For patients with established cardiovascular disease, a recent study found that aspirin 81 mg/day was just as effective as 325 mg/day in preventing combined risk of death and hospitalization for heart attack or stroke. Rates of major bleeding were the same regardless of dose.
Steve Parker, M.D.
PS: What else prevents heart attacks and strokes? The Mediterranean diet!
Posted in Heart Disease, Longevity, Stroke
Haven’t we know this for years? From New England Journal of Medicine:
Most data regarding the association between the glycemic index and cardiovascular disease come from high-income Western populations, with little information from non-Western countries with low or middle incomes. To fill this gap, data are needed from a large, geographically diverse population.
METHODS
This analysis includes 137,851 participants between the ages of 35 and 70 years living on five continents, with a median follow-up of 9.5 years. We used country-specific food-frequency questionnaires to determine dietary intake and estimated the glycemic index and glycemic load on the basis of the consumption of seven categories of carbohydrate foods. We calculated hazard ratios using multivariable Cox frailty models. The primary outcome was a composite of a major cardiovascular event (cardiovascular death, nonfatal myocardial infarction, stroke, and heart failure) or death from any cause.
RESULTS
In the study population, 8780 deaths and 8252 major cardiovascular events occurred during the follow-up period. After performing extensive adjustments comparing the lowest and highest glycemic-index quintiles, we found that a diet with a high glycemic index was associated with an increased risk of a major cardiovascular event or death, both among participants with preexisting cardiovascular disease (hazard ratio, 1.51; 95% confidence interval [CI], 1.25 to 1.82) and among those without such disease (hazard ratio, 1.21; 95% CI, 1.11 to 1.34). Among the components of the primary outcome, a high glycemic index was also associated with an increased risk of death from cardiovascular causes. The results with respect to glycemic load were similar to the findings regarding the glycemic index among the participants with cardiovascular disease at baseline, but the association was not significant among those without preexisting cardiovascular disease.
CONCLUSIONS
In this study, a diet with a high glycemic index was associated with an increased risk of cardiovascular disease and death.
Source: Glycemic Index, Glycemic Load, and Cardiovascular Disease and Mortality | NEJM
The Advanced Mediterranean Diet (2nd edition) is low glycemic index.
Steve Parker, M.D.
Posted in Heart Disease, Longevity
The opposite of vigor is frailty. Aging is a life-long fight with gravity. If you’re frail, you’ll lose the battle sooner. In the study at hand, frailty was measured by exhaustion, weakness, physical activity, walking speed, and weight loss. The Mediterranean diet was linked to decreased frailty. From the Journal of the American Medical Medical Directors Association way back in 2014:
Abstract
Background and objective: Low intake of certain micronutrients and protein has been associated with higher risk of frailty. However, very few studies have assessed the effect of global dietary patterns on frailty. This study examined the association between adherence to the Mediterranean diet (MD) and the risk of frailty in older adults.
Design, setting, and participants: Prospective cohort study with 1815 community-dwelling individuals aged ≥60 years recruited in 2008-2010 in Spain.
Measurements: At baseline, the degree of MD [Mediterranean Diet] adherence was measured with the Mediterranean Diet Adherence Screener (MEDAS) score and the Mediterranean Diet Score, also known as the Trichopoulou index. In 2012, individuals were reassessed to detect incident frailty, defined as having at least 3 of the following criteria: exhaustion, muscle weakness, low physical activity, slow walking speed, and weight loss. The study associations were summarized with odds ratios (OR) and their 95% confidence interval (CI) obtained from logistic regression, with adjustment for the main confounders.
Results: Over a mean follow-up of 3.5 years, 137 persons with incident frailty were identified. Compared with individuals in the lowest tertile of the MEDAS score (lowest MD adherence), the OR (95% CI) of frailty was 0.85 (0.54-1.36) in those in the second tertile, and 0.65 (0.40-1.04; P for trend = .07) in the third tertile. Corresponding figures for the Mediterranean Diet Score were 0.59 (0.37-0.95) and 0.48 (0.30-0.77; P for trend = .002). Being in the highest tertile of MEDAS was associated with reduced risk of slow walking (OR 0.53; 95% CI 0.35-0.79) and of weight loss (OR 0.53; 95% CI 0.36-0.80). Lastly, the risk of frailty was inversely associated with consumption of fish (OR 0.66; 95% CI 0.45-0.97) and fruit (OR 0.59; 95% CI 0.39-0.91).
Conclusions: Among community-dwelling older adults, an increasing adherence to the MD was associated with decreasing risk of frailty.
Did you notice another good reason to eat fish?
I wonder why the research was published in the Journal of the American Medical Medical Directors Association?
Steve Parker, M.D.
Posted in Longevity
Axel Sigurdsson, MD, PhD, published a great article on prevention of age-related sarcopenia (loss of muscle mass). Click through for details. To stay vigorous as you age, you want to preserve muscle mass and the strength it provides. If you’ve lost muscle mass, you can re-build it. Summary from the good doctor:
Age-related loss of muscle mass (sarcopenia) may start as early as in our thirties and appears to continue for the rest of our lives.
