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Monthly Archives: July 2017

The Mediterranean diet doesn’t benefit everyone, study says

(CNN)The Mediterranean diet can reduce the risk of cardiovascular disease, yet only people with higher incomes or more education, or a combination of the two, experience this benefit, found a study published Monday in the International Journal of Epidemiology.

The Mediterranean diet emphasizes eating plant-based foods, including vegetables, nuts, fruits and whole grains, in addition to fish and poultry. The diet also recommends that you limit red meat, replace butter with olive oil, and exercise. Red wine in moderation is optional on the diet, which past scientific research proves to be heart-healthy.

Marialaura Bonaccio, lead author of the new study and a researcher at IRCCS Istituto Neurologico Mediterraneo Neuromed, an Italian Clinical Research Institute, said in an email that this same problem — in which people from different income levels get different results from the same diet — may also be true for other diets.

The reason? Diets “focus on quantity, rather than on quality” of the food, she said.

Diet data

Bonaccio and her co-authors randomly recruited over 18,000 people living in the Molise region of southern Italy between March 2005 and April 2010. “The Pfizer Foundation, which helped fund enrollment costs, did not influence the analysis or interpretation of results,” Bonaccio noted.

She and her team calculated total physical activity, body mass index (BMI), smoking status and health history, including cardiovascular disease, diabetes and cancer. The data available for each participant also included education, household income and marital status.

Using the Mediterranean Diet Score, Bonaccio and her colleagues assessed participants’ food intake, examining the variety of fruits and vegetables, meat and fish consumed. They scored participants’ cooking methods, detailing whether they’re using healthy methods such as boiling and stewing or less healthy methods such as frying, roasting and grilling. Vegetables were categorized as organic or not, bread as whole-grain or not.

Over an average followup period of about four years, participants experienced a total of 5,256 cardiovascular disease events, including incidents of heart failure, diagnoses of coronary heart disease (a buildup of plaque in the arteries) and strokes.

Analyzing the data, the researchers found that a Mediterranean diet effectively reduced cardiovascular disease risk, but only among a select group of participants: those with higher income or more education.

“We found heart advantages were limited to high socioeconomic status groups, even if groups showed the same adherence to the Mediterranean diet,” Bonaccio wrote. No benefits occurred for participants in the low income and low education group.

Differences in food quality

Surprised by this result, the researchers dug into the data more deeply and unearthed a possible reason for the difference: The same Mediterranean diet adherence score still included slight differences in food consumption.

“For example, as compared to less advantaged counterparts, people with high socioeconomic status tended to consume fish more frequently,” Bonaccio wrote. She added that, beyond diet adherence, participants in the most advantaged category reported a higher quality diet, which included higher consumption of organic products and whole grain foods.

“Let’s give that two persons follow the same diet, that is equal amounts of vegetables, fruits, fish, olive oil etc. every day so that they report the same adherence score to Mediterranean diet,” Bonaccio said. “It might be that, beyond quantity, differences in quality may exist. For example, in olive oil.”

She said it’s unlikely that a bottle of extra virgin olive oil with a price tag of 2 to 3 euros has the same nutritional properties as one costing 10 euros. Given that it is reasonable to assume higher-income participants are more likely to buy the 10-euro bottle compared with lower-income participants, “our hypothesis is that differences in the price may yield differences in healthy components and future health outcomes,” Bonaccio said.

How the food is cooked or prepared might also contribute to differences in results, according to Bonaccio, though she said the differences in cooking procedures — “a kind of marker of the numerous differences still persisting across socioeconomic groups” — probably did not “substantially account” for the disparities in cardiovascular risk.

Similar results in US?

Mercedes Sotos-Prieto, an assistant professor and visiting scientist at Harvard Chan School of Public Health, said evidence, including from her own research, shows that a Mediterranean diet is “one of the best choices to improve health.”

Sotos-Prieto, who was not involved in the new research, wrote in an email that the new study, which relied on self-reported data, does not prove that socioeconomic status caused the health benefits seen; it shows only a relationship between income and/or education and health outcomes.

“Previous studies have already showed a socioeconomic gradient regarding adherence to diet quality,” Sotos-Prieto wrote. Because of this, a similar difference in health results depending on socioeconomic status may also be occurring in the United States among those who follow a Mediterranean diet, she said.

