Natural Compound in Vegetables Helps Fight Fatty Liver Disease

Paul Schattenberg wrote . . . . . . . . .

A new study led by Texas A&M AgriLife Research scientists shows how a natural compound found in many well-known and widely consumed vegetables can also be used to fight fatty liver disease.

The study demonstrates how non-alcoholic fatty liver disease, or NAFLD, can be controlled by indole, a natural compound found in gut bacteria – and in cruciferous vegetables such as cabbage, kale, cauliflower and Brussels sprouts. It also addresses how this natural compound may lead to new treatments or preventive measures for NAFLD.

The study was recently published in Hepatology and can be found on PubMed.gov.

“Based on this research, we believe healthy foods with high capacity for indole production are essential for preventing NAFLD and are beneficial for improving the health of those with it,” said Chaodong Wu, M.D., Ph.D., a Texas A&M AgriLife Research Faculty Fellow and principal investigator for the study. “This is another example where altering the diet can help prevent or treat disease and improve the well-being of the individual.”

About NAFLD and indole

NAFLD occurs when the liver becomes “marbled” with fat, sometimes due to unhealthy nutrition, such as excessive intake of saturated fats. If not properly addressed, this condition can lead to life-threatening liver disease, including cirrhosis or liver cancer.

Many diverse factors contribute to NAFLD. Fatty liver is seven to 10 times more common in people with obesity than in the general population. In addition, obesity causes inflammation in the body. Driving this inflammation are macrophages, types of white blood cells that normally battle infection. This inflammation exacerbates liver damage in those with liver disease.

Gut bacteria can also have an effect – either positive or negative — on the progression of fatty liver disease. These bacteria produce many different compounds, one of which is indole. This product of the amino acid tryptophan has been identified by clinical nutritionists and nutrition scientists as likely having preventive and therapeutic benefits to people with NAFLD.

The National Cancer Institute also notes the benefits of indole-3-carbinol found in cruciferous vegetables, including their anti-inflammatory and cancer-fighting properties.

A comprehensive and multi-level study on fatty liver disease

The present study examined the effect of indole concentrations on people, animal models and individual cells to help determine indole’s effect on liver inflammation and its potential benefits to people with NAFLD. It investigated the extent to which indole alleviates non-alcoholic fatty liver disease, incorporating previous findings on gut bacteria, intestinal inflammation and liver inflammation. It also incorporated investigation into how indole improves fatty liver in animal models.

For the study, researchers investigated the effects of indole on individuals with fatty livers. As research collaborator Qifu Li, M.D., was also a physician at Chongqing Medical University in China, the team decided he should lead the clinical research using Chinese participants.

In 137 subjects, the research team discovered people with a higher body mass index tended to have lower levels of indole in their blood. Additionally, the indole levels in those who were clinically obese were significantly lower than those who were considered lean. And in those with lower indole levels, there was also a higher amount of fat deposition in the liver.

This result will likely extend to other ethnicities, Li noted, though ethnic background may have some influence on gut bacteria populations and the exact levels of metabolites.

To further determine the impact of indole, the research team used animal models fed a low-fat diet as a control and high-fat diet to simulate the effects of NAFLD.

“The comparisons of animal models fed a low-fat diet and high-fat diet gave us a better understanding of how indole is relevant to NAFLD,” said Gianfranco Alpini, M.D., a study collaborator and former distinguished professor of Texas A&M Health Science Center, now the director of the Indiana Center for Liver Research.

Alpini said treatment of NAFLD-mimicking animal models with indole significantly decreased fat accumulation and inflammation in the liver.

The research team also studied how indole affected individual cells.

Shannon Glaser, Ph.D., a professor of Texas A&M Health Science Center, said that in addition to reducing the amount of fat in liver cells, indole also acts on cells in the intestine, which send out molecular signals that dampen inflammation.

“The link between the gut and the liver adds another layer of complexity to studies on non-alcoholic fatty liver disease, and future studies are very much needed to fully understand the role of indole,” Glaser said.

