Your Life Span May Be Foretold in Your Heart Beats

Dennis Thompson wrote . . . . . . . . .

Where your resting heart rate goes, so goes your health.

That’s the suggestion of a new study that found older Swedish men with a resting heart rate of 75 beats per minute had a doubled risk of an early death, even though that rate is well within the normal range of 50 to 100 beats per minute.

That increase in risk held for both death from any cause and death linked to heart disease.

What’s more, every additional heart beat per minute increased a person’s overall risk of early death by 3% and their risk of heart disease by 2%.

Based on these results, doctors might want to keep an eye on a person’s resting heart rate, said American Heart Association expert Dr. Vincent Bufalino. A gradual rise in heart rate could mean trouble ahead for your heart health.

“You wouldn’t have thought you’d have that level of impact from a change in your resting heart rate,” said Bufalino, senior vice president and senior medical director of cardiology-AMG at Advocate Health Care in Naperville, Ill.

At the same time, Bufalino said, it’s a “bit of a stretch” to consider resting heart rate as an independent heart health risk factor.

Rather, a rising heart rate probably is a red flag for other well-established heart risk factors, such as diabetes, high blood pressure, cigarette smoking and a family history of heart problems, he explained.

But, “if the heart rate’s higher, it’s going to possibly point you in a direction to be more vigilant with those folks,” Bufalino said.

For this study, researchers led by Dr. Salim Bary Barywani, from Sahlgrenska Academy at the University of Gothenburg, tracked about 800 men born in 1943 and living in Sweden.

In 1993, these men filled out questionnaires on their lifestyle and health, and underwent a comprehensive medical exam that included measuring resting heart rate, the study authors said.

Resting heart rate was measured again in 2003 and 2014 for those still alive and willing to take part.

During the 21-year period, about 15% of the original group of men died before their 71st birthday, while about 30% developed cardiovascular disease, the researchers reported.

A resting heart rate of 75 or higher in 1993 was associated with a doubled risk of death or heart disease during the subsequent years, compared with a resting heart rate of 55 or lower, the findings showed.

At the same time, a stable resting heart rate between ages 50 and 60 was associated with a 44% lower risk of heart disease between ages 60 and 70, according to the report published online April 15 in the journal Open Heart.

The researchers noted that because this is an observational study, a true cause-and-effect relationship can’t be established.

Dr. Prashant Vaishnava, a cardiologist at the Mount Sinai Hospital in New York City, agreed with Bufalino that resting heart rate is probably an indicator of other heart risk factors.

“It seems as if that’s where attention should continue to be focused rather than on resting heart rate, which can vary due to a whole slew of reasons, frankly,” Vaishnava said. “If I see a patient in that age range with a resting heart rate of 75 beats per minute, I’m not necessarily going to look at that as a risk factor, but I would continue to look at the rest of their risk factor profile.”

Doctors generally tend to look for extremes when checking heart rate, Bufalino said.

“We know as your heart starts to fail, your heart rate goes up for sure,” Bufalino said.

Too slow also isn’t good — a heart rate down in the 40s also can indicate that the heart’s natural pacemaker might be failing, he added.

“The extremes of real slow and real fast, those are well-established markers for us to observe and intervene,” Bufalino said.

Vaishnava said people should probably “take these findings with a grain of salt,” given that the study involved only men and that other factors might have played a role in those who died early.

People who have an elevated resting heart rate can improve it through more aerobic exercise, Bufalino said. They also ought to talk with their doctor about managing other heart health risk factors like high blood pressure and cholesterol.

Source: HealthDay

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Diet Rich in Animal Protein Is Associated with a Greater Risk of Death

A diet rich in animal protein and meat in particular is not good for the health, a new study from the University of Eastern Finland finds, providing further backing for earlier research evidence. Men who favoured animal protein over plant-based protein in their diet had a greater risk of death in a 20-year follow-up than men whose diet was more balanced in terms of their sources of protein. The findings were published in the American Journal of Clinical Nutrition.

