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Want strong muscles? Eat your leafy greens – The Globe and Mail

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Nitrate-rich leafy greens may help preserve muscle function and strength, according to the findings of a new study.

Svetlana Lukienko/iStockPhoto / Getty Images

There are many reasons to eat plenty of vegetables each day. Protection against high blood pressure, heart disease, stroke, macular degeneration and cognitive decline are among them.

Now, new study findings suggest another important reason – to preserve muscle strength and muscle function as you age.

Entering middle age with better muscle strength is thought to protect against disability and frailty later in life. In older adults, declines in strength increase the risk of falls, a major cause of bone fractures.

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When it comes to supporting muscle function, though, not all vegetables will do the trick. According to the Australian research team, veggies packed with compounds called nitrates – e.g., leafy greens, beets – are the ones that have muscle benefits.

About the study

Previous studies have shown that taking nitrate supplements improves muscle function during an exercise test. It’s not known, though, whether a regular intake of nitrates from diet affects muscle strength and function.

The study, published online in The Journal of Nutrition on March 24, investigated the link between dietary nitrate intake and muscle function in 3,759 healthy adults who were participating in a large continuing Australian health and lifestyle study.

Participants, age 48 on average at the start of the study, were followed for 12 years, during which time dietary intake was measured at least twice. Vegetables contributed the majority (81 per cent) of daily nitrate intake.

Muscle function was measured using knee-extension strength and the 2.4-metre-TUG (Timed-Up-And-Go) test.

For the TUG test, participants were asked to rise from a seated position, walk 2.4 metres, turn, walk back and sit down again. A shorter time to complete the test indicated better speed and mobility during different tasks (e.g., sitting, standing, walking, turning).

Compared to participants with the lowest nitrate intake, those who consumed the most had significantly better knee-extension strength and faster TUG performance.

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The researchers accounted for other factors that could influence muscle strength such as age, sex, body-mass index, physical activity and smoking status.

Since physical activity improves muscle strength, the researchers also looked at whether the relationship between nitrate intake and muscle function was influenced by a person’s level of daily physical activity.

Total physical activity did not alter the association between nitrate intake and muscle strength, suggesting that dietary nitrates have an independent effect on muscle function.

Caveats

This study was observational and, therefore, does not prove that eating nitrate-rich vegetables improves muscle strength.

As well, only the duration of physical activity, not the type, was measured. Since different types of exercise (e.g., walking versus resistance training) vary in their effectiveness for improving muscle function, the effect of nitrates may depend on the type of exercise performed.

Even so, these findings align with past research linking higher dietary nitrate intake to better muscle strength and function in older women.

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Nitrates, vegetables and muscle strength

According to Stuart Phillips, a professor in kinesiology at McMaster University and a Tier 1 Canada Research Chair in Skeletal Muscle Health and Aging, “there are plausible reasons why nitrates may benefit muscle function.”

Nitrates improve mitochondrial function, the power plant inside every cell, which could allow for better muscle strength. Nitrates are also converted to nitric oxide, a chemical that relaxes blood vessels, lowers blood pressure and improves circulation. Eating nitrate-rich vegetables could possibly increase the flow of oxygen to working muscles.

Vegetables that deliver the most nitrates include leafy greens (spinach, arugula, lettuce, kale, Swiss chard, collard greens), bok choy, celery, radish and carrots.

In the study, the greatest benefits to muscle function occurred at a daily nitrate intake of 90 mg, an amount that’s easily achieved by eating one cup of leafy green vegetables each day.

While these new findings suggest that certain vegetables play a role in supporting muscle health, it’s well established that resistance training plays a crucial role.

Says Phillips, “In my estimation, nothing tops physical activity for maintaining strength. That said, these are interesting data and certainly indicate another potential upside of eating your vegetables. It can’t hurt and can likely only help.”

