Tufts University Health and Nutrition Letter, November 2014

As the mercury drops, cold and flu outbreaks soar. It’s tempting to believe the marketing claims that this pill or that herbal remedy can protect you, but the science says there’s simply no “magic bullet” to boost your immune system. Eating a healthy diet, however, is even more important during cold and flu season. Experts may not fully understand how specific nutrients aid the immune system, and tests of individual vitamins and minerals against colds and flu do not always produce positive results. But it’s clear that the combination found in healthy foods can build your body’s ability to fight infections.

Researchers at Tufts’ Nutritional Immunology Laboratory are looking for new ways in which diet might affect the immune system. Simin Nikbin Meydani, DVM, PhD, laboratory director and head of Tufts’ Jean Mayer USDA Human Nutrition Research Center on Aging, says, “Several ongoing animal and human studies are designed to determine the impact of other dietary components and functional foods on immune response and resistance to infection. These projects include the effects of wolfberry and pre- and pro-biotics on resistance to influenza infection and immune response, and the effect of olive oil on immune and inflammatory responses.” Other research is investigating whether white button mushrooms could improve resistance to viral and bacterial infection by enhancing the body’s immune response.

KEEPING THE DOCTOR AWAY: Two studies published in late 2012 helped demonstrate the connection between healthy eating and immune function. In one, older adults who increased their fruit and vegetable consumption to at least five servings a day responded significantly better to a pneumonia vaccine than those in a control group. (One serving was defined as 80 grams of fruit – about one apple, orange or banana – or three-quarter cup of fruit juice, or three heaping tablespoons of vegetables.)

The second study tested both a dietary intervention and a supplement, finding that both groups needed fewer doctor and hospital visits than a control group. Those in the dietary group ate at least five servings of fruits and vegetables daily, fish twice a week, nuts at least weekly and only whole-grain bread. The supplement given a second group was designed to approximate the same increase in nutrients: 1,500 micrograms of beta-carotene, 2 milligrams vitamin E, 80 milligrams vitamin C, 2 milligrams zinc and 25 micrograms selenium.

Whole-grain bread and other whole-grain foods, while not a specific nutrient, may improve gut health by promoting “good bacteria.” This in turn may have a beneficial impact on the immune system. A 2009 review, for example, found that the beta-glucan fiber in oats improves the defenses of the immune system. At Tufts, the HNRCA is currently recruiting participants for a study of the effects of a diet rich in whole grains on intestinal health and immune response in adults ages 40-65.

Tufts Health and Nutrition Letter, November 2014

Unhealthy behaviors such as inactivity, poor diet and smoking have long been associated with a wide range of chronic diseases and risk of death. But a new study reveals that such lifestyle factors can also affect older adults’ risk of disability and loss of independence.

That’s no surprise to Miriam E. Nelson, PhD, professor at Tufts’ Friedman School and author of the “Strong Women” series of books – especially the findings about physical activity. “If you’ve ever been bedridden for a few days and felt weak when you tried to get up again,” she says, “you know what inactivity does to your body. A sedentary lifestyle doesn’t take its toll quite so rapidly, but it inflicts the same damage.”

In the new study, published in BMJ, French researchers report that people who were physically inactive, ate fruits and vegetables less than once a day, and smoked or had quit within 15 years were more than twice as likely to develop disability than those with none of those unhealthy behaviors. The research followed nearly 4,000 participants in the Tri-City Study over 12 years, during which they were evaluated for disability six times. Participants, all age 65 or older, were initially free of disability. Scientists combined three different scales gauging ability to function independently and perform daily tasks without assistance. Those scores were then compared to participants’ self-reported activity levels, fruit and vegetable consumption, smoking status and alcohol use. (After statistical analysis, there was no association between alcohol consumption – or non-drinking – and disability risk.)

FIRST, GET MOVING: The strongest predictor of developing disability was low or intermediate physical activity, which was associated with a 72% greater risk of disability. Low activity was defined as walking less than one hour a day and exercising less than once a week, while high activity was considered walking more than one hour a day and exercising more than once a week; levels in-between were classified as intermediate.

Next came smoking or having smoked within the past 15 years, which was associated with a 26% higher disability risk. But poor diet was not far behind, at a 24% greater risk. Diet was assessed by questions on frequency of consumption of raw and cooked fruit and vegetables; participants were grouped as consuming fruit or vegetables at least once a day, four to six times a week, and less than four times a week. Both the lower-consumption groups, averaging less than once a day, were rated as unhealthy behaviors for the study.

