Tag /

Mortality

Episodes

Posted on October 4th 2023 (over 1 year)

In this clip, Dr. Martin Gibala explains VO2 max's role in health and how non-athletes can optimize workouts to boost their cardiorespiratory fitness.

Posted on September 28th 2023 (over 1 year)

In this clip, Dr. Martin Gibala outlines the principle behind VILPA and discusses the ongoing research examining its potential impact on health and longevity.

Posted on May 21st 2022 (about 3 years)

In this clip, Drs. Levine and Patrick discuss the advantage of using epigenetic clocks in aging research to measure biological age.

Topic Pages

  • Exercise Intensity

    Greater exercise intensity mechanistically lowers mortality by augmenting cardiorespiratory fitness, endothelial function, insulin sensitivity, and anti-inflammatory pathways.

  • Multivitamins

    Multivitamins are composite supplements delivering multiple micronutrients at near-RDA doses intended to correct or prevent marginal deficiencies.

  • Omega-3 fatty acids

    Omega-3 fatty acids lower mortality by stabilizing cardiac ion channels, dampening eicosanoid-driven inflammation, and decreasing serum triglycerides.

News & Publications

  • Cancer remains one of the leading causes of death globally, with millions of new cases and deaths each year. Despite treatment advancements, cancer patients are at a greater risk of death due to muscle loss, heart complications, and inadequate physical activity. A recent study found that higher muscle strength and cardiorespiratory fitness reduce the risk of death in cancer patients, with a 31% to 46% lower likelihood of premature death.

    Researchers conducted a systematic review and meta-analysis of 42 studies involving more than 47,000 cancer patients across various types and stages to examine how muscle strength and cardiorespiratory fitness influence survival rates. They sought to determine whether higher fitness levels were associated with better outcomes in terms of overall and cancer-specific death.

    Their analysis revealed that patients with higher muscle strength or cardiorespiratory fitness were 31% to 46% less likely to die prematurely from any cause than those with lower fitness levels. Each increase in muscle strength was associated with an 11% lower risk of all-cause mortality. Furthermore, patients with advanced cancer stages, as well as those with lung and digestive cancers, saw significant reductions in death risks—ranging from 8% to 46% lower for all-cause mortality. Increments in cardiorespiratory fitness were particularly important, with each improvement in cardiorespiratory fitness linked to an 18% reduced risk of dying specifically from cancer.

    These findings suggest that boosting muscle strength and cardiorespiratory fitness can improve cancer patients' survival rates. Given the strong connection between physical fitness and mortality risk, health professionals should prioritize fitness assessments for cancer patients as part of their treatment strategies. Learn more about the role of exercise in cancer prevention and recurrence in this episode featuring Dr. Kerry Courneya.

  • Prostate cancer is the most diagnosed cancer among males in the U.S., but its progression varies widely, with some cases remaining harmless and others turning deadly. In recent years, concerns have grown over a rise in advanced prostate cancer, potentially linked to changes in screening recommendations. A recent study found that in California—a racially, ethnically, and geographically diverse state—the incidence of advanced-stage prostate cancer increased by nearly 7% over the past decade, while death rates, which had been declining, leveled off.

    Researchers analyzed data from nearly 388,000 prostate cancer cases diagnosed in California between 2004 and 2021. Using data from state and national cancer registries, they examined trends in incidence and death rates based on cancer stage, age, race, ethnicity, and geographic region. They used statistical models to measure how these rates changed over time, focusing on patterns before and after shifts in screening guidelines.

    They found that between 2011 and 2021, cases of advanced-stage prostate cancer increased by an average of 6.7% per year, with similar trends across racial and ethnic groups and nearly all regions of California. Meanwhile, prostate cancer death rates declined by 2.6% per year from 2004 to 2012 but remained steady through 2021, marking an end to previous declines in deaths from the disease.

    These findings suggest that more men in California are being diagnosed with advanced prostate cancer, and the progress in reducing deaths has stalled. The gold standard for prostate cancer screening is the prostate-specific antigen (PSA) test. The U.S. Preventive Services Task Force recommends PSA screening for prostate cancer in men aged 55 to 69, but only among those at high risk for the disease. This screening can potentially reduce death but also carries risks such as false positives and treatment complications, including incontinence and erectile dysfunction. For men 70 and older, PSA screening is not recommended due to the greater likelihood of harms outweighing benefits.

    Sulforaphane, a bioactive compound derived from broccoli, may reduce the risk for some types of cancer, including prostate cancer. Learn more in this episode featuring Dr. Jed Fahey.

  • Omega-3 fatty acids have long been praised for their health benefits, but their role in treating heart failure has been unclear. While some studies suggest they improve heart function, others have produced mixed results. A recent meta-analysis found that high-dose omega-3 supplementation for a year or more markedly improved heart function and exercise capacity in people with heart failure.

    Researchers analyzed the findings of 14 randomized controlled trials, including more than 9,000 participants with heart failure. They examined the effects of different omega-3 doses and treatment durations on heart function, exercise capacity, biomarkers of heart failure, and overall quality of life. They also analyzed safety outcomes, including dropout rates and overall death rates.

    They found that people who took high doses of omega-3 fatty acids (2,000 to 4,000 milligrams daily) for at least one year had better heart function and improved oxygen consumption during exercise than those in control groups. Lower doses or shorter treatment periods did not produce the same benefits. Importantly, omega-3 supplementation did not increase the risk of adverse events or death.

    These findings suggest that long-term, high-dose omega-3 supplementation effectively improves heart function in people with heart failure. Omega-3s reduce inflammation, a potent contributor to heart failure. Learn more about omega-3s' anti-inflammatory effects in this episode featuring Dr. Bill Harris.

  • Cancer is the second leading cause of death worldwide, claiming the lives of nearly 10 million people yearly. A recent study found that people who exercise regularly are nearly half as likely to die of cancer than those who are inactive.

    Researchers assessed the physical activity of more than 28,000 people diagnosed with stage 1 cancer in the year before their diagnosis based on data gathered from fitness devices, gym logs, and organized fitness events. They categorized the participants' activity as none, low (less than 60 minutes weekly), and medium to high (60 minutes or more weekly). Then, they measured their time to cancer progression and death rates.

    They found that participants with low physical activity were 16% less likely to experience cancer progression and 33% less likely to die than those who were inactive. However, those with medium to high activity levels were 27% less likely to experience progression and 47% less likely to die than those who were inactive.

    These findings highlight exercise’s protective role in reducing cancer progression and improving survival. Exercise boosts the body’s immune system, helping it to combat cancer. It also promotes shear—the frictional drag exerted by blood flowing against the inner walls of blood vessels. Shear damages cancer cells, driving their death. Learn more in this clip featuring Dr. Rhonda Patrick.

  • Tobacco use remains a primary contributor to disease, disability, and premature death across the globe. A recent editorial summarizes data demonstrating that smoking reduces life expectancy by approximately 20 minutes per cigarette smoked—17 minutes for men and 22 minutes for women.

    The estimate, which drew on data from long-term studies such as the British Doctors Study and the Million Women Study, accounts for factors like smoking rates and early death outcomes over several decades. It’s also grounded in better and more up-to-date data, including studies that tracked the effects of smoking for up to 50 years.

    While smoking rates have declined in recent decades, the harm caused per cigarette may not have decreased substantially, as smokers may inhale more deeply or compensate for fewer cigarettes smoked. However, urinary cotinine levels—a marker of toxicant exposure—show only modest changes, suggesting that the risks per cigarette remain consistent with earlier estimates.

