Different types of physical activity offer varying protection against heart disease

While it is well known that physical activity is important for heart health, neither research nor recommendations consistently differentiate between the benefits of different types of physical activity. New research, presented at the ACC Latin America Conference 2018 in Lima, Peru, found that while all physical activity is beneficial, static activities -- such as strength training -- were more strongly associated with reducing heart disease risks than dynamic activities like walking and cycling.

"Both strength training and aerobic activity appeared to be heart healthy, even in small amounts, at the population level," said Maia P. Smith, PhD, MS, statistical epidemiologist and assistant professor in the Department of Public Health and Preventive Medicine at St. George's University in St. George's, Grenada. "Clinicians should counsel patients to exercise regardless -- both activity types were beneficial. However, static activity appeared more beneficial than dynamic, and patients who did both types of physical activity fared better than patients who simply increased the level of one type of activity."
Researchers analyzed cardiovascular risk factors, such as high blood pressure, overweight, diabetes and high cholesterol, as a function of self-reported static and/or dynamic activity (strength training or walking/biking) in 4,086 American adults using data from the 2005-2006 National Health and Nutrition Examination Survey. The researchers then adjusted for age, ethnicity, gender and smoking and stratified by age: 21 to 44 years old or over 45 years old.
In total, 36 percent of younger and 25 percent of older adults engaged in static activity, and 28 percent of younger and 21 percent of older adults engaged in dynamic activity. Researchers found engaging in either type of activity was associated with 30 to 70 percent lower rates of cardiovascular disease risk factors, but associations were strongest for static activity and in youth.
"One interesting takeaway was that both static and dynamic activity were almost as popular in older people as younger," Smith said. "I believe this gives clinicians the opportunity to counsel their older patients that they will fit into the gym or the road race just fine. The important thing is to make sure they are engaging in physical activity."
Smith said future research and data collection should use definitions of physical activity that separate static from dynamic activity to further investigate independent effects.

Story Source:
Materials provided by American College of Cardiology.

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A new approach to detecting cancer earlier from blood tests

Cancer scientists led by principal investigator Dr. Daniel De Carvalho at Princess Margaret Cancer Centre have combined "liquid biopsy," epigenetic alterations and machine learning to develop a blood test to detect and classify cancer at its earliest stages.

The findings, published online today in Nature, describe not only a way to detect cancer, but hold promise of being able to find it earlier when it is more easily treated and long before symptoms ever appear, says Dr. De Carvalho, Senior Scientist at the cancer centre, University Health Network.
"We are very excited at this stage," says Dr. De Carvalho. "A major problem in cancer is how to detect it early. It has been a 'needle in the haystack' problem of how to find that one-in-a-billion cancer-specific mutation in the blood, especially at earlier stages, where the amount of tumour DNA in the blood is minimal."
By profiling epigenetic alterations instead of mutations, the team was able to identify thousands of modifications unique to each cancer type. Then, using a big data approach, they applied machine learning to create classifiers able to identify the presence of cancer-derived DNA within blood samples and to determine what cancer type. This basically turns the 'one needle in the haystack' problem into a more solvable 'thousands of needles in the haystack', where the computer just needs to find a few needles to define which haystack has needles.
The scientists tracked the cancer origin and type by comparing 300 patient tumour samples from seven disease sites (lung, pancreatic, colorectal, breast, leukemia, bladder and kidney) and samples from healthy donors with the analysis of cell-free DNA circulating in the blood plasma. In every sample, the "floating" plasma DNA matched the tumour DNA. The team has since expanded the research and has now profiled and successfully matched more than 700 tumour and blood samples from more cancer types.
Beyond the lab, next steps to further validate this approach include analysing data from large population health research studies already under way in several countries, where blood samples were collected months to years before cancer diagnosis. Then the approach will need to be ultimately validated in prospective studies for cancer screening.
Dr. De Carvalho is a trained immunologist (University of Sao Paulo, Brazil) with postdoctoral training in cancer epigenomics (University of Southern California, USA) whose research focuses on cancer epigenetics. He holds the Canada Research Chair in Cancer Epigenetics and Epigenetic Therapy and is an Associate Professor in Cancer Epigenetics, Department of Medical Biophysics, University of Toronto.
The research was supported by University of Toronto's McLaughlin Centre, Canadian Institutes of Health Research, Canadian Cancer Society, Ontario Institute for Cancer Research through the Province of Ontario, and The Princess Margaret Cancer Foundation.
 