There is also a loss of muscle strength and muscle function. The consequences may often be severe, particularly in the elderly.
Increased physical activity and adequate nutrition are the most powerful tools at our disposal to delay age-related loss of muscle mass.
Well-rounded exercise programs consisting of aerobic and resistance exercises are believed to be most effective.
Modification of dietary habits may be an important tool to prevent the decline in muscle mass and function that occurs with aging.
Adequate protein intake is of key importance. Animal-derived protein may provide a higher and broader biological value than vegetable protein.
Fish consumption is recommended and fruits and vegetables should be consumed regularly.
Nutritional supplements containing essential amino acids may be helpful. This is particularly true for whey protein.
Fish-derived protein hydrolysates also appear promising.
Adequate intake of vitamin D is essential.
“Fish-derived protein hydrolysates” doesn’t sound very appetizing. I’ll stick with real fish for now, especially cold-water fatty fish.
Steve Parker, M.D.
Dexter Kruger, a retired cattle rancher, is Australia’s oldest-ever living man. He’s 111 now. He attributes his longevity (only in part?) to eating chicken brains. The article doesn’t say whether the brains are cooked or raw. I’m heading over to Allrecipes lickety split.
Steve Parker, M.D.
PS: The Mediterranean dIet is famous for prolonging life. No chicken brains involved.
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Posted in Longevity
The study at hand involved 183 patients in Greece.
In multivariate analyses, hospital LOS [length of stay] decreased by 0.3 d for each unit increase of MedDiet score (P < 0.0001), 2.1 d for each 1 g/dL increase of albumin (P = 0.001) and increased 0.1 d for each day of previous admissions (P < 0.0001). Extended hospitalization (P < 0.0001) and its interaction with MedDiet score (P = 0.01) remained the significantly associated variables for financial cost. Mortality risk increased 3% per each year increase of age (hazard ratio [HR], 1.03; P = 0.02) and 6% for each previous admission (HR, 1.06; P = 0.04); whereas it decreased 13% per each unit increase of MedDiet score (HR, 0.87; P < 0.0001).
Conclusion
Adoption of the MedDiet decreases duration of admission and long-term mortality in hospitalized patients >65 y of age, with parallel reduction of relevant financial costs.
Steve Parker, M.D.
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Posted in Longevity
…at least in Greece, where the study was done.
In an observational study of folks over 65 admitted to a hospital, the Mediterranean diet was linked to:
The study at hand lasted two years.
Click for details of the traditional Mediterranean diet.
Objective:
Mediterranean diet (MD) has been related to reduced overall mortality and improved diseases’ outcome. Purpose of our study was to estimate the impact of MD on duration of admission, financial cost and mortality (from hospitalization up to 24 months afterwards) in elderly, hospitalized patients.
Research Methods & Procedures:
One hundred eighty three elderly patients (aged >65 years), urgently admitted for any cause in the Internal Medicine department of our hospital, participated in this observational study. Duration of admission and its financial cost, mortality (during hospitalization, 6 and 24 months after discharge), physical activity, medical and anthropometric data were recorded and they were correlated with the level of adherence to MD (MedDiet score).
Results:
In multivariate analyses, duration of admission decreased 0.3 days for each unit increase of MedDiet score (p<0.0001), 2.1 days for each 1g/dL increase of albumin (p=0.001) and increased 0.1 days for each day of previous admissions (p<0.0001). Extended hospitalization (p<0.0001) and its interaction with MedDiet score (p=0.01) remained the significant associated variables for financial cost. Mortality risk increased 3% per each year increase of age (HR=1.03, p=0.02), 6% for each previous admission (HR=1.06, p=0.04) whereas it decreased 13% per each unit increase of MedDiet score (HR=0.87, p<0.0001).
Conclusion:
Adoption of MD decreases duration of admission and long-term mortality in elderly hospitalized patients with parallel reduction of relevant financial cost.
I haven’t read the entire article. Didn’t see any need, based on my prior knowledge of the Mediterranean diet. The findings are not unexpected.
Steve Parker, M.D.
Public health authorities in the West have been trying for years to scare us away from eating meat. Here’s an abstract of one of the weak studies that support that contention. Herein, heavier consumers of processed meats, unprocessed red meat, and poultry were a increased risk of cardiovascular disease. Fish and poultry were not linked to increased risk of death, while processed meat and unprocessed red meat were. And fish was not linked to cardiovascular disease. The authors admit that the differences in outcome were small.
Importance
Although the associations between processed meat intake and cardiovascular disease (CVD) and all-cause mortality have been established, the associations of unprocessed red meat, poultry, or fish consumption with CVD and all-cause mortality are still uncertain.
Objective
To identify the associations of processed meat, unprocessed red meat, poultry, or fish intake with incident CVD and all-cause mortality.