    These findings emphasize that the harm from smoking is cumulative, and quitting earlier can markedly reduce the risk of early death and disease. Smokers who quit at any age can prevent substantial loss of life expectancy, with each cigarette avoided contributing to a longer, healthier life. Smokers in their 60s, for example, may experience health improvements that narrow the gap between their current health and that of a non-smoker several years younger.

    Though individual factors like smoking intensity and age of initiation vary, the general conclusion remains the same: Smoking shortens life at every stage, and cessation at any age offers considerable, tangible health benefits. Like many harmful lifestyle behaviors, smoking accelerates epigenetic aging. Learn more in this clip featuring Dr. Steve Horvath.

  • Lighting up a cigarette shaves years off a person’s life, shortening their lifespan by as much as a decade. However, a recent study found that quitting smoking, even later in life, can extend a person’s life expectancy by as much as eight years—depending on how early they quit.

    Researchers analyzed data from several large cohort studies and national death records to estimate the effects of smoking on life expectancy for people who never smoked, those who currently smoke, and those who previously smoked. They focused on people who quit at ages ranging from 35 to 75, assessing the years of life lost due to smoking and the years gained by quitting at each age.

    They found that those who continue smoking at ages 35, 45, 55, 65, or 75 could lose 9.1, 8.3, 7.3, 5.9, and 4.4 years of life, respectively, compared to people who never smoked. However, quitting smoking could save an average of 8.0, 5.6, 3.4, 1.7, and 0.7 years, depending on the age at which smoking cessation occurs. If a person quits at age 65, they have a 23.4% chance of gaining at least one extra year of life, while for someone quitting at age 75, the chance is 14.2%.

    These findings suggest that while quitting earlier provides the most substantial gains in life expectancy, even those who quit later can still extend their lives. Harmful behaviors like smoking are rooted in reward-based processes. Consequently, people often engage in these behaviors in response to triggers, such as stress or social pressures. Cognitive behavioral approaches like mindfulness can help people who engage in harmful behaviors become more mindful of these triggers. Learn more in this clip featuring Dr. Ashley Mason.

  • The choices people make in their daily lives—such as whether to smoke, what to eat, and how active they are—can have a profound effect on their cancer risk. These behaviors are not just habits; they are powerful determinants of health. A recent study found that nearly half of cancer deaths among adults in the U.S. are linked to modifiable lifestyle factors.

    The researchers used national data to estimate cancer cases and deaths for 30 types of cancer. They examined the effects of modifiable risk factors such as smoking, obesity, alcohol consumption, diet, physical inactivity, and ultraviolet light exposure on cancer risk.

    They found that 40% of cancer cases and 44% of cancer deaths were linked to modifiable risk factors. Smoking was the leading contributor, accounting for nearly 20% of cases and more than 28% of deaths. Other major risk factors included excess body weight and alcohol use, accounting for more than half of the cases and deaths for 19 out of 30 cancer types.

    These findings suggest that people can reduce their risk of developing cancer by making informed lifestyle choices. Exercise is a powerful lifestyle tool in cancer prevention and survival. During exercise, increased blood flow subjects circulating cancer cells to powerful forces, causing them to self-destruct. Learn more in this clip featuring Dr. Rhonda Patrick.

  • Olive oil is rich in bioactive compounds, including polyphenols, carotenoids, and oleic acid. It’s a fundamental component of the Mediterranean diet and is associated with a wide range of health benefits. A recent study found that high olive oil intake—more than 3 tablespoons daily—reduces the risk of early death from all causes by 20%.

    Researchers analyzed data from nearly 23,000 adults enrolled in a long-term cohort study in Italy. Participants completed questionnaires about their olive oil consumption, defined as high (3 tablespoons or more daily) or low (1.5 tablespoons or less daily). The researchers collected information about the participants' lifestyles, assessed their overall diet quality, and measured their biomarkers associated with chronic disease risk.

    They found that compared to low olive oil intake, high intake lowered the risk of early death from all causes by 20%, cancer by 23%, and cardiovascular disease by 25%. However, They found that the effect of high olive oil intake on reducing the risk of dying from all causes and cancer was slightly lower when considering the participants' biomarkers.

    These findings suggest that olive oil reduces the risk of early death from all causes, including cancer and cardiovascular disease. The polyphenols in olive oil exert potent antioxidant, anti-inflammatory, and anti-cancer effects. Learn more about the health benefits of polyphenols in our overview article.

  • The body’s circadian rhythms – its 24-hour biological, hormonal, and behavioral cycles – are optimized for daytime eating. Consequently, eating in the late evening or nighttime hours may increase a person’s risk of developing chronic diseases, such as type 2 diabetes. A recent study found that nighttime eating increased the risk of premature death from diabetes by as much as 131 percent.

    The investigation included more than 41,000 adults enrolled in NHANES, an ongoing study that assesses the health and nutritional status of people in the U.S. Researchers gathered information about the participants' eating habits (including timing and food quality) and tracked their health and death rates for about nine years.

    They found that compared to eating before 10 p.m., - Eating between 11 p.m. and midnight increased the risk of premature death from diabetes by 131 percent. - Eating between midnight and 1 a.m. increased the risk of premature death from any cause by 38 percent. - Eating between 1 a.m. and 2 a.m. increased the risk of premature death from cancer by 109 percent.

    When they considered the frequency of eating late, they found that eating at night at least once increased the risk of premature death from all causes, including diabetes. Food quality influenced death risk, too, with high-calorie foods increasing the risk of premature death from all causes by 21 percent and from diabetes by 97 percent. Participants who ate late tended to have higher HbA1c, fasting glucose, and oral glucose tolerance test results, indicative of poor glucose metabolism.

    These findings suggest that late-night eating, particularly high-calorie foods, increases the risk of early death from all causes, especially diabetes. Shift work, jet lag, parenting, and modern lifestyles contribute to late-night eating, increasing disease and early death risk. Learn more in this clip featuring Dr. Satchin Panda.

  • Statins are among the most widely prescribed drugs in the U.S., with more than 92 million users reported in 2018. Although the drugs are generally effective, nearly 22 percent of statin users with cardiovascular disease will experience a major adverse cardiovascular event within five years of drug initiation – a phenomenon known as “residual risk.” Findings from a recent meta-analysis indicate that combined statin-omega-3 therapy markedly reduces the risk of major adverse cardiovascular events and improves lipid and inflammatory markers.

    Researchers analyzed the findings of 14 randomized controlled trials involving more than 40,000 participants. The trials investigated links between statin use, omega-3s, and the risk of cardiovascular disease and related death. Omega-3 doses varied, ranging from 930 milligrams to 4,000 milligrams daily. However, most studies provided a dose of 1,800 milligrams daily.

    They found that combined statin-omega-3 therapy reduced the residual risk of experiencing myocardial infarction (heart attack) by 28 percent, a major adverse cardiovascular event by 15 percent, angina (chest pain) by 25 percent, and hospitalization for angina by 25 percent. Those receiving the combined treatment also experienced decreased cholesterol, triglycerides, and hsCRP (a marker of inflammation). However, the combined therapy did not reduce the residual risk of fatal and non-fatal stroke, coronary revascularization, and cardiovascular disease-related death.

    These findings suggest that combined statin-omega-3 therapy reduces the residual cardiovascular risks associated with statin therapy alone. Learn more about statins in this episode featuring Dr. Peter Attia.

  • Cigarette smoking is the number one risk factor for lung cancer, the second most common form of cancer and a leading cause of death worldwide. A 2017 study found that heavy smokers' lung cancer risk drops by nearly 40 percent just five years after quitting smoking,

    The study involved more than 8,900 people enrolled in two large cohort studies. Researchers tracked the participants' health for an average of 30 years and determined their cancer risk based on whether they were current, former, or never smokers.

