Yoga Improves Lives of Those With Ulcerative Colitis

by Dr Alex Jimenez | Diets, Fitness

Weekly yoga sessions may be associated with a better quality of life for patients with ulcerative colitis, a chronic inflammatory bowel disease that can be exacerbated by stress, a small study suggests.

People with ulcerative colitis have inflammation in the lining of the large intestine that can lead to symptoms like diarrhea and abdominal pain. When symptoms are severe, patients may have sudden loose or bloody stools so often that it impairs their ability to navigate normal daily activities like going to school or work.

Researchers studied 77 ulcerative colitis patients who reported a reduced quality of life due to the disease even though their symptoms were clinically in remission. They randomly assigned participants to receive either 12 weekly yoga sessions or written self-care advice and found the yoga group had greater improvements in quality of life.

“It seems to be safe and effective, so it is surely worth trying yoga as an add-on to other evidence-based interventions at least for maintenance of remission,” said lead study author Dr. Holger Cramer, a researcher at the University of Duisburg-Essen in Germany.

“It definitely should not be used as a replacement but rather as an ancillary intervention,” Cramer said by email. “That’s how it was used in our study.”

Previous research has linked higher perceived stress levels to more severe ulcerative colitis symptoms, and other studies have also tied yoga to reduced stress in both healthy and sick people, researchers note in the journal Alimentary Pharmacology and Therapeutics.

While there isn’t a standard treatment regimen that’s the same for all patients with ulcerative colitis, they may take a variety of different drugs to curb inflammation and achieve symptom remission. In more severe cases, they may need surgery to remove the colon and rectum.

At the start of the current study, patients had been in remission for at least four weeks and no longer than one year.

People were excluded if they weren’t in remission and had active symptoms, if they had surgery to remove their colon, or if they had medical problems that would make it hard for them to do even light yoga exercises.

Patients assigned to yoga during the study took 90-minute classes in what’s known as hatha yoga, with postures and breathing exercises designed to calm the body and mind. People in the yoga group were also given manuals to try poses at home and encouraged to keep a daily log of their practice time.

Everyone in the control group of self-care patients received two books with general information on ulcerative colitis and strategies for improving symptoms with lifestyle modifications, medication and other approaches. They were asked not to start a yoga practice or any other exercise regimen during the study.

With yoga, people reported a better quality of life after 12 weeks of classes, and again three months later.

Five patients in the yoga group had side effects like musculoskeletal pain that may have been related to the yoga, while none of the mild side effects in the self-care group appeared related to this intervention.

One limitation of the study is that many patients dropped out of the yoga class, mainly because it proved too time consuming, the authors note. It’s also possible that personal attention from yoga instructors contributed to outcomes for that group rather than the yoga itself, the researchers point out.

Still, some previous studies suggest that stress reduction may have direct anti-inflammatory effects, which may explain why yoga reduced disease activity and flares in patients with ulcerative colitis in the current study, said Dr. Gilaad Kaplan, a gastroenterologist, at the University of Calgary in Canada.

“Yoga should not replace the medications that help patients with ulcerative colitis go into remission,” Kaplan, who wasn’t involved in the study, said by email. “But yoga may serve as complementary intervention, particularly in patients experiencing stress or whose quality of life is poor.”

Caffeine Just 1 Factor in Energy Drink Risks

by Dr Alex Jimenez | Diets, Fitness

Drinking 32 ounces of energy drink is associated with potentially harmful changes in blood pressure and heart function that are beyond those seen with caffeine alone, according to a new study.

There are more than 500 energy drink products on the market, and their increased popularity is matched by a significant rise in energy drink-associated emergency department visits and deaths.

Manufacturers and fans of these products claim they are as safe as caffeine, but there is little evidence to support that claim.

Caffeine in doses up to 400 mg (about five cups of coffee) is generally recognized as safe by the Food and Drug Administration. While energy drinks usually contain caffeine, little is known about the safety of some of their other ingredients the study team writes in the Journal of the American Heart Association.

To see what effects these other components have, researchers compared physical changes in a group of 18 healthy men and women after consuming a commercially available energy drink and after drinking another concoction with the same amount of caffeine but none of the other ingredients.