Men whose primary sources of protein were animal-based had a 23% higher risk of death during the follow-up than men who had the most balanced ratio of animal and plant-based protein in their diet. A high intake of meat in particular seemed to associate with adverse effects: men eating a diet rich in meat, i.e. more than 200 grams per day, had a 23% greater risk of death during the follow-up than men whose intake of meat was less than 100 grams per day. The men participating in the study mainly ate red meat. Most nutrition recommendations nowadays limit the intake of red and processed meats. In Finland, for example, the recommended maximum intake is 500 grams per week.

The study also found that a high overall intake of dietary protein was associated with a greater risk of death in men who had been diagnosed with type 2 diabetes, cardiovascular disease or cancer at the onset of the study. A similar association was not found in men without these diseases. The findings highlight the need to investigate the health effects of protein intake especially in people who have a pre-existing chronic medical condition. The mean age of the men participating in the study was 53 years at the onset, and diets clearly lacking in protein were not typical among the study population. “However, these findings should not be generalised to older people who are at a greater risk of malnutrition and whose intake of protein often remains below the recommended amount,” PhD Student Heli Virtanen from the University of Eastern Finland points out.

Earlier studies have suggested that a high intake of animal protein, and especially the consumption of processed meats such as sausages and cold cuts, is associated with an increased risk of death. However, the big picture relating to the health effects of protein and different protein sources remains unclear.

The study is based on the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD) that analysed the dietary habits of approximately 2,600 Finnish men aged between 42 and 60 at the onset of the study in 1984-1989. The researchers studied the mortality of this study population in an average follow-up of 20 years by analysing registers provided by Statistics Finland. The analyses focused on the associations of dietary protein and protein sources with mortality during the follow-up, and other lifestyle factors and dietary habits were extensively controlled for, including the fact that those eating plenty of plant-based protein followed a healthier diet.

Source: University of Eastern Finland

Unhealthy Diets May Be World’s Biggest Killer

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

Bad diets are shortening lives worldwide — killing more people globally than either smoking or high blood pressure, a large, new research suggests.

The study, of nearly 200 countries, linked poor diet quality to nearly 11 million deaths globally in 2017. That translated to 22 percent of deaths among all adults that year.

Previous research has linked tobacco use to 8 million deaths per year worldwide, and high blood pressure to just over 10 million deaths.

But it’s not surprising that diet is so critical, said lead researcher Dr. Ashkan Afshin, of the University of Washington in Seattle.

Poor nutrition helps drive many health conditions, from high blood pressure to type 2 diabetes, he noted.

And it’s not just a matter of people eating too much junk food, which is common in wealthy nations like the United States.

“We often talk about the foods that are ‘bad,’ and what you shouldn’t eat,” Afshin said. “But this is also about what you should eat.”

The analysis pointed to some eating habits with particularly strong links to higher death rates: diets high in sodium, and those low in whole grains, fruits and vegetables, and nuts and seeds.

Basically, Afshin said, it all supports a common refrain when it comes to diet advice: Eat fewer processed foods and more “whole” plant-based foods.

That is the bottom line, agreed Dr. Andrew Freeman, who directs cardiovascular prevention and wellness at National Jewish Health in Denver.

“People are missing a lot from their diets,” he said. “If you include more whole, plant-based foods, that will push out some of the bad things.”

Freeman, who was not involved in the study, recently headed a research review examining some diet “hypes” — certain foods touted as having heart benefits.

The conclusion? The best evidence supports not miracle foods, but an overall diet high in fruits and vegetables, legumes and nuts, and fiber-rich whole grains.

For the new study, Afshin’s team used published nutrition surveys to look at typical dietary intakes across 195 countries, plus published research on the relationship between various diet factors and disease risks.

For example, to estimate the impact of salty diets, the researchers looked at the evidence on urinary sodium levels and changes in blood pressure — and then estimated the relationship between those blood pressure changes and disease outcomes.

There were, not surprisingly, differences in the typical diet across world regions: People in the United States and Canada tended to eat the most processed meats and trans fats from packaged foods, for example.

But consumption of sugary drinks and sodium was too high in nearly all world regions, the researchers noted.

Meanwhile, healthy foods were shortchanged almost universally, with a few exceptions: People in Central Asia tended to eat enough vegetables, while those in parts of Latin America, Africa and South Asia typically got plenty of legumes.