    They found that current and former smokers had a higher risk of developing lung cancer than those who never smoked, but that risk increased tenfold if they were heavy smokers (defined as smoking one pack daily for 21 years or longer), with nearly 93 percent of lung cancers occurring in heavy smokers.

    Five years after quitting, former heavy smokers saw a 39 percent reduction in their lung cancer risk compared to current smokers, and this risk continued to decrease over time. However, even 25 years after quitting, heavy smokers' risk of lung cancer was still more than three times higher than that of people who had never smoked.

    These findings suggest that smoking, especially heavy smoking, markedly increases a person’s risk of developing lung cancer. And although quitting smoking reduces lung cancer risk, former smokers' risks remain higher than never smokers'.

    Many harmful behaviors, such as smoking or overeating, are rooted in reward-based processes. Consequently, people often engage in these behaviors in response to triggers, such as emotional or mental stressors, or external prompts, such as advertising and social pressures. Cognitive behavioral approaches like mindfulness can help people who engage in harmful behaviors become more mindful of these triggers. In turn, they can reevaluate their habits and develop strategies that help them avoid engaging in harmful behaviors. Learn more in this clip featuring Dr. Ashley Mason.

  • Although obesity increases the risk of chronic disease and premature death, especially in those who have type 2 diabetes, exercise may counter some of those risks. However, the time of day a person exercises may influence the extent of risk reduction. A recent study found that moderate to vigorous physical activity in the evening reduced the risk of premature death by 61 percent in people with obesity.

    Researchers asked nearly 30,000 adults with obesity, some of whom (3,000) had type 2 diabetes, how often they engaged in moderate to vigorous physical activity (lasting at least three continuous minutes) and whether they did so in the morning, afternoon, or evening. They tracked the participants' health for about eight years.

    They found that engaging in moderate to vigorous physical activity in the evening reduced participants' risk of premature death from all causes by 61 percent. Afternoon exercise reduced the risk by 40 percent, and morning exercise reduced it by 33 percent. Similarly, evening exercise reduced the risk of cardiovascular disease by 36 percent and microvascular disease by 24 percent. They noted similar risk reductions in those who had type 2 diabetes.

    These findings suggest that moderate to vigorous physical activity reduces the risk of chronic disease and premature death in people with obesity (including those with type 2 diabetes), but evening exercise confers the greatest benefit. Learn more about the health benefits of vigorous exercise in this episode featuring Dr. Rhonda Patrick.

  • Vitamin D is a steroid hormone stored in the body’s liver and fatty tissues. Best known for its role in maintaining calcium balance and bone health, vitamin D is critical in many physiological processes, such as blood pressure regulation, immune function, and cell growth. A recent study found that people with the lowest vitamin D concentrations are 97 percent more likely to die prematurely.

    Researchers measured vitamin D concentrations in more than 19,000 adults with high blood pressure who participated in the National Health and Nutrition Examination Survey. They tracked the participants' health and dietary supplement usage for about nine years and assessed their risk of dying prematurely from all causes.

    They found that participants with vitamin D concentrations less than 25 nanomoles per liter (nmol/L) were 97 percent more likely to die prematurely, and those with concentrations between 25 and 49.9 nmol/L were 71 percent more likely. However, people with high blood pressure who took supplemental vitamin D were 25 percent less likely to die prematurely, with the greatest benefits observed with higher doses and among those without diabetes or cardiovascular disease.

    These findings from this study suggest that vitamin D supplementation reduces the risk of premature death in people with high blood pressure. Many medications accelerate vitamin D inactivation, including commonly prescribed blood pressure medications such as nifedipine and spironolactone. Learn more about vitamin D in our comprehensive overview article.

  • Cardiovascular disease claims the lives of nearly 20 million people worldwide every year. Exercise reduces the risk of cardiovascular disease, but experts aren’t sure which form of exercise is optimal for reducing that risk. A recent study found that aerobic exercise alone or combined with resistance exercise is more effective at reducing cardiovascular disease risk than resistance exercise alone.

    The study involved 406 middle-aged adults with high blood pressure and either overweight or obesity. Participants engaged in one of three training regimens – resistance, aerobic, or combined resistance and aerobic – for one hour, three times weekly, for one year. A fourth group remained sedentary. Researchers scored the participants' cardiovascular disease risk based on measures of their systolic blood pressure, low-density lipoprotein (LDL) cholesterol, fasting glucose, and percent body fat before and after the interventions.

    They found that participants who engaged in the aerobic or combined aerobic/resistance regimens showed improved cardiovascular disease risk scores at the one-year point. However, those who engaged in only resistance or were sedentary showed no improvements in their risk scores. When the researchers looked at individual risk factors, they found that all three exercising groups lost body fat, but their systolic blood pressure, LDL cholesterol, and fasting glucose did not decrease.

    These findings suggest that aerobic exercise alone or combined aerobic plus resistance reduces the cardiovascular disease risk profile in people with overweight or obesity. Other evidence indicates that high-intensity interval training (HIIT)’s cardiovascular benefits rival or surpass those of traditional aerobic exercise. Learn more about the benefits of HIIT in this episode featuring Dr. Martin Gibala.

  • Polybrominated diphenyl ethers (PBDEs) are flame retardants – a broad class of compounds commonly applied to fabrics, carpets, furniture, cell phones, and many other household items. New evidence suggests that exposure to flame retardants more than quadruples the risk of dying from cancer.

    Researchers analyzed blood samples from 1,100 adults enrolled in the National Health and Nutrition Examination Survey and tracked their health for about 16 years. They found that PBDE exposure markedly increased the risk of dying from cancer. Participants with the highest serum PBDE levels were more than four times more likely to die of cancer than those with the lowest levels, even after considering age, sex, race, ethnicity, lifestyle, and other factors that influence cancer death risk.

    These findings suggest that PBDE exposure increases the risk of dying from cancer. Although this observational study did not establish a cause-and-effect relationship between PBDEs and cancer risk, PBDEs are known endocrine disruptors. Endocrine disruptors mimic or interfere with normal hormonal processes in the human body and may influence health throughout the lifespan.

    Interestingly, evidence suggests that sweating promotes PBDE elimination. Sweat losses during a typical sauna session may reduce PBDE burden in the body, potentially reducing cancer death risk. Learn more about how sauna use facilitates the elimination of various toxicants in our overview article.

  • A recent study found that older adults who engaged in flexibility (stretching) exercises were 20 percent less likely to die prematurely than those who didn’t stretch.

    The study involved more than 34,000 adults between the ages of 20 and 79 years. Participants provided information about the frequency and duration of their engagement in moderate- and vigorous-intensity aerobic physical activities, including aerobic, resistance, and flexibility exercises. Researchers tracked the participants' health for roughly 10 years and noted any deaths.

    They found that engaging in just flexibility exercises like stretching or yoga five times per week reduced the risk of premature death from all causes by 20 percent and the risk of death from cardiovascular disease by 25 percent.

    Stretching can take three forms – static, dynamic, and proprioceptive neuromuscular facilitation (PNF). Static stretching involves holding a stretch for 10 to 30 seconds, as seen in yoga poses, such as “downward-facing dog.” Dynamic stretching involves active movements, such as arm circles (used in warm-ups without holding the stretch) or elements of Tai Chi. PNF stretching is used primarily in physical therapy for flexibility and rehabilitation.

    A 2014 review found that stretching’s effects vary by context. Dynamic stretching before exercise tends to improve strength, power, speed, and agility, enhancing sprint and agility test outcomes. Integrating dynamic stretching with exercises like front squats may further boost performance, but overdoing it can promote fatigue and hinder results. Although its effects on endurance sports are less certain, dynamic stretching is generally recommended in warm-ups for its benefits in speed and agility-focused activities.

