Health

AHA Plugs 'Dietary Patterns' Over Dietary Cholesterol Targets – TCTMD

Published

5 years ago

December 26, 2019

The new science advisory seeks to dispel confusion around the relevance of dietary cholesterol for heart health.

With a flurry of New Year’s resolutions around the corner, a newly released advisory paper from the American Heart Association (AHA) is seeking to dispel lingering confusion over dietary cholesterol intake that may have arisen when specific targets were eliminated in the recent guidelines.

Instead, the document emphasizes that a diet rich in fruits, vegetables, whole grains, low-fat or fat-free dairy products, lean protein sources, nuts, seeds, and liquid vegetable oils is the better bet for promoting cardiovascular health.

Whereas the 2010 Dietary Guidelines for Americans once put a limit on the consumption of dietary cholesterol at less than 300 mg/day, the 2016 update removed this specific threshold and shifted focus to more general healthy eating patterns.

“A recommendation that gives a specific dietary cholesterol target within the context of food-based advice is challenging for clinicians and consumers to implement; hence, guidance focused on dietary patterns is more likely to improve diet quality and to promote cardiovascular health,” write Jo Ann S. Carson, PhD, RDN (University of Texas Southwestern Medical Center, Dallas), and colleagues in their review paper published online in Circulation.

“There’s just a lot of confusion out there,” Andrew M. Freeman, MD (National Jewish Health, Denver, CO), who was not involved with the document, told TCTMD, calling the 300-mg cholesterol limit “arbitrary.”

“A lot of people interpreted that as you can have a free for all and eat whatever you want, and that’s obviously that’s not what the message was,” he said. “You still have to eat well, and diets that are heart healthy are naturally low in cholesterol. So that’s the key message there.” What has complicated matters in the interim is that a variety of food industries have spun the removal of the specific cholesterol threshold to mean people can eat however much of a once-limited food item they want, Freeman added.

Stop Counting, Think Holistically

In the paper, Carson and colleagues outline all of the contemporary studies looking at dietary cholesterol as well as egg consumption and cardiovascular risk, including a meta-analysis published in March showing a positive association (HR 1.17; 95% CI, 1.09-1.26). They note some discrepancies in the literature, but ultimately conclude that it “is difficult to distinguish between the effect of dietary cholesterol per se and the effect of dietary patterns high in cholesterol or saturated fat, for example, sausage or bacon eaten with eggs.”

There’s just a lot of confusion out there. Andrew M. Freeman

Additionally, studying dietary cholesterol can be complicated by the type of dietary fat included, they write. “In many intervention studies, the fatty acid composition of the diets was not matched; likewise, because the majority of observational studies do not adjust for saturated, monounsaturated, and polyunsaturated fat, it can be difficult to distinguish between the independent effects of dietary cholesterol and dietary fat type.”

There are two aspects of diet that cannot be ignored when considering the relationship between dietary cholesterol and risk of cardiovascular disease, the authors conclude. “First, most foods contributing cholesterol to the US diet are usually high in saturated fat or consumed with foods high in saturated fat. Second, heart-healthy dietary patterns (eg, Mediterranean-style and DASH-style diets) are inherently low in cholesterol, with typical menus containing < 300 mg/d cholesterol, similar to the current US intake.”

Freeman added that there are variations in metabolisms among people, giving the example that some can eat eggs without increasing their cholesterol and others have trouble doing so. “There are some studies from a long time ago that basically showed that if you’re eating a standard American diet and you add a few eggs, your overall cholesterol number may not go up very much,” he said. “But if you’re not used to eating that amount and then you suddenly eat some, your cholesterol can go up quite a bit, and I think that’s the distinction.”

Ultimately, “it’s not so important to count the amount of cholesterol that one’s consuming, . . . but there does seem to be an increased risk of cardiovascular events when people are consuming lots of eggs,” Freeman said.

For physicians advising patients with known cardiovascular disease, “the evidence to date, at least in my mind, still significantly pushes us toward a predominantly low fat, whole food, plant-based diet,” he concluded. “And then if you have a patient that’s particularly high risk, you might really want to push them to being very, very strict and not having lots of shellfish or eggs or whatever it may be.”