Eating more fruits and vegetables, of course, is only the start of a healthy dietary pattern, Tufts’ Nelson emphasizes: “Stick to whole and minimally processed foods, and emphasize the choices available on the perimeter of the supermarket – the produce and dairy aisles, for instance – rather than on the boxed, bagged and other packaged goods, many laden with added sugar, lining the center aisles.”

As the number of unhealthy behaviors rose, from zero to three, risk of disability increased significantly. The French scientists noted that part of this association could be explained by chronic conditions, depressive symptoms, trauma, body mass index and other health outcomes. But more than two-thirds of the additional disability risk appeared to be directly linked to unhealthy lifestyles.

Mayo Clinic Newsletter, October 2013:

“Drugs are the cornerstone of treatment for Parkinson’s disease. But accumulating evidence suggests that regular exercise can also be important when it comes to maintaining health and independence with Parkinson’s.

In a Mayo Clinic review of research published in the July 19, 2011 issue of Neurology, it was noted that exercise appears to reduce Parkinson’s disease risk. In one cited study, those who had been physically active at midlife or in the previous 10 years had a 35 percent or greater reduced risk of developing Parkinson’s compared with inactive people.

There’s accumulating, indirect evidence that this protective effect may extend to slowing disease progression in those who continue to exercise. Exercise appears to improve cognitive and motor skills — and increase longevity — in those with Parkinson’s. …In addition, exercise reduces the risk of dementia and Alzheimer’s disease. It may even improve cognition in those who have dementia. This may be important, as many people with Parkinson’s are at higher risk of dementia.

Mayo Clinic experts strongly recommend stretching, exercise and physical fitness as key for Parkinson’s management. Effective minimum exercise levels appear to consist of about 150 minutes a week – or 30 minutes a day, five days a week — of exercise that increases the heart rate and is roughly equivalent in intensity to brisk walking. If you balance have problems, pool exercises or a stationary bike might help.”

If you have balance issues, using hiking poles can help you stay on your feet and also add a good upper body and core workout.

September 2013: From the WebMD Women’s Health online magazine:

“Most women do gain some weight around the time of menopause, but hormones probably aren’t the only cause. Aging slows the metabolism, so you burn fewer calories, and changes in lifestyle (such as exercising less) play a role. But where you gain weight also may be related to menopause, with fat accumulating around your waist, not your hips and thighs.”

And as we all know, gaining weight around the waist is something we need to avoid not just because it doesn’t look great, but because a larger waist is a known risk factor.  “Men and women who are very large around the middle are at much greater risk of dying from any cause than people with thinner waists … and not just from weight-related problems” (2010 study quoted in WebMD, Aug 9, 2010).

One more reason to hit the gym!

Tufts Health and Nutrition Letter, May 2013 – For all you coffee drinkers out there, like me!

The evidence keeps percolating that coffee might have benefits beyond just helping you wake up in the morning. The latest such finding, from a large Swedish study, links coffee drinking to a reduced risk of stroke in women.

Although their study wasn’t designed to prove cause and effect, Susanna C. Larsson, PhD, of the Karolinska Institute in Stockholm, and colleagues commented in the journal Stroke, “Given that coffee is one of the most popular beverages consumed worldwide, even small health effects of substances in coffee may have large public health consequences.”

Larsson and colleagues analyzed data on 34,670 women, initially free of cardiovascular disease and cancer, participating in the Swedish Mammography Cohort. When that study began, the women filled out a questionnaire on diet that included coffee consumption; overall, they averaged three cups of coffee a day. Although the questionnaire didn’t ask about regular versus decaffeinated consumption, the researchers noted that few Swedes drink decaf.

Tufts University Health Letter, April 2013

 Here’s more evidence that walking helps boost your brain-but you might have to step it up: In a study of 299 Pittsburgh seniors, those walking at least 72 blocks weekly had significantly greater gray-matter volume in subsequent MRI scans.

Kirk Erickson, PhD, of the University of Pittsburgh, and colleagues studied people enrolled in the Cardiovascular Health Study, a long, multistate research project focused on risk factors for heart disease and stroke. Erickson and colleagues did additional research on 299 of the 1,479 Pittsburgh participants, all of whom were cognitively normal at the study’s start. Those participants, average age 78, also underwent MRI scans after nine years and were tested for mild cognitive impairment or dementia after 13 years.