    Some evidence suggests that stretching may be particularly beneficial for older adults and those who are sedentary. For example, a comprehensive meta-analysis found that stretching exercises reduce arterial stiffness, heart rate, and diastolic blood pressure while improving vascular endothelial function in middle-aged and older adults. Stretching may reduce the risk of fall-related injuries in older adults by improving balance.

    An abundance of research consistently singles out aerobic activities, especially at moderate to vigorous intensities, as the premier choice for improving health and extending life, as further supported by this study’s conclusions. However, the findings from this study point to the potential value of flexibility exercises. Although they may not offer the same cardiovascular benefits as aerobic activities, their beneficial effects on overall health are noteworthy. Embracing a diverse exercise regimen that includes aerobic and flexibility training may provide myriad health advantages. Learn more about the benefits of vigorous exercise in this episode featuring Dr. Martin Gibala.

  • Tea and coffee provide many health benefits, but for some people, the beverages are often a source of added sugar. A recent study found that adding sugar to tea or coffee increased the risk of premature death by 6 percent; adding sugar to coffee alone increased the risk by 11 percent.

    Researchers tracked the health of more than 2,900 men enrolled in the Copenhagen Male Study over thirty years. The men provided information about their tea and coffee consumption and whether they added sugar to these beverages.

    The researchers found that about a third of the men added sugar to their tea or coffee. Those who did were about 6 percent more likely to die prematurely from any cause than those who didn’t add sugar. Adding sugar to coffee alone increased the risk of dying early by about 11 percent.

    The findings from this large, epidemiological study suggest that adding sugar to tea or coffee increases the risk of dying early, negating some of the longevity benefits often ascribed to the two beverages.

    Sugars are natural components of the human diet, found in fruits, vegetables, and dairy products. However, the refined sugar typically added to beverages like tea or coffee is a highly processed product derived from sugar cane or sugar beets. It undergoes rapid metabolism in the body, causing insulin and blood sugar levels to skyrocket. Nearly 75 percent of adults in the US get about one-tenth of their daily calories from added, refined sugar. Learn more about the effects of sugar on human health in this episode featuring Dr. Rhonda Patrick.

  • Women generally have a longer life expectancy than men, a phenomenon often attributed to biological, behavioral, and lifestyle factors. Now, findings from a recent study demonstrate that women achieve greater benefits from equivalent amounts of moderate-to-vigorous activity than men do, reducing their risk of premature death from all causes by 24 percent.

    Researchers asked more than 412,000 healthy men and women in the United States to provide information about their physical activities, including the frequency, duration, intensity, and type. Then, they looked for links between physical activity and the risk of premature death from all causes and cardiovascular disease.

    They found that physical activity reduced the risk of premature death from all causes in women by 24 percent and men by 15 percent compared to inactivity. Interestingly, the reduction in risk seen in men topped out at 19 percent, achieved at about 300 minutes per week of moderate-to-vigorous activity. Women, on the other hand, achieved the same risk reduction at just 140 minutes per week, topping out at 24 percent at 300 minutes. They found similar effects for aerobic and strength training activities, with men reaching their peak benefit from three roughly half-hour sessions per week and women gaining the same benefit from about one strength-training session per week.

    These findings suggest that women can achieve substantial health benefits with shorter workouts than men. They also serve as a powerful encouragement, underscoring how limited time for physical activity can lead to considerable health advantages for women. Learn how to incorporate strength training into your workouts, maximizing your efforts in less time, in this clip featuring Dr. Brad Schoenfeld.

  • Regular physical activity can have profound effects on mental health by reducing depression and anxiety. Evidence suggests that cycling to work reduces the risk of premature death from all causes, including cardiovascular disease and cancer. A recent study found that people who cycle to work are also less likely to require mental health medications.

    The study, which took place in Scotland, involved more than 378,000 adult participants living in Edinburgh, Glasgow, and the surrounding areas. Researchers collected data regarding whether the participants cycled to work and if they required a prescription for mental health (anti-anxiety or antidepressant) medications.

    They found that very few commuters cycled to work, with just 4.8 percent of commuters in Edinburgh and 1.85 percent in Glasgow cycling. However, those who did cycle were less likely to have received a prescription for mental health medications than non-cyclists. This difference translated to a 15 percent reduction in mental health prescriptions over five years. Interestingly, men were more likely to cycle and less likely to take mental health medication than women.

    These findings suggest that cycling to work improves mental health and supports public health efforts that encourage commuters who travel shorter distances to consider cycling. Watch this episode in which Dr. Rhonda Patrick talks about her love of cycling for its powerful mood-enhancing effects and describes the compelling science suggesting exercise is a powerful tool for preventing or managing the symptoms of depression and mental illness.

  • Hearing loss is a common feature of aging and a known risk factor for poor quality of life, depression, dementia, and early death. Roughly two-thirds of adults over 70 have some degree of hearing loss, but few seek out treatment. A recent study found that hearing aids reduce the risk of premature death in older adults with hearing loss by 24 percent.

    The study involved more than 9,800 adults (average age, 48 years) enrolled in the NHANES studies. Participants underwent hearing tests and completed questionnaires about their hearing aid use over a ten-year period.

    The tests and questionnaires revealed that nearly 15 percent of the participants had some hearing loss. However, fewer than 13 percent of those with hearing loss regularly used hearing aids. Those with hearing loss who did wear hearing aids were 24 percent less likely to die prematurely than those who didn’t, even after taking demographics, hearing levels, and medical history into account.

    These findings suggest hearing aids reduce the risk of premature death in older adults with hearing loss. Other evidence demonstrates that hearing aids benefit older adults at high risk for cognitive decline. Interestingly, another study found that the risk of developing mild hearing loss was nearly 30 percent lower among people who adhered to healthy dietary patterns such as the DASH diet or the Mediterranean diet, suggesting that diet may play a role in preventing mild hearing loss.

  • Breathwork has shown promise in ameliorating oxidative stress – a driver of many chronic diseases – in healthy people and those with chronic conditions. However, scientists don’t fully understand the underlying mechanisms that drive these effects. A recent review found that breathwork promotes the activity of endogenous antioxidant enzymes.

    Researchers analyzed the findings of 10 randomized controlled trials (519 participants) investigating the effects of breathwork. The studies encompassed a range of breathwork styles and measured various biomarkers, including malondialdehyde, superoxide dismutase, glutathione, nitric oxide, vitamin C, and total antioxidant capacity levels.

    They found that participants who engaged in breathwork exhibited greater changes in the biomarkers than those who did not. In particular, breathwork increased the activity of the endogenous antioxidant enzymes superoxide dismutase and glutathione activities and decreased levels of malondialdehyde, a marker of oxidative stress.

    Breathwork is an umbrella term that refers to various breathing exercises and techniques. Evidence suggests that breathwork improves heart rate variability and promotes resilience to stress. People often engage in breathwork as part of general relaxation practices, yoga, or meditation.

    These findings suggest that breathwork reduces oxidative stress by promoting the activity of endogenous antioxidant enzymes. Only 10 studies were included in the analysis, however, so more research is needed to support the findings. Sulforaphane, a bioactive compound derived from broccoli, reduces oxidative stress, too. Learn more in this clip featuring sulforaphane expert Dr. Jed Fahey.

  • Current exercise guidelines recommend that adults engage in at least 150 to 300 minutes of moderate-intensity physical activity or 75 to 150 minutes of vigorous-intensity aerobic physical activity (or an equivalent combination of the two) weekly to promote cardiovascular health. However, a 2006 study challenged those recommendations, suggesting that a single weekly bout of vigorous exercise reduced the risk of cardiovascular disease-related death by 40 percent.