Additional nutrition research needed

“Foods with a high capacity of indole production or medicines that mimic its effects may be new therapies for treatment of NAFLD,” Wu said, adding prevention is another important aspect to consider.

“Preventing NAFLD’s development and progression may depend on nutritional approaches to ensure that gut microbes allow indole and other metabolites to function effectively,” he said. “Future research is needed to investigate how certain diets may be able to achieve this.”

Wu said in future research he hopes to collaborate with food scientists and clinical nutritionists to examine what healthy foods can alter gut microbiota and increase indole production.

Source: AgriLife Today

New Study Supports Lowering Age of First Colonoscopy

Amy Norton wrote . . . . . . . . .

The rate of colon cancer among Americans spikes sharply between the ages of 49 and 50, a new study finds — supporting the case for earlier screening for the disease.

Researchers say the uptick between those two ages does not reflect an actual increase in the occurrence of colon cancer but the fact that screening for the disease has traditionally begun at age 50. So “latent” cancers that had been present for some time are caught at that age.

Experts said the findings could have implications for colon cancer screening recommendations, which at the moment are conflicting.

For years, guidelines from various groups said that people at average risk of colon cancer should begin screening at age 50. Earlier screening was reserved for people at increased risk.

But in 2018, the American Cancer Society lowered its recommended threshold to age 45, largely due to a rising incidence of colon cancer among younger Americans.

But the U.S. Preventive Services Task Force — which sets federal screening standards — still recommends a starting age of 50 for people at average risk.

Given the debate, Dr. Jordan Karlitz said his team wanted to take a closer look at how Americans’ colon cancer rates change by yearly increments in age. Past studies, he explained, have looked at age blocks, like 45 to 49 and 50 to 54.

A year-by-year look, Karlitz said, could give a clearer picture of what’s going on among people in their 40s. It has long been suspected that incidence of colon cancer in that age range is higher than statistics show, because most people in their 40s are not screened.

The researchers expected to see an increase in colon cancer between age 49 and 50. What they found was a 46% rise.

“It was a steep uptick,” said Karlitz, an associate clinical professor at Tulane University School of Medicine in New Orleans. “We expected we’d see something, but not to that extent.”

The pattern probably reflects cancers that started before age 50 — even years before — but weren’t caught until screening started, according to Dr. Umut Sarpel.

Sarpel, who was not involved in the study, is an associate professor of surgical oncology at Mount Sinai’s Icahn School of Medicine in New York City.

“The results of this study support efforts to lower the screening age to less than 50 years,” Sarpel said.

The findings, published online in JAMA Network Open, are based on government cancer data for 2000 through 2015. Karlitz’s team focused on colon and rectal cancer rates among 30- to 60-year-olds.

During that period, the rate among 49-year-old Americans was just under 35 cases per 100,000 people. That jumped to 51 cases per 100,000 among 50-year-olds, the investigators found.

The vast majority of cases caught at age 50 — nearly 93% — were invasive, which means they would probably require more extensive treatment and had likely been there for some time.

Statistics show that most colon cancers are diagnosed after age 50. However, the rate among younger Americans has been on the rise, for reasons that remain unclear.

An American Cancer Society study found that since the mid-1990s, colon cancer rates among Americans aged 20 to 54 have been steadily inching up — by between 0.5% and 2% each year. Rectal cancer has risen faster, by 2% to 3% per year.

“It has been known for approximately 15 years that rates of colon and rectal cancers are rising among young patients,” said Dr. Joshua Meyer, a radiation oncologist at Fox Chase Cancer Center in Philadelphia. “This appears to be true both under age 40 and between age 40 and 50.”

What has been unclear, Meyer said, is how long colon tumors may be growing when they are finally caught through screening.

“This study makes it clear that these have been growing for a number of years,” said Meyer, who was not involved in the research.