On the whole, though, unbalanced diets were a health threat everywhere. Oceania and East Asia had the highest proportion of “diet-related” deaths from heart disease, for example. Diet-related deaths from type 2 diabetes complications were highest in the United States and Canada.

The impact of diet was seen not only in death rates, but in quality of life, according to Afshin.

In 2017, poor diets were associated with 255 million disability-adjusted life years — a summary of overall life years lost, plus time lived with a disability.

The findings were published April 3 in The Lancet journal.

To Freeman, it all points to the huge impact diet choices have on people’s longevity and well-being. “I don’t know how many alarms we need before we start making changes,” he said.

But it’s not only individuals who need to pay attention, both Freeman and Afshin said: Society as a whole, including health care systems and policymakers, needs to promote healthy whole foods over processed foods, red meat and butter.

It’s never too late to make wise diet changes — and Freeman said that patients are often motivated to “get off pills” for managing conditions like high blood pressure.

But ideally, he noted, people shouldn’t wait until diseases have developed.

Source: HealthDay

Higher Egg and Cholesterol Consumption Hikes Heart Disease and Death Risk

Marla Paul wrote . . . . . . . . .

Cancel the cheese omelet. There is sobering news for egg lovers who have been happily gobbling up their favorite breakfast since the 2015-2020 Dietary Guidelines for Americans no longer limited how much dietary cholesterol or how many eggs they could eat.

A large, new Northwestern Medicine study reports adults who ate more eggs and dietary cholesterol had a significantly higher risk of cardiovascular disease and death from any cause.

“The take-home message is really about cholesterol, which happens to be high in eggs and specifically yolks,” said co-corresponding study author Norrina Allen, associate professor of preventive medicine at Northwestern University Feinberg School of Medicine. “As part of a healthy diet, people need to consume lower amounts of cholesterol. People who consume less cholesterol have a lower risk of heart disease.”

Egg yolks are one of the richest sources of dietary cholesterol among all commonly consumed foods. One large egg has 186 milligrams of dietary cholesterol in the yolk.

Other animal products such as red meat, processed meat and high-fat dairy products (butter or whipped cream) also have high cholesterol content, said lead author Wenze Zhong, a postdoctoral fellow in preventive medicine at Northwestern.

Debate over disease

Whether eating dietary cholesterol or eggs is linked to cardiovascular disease and death has been debated for decades. Eating less than 300 milligrams of dietary cholesterol per day was the guideline recommendation before 2015. However, the most recent dietary guidelines omitted a daily limit for dietary cholesterol. The guidelines also include weekly egg consumption as part of a healthy diet.

An adult in the U.S. gets an average of 300 milligrams per day of cholesterol and eats about three or four eggs per week.

The study findings mean the current U.S. dietary guideline recommendations for dietary cholesterol and eggs may need to be re-evaluated, the authors said.

The evidence for eggs has been mixed. Previous studies found eating eggs did not raise the risk of cardiovascular disease. But those studies generally had a less diverse sample, shorter follow-up time and limited ability to adjust for other parts of the diet, Allen said.

“Our study showed if two people had exact same diet and the only difference in diet was eggs, then you could directly measure the effect of the egg consumption on heart disease,” Allen said. “We found cholesterol, regardless of the source, was associated with an increased risk of heart disease.

Exercise, overall diet quality and the amount and type of fat in the diet didn’t change the association between the dietary cholesterol and cardiovascular disease and death risk.

The new study looked at pooled data on 29,615 U.S. racially and ethnically diverse adults from six prospective cohort studies for up to 31 years of follow up.

It found:

  • Eating 300 mg of dietary cholesterol per day was associated with 17 percent higher risk of incident cardiovascular disease and 18 percent higher risk of all-cause deaths. The cholesterol was the driving factor independent of saturated fat consumption and other dietary fat.
  • Eating three to four eggs per week was associated with 6 percent higher risk of cardiovascular disease and 8 percent higher risk of any cause of death.

Should I stop eating eggs?

Based on the study, people should keep dietary cholesterol intake low by reducing cholesterol-rich foods such as eggs and red meat in their diet.

But don’t completely banish eggs and other cholesterol-rich foods from meals, Zhong said, because eggs and red meat aregood sources of important nutrients such as essential amino acids, iron and choline. Instead, choose egg whites instead of whole eggs or eat whole eggs in moderation.

