More Evidence Supplements Won’t Help the Heart

Steven Reinberg wrote . . . . . . . . .

If you take supplements hoping to ward off a heart attack or stroke, yet another study suggests you could find better uses for your hard-earned dollars.

A review of 277 published studies found that most supplements won’t protect you from cardiovascular disease or early death.

“The study carries a simple message — do not waste your money,” said lead researcher Dr. Safi Khan.

“Americans spend billions of dollars on supplements and vitamins, but this study provides evidence that few of these supplements have a significant effect on mortality or cardiovascular outcomes,” said Khan, an assistant professor of medicine at West Virginia University.

If not supplements, what will help your heart?

“Instead of nutritional supplements, behavioral modifications — such as good nutrition from healthy food sources, exercise and smoking cessation — remain the main factors for improving cardiovascular health,” he said.

Khan’s team looked at 16 nutritional supplements and eight diets in studies that included nearly 1 million people in all.

The investigators did find some evidence that a low-salt diet reduced premature death among those with normal blood pressure, and that omega-3 fatty acids in food protected against heart attack and heart disease. Also, folic acid was somewhat protective against stroke, they reported.

However, calcium plus vitamin D, which many people take for stronger bones, increased the risk for stroke, the researchers found.

Multivitamins and other supplements — including selenium, vitamin A, vitamin B6, vitamin C, vitamin E, vitamin D alone, calcium alone, folic acid and iron — did not have a significant effect on death or heart disease, according to the study.

Certain dietary interventions didn’t seem to make a big difference, either. The analysis found no proof that switching to the Mediterranean diet, reducing fats or saturated fats, or increasing fish oil supplements would keep heart disease or death from the door, the researchers said. (The Mediterranean diet centers around vegetables, fruits, nuts, whole grains and beans.)

Despite the lack of evidence, one out of two Americans takes supplements hoping to improve their health, the researchers said.

Dr. Eric Topol, a professor of molecular medicine at Scripps Research in La Jolla, Calif., said, “Forget about supplements — you don’t improve heart outcomes at all.”

Topol, co-author of an accompanying journal editorial, added that taking supplements could cause unwanted side effects.

Supplements aren’t harmless, he said. “They have all sorts of impurities, and they’re not regulated. We shouldn’t just take for granted that they’re inert,” he noted.

Topol also said the notion that salt causes high blood pressure has no evidence to back it up. “The salt question is still shaky,” he said. “The data are not clear.”

In addition, what keeps one person healthy might not work for someone else, Topol said.

“The idea that there is a magic diet for all people — we have to get over that. It’s never going to be the case, because we’re all so unique,” Topol explained.

This study follows two other papers that also found no benefit from supplements in reducing chances of heart disease or death.

One study was published last July in the journal Circulation and the other came out in April in the Annals of Internal Medicine.

Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, said the findings are to be expected.

“As surprising as these findings may be, there is no high-quality evidence to support the use of multivitamins, individual vitamins, mineral supplements or dietary interventions, including reduced dietary fat, reduced saturated fats, the Mediterranean diet or fish oil supplements for cardiovascular event reduction,” he said.

Fortunately, lowering cholesterol and blood pressure, and quitting smoking have been shown to reduce heart attacks, strokes and heart disease, Fonarow said.

A leading trade group for the dietary supplement industry objected to the study findings.

“This study is a coordinated, all-out assault on nutrition, and the critical role it plays in maintaining health and reducing the risk of chronic disease,” said Steve Mister, president and CEO of the Council for Responsible Nutrition, in Washington, D.C.

The study authors ignore the “proper role” of supplements for overall health and wellness, Mister said in a statement released Monday. Consumers should talk to their health care practitioners about their dietary supplement use, he advised.

The report was published online in the Annals of Internal Medicine.

Source : HealthDay

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Weightlifting Better at Reducing Heart Fat than Aerobic Exercise

Linda Carroll wrote . . . . . . . . .

Obese people who engaged in resistance training were more likely to see reductions in a type of heart fat that has been linked to cardiovascular disease, a new study finds.

In the small study, researchers determined that a certain type of heart fat, pericardial adipose tissue, was reduced in patients who did weight lifting, but not in those who worked on increasing their endurance with aerobic exercise, according to a report published in JAMA Cardiology. Both forms of exercise resulted in the reduction of a second type of heart fat, epicardial adipose tissue, which has also been linked with heart disease.

“We were surprised by this finding,” said the study’s lead author, Dr. Regitse Hojgaard Christensen, a researcher at the Center of Inflammation and Metabolism and the Center for Physical Activity Research at the Copenhagen University Hospital.

While the study doesn’t explain why weight training would have a different effect from endurance training, “we know from other studies that resistance training is a stronger stimulus for increased muscle mass and increased basal metabolism compared to endurance training and we therefore speculate that participants doing resistance training burn more calories during the day – also in inactive periods-compared to those engaged in endurance training,” Christensen said in an email.

To explore the impact of different types of exercise on heart fat, Christensen and her colleagues recruited 32 adults who were obese and sedentary but did not yet have heart disease, diabetes, or atrial fibrillation.

