certain types of fungal infection, such as Candida infections. Candida is the fungus responsible for vaginal yeast infections and oral thrush. Candida inside the mouth can also infect dentures.

A 2014 study found that a denture soak containing 4% ACV could prevent Candida from sticking to dentures.

The 30-minute denture soak also did not affect the surface roughness of the dentures, nor did it change their color. This suggests that a denture soak containing ACV may be a safe and effective way to prevent fungal infections of dentures.

However, there is no evidence to suggest that ACV pills would have this effect.

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Lowering cholesterol and reducing heart disease risk

Lipids are fatty substances in blood and body tissues. High levels of specific lipids in the blood can increase the risk of cardiovascular disease.

Supporters of ACV claim that it can lower the levels of blood lipids that damage health, such as triglycerides and low density lipoprotein (LDL) cholesterol, or "bad" cholesterol.

A 2011 animal study investigated the effects of ACV in rats that ate a high cholesterol diet. Researchers found that ACV lowered the rats' triglyceride levels. However, ACV also raised levels of LDL cholesterol and high density lipoprotein (HDL) cholesterol, or "good" cholesterol.

So far, studies on ACV and heart disease have focused on animals. It is therefore not possible to conclude the effects of ACV on human health.

However, current research suggests that the benefits do not outweigh the risks. Many experts believe that lifestyle changes and medication are probably more effective.

Treating or preventing bacterial infections

A 2018 study found that ACV has antimicrobial properties that are effective against various strains of bacteria. This suggests ACV may be useful as a bacterial disinfectant. However, using ACV to treat wounds can irritate and even burn the skin.

Controlling blood glucose and diabetes

a man eating lunch at a table.
Consuming ACV at mealtimes may help people with metabolic disorders.

Some people claim that ACV can cure diabetes. While there is no evidence to support this claim, several small studies suggest that ACV may help to control blood glucose.

A 2017 meta-analysis found that consuming ACV at mealtimes helped lower post meal blood glucose and insulin levels. This was the case for people with metabolic disorders, as well as healthy controls.

ACV may, therefore, be useful alongside standard treatments for diabetes. However, scientists need to carry out further research to confirm these effects.

Supporting weight loss

Some smaller studies suggest that ACV may improve weight loss. A 2018 randomized controlled trial found that taking ACV could increase weight loss among people consuming a reduced calorie diet (RCD).

Researchers divided the participants into two groups. The first group consumed a RCD along with 30 milliliters (ml) of ACV per day, and the second group followed the RCD only. After 12 weeks, the researchers compared the two groups.

Participants in the first group showed significant reductions in body weight, hip circumference, appetite, and the amount of fat surrounding the internal organs.

This data does not point to ACV alone as a remedy for weight loss. However, it does suggest that it might help people following an RCD lose more weight.

Reducing blood pressure

Supporters of ACV claim that the vinegar may lower blood pressure. One small animal study investigated this claim. The study involved feeding either ACV or acetic acid to rats with high blood pressure. Acetic acid is the main therapeutic component of ACV.

The rats that received the acetic acid showed more significant reductions in blood pressure compared with the other rats. These rats also had lower levels of renin in the blood. Renin is an enzyme that is involved in increasing blood pressure.

The researchers suggest that the acetic acid in the vinegar was responsible for reducing renin levels, which in turn, caused the drop in blood pressure.

ACV may indirectly lower blood pressure by helping people lose weight. However, there is no evidence that ACV alone causes weight loss.

As a result, people who are concerned about weight or blood pressure should focus on dietary and lifestyle changes. People can also talk to their doctor about medical treatments.