    The study involved more than 56,000 people who were free of cardiovascular disease at enrollment. Researchers tracked the participants' health for roughly 16 years to assess their activity levels and risk of death from heart disease or stroke.

    They found that even a single weekly session of intense exercise, lasting 30 minutes or longer, markedly reduced the risk of dying from heart disease or stroke compared to no exercise at all. Interestingly, exercising more frequently or for longer durations each week didn’t provide additional benefits. Another finding was that as men got older, the protective effect of exercise against cardiovascular death became more pronounced. However, this age-related benefit wasn’t evident in women.

    Vigorous-intensity exercise is physical activity that demands a significant and challenging effort, promoting a substantial increase in heart and breathing rates. It requires considerable energy expenditure and typically involves activities like running, cycling at high speeds, or intense aerobics. During vigorous-intensity exercise, a person’s target heart rate is approximately 60 to 85 percent of their maximum heart rate.

    These findings from this observational study suggest that even one vigorous, 30-minute or longer workout a week can have substantial cardiovascular health benefits. Current exercise guidelines may need to be revised to account for the effects of HIIT on cardiorespiratory fitness. Learn more about the health benefits of HIIT in this episode featuring Dr. Martin Gibala.

  • Cardiorespiratory fitness is a measure of the body’s aerobic capacity – the ability to deliver oxygen to skeletal muscles – during sustained physical activity. A 2009 meta-analysis found that people with low cardiorespiratory fitness were 70 percent more likely to die prematurely and 56 percent more likely to experience a heart or cardiovascular disease-related event.

    Researchers evaluated data from 33 studies examining connections between cardiorespiratory fitness and the risk of premature death from all causes (more than 102,000 participants) and combined heart disease and cardiovascular disease events (more than 84,000 participants). They used maximal aerobic capacity, measured in metabolic equivalent (MET) units, to estimate cardiorespiratory fitness. They grouped participants into three categories based on their cardiorespiratory fitness levels: low (<7.9 METs), intermediate (7.9-10.8 METs), and high (≥10.9 METs).

    They found that for each 1-MET increase in maximal aerobic capacity (equivalent to a 1-kilometer per hour increase in running/jogging speed), the risk of death from all causes and heart disease/cardiovascular disease events. Compared to participants with high cardiorespiratory fitness, those with low cardiorespiratory fitness were 70 percent more likely to die prematurely and 56 percent more likely to experience a heart disease/cardiovascular disease event. However, even intermediate cardiorespiratory fitness conferred substantial benefits. Compared to participants with intermediate cardiorespiratory fitness, those with low cardiorespiratory fitness were 40 percent more likely to die prematurely and 47 percent more likely to experience a heart disease/cardiovascular disease event.

    These findings demonstrate that having low cardiorespiratory fitness markedly increases one’s risk of dying prematurely or developing heart or cardiovascular disease. The most accurate way to assess cardiorespiratory fitness involves measuring maximal oxygen uptake, often referred to as VO2 max, during a graded exercise test in a laboratory, clinical, or research setting. However, online calculators, such as the World Fitness Level, can predict VO2 max based on various personal factors. Learn more about VO2 max and the World Fitness Level calculator in this episode featuring Dr. Martin Gibala.

  • Using a salt substitute helps reduce blood pressure, a 2022 review found. Swapping salt with a salt substitute dropped systolic blood pressure by nearly 5 mmHg and reduced the risk of premature death.

    Researchers reviewed the findings of 23 randomized controlled trials involving more than 32,000 people with high blood pressure. The various trials investigated the effects of switching sodium-based salt with a potassium-based salt substitute on blood pressure, urinary output of sodium and potassium, and the risk of premature death from cardiovascular disease and other causes.

    They found that, on average, using a salt substitute reduced systolic blood pressure by 4.80 mmHg and diastolic blood pressure by 1.48. As expected, urinary output of sodium decreased considerably, while urinary out of potassium, which exerts robust blood pressure-lowering effects, increased. Using a salt substitute reduced the risk of dying from all causes of premature death by 12 percent.

    Other research has shown that a 5-mmHg reduction of systolic blood pressure reduces the risk of major cardiovascular events by about 10 percent. When combined with other lifestyle behaviors, such as exercising, maintaining a healthy weight, and sauna use, using a potassium-based salt substitute is a promising, non-pharmacological approach to reducing blood pressure.

  • People who regularly engaged in vigorous-intensity exercise were less like to die from cancer, cardiovascular disease, or other causes, according to a new study. Engaging in vigorous-intensity exercise for as little as 54 minutes per week provides optimal mortality reduction – but the catch is that it must be sufficiently vigorous.

    Using wrist-worn accelerometers, nearly 72,000 middle-aged adults enrolled in the UK Biobank study tracked their activity. Researchers monitored the participants' health for approximately six years.

    They found that the participants' risk of dying during the study period varied based on their activity level. The risk of dying among those engaging in no vigorous-intensity activity per week was 4.17 percent; zero to less than 10 minutes, 2.12 percent; 10 to less than 30 minutes, 1.78 percent; 30 to less than 60 minutes, 1.47 percent; and for 60 minutes or more, 1.10 percent. They determined that the “optimal” dose of vigorous-intensity activity was approximately 54 minutes per week, and the “minimal” dose – sufficient to reduce the risk of dying from cancer, cardiovascular disease, or all other causes – was approximately 15 minutes.

    Vigorous-intensity exercise is defined as activity that achieves a heart rate that is 70 to 80 percent of one’s maximum. High-intensity interval training, often referred to as HIIT, is a popular form of vigorous exercise involving short bursts of intense aerobic exercise interspersed with periods of rest or lower-intensity exercise. During a typical HIIT session, exercisers typically achieve 80 to 100 percent of their VO2max (a measure of respiratory function) or maximum heart rate. Most HIIT workouts are brief, lasting just 15 to 30 minutes.

  • Poor hydration associated with a more advanced biological age.

    Press release: https://www.sciencedaily.com/releases/2023/01/230102100941.htm

    Drinking plenty of fluids promotes a long, healthy life, a recent study has found. Older adults who were well-hydrated were less likely to develop chronic diseases and die young compared to their less-hydrated peers.

    Normal blood sodium levels typically fall between 135 and 146 millimoles per liter (mmol/l). As hydration decreases, blood sodium levels decrease, so researchers measured blood sodium levels in nearly 12,000 older adults. They calculated the participants' biological ages (based on several markers of cardiometabolic health and lifestyle factors) and assessed their risk of disease and early death.

    The researchers found that participants with blood sodium levels above 142 mmol/l, suggesting poorer hydration, were 50 percent more likely to have a biological age that was older than their chronological age. Having an older biological age, in turn, increased the participants' risk for chronic diseases by 70 percent and their risk of dying prematurely by 59 percent.

    A person’s fluid needs vary according to weight, activity level, and individual sweat losses. In general, drinking one-half to one ounce of water for each pound of body weight per day is adequate. However, exercise, sauna use, and other activities can increase fluid needs markedly. For example, a person can lose roughly one pound (~0.5 kilograms) in a single traditional sauna session.

  • From the article:

    The researchers found that breast cancer incidence was higher in estrogen plus progestin users than incidence in nonusers. Women who started hormone therapy closer to menopause had a higher breast cancer risk with a weakening influence as the time from menopause increased.

    “Because survival after breast cancer diagnosis did not differ between estrogen plus progestin users and nonusers, the higher breast cancer incidence of those using estrogen plus progestin may lead to increased breast cancer mortality on a population basis,” the authors write.