The increase between ages 49 and 50 was seen not only for cancers confined to the colon and rectum, but also for regional cancers — meaning the disease has spread into nearby lymph nodes. There was also a small increase (just under 16%) in the most-advanced cancers — those that have spread to distant sites in the body.

Meyer said it’s concerning to see a rise in more-advanced cancers. The findings support “consideration of lowering of the screening age for colorectal cancer,” he said.

Researcher Karlitz said he hopes the results “shed light” on the fact that colon cancer is more common among people in their 40s than the statistics suggest.

For now, he said that people should discuss the best screening strategy, including starting age, with their doctor. And everyone — no matter how young they are — should act on potential cancer symptoms, Karlitz stressed.

Some potential red flags include a persistent change in bowel habits; abdominal pain or cramping; stool that is dark or has visible blood; and unintended weight loss.

Source: HealthDay

Report: Health Benefits of Gluten-free Diet are Misperceived

Conor Pope wrote . . . . . . . . .

More than 90 per cent of people who buy gluten-free foods do not have a gluten-related disorder or coeliac disease and mistakenly believe such a diet has health benefits and will help them lose weight, according to a new report from Ireland’s food safety watchdog.

The report from Safefood found that while 23 per cent of those surveyed buy gluten-free foods, 92 per cent of those who do so had no medical reason for choosing gluten free.

Among those polled, there was a misperception of the health benefits of gluten-free products. Almost a quarter of those surveyed said gluten-free products were lower in fat and one in five said such foods were lower in sugar and a healthy way to lose weight.

The research also includes a snapshot survey which looks at the nutritional content of 67 gluten-free snack foods.

These snack foods included nut products and savoury snacks, cereal and baked products, and confectionery.

It found that of all the gluten-free snack products surveyed, 75 per cent were high in fat and 69 per cent were high in sugar, with calorie levels similar to a standard chocolate bar.

“For those people who have a diagnosis of coeliac disease or those with a gluten-related disorder, avoiding gluten in their daily diet is an absolute must,” said Dr Catherine Conlon, director of human health and nutrition with Safefood.

‘Clean labels’

“However, we would have a concern that some of these snack foods have an unhealthy nutritional profile for everyone, whether or not they have a gluten-related disorder. Snacking on foods such as fruit and vegetables, unsalted plain nuts and gluten-free rice cakes and cheese, are healthier options for us all.”

She said 92 per cent of the people buying such products “have no medical reason to avoid gluten in their diet” and stressed that there was “no consistent evidence that a gluten-free diet will improve your health if you aren’t sensitive to gluten”.

According to industry estimates, the gluten-free food market in Ireland was worth €66 million in 2017, an increase of 33 per cent on the previous year.

Many gluten-free food products are promoted by media personalities and sports stars as part of a trend for “clean labels”, including “free-from” food products.

“Similar to recent trends we’ve seen with high-protein foods, gluten-free food is big business with an audience of people willing to purchase these products,” added Dr Conlon. “In the case of gluten-free snacks, you could end up purchasing snack foods with lots of added fat and sugar, which are of no added benefit to your health.”

Source: Irish Times

Study: Hospitalized Coronavirus (2019 nCoV) Patients Develop Pneumonia

E.J. Mundell wrote . . . . . . . . .

It’s still the early days, but a report on the first 99 cases of the new coronavirus treated at a hospital in Wuhan, China, finds severe respiratory infection that proved fatal in about 10% of cases.

It should be noted that the report only involved patients sick enough to warrant hospitalization with 2019-nCoV — the overall death rate from the infection remains much lower than that recorded in this study. As of Wednesday, Chinese authorities report that nearly 6,000 cases have been reported, including 132 deaths. That’s a death rate of about 2% — roughly similar to that seen with the flu.

All of the patients in China were admitted during the earliest stage of the outbreak, between Jan. 1 and Jan. 20, at Jinyintan Hospital in Wuhan, close to the seafood market where it’s thought the 2019-nCoV pathogen emerged in late December.