Thank you for supporting Medical News Today Risks and side effects For most people, ACV is safe in moderate doses. However, being an acid, drinking ACV may erode tooth enamel. It may also cause stomach discomfort, especially in people with a history of reflux or ulcers. Very high doses can injure the throat. Because ACV can affect blood glucose levels, some people, including those who take insulin and those with a with a history of low blood sugar, should check with a doctor before taking ACV. Most of the evidence for ACV side effects come from individual case reports rather than well controlled clinical trials. For this reason, doctors cannot be sure about which side effects a person might experience, or at what dosage. As a result, it is essential to start with a low dose and monitor any side effects. People with chronic health conditions should see a doctor before trying ACV. Dosage a woman deciding what to buy from a pharmacy shelve.
ACV supplements are available in a range of concentrations. Most research on ACV has focused on its liquid form, and not on pills. As such, the ideal dosage is unclear. The Food and Drug Administration (FDA) have not approved ACV. Different manufacturers may sell the supplement in a range of concentrations. It is essential to follow the manufacturer's instructions and do not exceed the recommended dosage. Many studies have looked at ACV dosages of around a tablespoon per day. Much higher dosages may increase the risk of side effects and injury. Thank you for supporting Medical News Today Summary ACV pills are generally safe for healthy people to use. They are not a replacement for medications to lower blood pressure or cholesterol. However, they may complement prescription medications and increase the effects of a healthful diet. ACV also possesses antibacterial and antifungal properties, which may protect against certain bacterial and fungal infections. As with all supplements, talk to a doctor who is knowledgeable about supplements before trying ACV pills. Apple cider vinegar pills are available to purchase in stores and online. We picked linked items based on the quality of products, and list the pros and cons of each to help you determine which will work best for you. We partner with some of the companies that sell these products, which means Healthline UK and our partners may receive a portion of revenues if you make a purchase using a link(s) above.
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Plant based diet may reduce cardiovascular death risk by 32%

New research adds to the mounting body of evidence that eating more plant based foods and fewer animal ones may contribute to a healthy heart and cardiovascular system.
person chopping vegetables
Eating more vegetables and less meat contributes to a healthy heart, new research suggests.

Not only is eating fewer animal products good for the planet, but it is also good for your health, as more and more studies suggest.

Particularly, a growing body of evidence is showing that a plant based diet could benefit cardiovascular health.

By way of example, one such recent study found that eating more plant based foods slashes the risk of heart failure by 40%, while another one found that a vegetarian diet cuts the risk of heart disease death by the same percentage.

Now, a new study appearing in the Journal of the American Heart Association strengthens these findings, as researchers find that eating more vegetables, legumes, nuts, and whole grains and fewer animal products correlate with a much lower risk of dying of a heart attack or other serious cardiovascular event.

Casey M. Rebholz, Ph.D., who is an assistant professor of epidemiology at Johns Hopkins Bloomberg School of Public Health in Baltimore, MD, is the lead author of the new study.

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Studying dietary intake and heart health

Rebholz and colleagues examined data from 12,168 middle aged people who had enrolled in the Atherosclerosis Risk in Communities (ARIC) study. The ARIC project clinically followed the participants between 1987 and 2016.

The researchers in the latest study categorized the participants' diet using four diet indexes: "In the overall plant based diet index and provegetarian diet index," they explain, "higher intakes of all or selected plant foods received higher scores."

"[I]n the healthy plant based diet index, higher intakes of only the healthy plant foods received higher scores," while "in the less healthy plant based diet index, higher intakes of only the less healthy plant foods received higher scores."

The researchers applied three Cox proportional hazards models to calculate hazard ratios and assess "the association between plant based diet scores and incident cardiovascular disease, cardiovascular disease mortality, and all cause mortality."

25% lower risk of death from any cause

The findings reveal that the participants who had the highest intake of plant based foods and scored the highest on the indexes were 16% less likely to have a cardiovascular condition — such as a heart attack, stroke, or heart failure — when the researchers compared them with adults who consumed the smallest amount of plant based foods.

High plant based food consumers were also 25% less likely to die from any cause and had a 32% lower risk of dying from a cardiovascular condition.

"While you don't have to give up foods derived from animals completely, our study does suggest that eating a larger proportion of plant based foods and a smaller proportion of animal based foods may help reduce your risk of having a heart attack, stroke or other type of cardiovascular disease," says the lead researcher.

"There might be some variability in terms of individual foods, but to reduce cardiovascular disease risk, people should eat more vegetables, nuts, whole grains, fruits, legumes, and fewer animal based foods."

Casey M. Rebholz

Dr. Mariell Jessup, the chief science and medical officer of the American Heart Association (AHA), who was not involved in the study, also comments on the results.

She says, "The [AHA] recommend[s] eating a mostly plant based diet, provided the foods you choose are rich in nutrition and low in added sugars, sodium (salt), cholesterol and artery clogging saturated and trans fats."