Design, Setting, and Participants
This cohort study analyzed individual-level data of adult participants in 6 prospective cohort studies in the United States. Baseline diet data from 1985 to 2002 were collected. Participants were followed up until August 31, 2016. Data analyses were performed from March 25, 2019, to November 17, 2019.
Exposures
Processed meat, unprocessed red meat, poultry, or fish intake as continuous variables.
Main Outcomes and Measures
Hazard ratio (HR) and 30-year absolute risk difference (ARD) for incident CVD (composite end point of coronary heart disease, stroke, heart failure, and CVD deaths) and all-cause mortality, based on each additional intake of 2 servings per week for monotonic associations or 2 vs 0 servings per week for nonmonotonic associations.
Results
Among the 29 682 participants (mean [SD] age at baseline, 53.7 [15.7] years; 13 168 [44.4%] men; and 9101 [30.7%] self-identified as non-white), 6963 incident CVD events and 8875 all-cause deaths were adjudicated during a median (interquartile range) follow-up of 19.0 (14.1-23.7) years. The associations of processed meat, unprocessed red meat, poultry, or fish intake with incident CVD and all-cause mortality were monotonic (P for nonlinearity ≥ .25), except for the nonmonotonic association between processed meat intake and incident CVD (P for nonlinearity = .006). Intake of processed meat (adjusted HR, 1.07 [95% CI, 1.04-1.11]; adjusted ARD, 1.74% [95% CI, 0.85%-2.63%]), unprocessed red meat (adjusted HR, 1.03 [95% CI, 1.01-1.06]; adjusted ARD, 0.62% [95% CI, 0.07%-1.16%]), or poultry (adjusted HR, 1.04 [95% CI, 1.01-1.06]; adjusted ARD, 1.03% [95% CI, 0.36%-1.70%]) was significantly associated with incident CVD. Fish intake was not significantly associated with incident CVD (adjusted HR, 1.00 [95% CI, 0.98-1.02]; adjusted ARD, 0.12% [95% CI, −0.40% to 0.65%]). Intake of processed meat (adjusted HR, 1.03 [95% CI, 1.02-1.05]; adjusted ARD, 0.90% [95% CI, 0.43%-1.38%]) or unprocessed red meat (adjusted HR, 1.03 [95% CI, 1.01-1.05]; adjusted ARD, 0.76% [95% CI, 0.19%-1.33%]) was significantly associated with all-cause mortality. Intake of poultry (adjusted HR, 0.99 [95% CI, 0.97-1.02]; adjusted ARD, −0.28% [95% CI, −1.00% to 0.44%]) or fish (adjusted HR, 0.99 [95% CI, 0.97-1.01]; adjusted ARD, −0.34% [95% CI, −0.88% to 0.20%]) was not significantly associated with all-cause mortality.
Conclusions and Relevance
These findings suggest that, among US adults, higher intake of processed meat, unprocessed red meat, or poultry, but not fish, was significantly associated with a small increased risk of incident CVD, whereas higher intake of processed meat or unprocessed red meat, but not poultry or fish, was significantly associated with a small increased risk of all-cause mortality. These findings have important public health implications and should warrant further investigations.
Steve Parker, M.D.
PS: The traditional Mediterranean diet is low in meat and prominently features fish.
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Posted in Diet-Heart Hypothesis, Heart Disease, Longevity, Stroke
From JAMA Network:
By analyzing additional experimental states over a more recent time period, we have provided additional data that legalization of recreational marijuana is associated with increased traffic fatality rates. Applying these results to national driving statistics, nationwide legalization would be associated with 6800 (95% CI, 4200-9700) excess roadway deaths each year.
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Posted in Longevity
I’ve been reading and watching Downtown Josh Brown for three years. Recently at his website I watched Blair duQuesnay interview George Kinder. He’s a financial Life Planner who now trains financial planners.
The title of the interview was “How Would You Change Your Life If There Were Only Ten Years Left?”
Nobody knows how much time we have left on this planet. My answers to the questions at age 25, when I though I’d live forever, would be different than my answers now, at age 65.
Now that you’re under house arrest by your governor in this time of Coronavirus Pandemic, you should have time to watch the interview and answer the questions for yourself. If you have a “significant other,” the two of you should discuss.
So you’re not going to watch the video? Below are the questions, in order. Decide your answers before moving to the next question. In fact, it’s best if you don’t even read the subsequent questions before answering the earlier ones. I suggest writing down your (and your SO’s) answers. It may take a few hours or days of contemplation.
George says that five areas typically come up for consideration with these questions:
Blair volunteered that when she considered the three questions, the issue of children came up. My sense is that she decided to have them, and did.
Go.
Steve Parker, M.D.
PS: Have you ever heard of The Sinner’s Prayer?
PPS: Happy Easter to all my Christian readers!
Click the pic to purchase at Amazon.com. E-book versions also available at Smashwords. com.
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Posted in Advice To My Children, Longevity
Click the pic to purchase at Amazon.com. E-book versions also available at Smashwords.com.
