Gaining weight in mid-20s linked to early death:

Gaining weight from your mid-20s into middle age is associated with an increased risk of premature death, warn researchers.

According to the study, weight loss at older ages (from middle to late adulthood) was also linked to higher risk. 

"The results highlight the importance of maintaining normal weight across adulthood, especially preventing weight gain in early adulthood, for preventing premature deaths in later life," said study researchers.


 For the study, researchers set out to investigate the association between weight changes across adulthood and mortality. 

Their findings were based on data from the 1988-94 and 1999-2014 US National Health and Nutrition Examination Survey (NHANES), a nationally representative annual survey that includes interviews, physical examinations and blood samples, to gauge the health of the US citizens.

 

Their analysis included 36,051 people aged 40 years or over with measured body weight and height at the start of the survey (baseline) and recalled weight at young adulthood (25 years old) and middle adulthood (average age 47 years).

Deaths from any cause and specifically from heart diseases were recorded for an average of 12 years, during which time there were 10,500 deaths.

After taking account of potentially influential factors, the researchers found that people who remained obese throughout adult life had the highest risk of mortality, while people who remained overweight throughout adult life had a very modest or no association with mortality.

Weight gain from young to middle adulthood was associated with increased risk of mortality, compared with participants who remained at normal weight.

Weight loss over this period was not significantly related to mortality.

But as people got older, the association between weight gain and mortality weakened, whereas the association with weight loss from middle to late adulthood became stronger and significant.

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Drops in Income may hurt your brain along with Wallet

Young adults, who experienced annual income drops of 25 per cent or more might be more at risk of having thinking problems and reduced brain health in middle age, a study said. 

"Our exploratory study followed participants in the US through the recession in the late 2000s when many people experienced economic instability," said the study's lead author.

Our results provide evidence that higher income volatility and more income drops during peak earning years are linked to unhealthy brain ageing in middle age," he  said. 

The study, involved 3,287 people who were 23-35 years old at the start of the study and were enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study, which includes a racially diverse population. 

Participants reported their annual pre-tax household income every three to five years from 1990-2010. 

Researchers have examined how often income dropped as well as the percentage of change in income between 1990-2010 for each participant. 

Participants were given thinking and memory tests that measured how well they completed tasks and how much time it took to complete them. 

The study found that people with two or more income drops had worse performances in completing tasks than people with no income drops. 

Participants with more income drops also scored worse on how much time it took to complete some tasks. 

The results were the same after researchers adjusted for other factors that could affect thinking skills, such as high blood pressure, education level, physical activity and smoking. 

There was no difference between the groups on tests that measured verbal memory. 

Of the study group, 707 participants also had brain scans with magnetic resonance imaging (MRI) at the beginning of the study and 20 years later to measure their total brain volume as well as the volumes of various areas of the brain. 

Researchers found when compared to people with no income drops, people with two or more income drops had smaller total brain volume. 

People with one or more income drops also had reduced connectivity in the brain, meaning there were fewer connections between different areas of the brain.

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Heart-healthy diets in early adulthood linked to better brain function in middle age

Eating a diet rich in fruits and vegetables, moderate in nuts, fish and alcohol and low in meat and full-fat dairy is associated with better cognitive performance in middle age, according to a study. Cognitive abilities include thinking and memory skills.

"Our findings indicate that maintaining good dietary practices throughout adulthood can help to preserve brain health at midlife" said study author.

The study involved 2,621 people who were an average age of 25 at the start and were then followed for 30 years. They were asked about their diet at the beginning of the study and again seven and 20 years later. The participants' cognitive function were tested twice, when they were about 50 and 55 years old.

The participants' dietary patterns were evaluated to see how closely they adhered to three heart-healthy diets: the Mediterranean diet, the Dietary Approaches to Stop Hypertension (DASH) diet and diet quality score designed as part of the study called the CARDIA a priori Diet Quality Score, or APDQS.

The Mediterranean diet emphasizes whole grains, fruits, vegetables, healthy unsaturated fats, nuts, legumes and fish and limits red meat, poultry and full-fat dairy.

The DASH diet emphasizes grains, vegetables, fruits, low-fat dairy, legumes and nuts and limits meat, fish, poultry, total fat, saturated fat, sweets and sodium.

The APDQS diet emphasizes fruits, vegetables, legumes, low-fat dairy, fish, and moderate alcohol, and limits fried foods, salty snacks, sweets, high-fat dairy and sugar-sweetened soft drinks.

For each diet, study participants were divided into one of three groups—low, medium or high adherence score—based on how closely they followed the diet.

The researchers found that people who followed the Mediterranean diet and the APDQS diet, but not the DASH diet, had less 5-year decline in their cognitive function at middle-age.

People with high adherence to the Mediterranean diet were 46 percent less likely to have poor thinking skills than people with low adherence to the diet. Of the 868 people in the high group, 9 percent had poor thinking skills, compared to 29 percent of the 798 people in the low group.