    […]

    “In general, tumors in estrogen plus progestin users in the WHI Observational Study were not significantly different from those in non-hormone users with regard to number of positive lymph nodes or tumor size, but were more likely to be well differentiated and positive for hormone receptors, findings which are similar to other observational studies.” This, however, did not translate into a survival benefit.

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  • From the article:

    The research by Chan and her colleagues drew on data from 834 postmenopausal women enrolled in the Nurses' Health Study – which has tracked the health of more than 100,000 female nurses since 1976 – who had been diagnosed with colon cancer between 1976 and 2000. The researchers found that, compared to women who had never used estrogen, those using the hormone at the time of diagnosis had a 36 percent lower chance of dying of colon cancer and a 26 percent lower chance of dying of any cause. The benefit was most pronounced in women who used estrogen for less than five years. Using it for longer, however, did not seem to provide a similar advantage.

    The authors do not know why using estrogen for more than five years did not improve women’s chances of survival. They theorize that colon tumors that developed in women who had used estrogen for many years may have been less susceptible to estrogen’s growth-slowing effects.

    The precise way by which estrogen foils the growth of colon cancer cells is unclear, as well. The study authors offer three possibilities: the hormone directly suppresses the cells' growth; it decreases the production of bile acids which are known to spur cancer; or it blocks certain genetic changes within colon cells that lead to cancer.

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  • From the publication:

    Participants: 307 601 unrelated UK Biobank participants of White European ancestry (aged 37 to 73 years at recruitment) with available measurements of 25-hydroxyvitamin D (25-(OH)D) and genetic data.

    Measurements: Genetically predicted 25-(OH)D was estimated using 35 confirmed variants of 25-(OH)D. All-cause and cause-specific mortality (cardiovascular disease [CVD], cancer, and respiratory) were recorded up to June 2020.

    Results: There were 18 700 deaths during the 14 years of follow-up. The association of genetically predicted 25-(OH)D with all-cause mortality was L-shaped, and risk for death decreased steeply with increasing concentrations until 50 nmol/L. Evidence for an association was also seen in analyses of mortality from cancer, CVD, and respiratory diseases. Odds of all-cause mortality in the genetic analysis were estimated to increase by 25% for participants with a measured 25-(OH)D concentration of 25 nmol/L compared with 50 nmol/L.

  • More than 20 percent of deaths in the United States are attributable to alcohol.

    Nearly 13 percent of all deaths among young and middle-aged adults in the United States were caused by drinking too much alcohol, a new study finds. Among adults between the ages of 20 and 49 years, excessive alcohol consumption caused more than 20 percent of all deaths.

    Researchers reviewed alcohol consumption data from more than 2 million people living in the United States between 2015 and 2019. Then they looked at the rates and causes of death during the same period.

    They found that 12.9 percent of all deaths among adults aged 20 to 64 years were attributable to excessive alcohol consumption. Men were roughly 50 percent more likely to die from alcohol-related deaths than women. When they limited the age range to 20 to 49 years, they found that 20.3 percent of deaths were attributable to excessive alcohol consumption.

    Alcohol affects multiple organ systems. Drinking too much alcohol is linked with many leading causes of death, including heart disease, cancer, unintentional injury, and liver disease.

    This study shows that alcohol contributed to nearly one in eight deaths among adults living in the United States. However, the researchers noted that the data for this study pre-date the COVID pandemic, during which many people reported drinking more alcohol, so the current number of alcohol-related deaths might now be higher. Learn how exercise can help reduce cravings for alcohol.

  • Having a large waist circumference may double a person’s risk of premature death.

    People with a large waist circumference were roughly twice as likely to die prematurely compared to those with a smaller waist, according to a 2008 study. Notably, every two-inch increase in waist circumference increased the risk of premature death by 17 percent in males and 13 percent in females.

    Researchers took various body measurements (body mass index [BMI], waist circumference, and waist-to-hip ratio) from nearly 360,000 adults enrolled in EPIC, an ongoing study in Europe. Then they investigated possible links between these measures and the risk of premature death over a period of about ten years.

    They found that males who had a BMI of 25.3 and females who had a BMI of 24.3 were the least likely to die during the study period. However, a person’s waist circumference and waist-to-hip ratio were strongly linked with the risk of dying, even after considering factors that influence risk, including BMI, educational level, smoking status, alcohol consumption, physical activity, and height. For any given BMI, they noted that every five-centimeter (two-inch) increase in waist circumference markedly increased the risk of premature death.

    A large waist circumference may be an indicator of visceral fat – body fat that is stored in the abdominal cavity and plays a central role in the links between obesity and systemic inflammation. Health experts recommend having a waist circumference of 40 inches or less for males and 35 inches or less for females.

    Similarly, a large waist-to-hip ratio may increase a person’s risk of cardiovascular disease. The World Health Organization recommends having a waist-to-hip ratio of 0.9 or less for males and 0.85 or less for females.

    See the Digest story below to learn how heavy drinking may influence waist circumference.

  • From the article:

    Professor Jones' team conducted a six year study of 587 men with type 2 diabetes, splitting them into three groups: those with normal total testosterone levels (above 10.4nmol/L, n=338), those with low testosterone levels (below 10.4nmol/L) that weren’t treated with testosterone replacement therapy (n=182), and those with low testosterone levels treated with testosterone replacement therapy for two years or more during the follow up period (n=58).

    The findings show for the first time that low testosterone puts diabetic men at a significantly increased risk of death (p=0.001 log rank): 36 of the 182 diabetic men with untreated low testosterone died during the six year study, compared to 31 of the 338 men with normal testosterone levels (20% vs 9%). Furthermore, only 5 of the 58 diabetic men that were given testosterone replacement therapy died during the study (8.6%), meaning they showed significantly better survival compared to the non-treated group (p=0.049 log rank).

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  • From the publication:

    Published in Annals of Internal Medicine, the study found that the more severe the vitamin D deficiency, the greater the risk of mortality.

    […]

    “Our study provides strong evidence for the connection between low levels of vitamin D and mortality, and this is the first study of its kind to also include respiratory disease related mortality as an outcome.

    […]

    The Mendelian randomization study evaluated 307,601 records from the UK Biobank. Low levels of vitamin D were noted as less than <25 nmol/L with the average concentration found to be 45.2 nmol/L. Over a 14-year follow up period, researchers found that the risk for death significantly decreased with increased vitamin D concentrations, with the strongest effects seen among those with severe deficiencies.

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  • From the publication:

    In the study, Haring and co-workers looked at death from any cause in nearly 2,000 men aged 20 to 79 years who were living in northeast Germany and who participated in the Study of Health in Pomerania (SHIP). Follow-up averaged 7 years. At the beginning of the study, 5 percent of these men had low blood testosterone levels, defined as the lower end of the normal range for young adult men. The men with low testosterone were older, more obese, and had a greater prevalence of diabetes and high blood pressure, compared with men who had higher testosterone levels, Haring said.

    Men with low testosterone levels had more than 2.5 times greater risk of dying during the next 10 years compared to men with higher testosterone, the study found. This difference was not explained by age, smoking, alcohol intake, level of physical activity, or increased waist circumference (a risk factor for diabetes and heart disease), Haring said.

    In cause-specific death analyses, low testosterone predicted increased risk of death due to cardiovascular disease and cancer but not death of any other single cause.

    View full publication

  • From the publication:

    In the study, Laughlin and co-workers looked at death, no matter the cause, in nearly 800 men, ages 50 to 91 years, who were living in Rancho Bernardo, California. The participants have been members of the Rancho Bernardo Heart and Chronic Disease Study since the 1970s. At the beginning of the 1980s, almost one-third of these men had suboptimal blood testosterone levels for men their age.