Journal Reference:

1. Shu Yi Shen, Rajat Singhania, Gordon Fehringer, Ankur Chakravarthy, Michael H. A. Roehrl, Dianne Chadwick, Philip C. Zuzarte, Ayelet Borgida, Ting Ting Wang, Tiantian Li, Olena Kis, Zhen Zhao, Anna Spreafico, Tiago da Silva Medina, Yadon Wang, David Roulois, Ilias Ettayebi, Zhuo Chen, Signy Chow, Tracy Murphy, Andrea Arruda, Grainne M. O’Kane, Jessica Liu, Mark Mansour, John D. McPherson, Catherine O’Brien, Natasha Leighl, Philippe L. Bedard, Neil Fleshner, Geoffrey Liu, Mark D. Minden, Steven Gallinger, Anna Goldenberg, Trevor J. Pugh, Michael M. Hoffman, Scott V. Bratman, Rayjean J. Hung, Daniel D. De Carvalho. Sensitive tumour detection and classification using plasma cell-free DNA methylomes. Nature, 2018; DOI: 10.1038/s41586-018-0703-0 

Courtesy: ScienceDaily
 

Protection against Malaria: A matter of balance

A balanced production of pro and anti-inflammatory cytokines at two years of age protects against clinical malaria in early childhood, according to a study led by the Barcelona Institute for Global Health (ISGlobal), an institution supported by "la Caixa" Foundation. The results also indicated that early exposure to the parasite does not affect the risk of developing the disease, although it could affect the parasite-specific immune response later in life.

Malaria particularly affects children under five years of age, who need to develop effective immunity against the most severe forms of the disease. Certain parasite-specific antibodies are known to protect, but little is known about the protective role of mediators (cytokines) produced by cells of the immune system. Furthermore, it is not clear whether the timing of first parasite exposure during infancy affects the secretion of such cytokines.
In this study, Carlota Dobaño and her team evaluated whether the cytokines produced in the first two years after birth affect the risk of subsequent malaria. They also analysed whether the timing of parasite exposure alters the cytokine response. The study included over 300 newborns from Magrara, a village in Southern Mozambique, who received -- or not- preventive malaria treatment during their first year of life. Cytokine production by blood cells was measured at different time-points during the first two years, and the participants were followed up for clinical malaria until four years of age.
The results show that a pro-inflammatory signature (IL-1, IL-6 and TNF cytokines) followed by an anti-inflammatory (IL-10 cytokine) signature between the first and second year of life is associated with a lower risk of clinical malaria between ages 3 and 4. "This makes sense, since IL-10 suppresses excessive inflammation," explains Dobaño.
In contrast, timing of parasite exposure did not have a clinical effect: children who received preventive treatment -- and were therefore exposed later to the parasite -- had an altered cytokine profile, but this did not reduce the risk of developing malaria in the following two years. "Preventive malaria treatment during the first year after birth does not decrease the risk of malaria in early childhood, but it could be relevant later in life by influencing the development of parasite-specific immunity," adds the ISGlobal researcher.
 

Journal Reference:

1. Carlota Dobaño, Augusto J Nhabomba, Maria N Manaca, Tamara Berthoud, Ruth Aguilar, Llorenç Quintó, Arnoldo Barbosa, Mauricio H Rodríguez, Alfons Jiménez, Penny L Groves, Rebeca Santano, Quique Bassat, John J Aponte, Caterina Guinovart, Denise L Doolan, Pedro L Alonso. A balanced pro-inflammatory and regulatory cytokine signature in young African children is associated with lower risk of clinical malaria. Clinical Infectious Diseases, 2018; DOI: 10.1093/cid/ciy934 

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To ward off fatty liver, breast is best for mom

Researchers at University of California San Diego School of Medicine and Kaiser Permanente have discovered that mothers who breastfed a child or children for six months or more are at lower risk for developing non-alcoholic fatty liver disease (NAFLD) years later during mid-life. With no other current prevention options aside from a healthy lifestyle, they say the finding may represent an early modifiable risk factor for a serious and chronic disease.