Participants were divided into four groups based on weekly walking distance at the study’s start. The groups averaged 8, 21, 45, and 156 blocks per week. When scanned nine years later, those in the lower three groups of walking distance did not show significant difference in brain volumes, although there was a trend toward greater volume with increased activity. But the group averaging 156 blocks weekly had markedly greater volumes in three gray- matter areas of the brain-the inferior frontal gyrus, the hippocampal formation and the supplementary motor area.

Tufts University Newsletter, April, 2013

A new review of more than 50 clinical trials, designed to update prevention recommendations for physicians, finds exercise and vitamin D supplements are the most effective ways to prevent falls in older adults. The report says exercise was associated with a 13% reduction in the risk of falling, while trials of vitamin D supplementation saw a 17% reduction in falls. The review will be used to update the US Preventive Services Task Force (USPSTF) recommendations for strategies to prevent falls. “Our evidence review shows that exercise and vitamin D supplementation are the most effective primary care interventions to prevent falls,” says lead author Yvonne L. Michael, ScD, MS, of the Drexel University School of Public Health. “This is important news because falls are extremely common in this population and they are the leading cause of death and injury for the elderly. We need to help primary care clinicians find better ways to prevent falls, and this review will help to do that.” Michael and colleagues reviewed 54 randomized controlled trials-out of more than 4,000 studies that were screened-totaling 26,101 participants ages 65 and older. Of these, 18 studied exercise and physical therapy involving nearly 4,000 people. Some of the trials involved group exercise or Thai Chi classes; others involved individualized exercise instruction at home. Although a variety of exercises were studied, most were aimed at improving gait, balance, strength and flexibility needed to do everyday activities. The interventions ranged from six weeks to 12 months or longer and the evaluation periods lasted up to 18 months after the programs ended.

Arthritis Today Web Magazine
By Donna Rae Siegfried

Lift weights with sore joints? Yeah, right. You might think weight lifting would make arthritis worse. But think again. The benefits of strength training for arthritis are just being recognized. Weight lifting can help people with rheumatoid arthritis (RA) function better and reduce soreness, stiffness and pain.

A study from Great Britain shows that a strength-training program called progressive resistance training (PRT) may improve physical function in people with mildly disabling, well-controlled RA. PRT involves periodically increasing the amount of weight used during an exercise so benefits continue as muscle strength improves.

Data from participants in the high-intensity – not high-impact – program dispelled the long-held notion that joints affected by RA needed more rest and protection than movement. None of the participants experienced a flare, and all improved endurance, gained lean body mass and lost abdominal, back and chest fat. Improve­ments also were seen in people with cachexia (see “What Is Cachexia?” below) – so much so that a larger trial is nearing completion to determine the effectiveness of PRT as a treatment for cachexia along with medications that control RA.

In the 12-week study, participants three times a week performed three sets of eight of each of the following exercises: biceps curl, triceps pushdown, chest press, seated row, leg press, leg extension, leg curl and standing calf raise.

“The novelty of the study was not in the kind of exercises used – because over the course of a long-term training program, the exercises performed must be changed regularly, anyway – but rather in seeing the frequency and intensity at which people with RA could work,” says Samuele Marcora, PhD, exercise physiologist at the University of Wales in Bangor, United Kingdom.

To initially increase muscle strength, Marcora recommends using weight machines and then progressing to dumbbells. After several months working under the supervision of a qualified instructor to increase strength, Marcora says resistance bands could then be used at home for “maintenance” training.

Tufts University Newsletter, September 2012

Staying healthy and maintaining a normal weight helps protect your brain, according to a 10-year study of 6,401 British civil servants. Participants, initially ages 39-63, were less likely to have impaired cognitive function if they were not overweight or obese. Those with multiple markers of “metabolic abnormality” were more likely to suffer impaired cognitive function; these markers included high cholesterol or triglycerides, high blood pressure, low “good” HDL cholesterol, high glucose or diabetes. In follow up mental testing at the 5- and 10-year points, those who were both obese and “metabolically abnormal” were significantly more likely to show a faster rate of cognitive decline. Researchers speculated that vascular problems associated with weight might affect brain function, along with fat-related secretions that impact the aging brain. – Neurology