Besides 320 mg of caffeine – the amount in about four cups of coffee – the energy drink contained 4 ounces of sugar, several B vitamins and a proprietary “energy blend” of taurine and other ingredients that are often found drinks like Monster Energy, Red Bull and 5-Hour Energy.

Sachin A. Shah of David Grant Medical Center on Travis Air Force Base and University of the Pacific in Stockton, California, and colleagues measured the participants’ blood pressure and used an electrocardiogram (often called an ECG or EKG) to measure heart electrical activity for 24 hours after the subjects consumed the drinks.

An ECG change known as QTc prolongation and sometimes associated with life-threatening irregularities in the heartbeat was seen after drinking the energy drink, but not after drinking the caffeine beverage, the study team reports.

Several drugs have been withdrawn from the market just for causing ECG changes of a similar magnitude, the authors note.

Blood pressure increased by close to 5 points after drinking the energy drink, but by just under 1 point after drinking the caffeine beverage. Blood pressure also remained elevated six hours later.

These changes are by no means worrisome for healthy individuals, the researchers say, but patients with certain heart conditions might need to exercise caution consuming energy drinks.

Larger studies are needed to evaluate the safety of the noncaffeine ingredients contained in energy drinks, they conclude.

“The energy drink industry claims that their products are safe because they have no more caffeine than a premium coffee house coffee,” said Dr. Jennifer L. Harris from University of Connecticut’s Rudd Center for Food Policy and Obesity in Storrs, who wasn’t involved in the study.

“However, energy drinks also contain a proprietary ‘energy blend,’ which typically consists of stimulants and other additives. Some of these ingredients (including taurine and guarana) have not been FDA-approved as safe in the food supply, and few studies have tested the effects of caffeine consumption together with these ‘novelty’ ingredients,” she said by email.

“On top of that, energy drinks are highly marketed to adolescent boys in ways that encourage risky behavior, including rapid and excessive consumption,” she said. “As a result, emergency room visits by young people in connection with energy drinks are rising.”

Any research that compares the effects of consuming energy drinks versus caffeine alone provides important evidence for public health advocates who have urged the energy drink companies to stop targeting youth with these potentially harmful products, Harris added.

Diet Products Can Make You Fat

by Dr Alex Jimenez | Diets, Fitness

When you’re on a diet, you may gravitate to the “diet” food section at the supermarket, but beware: Diet foods can destroy your diet and make you fat. Although labeled “diet” or “low-fat,” they may be high in sugar and can make you gain weight, not lose it.

Researchers from the University of Georgia fed rats a diet high in sugar but low in fat that was meant to imitate many popular diet foods, and found that the animals gained weight when compared to rats fed a balanced rodent diet.

In addition, the high-sugar diet induced a host of medical problems, including liver damage and brain inflammation.

“Most so-called diet products containing low or no fat have an increased amount of sugar and are camouflaged under fancy names, giving the impression that they are healthy, but the reality is that those foods may damage the liver and lead to obesity as well,” said the study’s principal investigator, Krzysztof Czaja.

“What’s really troubling in our findings is that the rats consuming high-sugar, low-fat diets didn’t consume significantly more calories than the rats fed a balanced diet,” said Czaja, an associate professor of veterinary biosciences and diagnostic imaging in UGA’s College of Veterinary Medicine.

“Our research shows that in rats fed a low-fat, high-sugar diet, the efficiency of generating body fat is more than twice as high — in other words, rats consuming low-fat high-sugar diets need less than half the number of calories to generate the same amount of body fat,” he said.

Researchers divided rats into three groups and monitored their body weight, caloric intake, body composition, and fecal samples over a period of four weeks. One group consumed a diet high in fat and sugar, another group was fed a low-fat, high-sugar diet, and a third group was given a balanced or “normal” diet.

Both the low-fat, high-sugar and high-fat, high-sugar groups showed significant increases in both body weight and body fat when compared to the balanced group. They also showed an increase in liver fat.

The accumulation of liver fat in the high-sugar, low-fat group, Czaja said, “is a very dangerous situation, because the liver accumulating more fat mimics the effect of non-alcoholic fatty liver disease.”

Non-alcoholic fatty liver disease is caused by fat buildup in the liver. Serious forms of the disease can cause liver damage similar to that caused by heavy alcohol use.