The findings are published in the November 1 issue of the Journal of Hepatology.
"Breastfeeding and its benefits to the child have been widely studied for years," said Veeral Ajmera, MD, hepatologist at UC San Diego Health and an assistant professor of medicine at UC San School of Medicine. "However, this new analysis contributes to the growing body of evidence showing that breastfeeding a child also offers significant health benefits to the mother -- namely, protecting her from developing non-alcoholic fatty liver disease in middle age."
Ajmera and colleagues used data collected through the Coronary Artery Risk Development in Young Adults (CARDIA) study, a multicenter prospective cohort study of 844 black and white women who were monitored every two to five years for up to 30 years. The women were assessed for biochemical and other risk factors at enrollment in 1985 to 1986. Those who subsequently gave birth reported the duration of breastfeeding for each birth over the following 25 years. At the end of the study, participants underwent a computed tomography (CT) scan of their abdomens, which allowed researchers to look at levels of liver fat, a sign of NALFD.
"The CARDIA study's unique strength is the evaluation of cardiovascular and metabolic risk factors in young women before pregnancy and across the childbearing years," said senior author Erica P. Gunderson, PhD, MPH, a senior research scientist with the Kaiser Permanente Northern California Division of Research and investigator at the Oakland, Calif., CARDIA field site. "This design accounts for pre-pregnancy risk factors and identifies more closely the specific relation of lactation to a woman's future disease risk."
According to study findings, women in the cohort who breastfed one or more children for longer than six months had a lower risk of NAFLD compared to those who did not breastfeed or breastfed for under one month. Typical of NAFLD, women diagnosed with the disease 25 years later had a higher body mass index, larger waist circumference, higher triglycerides and lower HDL cholesterol when compared to those without NAFLD.
NAFLD remains the most common cause of chronic liver disease in the United States. It is usually asymptomatic until advanced stages of liver disease and includes a spectrum of disease severity, with nonalcoholic steatohepatitis (NASH) being the most aggressive type. Multiple genetic and environmental factors contribute to NAFLD, and certain health conditions, such as obesity and type 2 diabetes, can be predisposing factors. It is estimated that tens of millions of people globally are living with NAFLD and NASH. Weight loss and a healthier diet are the current standards of care.
Because these diseases are linked with obesity, diabetes, insulin resistance and lifestyle behaviors, Ajmera and team adjusted for these pre-pregnancy metabolic risk factors, physical activity and dietary intake. The analysis helped demonstrate that any beneficial impact of lactation duration goes beyond confounding factors of pre-pregnancy risk and lifestyle behaviors.
"Non-alcoholic fatty liver disease and all metabolic diseases have a unique relationship with socioeconomic factors," said Ajmera. "The inclusion of additional information regarding diet and exercise only further strengthen our claim that breastfeeding is beneficial in the prevention of non-alcoholic fatty liver disease."
Ajmera said more studies are needed to look at the underlying mechanisms of how lactation affects NAFLD and whether it can reduce disease severity.
Co-authors include: Norah A. Terrault and Monika Sarkar, UC San Francisco; Lisa B. VanWagner, Northwestern University; Cora E. Lewis, University of Alabama Birmingham; and John J. Carr, Vanderbilt University.
 

Reference:

Veeral H. Ajmera, Norah A. Terrault, Lisa B. VanWagner, Monika Sarkar, Cora E. Lewis, John J. Carr, Erica P. Gunderson. Longer lactation duration is associated with decreased prevalence of non-alcoholic fatty liver disease in women. Journal of Hepatology, 2018; DOI: 10.1016/j.jhep.2018.09.013 

 

Courtesy: ScienceDaily

Pessimism around youth suicide prevention approaches is unfounded

A comprehensive Australian study examining the global impact of suicide prevention approaches in young people has found that youth-specific interventions conducted in clinical, educational and community settings can be effective in reducing suicide-related behaviour in young people at risk.

The review, by researchers at Orygen, the National Centre of Excellence in Youth Mental Health, has been published this week in the UK journal E Clinical Medicine.

The comprehensive review examined 99 individual studies of which 52 were conducted in clinical settings, 31 in educational or workplace settings, and 15 in community settings, and found interventions delivered in these settings appeared to reduce self-harm and suicidal thinking in young people.

Large school-based studies showed that the interventions with the most promise for suicide prevention were integrated approaches, in particular those that combined educational workshops about suicide prevention with case detection designed to identify young people at risk.

In community settings it was also large-scale studies that combined a number of components that showed the most promise. Again, these typically included universal educational programs, training those who come into contact with at risk young people, screening for risk, and linking people to services, where appropriate.