"For example, French fries or cauliflower pizza with cheese are plant based but are low in nutritional value and are loaded with sodium (salt). Unprocessed foods, like fresh fruit, vegetables, and grains, are good choices," Dr. Jessup explains.

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Study strengths and limitations

The study's lead researcher also points out that this is one of the first studies to examine this association in the general population. By contrast, most previous research has found cardiovascular benefits for plant based diets in smaller populations, such as vegetarians.

Also, the "findings are pretty consistent with previous findings about other dietary patterns, including the Dietary Approaches to Stop Hypertension, or DASH diet, which emphasize the same food items," Rebholz adds.

However, the study has some limitations, such as the self-reported nature of the dietary intake.

Also, the ARIC study measured the dietary intake of plant based and animal based foods decades ago, say the scientists, so the measurements may not reflect the modern food industry.

Finally, the study cannot prove causation.

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Do rising obesity levels explain cardiovascular mortality trends?

For decades, deaths caused by cardiovascular events, such as stroke, had been on the decline in high income countries. Recently, however, this decline has come to a halt, and some countries are even experiencing rising rates of stroke and heart disease-related deaths. Why?
crowd of people in movement
In some high income countries, cardiovascular-related mortality rates are increasing, and researchers are wondering why this is happening.

"In high income countries, the very substantial decline in [cardiovascular] mortality over the past half-century has been a major, yet often unheralded, global public health achievement."

This is what Prof. Alan Lopez and Tim Adair, Ph.D. write in the introduction to a new study paper, published in the International Journal of Epidemiology. The journal reviews current trends in mortality associated with stroke, heart disease, and other cardiovascular diseases (CVD).

Prof. Lopez and Adair, from the University of Melbourne in Parkville, Australia, note that "recent evidence from national vital statistics systems in these countries suggests that the long term decline in CVD and specifically heart disease mortality may be stagnating, with rates even rising in some populations, particularly at ages [of under] 75 years."

The researchers looked at vital statistics recorded from 2000 onwards in 23 high income countries. These are Australia, France, Japan, Spain, Austria, Germany, the Netherlands, Sweden, Belgium, Greece, New Zealand, Switzerland, Canada, Ireland, Norway, United Kingdom, Denmark, Israel, the Republic of Korea, the United States, Finland, Italy, and Singapore.

These statistics all came from the World Health Organization (WHO) Mortality Database and included mortality rates related to cardiovascular events.

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Obesity trends may play key role

Lopez and Adair found that the rate of decline in CVD-related mortality has slowed down 'considerably' in 12 of the high income countries they investigated in their study. This, in particular, was the case for adults aged 35–74.

Moreover, the most recent data show that CVD death rates have increased for females in the U.S. and Canada over the last year. In Australia, the U.K., and New Zealand, the decline in cardiovascular mortality has slowed down from year to year.

So, why are people once more at an increased risk of premature death due to events such as stroke and heart disease, even in the richer countries of the world?

Prof. Lopez and Adair have a theory. They believe that part of the answer lies in the ever increasing rates of obesity that coincide with the trends in stroke and heart disease mortality.

"Each of these countries has very high levels of obesity. In Australia, close to one-third of adults are obese," notes Prof. Lopez.

"These increases in obesity levels mean that a significant portion of the population has been exposed to the cardiovascular disease risks associated with being overweight for several decades," he continues.

However, not all high income countries face an obesity epidemic. For instance, the researchers point out that Italy and France report the lowest number of cases of obesity among the 23 countries featured in the current study.

A threat to future life expectancy rates

This is why the researchers believe that obesity may only be one part of the problem. The rest may come down to the prevalence of other risk factors for cardiovascular problems, such as smoking, high blood pressure, and high cholesterol.

"Obesity, of course, is likely to be only a partial explanation; Italy and France, where the deceleration in [cardiovascular] mortality in recent years is among the most notable [...], each has below-average obesity levels but higher smoking prevalence among both men and women," the researchers write in their paper.

Going forward, the two authors suggest that countries should invest more in inputting preventive strategies and advising their citizens on the most healthful lifestyle choices.

"In order to combat this, significant investment in preventive health measures is needed, particularly those aimed at increasing physical activity, improving diet and reducing obesity," says Adair.

"Failure to address these issues could confirm the end of the long term decline in cardiovascular disease deaths and threaten future gains in life expectancy."

Tim Adair, Ph.D.

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