“We want to remind people there is cholesterol in eggs, specifically yolks, and this has a harmful effect,” said Allen, who cooked scrambled eggs for her children that morning. “Eat them in moderation.”

Estimating dietary intake

Diet data were collected using food frequency questionnaires or by taking a diet history. Each participant was asked a long list of what they’d eaten for the previous year or month. The data were collected during a single visit.The study had up to 31 years of follow up (median: 17.5 years), during which 5,400 cardiovascular events and 6,132 all-cause deaths were diagnosed.

A major limitation of the study is participants’ long-term eating patterns weren’t assessed.

“We have one snapshot of what their eating pattern looked like,” Allen said. “But we think they represent an estimate of a person’s dietary intake. Still, people may have changed their diet, and we can’t account for that.”

Source: Northwestern University

Higher Fitness Level Can Determine Longer Lifespan After Age 70

Researchers have uncovered one more reason to get off the couch and start exercising, especially if you’re approaching your golden years. Among people over age 70, physical fitness was found to be a much better predictor of survival than the number of traditional cardiovascular risk factors in a study being presented at the American College of Cardiology’s 68th Annual Scientific Session.

While high blood pressure, high cholesterol, diabetes and smoking are closely linked with a person’s chance of developing heart disease, these factors are so common in older people that the total number of risk factors becomes almost meaningless for predicting future health, researchers said. The new study suggests doctors can get a better picture of older patients’ health by looking at how fit they are, rather than how many of these cardiovascular risk factors they have.

“We found fitness is an extremely strong risk predictor of survival in the older age group—that is, regardless of whether you are otherwise healthy or have cardiovascular risk factors, being more fit means you’re more likely to live longer than someone who is less fit,” said Seamus P. Whelton, MD, MPH, assistant professor of medicine at Johns Hopkins School of Medicine and the study’s lead author. “This finding emphasizes the importance of being fit, even when you’re older.”

Doctors use cardiovascular risk factors to help guide decisions about preventive measures and medications. Previous studies have shown that quitting smoking and controlling blood pressure, cholesterol and diabetes can reduce heart disease risk. However, most studies of cardiovascular risk factors have focused on middle-aged people, leaving a knowledge gap regarding the importance of these risk factors in older people, Whelton said.

The team analyzed medical records from more than 6,500 people aged 70 years and older who underwent an exercise stress test at a Henry Ford Health Systems-affiliated medical center between 1991 and 2009. They assessed fitness based on patients’ performance during the exercise stress test, which required patients to exercise on a treadmill as hard as they could. They divided patients into three groups reflecting their fitness based on the number of METs (metabolic equivalents, a measure of exercise workload) they achieved during the test: most fit (10 or more METs), moderately fit (six to 9.9 METs) and least fit (six or fewer METs). For this study, the researchers grouped patients with zero, one, two, or three or more cardiovascular risk factors.

On average, participants were 75 years old when they underwent the stress test. Researchers tracked the patients for an average of just under 10 years, during which time 39 percent of them died. Over this period, the researchers found higher fitness was associated with significantly increased rates of survival. The most fit individuals were more than twice as likely to be alive 10 years later compared with the least fit individuals.

In contrast, a patient’s total number of cardiovascular risk factors was not associated with their risk of death and patients with zero risk factors had essentially the same likelihood of dying as those with three or more risk factors.

Whelton said the findings demonstrate that fitness level is an important indicator of an older patient’s health that doctors could benefit from considering more often. While an exercise stress test using a treadmill or stationary bicycle provides the most precise way to measure fitness, doctors can also get a general idea of a patient’s fitness level by asking about their exercise routine.

“Assessing fitness is a low-cost, low-risk and low-technology tool that is underutilized in clinical practice for risk stratification,” Whelton said.

The study did not account for any changes in fitness level that the participants may have experienced over time. However, previous studies have suggested that improving fitness can help improve heart health, even late in life.

“People who aren’t exercising or are sedentary would likely benefit from starting a routine of low- to moderate-intensity exercise, though they should talk with their physician first,” Whelton said.

Source: American College of Cardiology


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