The study's lead researcher, Dr Jo Robinson, said the study findings challenged the pessimism that often pervades discussions around suicide prevention. "At a time when we're seeing suicide rates around the world growing, this study shows us that we should feel hopeful that interventions specifically designed to reduce suicide risk in young people do work and can impact on suicide ideation and self-harm," Dr Robinson said.

"In Australia, we've seen a lot of investment in suicide prevention, but It's very important that this investment is directed in a strategic way and is being invested in evidence-based interventions.

"That's why this study is important, it will guide not just clinical services and interventions and research, but policy makers as well to ensure that we're putting funds into evidence-based suicide prevention interventions that work."

Despite the encouraging findings of the study, Dr Robinson said the research had identified some clear gaps in suicide prevention approaches.

"Many studies simply tested interventions that had previously been designed for adults as opposed to young people specifically, there was also an absence of studies that included indigenous, same sex attracted and/or gender diverse young people and those who live in low to middle income countries," Dr Robinson said.

"These findings suggest that important opportunities for youth suicide prevention are currently being missed and need to be addressed by researchers, research funders, and by policy makers, if we are to successfully address the rising rates of suicide among young people worldwide."

The research was supported by the Future Global Generations Fund, William Buckland Foundation, National Health and Medical Research Council, Auckland Medical Research Foundation, a Victorian Health and Medical Research Fellowship and the American Foundation for Suicide Prevention.

Reference:

Orygen, the National Centre of Excellence in Youth Mental Health. "Pessimism around youth suicide prevention approaches is unfounded." ScienceDaily. ScienceDaily, 2 November 2018. .

Courtesy: ScienceDaily

Grandparents: Raising their children's children, they get the job done

Millions of children are being raised solely by their grandparents, with numbers continuing to climb as the opioid crisis and other factors disrupt families. New research being presented at the American Academy of Pediatrics (AAP) 2018 National Conference & Exhibition shows that caregivers who step up to raise their grandchildren are overcoming unique challenges to manage just as well as biological and adoptive parent caregivers.

The study abstract, "Grandparents Raising Grandchildren: Are They Up to the Job?" will be presented on Monday, Nov. 5, at the Orange County Convention Center in Orlando, Fla. The study is the first to examine a nationally representative sample of children and directly compare households where children are being raised by their grandparents with those being raised by their parents.

"A large and increasing number of mothers and fathers aren't able to meet the responsibilities of parenthood, prompting their own parents to take on the primary caregiver role for their grandchildren," said senior author Andrew Adesman, MD, FAAP, Chief of Developmental and Behavioral Pediatrics for Cohen Children's Medical Center of New York. "Although these children are more likely to have endured one or more adverse childhood experiences and the grandparents themselves often face extra health and socioeconomic hurdles, our findings suggest they appear to be coping well."

The researchers analyzed and compared 2016 National Survey of Children's Health data from 44,807 parent-led households and 1,250 grandparent households. They determined that caregivers raising their grandchildren were more likely to have a greater number of physical and mental health problems, have household incomes at or below the federal poverty line, have lower levels of education, and be single.

In addition, the grandchildren they were raising were more likely to become angry/anxious with transitions, lose their temper and have other behavioral issues.

"This was not surprising, since we know that children in non-parental care are likely to have experienced more adverse childhood experiences and have an increased risk of behavioral problems as a result," said abstract co-author Sarah Keim, PhD, Principal Investigator at Nationwide Children's Hospital.

However, Keim said, grandparents and parents showed no difference when asked if the child "does things that really bother" them, is "harder to care for" than peers, or if they "felt angry with this child." In fact, grandparents and parents did not differ on most measures of parent coping, parenting stress, or caregiver-child interactions when stratified by child health and child age.

The study also found that a substantial proportion of both grandparent caregivers (31 percent) and parent caregivers (24 percent), reported that they did not have anyone "to turn to for day-to-day emotional support with parenting."

"Given that children being raised by their grandparents may pose greater behavioral challenges, and that nearly a third of the parenting grandparents reported they had no one to turn to for day-to-day emotional support with parenting, pediatricians and other health professionals caring for 'grandfamilies' must be mindful of these issues and be ready to refer families to counseling when needed, as well as refer them to supports groups locally and online," Dr. Adesman said.

 Reference: 

American Academy of Pediatrics. "Grandparents: Raising their children's children, they get the job done." ScienceDaily. ScienceDaily, 2 November 2018. .

Courtesy: ScienceDaily