    The group with low testosterone levels had a 33 percent greater risk of death during the next 18 years than the men with higher testosterone. This difference was not explained by smoking, drinking, physical activity level or pre-existing diseases (such as diabetes or heart disease).

    In this study, “low testosterone” levels were set at the lower limit of the normal range for young adult men. Testosterone declines slowly with aging in men and levels vary widely, with many older men still having testosterone levels in the range of young men. Twenty-nine percent of Rancho Bernardo men had low testosterone.

    Distinguishing Factors

    Men with low testosterone were more likely to have elevated markers of inflammation, called inflammatory cytokines, which contribute to many diseases. Another characteristic that distinguished the men with low testosterone was a larger waist girth along with a cluster of cardiovascular and diabetes risk factors related to this type of fat accumulation. Men with low testosterone are three times more likely to have the metabolic syndrome than men with higher testosterone levels;

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  • From the article:

    Obesity is very common in men with testosterone deficiency (hypogonadism),” said lead study author Karim Haider, M.D., a urologist and andrologist in private practice in Bremerhaven, Germany.

    […]

    The 462 (57.4 percent) patients with obesity were given the choice whether to be treated with long-term testosterone therapy (TTh) with testosterone undecanoate injections (TU) 1,000 mg every 12 weeks. Of these, 273 opted to receive testosterone, and the 189 who declined treatment served as controls.

    Over 10 years, the testosterone-treated men lost 20.3 percent of their baseline weight (50.5 lb; 22.9 kg); their waist circumference dropped by 12.5 cm (4.9 in). BMI decreased by 7.3 kg/m2, and the waist-to-height ratio decreased by 0.07.

    By contrast, the untreated men gained 3.9 percent of their baseline weight (3.2 kg; 7.1 lb), and their waist size increased by 4.6 cm (1.8 in). In this group, BMI increased by 0.9 kg/m2, and waist-to-height ratio increased by 0.03.

    During this time, 12 (4.4 percent) men in the testosterone group died, while in the untreated control group, 57 deaths (30.2 percent), 47 myocardial infarctions (24.9 percent) and 44 strokes (23.3 percent) occurred.

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  • Sauna use offsets the increased risk of premature death associated with low socioeconomic status.

    A person’s socioeconomic status – a measure of their income, education, and occupation – is a robust predictor of their overall health and longevity. For example, people of low socioeconomic status typically have less access to financial, educational, social, and health resources than those with a higher socioeconomic status and are at greater risk of developing cardiovascular disease. Findings from a recent study suggest that sauna use negates some of the harmful effects of low socioeconomic status.

    Sauna use induces hyperthermia, an increase in the body’s core temperature that stresses the body and switches on physiological responses involving neuroendocrine, cardiovascular, and cytoprotective mechanisms. These mechanisms work together to restore homeostasis and condition the body for future heat stressors, a phenomenon known as hormesis. Sauna use also mimics many of the cardiovascular effects of exercise, including increased heart rate and blood pressure

    The investigators drew on data from the Kuopio Ischemic Heart Disease Risk Factor Study, an ongoing prospective population-based cohort study of health outcomes in more than 2,500 middle-aged men (42 to 61 years) from eastern Finland, where saunas are readily available. They calculated the men’s socioeconomic status based on information the men provided about their income, education, occupational prestige, standard of living, and housing conditions. They also collected information about the men’s sauna habits and categorized them as infrequent users (two times per week or less) or frequent users (three to seven times per week).

    They found that over a 27-year period, men who were frequent sauna users were 14 percent less likely to die from all causes of premature death than infrequent users. However, men who were infrequent users but had low socioeconomic status were 35 percent more likely to die than men who were infrequent users but had high socioeconomic status. Men who were frequent users but had low socioeconomic status were just 7 percent more likely to die.

    These findings suggest that sauna use offsets some of the increased risk of premature death associated with low socioeconomic status. Although saunas are not as readily available in many locations outside Finland, evidence suggests that very hot baths provide similar health benefits.

  • Eating walnuts prevents premature death and extends life expectancy.

    Walnuts are a nutrient-dense food, rich in omega-3 fatty acids, protein, fiber, and many vitamins and minerals. Evidence suggests that consuming walnuts as part of a healthy diet improves cognitive function and cardiovascular health and reduces the risk of developing certain types of cancer. Findings from a 2021 study suggest that eating walnuts reduces the risk of dying from all causes of premature death and promotes longevity.

    The investigation involved more than 93,000 healthy men and women (average age, 63 years) who were enrolled in the Nurses' Health Study and the Health Professionals Follow-up Study, two ongoing studies focused on identifying risk factors that drive chronic disease. Every two to four years, participants completed a food frequency questionnaire in which they answered questions about their walnut consumption as well as other dietary habits. The investigators ranked the participants according to the number of servings of walnuts they consumed each week. They also assessed the overall quality of the participants' diets, based on foods and nutrients that predict chronic disease risk. They tracked the participants' disease and death rates for approximately 20 years.

    They found that during the 20-year period, nearly half of the participants died. Compared to participants who never ate walnuts, the risk of death from all causes among those who ate fewer than one serving of walnuts per week was 5 percent lower; for one serving, 6 percent lower; for two to four servings, 13 percent lower; and for those who ate five or more servings, 14 percent lower. When the investigators looked at individual causes of death, they found that participants who ate walnuts more than five times a week were 25 percent less likely to die from cardiovascular disease than those who ate no walnuts. The benefits associated with eating walnuts was independent of the participants' overall diet quality; however, among participants whose diet was suboptimal, eating one-half serving of walnuts daily decreased their risk of premature death by 12 percent. Eating walnuts five times a week or more also prolonged life expectancy, with women gaining 2.43 years, and men gaining 1.56 years.

    These findings suggest that eating walnuts reduces the risk of dying from all causes of premature death and promotes longevity, especially among people whose diets may be lacking in other beneficial components. Some of the benefits of walnuts may be attributed to their high alpha-linolenic acid content. Alpha-linolenic acid is a type of omega-3 fatty acid that exerts potent cardioprotective and neuroprotective properties. Learn more about the health benefits of omega-3s in this episode featuring Dr. Bill Harris.

  • Breast cancer is the most common form of cancer among women, with roughly 237,000 cases diagnosed in the United States each year. Nearly one-fourth of women with breast cancer will die within 15 years of diagnosis. Findings from a 2014 study indicate that running reduces the risk of death from breast cancer.

    Most public health organizations recommend that adults of all ages engage in at least 150 minutes of moderate-intensity exercise or at least 75 minutes of vigorous-intensity exercise each week, or an equivalent combination of both. Most adults fall far short of these recommendations, however.

    Data from epidemiological, clinical, and mechanistic studies suggest that exercise reduces the risk of cancer-related death. However, scientists are unsure about how much or what type of exercise is best. Running and walking are both aerobic forms of exercise, but they differ in intensity, with running categorized as vigorous, and walking categorized as moderate. The authors of the study investigated whether running and walking differed in their effects on breast cancer-related death risk.

    The authors drew on data collected in the National Runners' and Walkers' Health Study, a long-term assessment of the health benefits associated with running and walking. They compared death rates among 272 runners and 714 walkers who had previously been diagnosed with breast cancer, taking age, race, menopause, family history, breastfeeding and oral contraceptive use into account. They quantified the intensity of the women’s activity as metabolic equivalents, or METs, a measure of the rate of energy expended per unit of time.

    Over a nine-year period, the risk of death from breast cancer was 49 percent lower among women who ran or walked 1.8 to 3.6 MET-hours per day and 68 percent lower for 3.6 MET-hours per day, when compared to less active women. Among runners only, the risk of death from breast cancer was 14 percent lower among women who ran 1.07 to 1.8 MET-hours per day, 87 percent lower for 1.8 to 3.6 MET-hours per day had a, and 95 percent lower for 3.6 hours or more per day, when compared to those who ran for less than 1.07 MET-hours per day.