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Whooping cough is at a decade-high level in US

Published

3 days ago

October 17, 2024

Anne Joseph

MILWAUKEE (AP) — Whooping cough is at its highest level in a decade for this time of year, U.S. health officials reported Thursday.

There have been 18,506 cases of whooping cough reported so far, the Centers for Disease Control and Prevention said. That’s the most at this point in the year since 2014, when cases topped 21,800.

The increase is not unexpected — whooping cough peaks every three to five years, health experts said. And the numbers indicate a return to levels before the coronavirus pandemic, when whooping cough and other contagious illnesses plummeted.

Still, the tally has some state health officials concerned, including those in Wisconsin, where there have been about 1,000 cases so far this year, compared to a total of 51 last year.

Nationwide, CDC has reported that kindergarten vaccination rates dipped last year and vaccine exemptions are at an all-time high. Thursday, it released state figures, showing that about 86% of kindergartners in Wisconsin got the whooping cough vaccine, compared to more than 92% nationally.

Whooping cough, also called pertussis, usually starts out like a cold, with a runny nose and other common symptoms, before turning into a prolonged cough. It is treated with antibiotics. Whooping cough used to be very common until a vaccine was introduced in the 1950s, which is now part of routine childhood vaccinations. It is in a shot along with tetanus and diphtheria vaccines. The combo shot is recommended for adults every 10 years.

“They used to call it the 100-day cough because it literally lasts for 100 days,” said Joyce Knestrick, a family nurse practitioner in Wheeling, West Virginia.

Whooping cough is usually seen mostly in infants and young children, who can develop serious complications. That’s why the vaccine is recommended during pregnancy, to pass along protection to the newborn, and for those who spend a lot of time with infants.

But public health workers say outbreaks this year are hitting older kids and teens. In Pennsylvania, most outbreaks have been in middle school, high school and college settings, an official said. Nearly all the cases in Douglas County, Nebraska, are schoolkids and teens, said Justin Frederick, deputy director of the health department.

That includes his own teenage daughter.

“It’s a horrible disease. She still wakes up — after being treated with her antibiotics — in a panic because she’s coughing so much she can’t breathe,” he said.

It’s important to get tested and treated with antibiotics early, said Dr. Kris Bryant, who specializes in pediatric infectious diseases at Norton Children’s in Louisville, Kentucky. People exposed to the bacteria can also take antibiotics to stop the spread.

“Pertussis is worth preventing,” Bryant said. “The good news is that we have safe and effective vaccines.”

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AP data journalist Kasturi Pananjady contributed to this report.

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The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

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Scientists show how sperm and egg come together like a key in a lock

Published

3 days ago

October 17, 2024

Anne Joseph

How a sperm and egg fuse together has long been a mystery.

New research by scientists in Austria provides tantalizing clues, showing fertilization works like a lock and key across the animal kingdom, from fish to people.

“We discovered this mechanism that’s really fundamental across all vertebrates as far as we can tell,” said co-author Andrea Pauli at the Research Institute of Molecular Pathology in Vienna.

The team found that three proteins on the sperm join to form a sort of key that unlocks the egg, allowing the sperm to attach. Their findings, drawn from studies in zebrafish, mice, and human cells, show how this process has persisted over millions of years of evolution. Results were published Thursday in the journal Cell.

Scientists had previously known about two proteins, one on the surface of the sperm and another on the egg’s membrane. Working with international collaborators, Pauli’s lab used Google DeepMind’s artificial intelligence tool AlphaFold — whose developers were awarded a Nobel Prize earlier this month — to help them identify a new protein that allows the first molecular connection between sperm and egg. They also demonstrated how it functions in living things.

It wasn’t previously known how the proteins “worked together as a team in order to allow sperm and egg to recognize each other,” Pauli said.

Scientists still don’t know how the sperm actually gets inside the egg after it attaches and hope to delve into that next.

Eventually, Pauli said, such work could help other scientists understand infertility better or develop new birth control methods.

The work provides targets for the development of male contraceptives in particular, said David Greenstein, a genetics and cell biology expert at the University of Minnesota who was not involved in the study.

The latest study “also underscores the importance of this year’s Nobel Prize in chemistry,” he said in an email.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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Turn Your Wife Into Your Personal Sex Kitten

Published

3 days ago

October 17, 2024

Sven Eggers

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