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Consistent with the compression-of-morbidity hypothesis, several studies have reported that a significant proportion of centenarians delay or escape age-related diseases. Of those who live with such diseases for a long time, many appear to do so with better functional status than do younger persons who do not achieve extreme old age. The authors describe the first autopsy in an Okinawan-Japanese centenarian who escaped many age-related illnesses and delayed frailty toward the end of her very long life. Her late-life morbidity pattern is contrasted with that of white centenarians.

Introduction Cooking meat at high temperature and for a long duration produces several mutagenic compounds such as heterocyclic amines (HCAs). In the human diet, major HCAs include 2-Amino-3,8-dimethylimidazo(4,5-j) quinoxaline (MeIQx), [...], BACKGROUND: Heterocyclic amines (HCAs) in cooked meats may play a role in colorectal cancer (CRC) development. OBJECTIVES: We aimed to prospectively examine the association between estimated intakes of HCAs and meat-derived mutagenicity (MDM) in two cohorts of health professionals, the Health Professionals Follow-up Study (HPFS) and the Nurses' Health Study (NHS). METHODS: In 29,615 men and 65,875 women, intake of the HCAs 2-amino3,8-dimethylimidazo(4,5-f)quinoxaline (MeIQx), 2-amino-1-methyl-6-phenylimidazo(4,5-j) pyridine (PhIP), 2-amino-3,4,8-trimethylimidazo(4,5-f)quinoxaline (DiMelQx), and MDM was estimated using a 1996 cooking questionnaire, the 1994 food frequency questionnaire, and an online database. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) and to adjust for potential confounders. Estimates for both cohorts were pooled using random-effects meta-analysis. RESULTS: Between 1996 and 2010, 418 male and 790 female CRC cases were identified. Meat mutagen intake was not statistically significantly associated with risk of CRC [highest vs. lowest quintile, pooled HR (95% CI) for MelQx: 1.12 (0.93, 1.34), p for trend 0.23; PhIP: 1.10 (0.90, 1.33), p for trend 0.35; MDM: 1.03 (0.86, 1.24), p for trend 0.75] or subtypes of CRC defined by tumor location (proximal or distal colon, or rectum). When analyzed by source of meat, PhIP from red but not from white meat was nonsignificantly positively associated with CRC and significantly positively associated with proximal cancers [HR (95% CI) per standard deviation increase of log-transformed intake: PhIP red meat: CRC: 1.06 (0.99, 1.12), proximal: 1.11 (1.02, 1.21); PhIP white meat: CRC: 0.99 (0.94, 1.04), proximal: 1.00 (0.93, 1.09)]. CONCLUSIONS: Estimated intakes of meat mutagens were not significantly associated with CRC risk over 14 years of follow-up in the NHS and HPFS cohorts. Results for PhIP from red but not from white meat warrant further investigation. CITATION: Le NT, Michels FA, Song M, Zhang X, Bernstein AM, Giovannucci EL, Fuchs CS, Ogino S, Chan AT, Sinha R, Willett WC, Wu K. 2016. A prospective analysis of meat mutagens and colorectal cancer in the Nurses' Health Study and Health Professionals Follow-up Study. Environ Health Perspect 124:1529--1536; http://dx.doi.org/10.1289/EHP238

Background: Insomnia is a common complaint of individuals presenting to healthcare providers and is associated with decreased quality of life and higher healthcare utilization. In-person cognitive behavioral therapy (CBT) is an effective treatment for insomnia but is hindered by cost and limited access to treatment. Initial research suggests that Web-based CBT may mitigate these obstacles. Introduction: This study tests the effectiveness of a Web-based program for insomnia based on principles of CBT and stress management. Materials and Methods: We conducted a randomized trial with wait-list controls among adults with primary insomnia ( n = 88). Two hundred sixty-three adults with comorbid insomnia were also included and analyzed separately. The intervention was a 6-week online program, and effectiveness was measured via the Insomnia Severity Index (ISI). Results: Baseline ISI score for the intervention group ( n = 43) was 17.0; 16.6 for the control group ( n = 45). At first follow-up, the intervention group ( n = 25) had a mean change from baseline of −7.3 (95% CI: −9.0, −5.6), sustained through second follow-up, while the control group ( n = 35) had a change of −1.3 (−2.7, 0.1). The between-group difference was statistically significant ( p < 0.001). Participants in the comorbid insomnia group had a baseline ISI score of 16.7 with improvement similar to the primary insomnia group (−6.9; −7.6, −6.2). Discussion: We observed clinically meaningful improvements in insomnia severity in adults with primary or comorbid insomnia. Sustained improvement over 4 months underscores the effectiveness of a well-constructed online CBT for insomnia program. Conclusions: Go! to Sleep© offers a potentially effective treatment option for adults with insomnia by eliminating geographical barriers to care. [ABSTRACT FROM AUTHOR]