People with high adherence to the APDQS diet were 52 percent less likely to have poor thinking skills than people with low adherence to the diet. Of the 938 people in the high group, 6 percent had poor thinking skills, compared to 32 percent of the 805 people in the low group.

The results were adjusted for other factors that could affect cognitive function, such as the level of education, smoking, diabetes and physical activity.

He noted large differences in fruit and vegetable intake between the low and high groups for the diets. For the Mediterranean diet, the low group had an average of 2.3 servings of fruit per day and 2.8 of vegetables, compared to 4.2 servings of fruit and 4.4 of vegetables for the high group. For the APDQS diet, the low group ate 2.7 servings of fruit and 4.3 of vegetables, compared to 3.7 and 4.4 for the high group.

He said that the study does not show that a heart-healthy diet results in better thinking skills; it only shows an association between the two.

It's unclear why the DASH diet did not show a link to better thinking skills.

"One possibility is that DASH does not consider moderate alcohol intake as part of the dietary pattern, whereas the other two diets do," he said. "It's possible that moderate alcohol consumption as part of a healthy diet could be important for brain health in middle age, but further research is needed to confirm these findings."

He continued, "While we don't yet know the ideal dietary pattern for brain health, changing to a heart-healthy diet could be a relatively easy and effective way to reduce the risk for developing problems with thinking and memory as we age."

Despite being able to adjust for some factors that could affect thinking and memory skills, it is possible that other factors could be affecting the results that were not identified, according to him. 

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High blood pressure before age 40 linked to higher risk of cardiovascular disease

New  research has found that younger adults with high blood pressure before the age of 40 have an increased risk of cardiovascular events such as heart failure, strokes and blood vessel blockages as they age.

The study used the new blood pressure guidelines issued in 2017, which lowered the clinical definition of high blood pressure from earlier levels, to investigate the association between level of blood pressure (BP) in young adulthood and the risk of cardiovascular disease (CVD) by middle age.

Participants included 4,851 young adults aged 18 to 30 years who had blood pressure measurements taken before age 40 as part of the Coronary Artery Risk Development study  which began in 1985. 

Participants were then categorised into four groups based on their blood pressure levels: Normal (120 or lower systolic blood pressure over 80 diastolic or less); elevated (120-129 over less than 80); stage 1 hypertension (130-139 over 80-89); or stage 2 hypertension (140 or greater over 90 or greater). 
The researchers looked at participants’ data over a median of 18.8 years.

The findings,  showed that participants with elevated blood pressure, stage 1 hypertension, and stage 2 hypertension before age 40, as defined by the 2017 guidelines, had a significantly higher risk of cardiovascular disease events compared with those with normal blood pressure before the age of 40.

"This is a first step in assessing whether high blood pressure, as defined by the new criteria, is something that younger people should be concerned about as a potential precursor to serious problems," commented lead author. "Although this is an observational study, it demonstrates that the new blood pressure guidelines are helpful in identifying those who might be at risk for cardiovascular events."

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Lung disease associated with dementia in later life

According to a recent study, lung disease in middle age could be a risk factor for dementia or cognitive impairment later in life. 
 
A group of researchers report that both restrictive and obstructive lung diseases were associated with dementia, including Alzheimer's disease and with mild cognitive impairment. The link was stronger for restrictive lung diseases, such as idiopathic pulmonary fibrosis and sarcoidosis, than it was for chronic obstructive pulmonary disease (COPD).

"Preventing dementia is a public health priority, and previous studies have suggested that poor lung health, which is often preventable, may be linked to a greater risk of developing dementia," said the Dr.

"In this study, we looked at the long-term association between poor lung function and the risk of developing dementia, using high-quality measures," added the author.

The study found that compared to those without lung disease, the odds of dementia or mild cognitive impairment were:
- 58 percent higher among those with restrictive lung disease.
- 33 percent higher among those with obstructive lung disease.
The study also found that low results on two spirometry tests--forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) - were associated with dementia. FEV1 is the amount of air a person can forcefully exhale in one second. FVC is a measurement of lung size.

According to the authors, possible explanations for these findings are that lung disease produced low blood oxygen levels, which in turn may have led to inflammation, stress and damage to the brain's blood vessels.

Study limitations included the fact that participants' lung function was assessed only at the beginning of the study and that many patients died before being assessed for dementia or cognitive impairment.

Because it was not a randomised, controlled trial, the study cannot prove a cause and effect relationship between lung disease and dementia or mild cognitive impairment.

If these associations are causal, the researchers wrote, this would give added weight to efforts to improve air quality and to help people quit smoking. These public health measures might also lower rates of dementia as well as decrease lung disease.

"Preventing lung disease is inherently important," the Dr. said, adding that if other studies confirm their study's findings, "both individuals and policymakers will have an added incentive to make changes that protect lung health, as doing so may also prevent dementia."

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Middle-aged can reverse heart risk with exercise

The new year is a time when many plan to shape up after the excesses of the festive period.