Dr. Barbara Berkeley, who specializes in weight management and practices medicine in Beachwood, Ohio, said “one caveat in interpreting studies like this is that they are based on diet recall. It is generally very difficult for people to keep accurate food records and there is a tendency for participants to record their diets in the best possible light.”

Berkeley, who was not involved in this research, agreed with the hypothesis of the authors.

“A good diet is undoubtedly more than just a shopping list,” she said. “Quality, freshness, variety and purity of production may truly differentiate diets even when they appear to be the same.”

Berkeley noted that “food deserts” in lower-income areas means both quality and variety of fresh foods may be limited, while organic produce may be unavailable or too expensive.

“A healthy diet is likely not the sum of its parts but the quality of its elements,” Berkeley said.

Maria Korre, a research fellow at Harvard Chan School of Public Health, noted that “among the most important perceived barriers to healthy eating are the time and cost of shopping.” Korre, who did not contribute to the new study, added that “we need to work toward identifying ways … to overcome these barriers.”

“As a result of the worldwide epidemics of obesity and diabetes, we witness a strong and renewed interest in the traditional Mediterranean diet,” Korre said. Yet the appeal of this diet extends well beyond proven health benefits.

With its wide range of colorful foods, the diet provides “delicious meals” and “because of its emphasis on limited consumption, rather than abstention from red meat and sweets” plus its inclusion of moderate drinking of alcoholic beverages, “the Mediterranean diet represents a healthy yet indulgent and appealing lifestyle that can be sustained over long periods of time,” Korre said.

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According to the study authors, people of high socioeconomic status may actually be selecting foods that are higher in both polyphenols (plant-based micronutrients) and antioxidants (a nutrient found in fruits and vegetables that helps repair damage in our bodies). Such daily choices could result in health advantages unseen by those who make different selections.

“This hypothesis could be only tested by a direct measure of such natural compounds in biological samples, e.g., blood levels or urinary polyphenol excretion,” Bonaccio said. She said her groups’ future research and analysis will test this theory.

Read more: http://www.cnn.com/2017/07/31/health/mediterranean-diet-heart-benefits-socioeconomic-study/index.html

NFL Still Owes More Than Half Its Brain-Research Pledge

WASHINGTON The National Institutes of Health is ending its partnership with the NFL to study concussions and brain disease, with more than half of the $30 million the league pledged unpaid, according to ESPN.

The NIH decision to let the agreement expire follows a bitter dispute in 2015 in which the NFL backed out of a major study into chronic traumatic encephalopathy, or CTE, that was awarded to Dr. Robert Stern, a neuroscientist at Boston University School of Medicine with a history of criticizing the league, ESPN reported.

In 2012, the NFL described its $30 million contribution to NIH, the government’s primary biomedical research center, as unrestricted, and said it was the single-largest donation to any organization in the league’s 92-year history. NIH said the money came with no strings attached.

In reality, the league maintained veto power over how the money was spent, according to ESPN.

A May 2016 study by the House Committee on Energy and Commerce concluded that the league and its brain injury committee tried to steer the CTE study away from Stern and toward a doctor with NFL ties, The New York Times reported.

Our investigation has shown that while the NFL had been publicly proclaiming its role as funder and accelerator of important research, it was privately attempting to influence that research, the congressional study said. The NFL attempted to use its unrestricted gift as leverage to steer funding away from one of its critics. The League, its players, and the public have a vested interest in advancing our knowledge of the relationship between degenerative diseases and sports-related head trauma.

The research deal between the NFL and NIH is set to end Aug. 31, with $16 million more than half of the amount the league pledged unpaid.

“There are no current research plans for the funds remaining from the original $30 million NFL commitment,” NIH told ESPN in a statement. NIH is currently funding concussion research directly.

The statement continued: “If [the] NFL wishes to continue to support research at NIH, a simple donation to the NIH Gift Fund to support research on sports medicine would be favorably viewed, as long as the terms provided broad latitude in decisions about specific research programs.”