The participants were randomly assigned to a three-month program of aerobic exercise, weight training or no change in activity (the control group). Each person had an MRI scan of the heart done at the beginning of the study and at the end.

Both types of exercise training reduced epicardial adipose tissue mass compared to no exercise: endurance training, by 32% and weight training, by 24%. However, only weight training had an impact on pericardial adipose tissue, which was reduced by 31% compared to no exercise.

“The resistance exercise training in this study was designed as a 45-minute interval type, medium load, high-repetition, time-based training,” Christensen said. “Participants performed three to five sets of 10 exercises and the sessions were supervised. This specific exercise intervention alone was effective in reducing both fat depots of the heart. We did not combine resistance and endurance training, which would have been interesting to reveal their potential additive effects.”

While there are plenty of studies looking at the impact of reducing abdominal obesity, the new study is interesting because it looks specifically at the relation between exercise and fat (around the heart),” said Dr. Chadi Alraeis, a staff interventional cardiologist and director of Interventional Cardiology at Detroit Medical Center’s Heart Hospital.

Alraeis suspects, based on the new study, that the best way to combat heart fat is to do both endurance and weight training. “Along with the time you spend on the treadmill, you might want to add some work with dumbbells, or some lunges, sit-ups or pushups,” Alraeis said. “It might even be enough to bring some weights to the office so you can use them there. “

While the findings are interesting, “we don’t know what the implication of this is 10 years later,” Alraeis said. “We don’t know if outcomes are really being changed. We need some long-term studies to look at that.”

Source: Reuters


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Big Picture Genetic Scoring Approach Reliably Predicts Heart Disease

Specialized risk scores derived from testing that calculates the cumulative effect of an individual’s entire DNA sequence, the genome, may reliably predict heart disease in people who have not yet had a heart attack, according to new research in Circulation: Genomic and Precision Medicine, an American Heart Association journal.

The study is the latest to use polygenic risk scores (PRSs) based on an individual’s entire genome sequence as biomarkers to predict the risk to develop coronary artery disease and heart attack. Several published studies have used PRSs with high accuracy in people of European ancestry. Researchers in this most recent study set out to determine if the results would translate to a different population, in this case French Canadians.

Researchers studied two similar PRSs in 3,639 French Canadian adults with cardiovascular disease and 7,382 adults without heart disease. They found that the PRSs developed and tested in other populations also had the sensitivity and specificity for predicting heart disease in French Canadians.

“PRSs, built using very large data sets of people with and without heart disease, look for genetic changes in the DNA that influence disease risk, whereas individual genes might have only a small effect on disease predisposition,” said Guillaume Lettre, Ph.D., lead author of the study and an associate professor at the Montreal Heart Institute and Université de Montréal in Montreal, Quebec, Canada. “The PRS is like having a snapshot of the whole genetic variation found in one’s DNA and can more powerfully predict one’s disease risk. Using the score, we can better understand whether someone is at higher or lower risk to develop a heart problem.”

Early prediction would benefit prevention, optimal management and treatment strategies for heart disease. Because PRSs are simple and relatively inexpensive, their implementation in the clinical setting holds great promises. For heart disease, early detection could lead to simple yet effective therapeutic interventions such as the use of statins, aspirin or other medications.

Results from the study also confirmed original reports showing that the PRSs can identify about 6% to 7% individuals at high risk for cardiac disease. Lettre said this risk was similar to the high heart disease risk among people with familial hypercholesterolemia, a rare but severe disease that predisposes people to very high levels of low-density lipoprotein (LDL or bad) cholesterol, which puts them at a high risk of heart attack.

“Using the polygenic risk score, even in a normal population, we can find people whose risk is as high as those who have this rare disease,” Lettre said.

PRSs, however, did not perform as well in predicting new events in people who had already had heart attacks, possibly because the participants were older and 76% of those them were on statin treatment which could impact PRS performance.

More research needs to be done before PRSs go mainstream for determining individual heart disease risk, according to Lettre.

The next step is to test the genetic scoring systems long term in large clinical studies to determine if managing and treating people based on their risk scores improves individuals’ heart health. Researchers should also do studies to better understand how to integrate polygenic risk scores with the other known risk factors, such as blood pressure, diabetes and cholesterol levels, but also to extend these studies to non-European ancestry populations, he said.

The American Heart Association named the use of polygenic risk scores as one of the biggest advances in heart disease and stroke research in 2018.

“Eventually, clinicians could use polygenic risk scores along with family history, cholesterol and blood pressure to determine heart disease risk. Used early in a person’s life it might help clinicians more precisely tailor treatment aimed at preventing a heart attack in later years,” said Jennifer Hall, Ph.D., Chief of the American Heart Association’s Institute for Precision Medicine. “This type of research is the basis for the work we are doing within the Institute of Precision Medicine.”

“There is a lot of interest not only in the science arena but also in the general community about using genetics to capture information about disease risk,” Lettre said. “This research is exciting, as genetic testing is becoming more powerful, affordable and it’s easy – often requiring only a swab of one’s saliva.”