The two high-sugar diets also caused chronic inflammation in the intestinal tract and brain. Previous studies found that the brain inflammation changed signals in the brain that controlled the ability to determine when one is full.

“The brain changes resulting from these unbalanced diets seem to be long term, and it is still not known if they are reversible by balanced diets,” Czaja said.

 Previous studies have shown other problems with low-fat diets. A study published in the Journal of Affective Disorders linked low-fat diets with depression. Low-fat diets have also been linked to heart disease. One study found that diets low in fat lowered the body’s level of HDL — the “good” cholesterol that helps protect against heart disease.

Fattest US Cities: Did Your Hometown Make New Ranking?

by Dr Alex Jimenez | Diets, Fitness

Seattle, take a bow. Jackson, hit the gym. A new study ranking the nation�s 100 fattest cities has found residents of the Mississippi city topped the scales nationally, while Jimi Hendrix�s hometown has the smallest proportion of overweight residents.

The analysis, by Wallethub.com, found that 70 percent of Americans aged 15 and older are overweight or obese � in line with statistics compiled by the Centers for Disease Control and Prevention. But some cities are more likely to have more residents who hit those thresholds than others.

On balance, the south tended to rank higher in the new study, which has historically been the case, while residents of colder, northern states and the Pacific Northwest fared better.

Dr. Charles Platkin, director of the New York City Food Policy Center and Distinguished Lecturer at Hunter College, City University of New York, tells Newsmax Health the new rankings aren�t entirely surprising but bring attention to regional factors that may play a role in U.S. obesity trends.

“There isn’t any major new information here,” Platkin explains. “There are a lot of variables that go into diet and obesity, including poverty levels, and diet and culture of southern states, for instance.”

The 10 fattest cities on the new list tended to be southern:

• Jackson
• Memphis, Tenn.
• Little Rock, Ark.
• McAllen, Texas
• Shreveport, La.
• Chattanooga, Tenn.
• Mobile, Ala.
• Lafayette La.
• Winston-Salem, N.C.
• Knoxville, Tenn.

At the other end of the spectrum, researchers found the following 10 cities to be on the lowest end of the �obesity� scale:

• Seattle-Tacoma-Bellevue, Wash.
• Portland, Ore.
• Minneapolis-St. Paul, Minn.
• Denver and Colorado Springs, Colo.
• Boston-Cambridge, Mass.

The researchers, as well as the U.S. Department of Agriculture, suggested a variety of factors play a role in U.S. obesity trends. Among them:

Regional variations in diet. The south is famous for barbecue, fried foods, and sweet tea; northern and coastal cities may offer a wider range of healthy options of vegetables, whole grains, and fruits. These differences in dietary patterns are influenced by social, demographic, cultural, historical, and economic factors

Poverty. Economic factors play a role in food choices and activity levels. According to the USDA, 42.2 million people live in households where access to healthy foods is limited, often because of poverty-related issues. In such households, families may not be able to afford to eat regular, balanced, healthy meals, or may turn to less-healthy alternatives to save money. Such households are more prominent in the south than the northeast, the west, and the Midwest.

Education. Schooling and personal achievement, uncertainty about jobs, and even access to good grocery stores also factor into food choices linked to obesity rates.

Activity, exercise trends. Northern metropolitan cities and other areas, such as the Denver area, that are popular places for healthy physical activities � such as hiking, skiing, and other outdoor sports � tend to rank lower in obesity scores.

Shopping habits. The shopping and dietary habits of people who participate in the Supplemental Nutrition Assistance Program (SNAP), formerly known as Food Stamps, are other factors. Most households receiving SNAP benefits, according to the USDA, don�t consume the same quantities of fruit, whole grains, and other healthy foods as people who aren�t on receiving food assistance.

USDA research has shown that 11 states � located along the western and southern borders of the country plus the District of Columbia � have higher-than-average levels of poverty and more people receiving SNAP benefits. These factors explain, at least in part, the prevalence of obesity across southern states. There is a higher level of food insecurity and greater use of SNAP benefits.

Platkin notes the survey rankings don�t aim to solve the nation�s obesity crisis, but they could inform aggressive promotions and education � similar to what Americans have done with in past public health campaigns, such as those aimed at tobacco use.