Although the association between red meat consumption and colorectal cancer (CRC) is well established, the association across subsites of the colon and rectum remains uncertain, as does time of consumption in relation to cancer development. As these relationships are key for understanding the pathogenesis of CRC, they were examined in two large cohorts with repeated dietary measures over time, the Nurses’ Health Study (n = 87,108 women, 1980–2010) and Health Professionals Follow-up Study (n = 47,389 men, 1986–2010). Cox proportional hazards regression models generated hazard ratios (HRs) and 95% confidence intervals (CIs), which were pooled by random-effects meta-analysis. In combined cohorts, there were 2,731 CRC cases (1,151 proximal colon, 816 distal colon, and 589 rectum). In pooled analyses, processed red meat was positively associated with CRC risk (per 1 serving/day increase: HR = 1.15, 95% CI: 1.01–1.32; P for trend 0.03) and particularly with distal colon cancer (per 1 serving/day increase; HR = 1.36; 95% CI: 1.09–1.69; P for trend 0.006). Recent consumption of processed meat (within the past 4 years) was not associated with distal cancer. Unprocessed red meat was inversely associated with risk of distal colon cancer and a weak non-significant positive association between unprocessed red meat and proximal cancer was observed (per 1 serving/day increase: distal HR = 0.75; 95% CI: 0.68–0.82; P for trend <0.001; proximal HR = 1.14, 95% CI: 0.92–1.40; P for trend 0.22). Thus, in these two large cohorts of US health professionals, processed meat intake was positively associated with risk of CRC, particularly distal cancer, with little evidence that higher intake of unprocessed red meat substantially increased risk of CRC. Future studies, particularly those with sufficient sample size to assess associations by subsites across the colon are needed to confirm these findings and elucidate potentially distinct mechanisms underlying the relationship between processed meat and subtypes of unprocessed red meat with CRC. [ABSTRACT FROM AUTHOR]

The article focuses on a study related to the health benefits of yoga practice as a therapeutic approach for managing stress and anxiety. It mentions the health impact of psychosocial stress which includes risks of diabetes, cardiovascular disease and chronic health conditions. It also presents a table depicting a pilot study of yoga for management of stress among staffs of intensive care unit.

Background Purified palmitoleic acid (16-1; omega-7) has shown lipid-lowering and anti-inflammatory benefits in open label, epidemiologic, and animal studies. Objective Our objective was to perform the first randomized controlled trial of purified palmitoleic acid supplementation in humans. Methods Adults with dyslipidemia and evidence of mild systemic inflammation (high-sensitivity C-reactive protein [hs-CRP] between 2 and 5 mg/L) were randomly allocated to receive either 220.5 mg of cis -palmitoleic acid (n = 30) or an identical capsule with placebo (1000 mg of medium chain triglycerides, n = 30) once per day for 30 days. Participants were asked to maintain their current diet. Serum lipids and hs-CRP were drawn at baseline and study completion. Results At 30 days, there were significant mean (95% confidence interval [CI]) reductions in CRP (−1.9 [−2.3 to −1.4] mg/L), triglyceride (−30.2 [−40.2 to −25.3] mg/dL), and low-density lipoprotein (LDL) (−8.9 [−12.0 to −5.8] mg/dL), and a significant increase in high-density lipoprotein (HDL) (2.4 [1.5, 3.3] mg/dL) in the intervention group compared with control. These changes equated to 44%, 15%, and 8% reductions in CRP, triglyceride, and LDL respectively, and a 5% increase in HDL compared with control. Conclusions Purified palmitoleic acid may be useful in the treatment of hypertriglyceridemia with the beneficial added effects of decreasing LDL and hs-CRP and raising HDL. Further study is needed to elucidate mechanisms and establish appropriate human doses. [ABSTRACT FROM AUTHOR]

Focus groups were held to better understand conceptions of disease prevention among low-income African American women at risk for diabetes. Mental calm was associated with health more than nutrition, exercise, or social connection. This finding suggests that prioritizing stress reduction will help with successful implementation of community holistic diabetes prevention programs. [ABSTRACT FROM AUTHOR]

BACKGROUND Current guidelines recommend diet and lifestyle modifications for primary prevention and treatment of hypertension, but do not encourage dietary pulses specifically for lowering blood pressure (BP). To quantify the effect of dietary pulse interventions on BP and provide evidence for their inclusion in dietary guidelines, a systematic review and meta-analysis of controlled feeding trials was conducted. METHODS MEDLINE, EMBASE, Cochrane Library, and CINAHL were each searched from inception through 5 May 2013. Human trials ≥3 weeks that reported data for systolic, diastolic, and/or mean arterial BPs were included. Two reviewers independently extracted data and assessed methodological quality and risk of bias of included studies. Effect estimates were pooled using random effects models, and reported as mean differences (MD) with 95% confidence intervals (CIs). Heterogeneity was assessed (χ2 test) and quantified (I2). RESULTS Eight isocaloric trials (n = 554 participants with and without hypertension) were included in the analysis. Dietary pulses, exchanged isocalorically for other foods, significantly lowered systolic (MD = −2.25 mm Hg (95% CI, −4.22 to −0.28), P = 0.03) and mean arterial BP (MD = −0.75 mm Hg (95% CI, −1.44 to −0.06), P = 0.03), and diastolic BP non-significantly (MD = −0.71 mm Hg (95% CI, −1.74 to 0.31), P = 0.17). Heterogeneity was significant for all outcomes. CONCLUSIONS Dietary pulses significantly lowered BP in people with and without hypertension. Higher-quality large-scale trials are needed to support these findings. CLINICAL TRIAL REGISTRATION NCT01594567 [ABSTRACT FROM AUTHOR]