On Tuesday, researchers at Boston University School of Medicine and VA Boston Healthcare System reported finding CTE, a degenerative brain disease commonly found in athletes with a history of head trauma, in 110 of 111 deceased NFL players. Among college football players involved in the study, 91 percent were diagnosed with the disease.

A day later, Democratic members of the House Committee on Energy and Commerce sent a letter to NFL Commissioner Roger Goodell requesting information about how the league planned to spend the remainder of the NIH pledge, which it listed at $18 million.

“Since this research is critical to improving our understanding of the increased health risks that athletes face from their sport as well as ways to prevent and mitigate such risks for the future, we would hope that the NFL would follow through on its commitment to provide the balance of its $30 million donation,” the lawmakers wrote.

A league spokesperson said in a statement to The Washington Post that “the NFL is currently engaged in constructive discussions with the [Foundation for the National Institutes of Health] regarding potential new research projects and the remaining funds of our $30 million commitment.”

Rep. Frank Pallone Jr. (D-N.J.), ranking member of the House Energy and Commerce Committee and a co-author of the letter, told ESPN it’s disappointing that the NFLs inappropriate actions soured the relationship to the point where it appears that NIH couldnt see a path forward.

“However, at a time when there’s a desperate need for research dollars, I strongly encourage the NIH and NFL to work to use the remaining funding that the NFL committed to support critical research that could help protect current, former and future football players,” Pallone said.

A number of NFL players who committed suicide in recent years had subsequently been diagnosed with CTE. In March 2016, the NFL’s senior vice president for health and safety acknowledged a link between football and brain disease; a first in the league’s history.

Read more: http://www.huffingtonpost.com/entry/nfl-nih-cte_us_597ba1e6e4b0da64e8793819

Report: Scientists edit human embryos for first time in US

(CNN)America reportedly has moved ahead in a controversial race to tinker with human DNA — but the scientific feat is shrouded in unanswered questions.

The MIT Technology Review published on Wednesday a news report about the first-known experiment to create genetically modified human embryos in the United States using a gene-editing tool called CRISPR.

Shoukhrat Mitalipov, director of the Oregon Health & Science University’s Center for Embryonic Cell and Gene Therapy, reportedly led the new research. Mitalipov and the university would not confirm details of the research to CNN.

“Results of the peer-reviewed study are expected to be published soon in a scientific journal. No further information will be provided before then,” according to an emailed statement from the university’s press office. Another researcher cited in the MIT report, the Salk Institute’s Jun Wu, did not reply to CNN’s request for comment.

Mitalipov also declined to comment in the MIT Technology Review report, referencing that the research results have not been published yet in a peer-reviewed scientific journal, which is considered the gold standard for scientific research. The author of the MIT report would not confirm to CNN whether he had seen the paper.

On China: Genetically modifying human embryos

Previously, Mitalipov and his colleagues reported the first success in cloning human stem cells in 2013, successfully reprogramming human skin cells back to their embryonic state. In 2007, a research team led by Mitalipov announced they created the first cloned monkey embryo and extracted stem cells from it.

The MIT Technology Review reported that the researchers in Portland, Oregon, edited the DNA of a large number of one-cell embryos, specifically targeting genes associated with inherited diseases in those embryos. The MIT Technology Review could not determine which disease genes had been chosen for editing in the new research.

“I’m not surprised that they were looking at genetic diseases to try and see if they could target them, because that’s exactly where I think the future inevitably leads,” said Arthur Caplan, a professor and founding head of the pision of bioethics at New York University Langone Medical Center, who was not involved in the research.

CRISPR research and controversy

Previously, scientists in China were the first in the world to reveal attempts to modify genes in human embryos using CRISPR. Three separate papers were published in scientific journals describing various studies in China on gene editing in human embryos.

When it comes to the new research, “my reaction was, this is an interesting incremental step, and boy, I bet it’s going to get blown up as being more important than it is,” said Hank Greely, professor of law and genetics at Stanford University, who was not involved in the research.

“It’s not the first time anybody has CRISPR-ed human embryos. It’s not the first time anybody’s CRISPR-ed viable human embryos. It’s certainly not the first time people have CRISPR-ed viable mammalian embryos,” Greely said. “It’s the first time it’s been done in the US, but the embryos don’t care where they are.”