Source: American Heart Association


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Study: Cholesterol in Eggs Tied to Cardiac Disease, Death

The risk of heart disease and death increases with the number of eggs an individual consumes, according to a UMass Lowell nutrition expert who has studied the issue.

Research that tracked the diets, health and lifestyle habits of nearly 30,000 adults across the country for as long as 31 years has found that cholesterol in eggs, when consumed in large quantities, is associated with ill health effects, according to Katherine Tucker, a biomedical and nutritional sciences professor in UMass Lowell’s Zuckerberg College of Health Sciences, who co-authored the analysis. The study was published in the Journal of the American Medical Association.

The study results come as egg consumption in the country continues to rise. In 2017, people ate an average of 279 eggs per year, compared with 254 eggs in 2012, according to the U.S. Department of Agriculture.

Current U.S. Dietary Guidelines for Americans do not offer advice on the number of eggs individuals should eat each day. The guidelines, which are updated every five years, do not include this because nutrition experts had begun to believe saturated fats were the driving factor behind high cholesterol levels, rather than eggs, according to Tucker. However, prior to 2015, the guidelines did recommend individuals consume no more than 300 milligrams of cholesterol a day, she said.

One large egg contains nearly 200 milligrams of cholesterol, roughly the same amount as an 8-ounce steak, according to the USDA. Other foods that contain high levels of cholesterol include processed meats, cheese and high-fat dairy products.

While the new research does not offer specific recommendations on egg or cholesterol consumption, it found that each additional 300 milligrams of cholesterol consumed beyond a baseline of 300 milligrams per day was associated with a 17 percent higher risk of cardiovascular disease and an 18 percent higher risk of death.

Eating several eggs a week “is reasonable,” said Tucker, who noted they include nutrients beneficial to eye and bone health. “But I recommend people avoid eating three-egg omelets every day. Nutrition is all about moderation and balance.”

Research results also determined that study participants’ exercise regimen and overall diet quality, including the amount and type of fat they consumed, did not change the link between cholesterol in one’s diet and risk of cardiovascular disease and death.

“This is a strong study because the modeling adjusted for factors such as the quality of the diet,” Tucker said. “Even for people on healthy diets, the harmful effect of higher intake of eggs and cholesterol was consistent.”

Source: EurekAlert!


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Why Lack of Sleep Is Bad for Your Heart

Lisa Marshall wrote . . . . . . . . .

In recent years, numerous studies have shown that people who don’t get enough sleep are at greater risk of stroke and heart attack.

A new University of Colorado Boulder study, published in the journal Experimental Physiology, helps explain why.

It found that people who sleep fewer than 7 hours per night have lower blood levels of three physiological regulators, or microRNAs, which influence gene expression and play a key role in maintaining vascular health.

The findings could potentially lead to new, non-invasive tests for sleep deprived patients concerned about their health, the authors said.

“This study proposes a new potential mechanism through which sleep influences heart health and overall physiology,” said senior author Christopher DeSouza, a professor of Integrative Physiology.

Despite recommendations by the American Heart Association that people get 7 to 9 hours of sleep each night, about 40 percent of adults in the United States fall short. Overall, the average American’s sleep duration has plummeted from 9 hours nightly to 6.8 hours nightly over the past century.

In another recent study, DeSouza’s group found that adult men who sleep 6 hours per night have dysfunctional endothelial cells — the cells that line blood vessels — and their arteries don’t dilate and constrict as well as those who get sufficient sleep.

But the underlying factors leading to this dysfunction aren’t well known.

MicroRNAs are small molecules that suppress gene expression of certain proteins in cells. The exact function of circulating microRNAs in the cardiovascular system, and their impact on cardiovascular health is receiving a lot of scientific attention, and drugs are currently in development for a variety of diseases, including cancer, to correct impaired microRNA signatures.

“They are like cellular brakes, so if beneficial microRNAs are lacking that can have a big impact on the health of the cell,” said DeSouza.

For the new study, which is the first to explore the impact of insufficient sleep on circulating microRNA signatures, DeSouza and his team took blood samples from 24 healthy men and women, age 44 to 62, who had filled out questionnaires about their sleep habits. Half slept 7 to 8.5 hours nightly; Half slept 5 to 6.8 hours nightly.

They measured expression of nine microRNAs previously associated with inflammation, immune function or vascular health.

They found that people with insufficient sleep had 40 to 60 percent lower circulating levels of miR-125A, miR-126, and miR-146a, (previously shown to suppress inflammatory proteins) than those who slept enough.

“Why 7 or 8 hours seems to be the magic number is unclear,” said DeSouza. “However, it is plausible that people need at least 7 hours of sleep per night to maintain levels of important physiological regulators, such as microRNAs.”

Research is now underway in DeSouza’s lab to determine whether restoring healthy sleep habits can restore healthy levels of microRNAs.

Ultimately, he said, it’s possible that microRNAs in blood could be used as a marker of cardiovascular disease in people with insufficient sleep, enabling doctors to glean important information via a blood test rather than current, more invasive tests.

For now, DeSouza says, the takeaway message for those burning the midnight oil is this:

“Don’t underestimate the importance of a good night’s sleep.”

Source: University of Colorado Boulder


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