Now there is good news for those who fear it might be too late in life to improve their fitness.
People into late middle age can reverse or reduce the risk of heart failure caused by decades of sedentary living by exercising, a study has found.
But there is a catch - it takes two years of aerobic exercise, four to five days a week, researchers said.

'Sweet spot'

The study,  analysed the hearts of 53 adults aged 45-64 who were healthy but had no history of exercising regularly. 

Research has shown that sedentary behaviours - such as sitting or reclining for long periods of time - increase the risk of heart disease. 

The study's participants were divided into two groups, with one following an aerobic exercise routine that progressed in intensity over the two years and another doing yoga, balance training and weight training three times a week, also for two years. 

The aerobic exercise group showed an 18% improvement in their maximum oxygen intake during exercise and a more than 25% improvement in "plasticity" in the left ventricular muscle of the heart - both markers of a healthier heart.

However, the benefits were not seen in the second group.
Middle-aged told to walk faster
More than 20 million people physically inactive
Exercise keeps the mind sharp in over 50s 

The lead author of the study said: "The key to a healthier heart in middle age is the right dose of exercise, at the right time in life.

"We found what we believe to be the optimal dose of the right kind of exercise, which is four to five times a week, and the 'sweet spot' in time, when the heart risk from a lifetime of sedentary behaviour can be improved - which is late-middle age. 

"The result was a reversal of decades of a sedentary lifestyle on the heart for most of the study participants."
 
Participants exercised generally in 30-minute sessions, plus a warm-up and cool-down.
Their routine included:
*One high-intensity aerobic session, such as four-by-four interval training where participants did four sets of four minutes of exercise at 95% of their maximum heart rate followed by three minutes of active recovery at 60-75% peak heart rate.
*Two or three days a week of moderate intensity exercise (where exercisers sweat but can still carry on a conversation)
*At least one weekly strength training session
*At least one long session of aerobic exercise a week, such as an hour of tennis, cycling, running, dancing or brisk walking

They built up to those levels, beginning with three 30-minute moderate exercise sessions for the first three months after which high intensity exercise was included. 

Dr.  told the take-home message from the research is that exercise needs to be a part of people's personal hygiene, like teeth brushing.

"It's not something that gets added on to the end of the day: You brush your teeth, you change your clothes, you eat food and drink water. 

"You do these things for personal hygiene. Exercise is equally important. You need to find ways to incorporate it into your daily activities." 

Dr.  told  the study was valuable in that shows we can delay cardiovascular ageing.He said it provided further evidence that "we can, in a way, rejuvenate or make the cells in the heart, and also in the blood vessels for that matter, resemble younger cells through an exercise programme". 

"I think that's a very important take-home message for those of us who may have a doom and gloom view there's nothing we can do about it. Yes there is, we can start by getting off the couch to have a more active lifestyle."

Little change after 65

Dr. said the study also had ramifications for conditions relating to cognitive decline, such as dementia, because improved heart function facilitates blood flow to the brain.

"The wider ramifications of this study for healthy ageing need to be explored," he said.

Previous studies have shown improvements in heart elasticity in young people after a year of training, but little change if the training was started after the age of 65, the report's authors said.

They said the aerobic exercise regimen should be started before the age of 65 when the heart appears to retain "plasticity" and the ability to remodel itself.

Dr. and his team would next look at whether the same kind of improvements shown in the study can be made in people at high risk of heart failure, such as those with high blood pressure or diabetes and those who are obese. 

However, researchers said there were a couple of limitations to the study. 

One was that volunteers were willing and able to participate in an intensive exercise regimen, which may not be the case for the general adult population. 

Another potential limitation was that most of the study's participants were white and it was not clear whether the results would apply to other racial groups, researchers said.

It also does not mention diet or other factors that can affect health, such as pollution. 

"It needs to be taken into the context of a healthy lifestyle as well," Dr.  added.

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This gene can cause vision loss in middle-age

According to researchers, chemical changes in the eye can lead to blindness in middle-age.

Their findings aid understanding of a genetic condition that causes sight loss for one in 3,000 people.

The team examined how changes in a gene - known as RPGR - can damage eye cells to cause a disorder known as X-linked retinitis pigmentosa - a chronic hereditary eye disease characterized by black pigmentation and gradual degeneration of the retina.

The condition is incurable and affects night and peripheral vision before gradually causing blindness in middle age.

The team  took skin samples from two patients and transformed stem cells - which can change into any cell type - into light-sensing eye cells known as photo-receptors.

They compared these with cells from healthy relatives of the patients.

Photoreceptors - which decay in retinitis pigmentosa patients - differed in their fundamental structure when compared with those from family members.

Follow-up studies in mice identified key molecules that interact with RPGR to maintain the structure of photoreceptors.

When RPGR is flawed, the structure is compromised and photoreceptors cannot function correctly, leading to sight loss.

Lead researcher said that by furthering the understanding of the RPGR gene and its effects on photoreceptor cells, they hope that these findings bring them closer to developing a possible treatment for this devastating disease.

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