Although yoga may help manage conditions comorbid with overweight and obesity, such as low back pain, whether yoga helps with weight loss or maintenance beyond that which can be achieved with diet and exercise remains unclear. A search of multiple databases through September 2012 was undertaken identifying peer-reviewed studies on yoga, meditation, mindfulness, obesity, and overweight. Studies on yoga and weight loss are challenged by small sample sizes, short durations, and lack of control groups. In addition, there is little consistency in terms of duration of formal group yoga practice sessions, duration of informal practices at home, and frequency of both. Studies do however suggest that yoga may be associated with weight loss or maintenance. Mechanisms by which yoga may assist with weight loss or maintenance include the following: (a) energy expenditure during yoga sessions; (b) allowing for additional exercise outside yoga sessions by reducing back and joint pain; (c) heightening mindfulness, improving mood, and reducing stress, which may help reduce food intake; and (d) allowing individuals to feel more connected to their bodies, leading to enhanced awareness of satiety and the discomfort of overeating. Thus, yoga appears promising as a way to assist with behavioral change, weight loss, and maintenance. [ABSTRACT FROM PUBLISHER]

The article investigates the association between red meat intake and cause specific and total mortality in two cohorts with repeated measures of diet and up to 28 years of follow-up. Based on the findings, the researchers concluded that red meat consumption is associated with an increased risk of total, cardiovascular disease (CVD), and cancer mortality. They also found substituting other protein sources for red meat will lower mortality risk.

Accepted Manuscript

Objectives: Little is known about healthcare providers' knowledge of dietary evidence or about what dietary advice providers offer to patients. The objective of our study was to determine which diets providers recommended to patients and providers' beliefs about the evidence behind those recommendations., Methods: This was a 22-question cross-sectional survey conducted between February 2013 and September 2013, in 45 ambulatory practices within two health systems. Attending physicians, housestaff, and advanced practitioners in internal medicine, medicine-pediatrics, family medicine, cardiology, and endocrinology practices were audited. Providers' attitudes, perceptions, and beliefs about diet modification were collected. Knowledge scores were constructed based on the number of correct responses to specific questions., Results: Of 343 provider responses, largely from primary care specialties (n = 3027, 90%), the top dietary recommendations were low-salt diet (71%) for hypertension, low-carbohydrate diet (64%) for uncontrolled diabetes mellitus, low saturated fat diet (73%) for dyslipidemia, low-calorie diet (72%) for obesity, and low saturated fat diet (63%) for coronary heart disease. Providers believed that 51% of diet recommendations were supported by randomized trial evidence when they were not. Respondents' overall knowledge of randomized trial evidence for dietary interventions was low (mean [standard deviation] knowledge score 44.3% [22.4%], range 0.0%-100.0%). The survey study from two health systems, using a nonvalidated survey tool limits external and internal validity., Conclusions: Providers report recommending different diets depending on specific risk factors and generally believe that their recommendations are evidence based. Substantial gaps between their knowledge and the randomized trial evidence regarding diet for disease prevention remain.

Background: With the exception of fish, few major dietary protein sources have been studied in relation to the development of coronary heart disease (CHD). Our objective was to examine the relation between foods that are major dietary protein sources and incident CHD., Methods and Results: We prospectively followed 84,136 women aged 30 to 55 years in the Nurses' Health Study with no known cancer, diabetes mellitus, angina, myocardial infarction, stroke, or other cardiovascular disease. Diet was assessed by a standardized and validated questionnaire and updated every 4 years. During 26 years of follow-up, we documented 2210 incident nonfatal infarctions and 952 deaths from CHD. In multivariable analyses including age, smoking, and other risk factors, higher intakes of red meat, red meat excluding processed meat, and high-fat dairy were significantly associated with elevated risk of CHD. Higher intakes of poultry, fish, and nuts were significantly associated with lower risk. In a model controlling statistically for energy intake, 1 serving per day of nuts was associated with a 30% (95% confidence interval, 17% to 42%) lower risk of CHD compared with 1 serving per day of red meat. Similarly, compared with 1 serving per day of red meat, a lower risk was associated with 1 serving per day of low-fat dairy (13%; 95% confidence interval, 6% to 19%), poultry (19%; 95% confidence interval, 3% to 33%), and fish (24%; 95% confidence interval, 6% to 39%)., Conclusions: These data suggest that high red meat intake increases risk of CHD and that CHD risk may be reduced importantly by shifting sources of protein in the US diet.