“Look at things we have done successfully, like smoking cessation and recycling,” he says.

Culturally significant programs like food access and cooking classes might make a difference in regions of the country where obesity rates are especially high, he adds.

Combatting poverty could also lead to improvements in diet and activity levels in some cities.

“Culturally, what are the diets, how much outdoor appeal is there, physical activity, and what about binge drinking in these areas?� he says.

To check out the complete list of the nation�s 100 fattest cities, check out Wallethub.com.

Common Nutrient in Food Tied to Risky Blood Clotting

by Dr Alex Jimenez | Diets, Fitness

A nutrient in meat and eggs may conspire with gut bacteria to make the blood more prone to clotting, a small study suggests.

The nutrient is called choline. Researchers found that when they gave 18 healthy volunteers choline supplements, it boosted their production of a chemical called TMAO.

That, in turn, increased their blood cells’ tendency to clot. But the researchers also found that aspirin might reduce that risk.

TMAO is short for trimethylamine N-oxide. It’s produced when gut bacteria digest choline and certain other substances.

Past studies have linked higher TMAO levels in the blood to heightened risks of blood clots, heart attack and stroke, said Dr. Stanley Hazen, the senior researcher on the new study.

These findings, he said, give the first direct evidence that choline revs up TMAO production in the human gut, which then makes platelets (a type of blood cell) more prone to sticking together.

Choline is found in a range of foods, but it’s most concentrated in animal products such as egg yolks, beef and chicken.

Hazen said he and his colleagues at the Cleveland Clinic wanted to isolate the effects of choline on people’s levels of TMAO and their platelet function. So they studied supplements.

The researchers had 18 healthy adults –10 meat-eaters and eight vegetarians/vegans — take choline supplements for two months.

The supplements provided around 450 milligrams of choline daily — roughly the amount in two or three eggs, Hazen said.

One month in, the study found, the supplements had raised participants’ TMAO levels 10-fold, on average. And tests of their blood samples showed that their platelets had become more prone to clotting.

“This study gives us one of the mechanisms by which TMAO may contribute to cardiovascular disease,” said Dr. J. David Spence.

Spence, who was not involved in the study, directs the Stroke Prevention & Atherosclerosis Research Centre at Western University in London, Ontario, Canada.

For the healthy people in this study, Spence said, the TMAO rise from choline might not be worrisome. But, he added, it might be a concern for people at increased risk of heart disease or stroke.

Spence suggested those individuals limit egg yolks, beef and other foods high in choline.

Hazen had similar advice. “You don’t have to become a vegetarian,” he said. “But you could try eating more plant-based foods, and more vegetarian meals.”

He also pointed to the Mediterranean diet — rich in olive oil, vegetables and fish. In an earlier study, Hazen said, his team found that a compound in olive oil seems to inhibit TMAO formation.

The new study uncovered yet another compound that may counter TMAO: low-dose aspirin.

In a separate experiment, the researchers had some participants take 85 milligrams of aspirin (a baby aspirin) a day, in addition to choline supplements. That, it turned out, lessened the rise in TMAO and the change in platelet activity.

Doctors already prescribe low-dose aspirin to certain people at risk of heart disease and stroke.

It’s possible, Hazen said, that aspirin’s effects on TMAO are one reason it helps ward off cardiovascular trouble.

The current study is small and preliminary. But it’s the latest to suggest that the gut “microbiome” plays a key role in cardiovascular disease, Spence said.

The “microbiome” refers to the trillions of bacteria that dwell in the gut. Spence said researchers are just beginning to understand how gut bacteria and their byproducts affect the cardiovascular system.

But one hope, he said, is to figure out what balance of gut bacteria supports cardiovascular health — and possibly use probiotic (“good” bacteria) supplements to help treat people at high risk of heart disease or stroke.

Spence said his own lab is working on just that.

There are, of course, many factors in heart disease risk — from age to high blood pressure to diabetes to smoking, Hazen pointed out.

“We’re saying a portion of the risk is related to the gut microbiome,” he said.

Hazen and a colleague report potential royalty payments from several companies related to “cardiovascular diagnostics and therapeutics.” One company, Cleveland HeartLab, recently launched a test for measuring TMAO levels.

The findings appear in the April 25 online issue of Circulation.