    The findings indicate that running promotes greater survival among women who have had breast cancer. The authors noted that the amount of exercise that provided the greatest protection exceeded current guidelines, suggesting that breast cancer survival could be increased by engaging in greater exercise doses than recommended. Other behaviors that may promote breast cancer survival include dietary modifications, especially time-restricted eating. Learn more about the effects of time-restricted eating on breast cancer survival in this clip featuring Dr. Ruth Patterson.

  • Cardiovascular disease is an umbrella term that encompasses coronary artery disease, heart attack, stroke, hypertension, and other conditions. Together, they are the primary cause of death worldwide, claiming the lives of nearly 18 million people every year. Findings from a recent meta-analysis suggest that omega-3 fatty acids reduce the risk of developing cardiovascular disease.

    Omega-3 fatty acids are essential nutrients that play critical roles in cardiovascular function, due to their participation in pathways involved in blood clotting, inflammation, and the contraction and relaxation of arteries. Omega-3s with the greatest relevance for humans include alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). ALA is found mainly in plant oils such as flaxseed, soybean, and canola oils. EPA and DHA are found in the meat and oils of fatty cold-water fishes and seafood. The human body can convert some dietary ALA into EPA and then to DHA, but the process is inefficient.

    The findings from studies investigating the health effects of omega-3s have been inconsistent, likely due to differences in study design, many of which rely on data from food frequency questionnaires, which are subject to recall bias, and nutrient databases, which can be inaccurate. Measuring omega-3 blood levels provides a more accurate assessment of exposure.

    The authors of the meta-analysis reviewed data from 17 studies that investigated links between blood levels of omega-3s and the risk for all causes of premature death. The studies included more than 42,000 adults (average age, 65 years) living in 10 countries. The authors classified the participants according to five categories of omega-3 intake, ranging from high to low.

    They found that participants with the highest blood levels of EPA and DHA combined were 18 percent less likely to die from all causes of premature death, compared to those with the lowest levels. When they analyzed death rates by specific causes, they found that those with the highest blood levels of EPA and DHA combined were 20 percent less likely to die from cardiovascular disease and 13 percent less likely to die from cancer.

    These findings suggest that omega-3s reduce the risk of premature death from all causes and from cardiovascular disease. The authors noted that their findings did not establish causality and may in fact be indicators of healthy lifestyles among the participants. Further study is warranted.

  • During the study period of March 15 through April 19, 2020, out of 3,556 hospitalized patients with diagnosis of COVID-19 infection, 32 patients (0.9%) had imaging-proven ischemic stroke. They compared those 32 patients admitted with stroke and COVID-19 to those admitted only with stroke (46 patients) and found that the patients with COVID-19:

    tended to be younger, average age of 63 years vs. 70 years for non-COVID stroke patients; had more severe strokes, average score of 19 vs. 8 on the National Institutes of Health Stroke Scale; had higher D-dimer levels, 10,000 vs. 525, which can indicate significant blood clotting; were more likely to be treated with blood thinners, 75% vs. 23.9%; were more likely to have a cryptogenic stroke in which the cause is unknown, 65.6% vs. 30.4%; and were more likely to be dead at hospital discharge, 63.6% vs. 9.3%. Conversely, COVID-19 stroke patients were less likely than those stroke patients without the novel coronavirus to have high blood pressure (56.3% vs. 76.1%) or to have a prior history of stroke (3.1% vs. 13%).

  • The global influenza pandemic of 1918 was the deadliest in history, claiming the lives of more than 50 million people worldwide. Although the cause of the outbreak has been attributed to infection from the H1N1 virus, a 2008 study co-authored by Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, suggested the primary cause of death among those infected was pneumonia.

    Fauci and his colleagues conducted an extensive review of the scientific literature detailing the pathological and bacteriological evidence regarding the pandemic, derived from the findings of more than 8,000 autopsies. Then they examined preserved lung tissue samples from 58 of those autopsies to determine the cause of death.

    They found that the death rate followed an age-specific, W-shaped curve, with the highest peaks occurring among infants and elderly people and a slightly lower peak occurring among young adults between the ages of 20 and 40 years old. Examination of the tissue samples revealed that severe acute bacterial pneumonia was present in nearly every case as either the primary pathological feature or coincidental to other features commonly associated with influenza infection, including serious injury to the tissues of the respiratory tract.

    The primary pathogens identified in the samples were pneumococci, streptococci, and staphylococci – bacteria that commonly reside in the throat and upper respiratory tract and typically pose no harm. However, the injurious tissue changes that accompanied the primary viral infection created an environment conducive to secondary bacterial infection and subsequent pneumonia. Also present in the samples were Bacillus influenzae, bacteria that often facilitate the infiltration of other pneumonia-causing bacteria.

    Taken together, these findings suggest that pandemic preparedness should include the stockpiling of antibiotics and bacterial vaccines.

  • Mechanical ventilation – a therapeutic measure used to assist or replace spontaneous breathing – is an important strategy used to treat people experiencing respiratory failure. A recent meta-analysis found that vitamin C treatment shortened the duration of mechanical ventilation among patients in the intensive care unit.

    The investigators looked at the findings from eight trials involving 685 patients. They found that vitamin C shortened the duration of mechanical ventilation an average of 14 percent. But the investigators noted major differences in the effect of vitamin C between the trials, with the greatest benefit observed among patients who were on mechanical ventilation for the longest duration – the patients who were most critical. In five trials involving more than 470 patients requiring ventilation for more than 10 hours, providing 1 to 6 grams of vitamin C per day shortened ventilation time an average of 25 percent.

    These findings indicate that vitamin C shortens the duration of mechanical ventilation, especially among critically ill patients.

  • Most of the studies on air pollution have included populations whose socioeconomic status is higher than the national average and who reside in well-monitored urban areas. This does not tell us what the health effects are of long-term exposure to low levels of air pollution in smaller cities and rural areas or among minorities or persons with low socioeconomic status (sensitive populations). This study involved 60 million people in the United States who receive Medicare and live in smaller cities or rural areas. This study showed that long-term exposures to particulate matter less than 2.5 μm and ozone were associated with a 7.3% increased risk of death, even at levels below the current annual national safety standards. In another study, the authors also looked at Medicare recipients and air pollution exposure risks and found that lifestyle factors such as smoking, BMI, and many other potential confounders did not change the data. With air pollution declining, it is critical to estimate the health effects of low levels of air pollution, below the current National standards, in order to determine whether these levels are adequate to minimize the risk of death. The Clean Air Act requires the EPA to set air quality standards that protect sensitive populations (such as those on Medicare) and studies like this may be important in order to inform regulatory policy going forward.

  • Multiple studies have now linked chronic use of these painkillers with an increased risk of heart attack and stroke. They mechanisms appear to be mediated through the inhibition of an enzyme known as Cox 2. There have been a couple of mechanisms investigated in animal studies. First, NSAIDs have been shown to inhibit the production of a molecule called prostacyclin that relaxes blood vessels and “unglues” platelets. Second, they have been shown to inhibit the production of nitric oxide (which cox 2 also regulates to some degree).

    Other studies have shown that people taking 2 grams of phytosomal curcumin (called Meriva) had pain reduction equivalent to 800 mg of ibuprofen.

    To hear a longer discuss surounding NSAIDS and heart attack risk, as well as the relevance of curcumin in pain-relief make sure to check out JRE#773 or, more recently, Tim Ferriss Show #237 where both topics are discussed.