Yet the research has already generated attention and controversy.

“This is pushing the research faster than I thought we would see,” said Dana Carroll, professor of biochemistry at the University of Utah, if the MIT Technology Review report rings true. Carroll has used CRISPR in his own studies, but was not involved in the new research.

He pointed out that the new research reportedly involved earlier, more delicate embryos, and CRISPR reportedly was still demonstrated as efficient.

“From the perspective of research that would ultimately make germline editing safer and more effective, the earlier embryos will provide more relevant information,” he said.

CRISPR — an acronym for clustered, regularly interspaced, short palindromic repeats — allows scientists to cut and edit small pieces of DNA at precise areas along a DNA strand, essentially modifying DNA.

Once scientists discovered that they could develop a system that modifies pieces of DNA, they tested the gene-editing technology in microbes, then non-human mammals, then non-human primates, and then, by 2015, human embryos.

The controversy surrounding gene-editing in human embryos partly stems from concern that the changes CRISPR makes in DNA can be passed down to the offspring of those embryos later in life, from generation to generation. Down the line, that could possibly impact the genetic makeup of humans in erratic ways.

“There is also considerable concern about off-target effects, such as making mutations at sites in the genome other than the intended target,” Carroll said. In other words, an edit made in one area of DNA possibly could cause problems in another, as a ripple or domino effect, which could be concerning.

Some CRISPR critics also have argued that gene-editing may give way to eugenics and to allowing embryos to be edited with certain features in order to develop so-called designer babies.

Though, not all experts are too concerned.

Treating diseases

“Some people are worried about, where’s this all going to head? Are we going to wind up with super babies and eugenics? And to me, I don’t find that an interesting objection. It’s too soon for that objection,” Caplan said. “Clearly, if we’re going to let this research proceed, it’s going to be to treat diseases and prevent diseases.”

On GPS: Are designer babies in our future?

The enthusiasm surrounding gene-editing in human embryos partly stems from the promise CRISPR has shown in editing away and treating devastating intractable diseases. Earlier this year, the National Academies of Sciences, Engineering, and Medicine published a report on human genome editing, addressing potential applications of gene editing, including the possible prevention or treatment of disease.

“I hope the applications will be for the treatment of serious diseases and in cases where a sensible alternative is not available, as the National Academies’ report proposes,” Carroll said.

Greely said: “The National Academy of Sciences came out with a big report on Valentine’s Day this year about genome editing in humans, and I thought they very usefully pided it into three categories: basic research, treating living people, and making changes that will pass down from generation to generation.”

As for the reported new research, “this is category one. This is basic research,” he said. “Category three is the ethically crucial one; this isn’t that. We’re still a long way from that.”

What’s next

Other strides have been made recently in CRISPR research. Scientists at the Memorial Sloan Kettering Cancer Center in New York used the technology to genetically engineer immune cells to target and kill tumor cells in mice.

GPS Web Extra: Editing DNA to cure cancer

The mouse study was published in the journal Nature in February. More research is needed to determine whether similar results would appear in humans.

Last year, scientists in the Netherlands published a study in the journal PLOS Pathogens demonstrating that CRISPR could be used to edit the DNA of three types of herpes viruses in a petri dish. More research is needed to see whether this tool could be used to fight herpes in actual humans.

Other examples of diseases where CRISPR could show promise as a treatment or preventive approach in the future include cystic fibrosis, sickle cell, hemophilia, and mitochondrial diseases, such as the rare degenerative condition that the terminally-ill British infant Charlie Gard has, Caplan said.

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“There are what are called point mutations where you can go in and fix one genetic error. The simpler the genetic error, the easier it might be to try to repair it using a CRISPR gene-insertion technique,” Caplan said about genetic diseases.

“I think rather than trying to treat cystic fibrosis, or treat sickle cell, or treat hemophilia, it does make ethical sense to figure out ways to prevent it,” he said. “Now, obviously if it’s too risky we won’t do it. If it’s too dangerous or maybe it won’t work, we still don’t know. We’re in the early, early days (of research), but I don’t think it’s fear of eugenics that should stop us.”

Read more: http://www.cnn.com/2017/07/27/health/crispr-human-embryos-genome-editing-bn/index.html

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