All had pneumonia when they were admitted, and most (75%) had pneumonia in both lungs, said a team reporting in the Jan. 29 issue of The Lancet medical journal.

The typical patient was male (two-thirds of those treated), middle-aged or older (average age was 55.5 years) and almost half had underlying chronic diseases such as heart disease or diabetes, said a team led by Li Zhang, of the Tuberculosis and Respiratory Department at Wuhan Jinyintan Hospital.

Besides pneumonia, most patients had fever and coughing, and about a third had shortness of breath.

But the large majority — 88 — have survived their coronavirus infection, the group noted, and patients were treated with antiviral or antibiotic drugs and/or oxygen therapy.

However, 17 of the patients developed a critical condition known as acute respiratory distress syndrome (ARDS). According to the American Lung Association, “the main complication in ARDS is that fluid leaks into the lungs making breathing difficult or impossible.” Eleven of the 17 people affected died after multiple organ failure, the Wuhan medical team said.

As for the rest, more than half (57) were still in the hospital as of Jan. 25, while about a third have been discharged.

According to the Wuhan team, the new data shows that “early identification and timely treatment of critical cases of 2019-nCoV are important.”

“Effective life support and active treatment of complications should be provided to effectively reduce the severity of patients’ conditions and prevent the spread of this new coronavirus in China and worldwide,” the group concluded.

They stressed that many of the 11 patients who died were older and had underlying health issues: “five were older than 60 years, three had hypertension, and one was a heavy smoker,” the team noted. The researchers said that pattern fits the typical profile of people who die from a viral pneumonia, as can happen with another viral disease, influenza.

Dr. Len Horovitz is a pulmonary specialist at Lenox Hill Hospital in New York City. Reading over the findings, he agreed that the clinical progress of 2019-nCoV appears to mimic that of flu.

“Complications and fatalities are associated with older adult men with comorbidities such as diabetes and pre-existing pulmonary conditions,” Horovitz said. And he added that “this is not SARS.” The death rate with SARS was roughly 10%, according to the The Lancet study.

An outbreak of SARS (severe acute respiratory syndrome) in China made headlines in 2003. SARS is from the same family of coronaviruses as 2019-nCoV, although it has key differences from the new germ.

One key difference is that it now appears people can transmit 2019-nCoV even when they are not showing symptoms — a factor that could encourage the spread of the virus, experts say.

So far, only five cases of 2019-nCoV have been reported in the United States, all of them originating in people who were infected in China. No U.S. person-to-person transmission of the coronavirus has yet been reported, though a handful of other countries have seen such transmissions.

In related news, the U.S. Centers for Disease Control and Prevention said on Wednesday that a plane carrying U.S. citizens from Wuhan arrived at March Air Reserve Base in California on Wednesday morning and was met by CDC medical officers.

The 210 passengers were screened, monitored and evaluated by medical personnel at every stage of their journey, including before takeoff, during the flight, during a refueling in Anchorage, Alaska, and upon arrival in California, the CDC said.

Risk assessments — including temperature checks and observing for respiratory symptoms — have been conducted by CDC staff to check the health of each passenger, the agency said.

According to Horovitz, Americans should be vigilant about the new coronavirus, but should not panic. He said the comparisons to flu might be useful.

“It’s clear that while there is cause for concern, mortality from coronavirus does not appear to be high,” Horovitz said. “Up to 40,000 people die annually from influenza in this country in an average year — and people still refuse the flu shot.”

Source: HealthDay

First Clinical Studies Find Wuhan Virus Closely Resembles SARS

The new coronavirus rapidly spreading in China and nearby countries seems to trigger symptoms similar to those seen in the severe acute respiratory distress syndrome (SARS) coronavirus outbreak in 2003, two new studies show.

Published Jan. 24 in The Lancet journal, these are the first clinical studies conducted on patients struck by the new coronavirus, dubbed 2019-nCoV. As of Friday morning, there were 830 confirmed cases and 26 deaths in China tied to the coronavirus, which originated in the central Chinese city of Wuhan.

Officials at the U.S. Centers for Disease Control and Prevention on Friday also announced a second U.S. case of the virus, in a person in Illinois. The first case occurred in a man in Washington state. Both patients had returned from travel in China, the CDC said, and are being monitored.

The two new studies examine the course of infection in some of the first cases of the Wuhan virus.

In one study, researchers looked at clinical records, laboratory results, imaging findings and epidemiological data on the first 41 infected people admitted to the hospital in Wuhan between Dec. 16, 2019 and Jan. 2, 2020.

Patients were typically middle-aged (average age 49), three-quarters were men, and two-thirds had visited a local seafood market thought to be where the virus originated.

Similar to the 2003 SARS outbreak in China, most patients who came down with the Wuhan coronavirus were healthy, without any chronic underlying health issues. And symptoms also resembled those of SARS, said Chinese researchers led by Bin Cao, from the China-Japan Friendship Hospital and Capital Medical University, both in Beijing.

All of the hospitalized patients had developed pneumonia, nearly all (98%) had a fever, three-quarters developed a cough, 44% felt fatigued, and 55% had some shortness of breath. Symptoms such as headache or diarrhea were rare, however.

On the other hand, “despite sharing some similar symptoms to SARS [such as fever, dry cough, shortness of breath], there are some important differences,” Cao said in a Lancet news release.

For example, people with the new virus typically didn’t have runny noses or other symptoms involving the upper respiratory tract, he said. And very few had intestinal symptoms such as diarrhea, which occurred in about a quarter of SARS patients.

Severe illness — enough to require admittance to the ICU — occurred in about a third of the hospitalized patients, Cao’s team said, and six patients died.

A condition involving immune system dysfunction known as a “cytokine storm” occurred in some of these very ill patients, but it’s not yet clear how the new virus affects the immune system, the researchers said.

As of Jan. 22, a majority of patients in the study (68%) have recovered enough to be discharged from the hospital, the report noted.

In the second study, the first to involve gene analysis, researchers tracked the course of 2019-nCoV in a family of seven people. Five family members had recently traveled to Wuhan and were found to carry 2019-nCoV, and one family member who had not traveled with them also was found to be infected with the virus.

None of the infected family members had visited food markets or animals while in Wuhan, suggesting that person-to-person transmission was at play.

The seventh family member — a child whose mother said had worn a surgical mask during their stay in Wuhan — was not infected with the virus.

As well, a second child was infected but showed no clinical symptoms of the illness, according to researchers led by Dr. Kwok-Yung Yuen, from the University of Hong Kong-Shenzhen Hospital. That suggests that 2019-nCoV could be spread person-to-person by people who don’t even realize they are infected, the researchers said.

“Our findings are consistent with person-to person transmission of this new coronavirus in hospital and family settings, and the reports of infected travelers in other countries,” Yuen said in the release. “Because asymptomatic infection appears possible, controlling the epidemic will also rely on isolating patients, tracing and quarantining contacts as early as possible, educating the public on both food and personal hygiene, and ensuring health care workers comply with infection control.”

Examining the course of illness among the various family members, symptoms appeared to develop within a few days of contact with sick individuals.

Gene tests revealed that five of the family members carried a form of 2019-nCoV that had a type of protein allowing it to enter healthy cells. Yuen’s team was also able to use samples from two patients to map the full genome of 2019-nCoV.

“With the improved surveillance network and laboratory capability developed following the SARS pandemic, China has now been able to recognize this new outbreak within a few weeks and has made the virus genome publicly available to help control its spread,” said study co-author Dr. Rosana Wing-Shan Poon, from the University of Hong Kong.

“Learning the lessons from SARS, which started as animal-to-human transmission, all game meat trading should be better regulated to terminate this potential transmission route,” Poon said. “Further investigations are needed to clarify the potential threat posed by this emerging virus and asymptomatic cases.”

Source: Healthday