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Leslie Beck, a Toronto-based private practice dietitian, is director of food and nutrition at Medcan. Follow her on Twitter @LeslieBeckRD

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Canada will not restrict AstraZeneca COVID-19 vaccine, says benefits outweigh risk

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OTTAWA (Reuters) – Canada‘s health ministry said on Wednesday it would not restrict use of AstraZeneca Plc’s COVID-19 vaccine after a review showed the benefits outweighed the very rare risk of blood clots.

A separate advisory council had earlier recommended Canada stop offering the vaccine to people under 55. The panel is now reviewing that advice, the health ministry said in a statement.

Denmark on Wednesday became the first country to stop using the vaccine altogether over a potential link to the rare blood clots. Other nations have imposed limits on its use.

But Health Canada, the federal health ministry, said in a statement that a review of data from Europe, Britain and AstraZeneca had not identified specific risk factors.

“Therefore, Health Canada is not restricting the use of the vaccine in any specific populations at this time … The potential risk of these events is very rare, and the benefits of the vaccine in protecting against COVID-19 outweigh its potential risks,” it said.

Canada on Tuesday said it had recorded its first case of blood clotting with low platelets after someone received the AstraZeneca shot. The patient in question, a woman from Quebec, is recovering. (Graphic on vaccines: https://tmsnrt.rs/3tUM8ta)

COVID-19 cases are surging in Canada with the country reporting a near-record number of new cases recently. (Graphic on cases: https://tmsnrt.rs/34pvUyi)

 

(Reporting by David Ljunggren in Ottawa and Allison Martell in Toronto; Editing by Lisa Shumaker)

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Factbox-Some countries limit AstraZeneca vaccine use, US pauses J&J shot

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(Reuters) -Some countries are restricting use of the AstraZeneca COVID-19 vaccine to certain age groups or suspending use after European and British regulators confirmed possible links to rare blood clots.

Denmark became the first country to stop using the vaccine altogether, as it said results of investigations showed “real and serious side-effects”.

Johnson & Johnson’s single-shot vaccine has also been hit by concerns over blood clots, with European regulators reviewing such cases and U.S. federal health agencies recommending pausing its use for a few days. J&J noted no clear causal relationship had been established between the clots and its vaccine.

The developments pose a risk to vaccination plans in Europe.

Regulators have said the benefits of the AstraZeneca shot outweigh risks.

Anglo-Swedish drugmaker AstraZeneca said it was working with regulators to list the possible brain blood clots as “an extremely rare potential side effect” on the vaccines labels.

As of April 4, the European Medicines Agency had received reports of 169 cases of a rare brain blood clot known as cerebral venous sinus thrombosis (CVST), after 34 million doses had been administered in the European Economic Area. Most cases were in women under 60 years of age.

ASTRAZENECA VACCINE BEING USED, WITH OR WITHOUT RESTRICTIONS

AUSTRALIA

Said on April 8 it recommends people under 50 should get Pfizer’s COVID-19 vaccine in preference to AstraZeneca’s shot.

AUSTRIA

Has resumed use.

BRAZIL

Authorities said they would not limit use of the AstraZeneca vaccine, saying benefits outweigh risks.

BRITAIN

The Joint Committee on Vaccination and Immunisation has said an alternative to the vaccine should be given for people under 30 where possible, but people should continue to have a second shot if they have received a first dose.

BULGARIA

Resumed inoculations from March 19.

CYPRUS

Resumed inoculations on March 19.

CANADA

Authorities said in early April they would pause offering the vaccine to people under 55 and require a new analysis of the shot’s benefits and risks based on age and gender. On April 13, the country said it had recorded its first case of blood clotting with low platelets.

ESTONIA

Suspended use of the vaccine for people under 60 on April 7.

FRANCE

Approved resumption of the vaccine on March 19 but said it should be given only to people aged 55 and over. On April 9, recommended that recipients of a first dose of the AstraZeneca shot who are under 55 should receive a second dose with a messenger RNA vaccine.

FINLAND

Resumed using the AstraZeneca vaccine from March 29, but only for people aged 65 and over.

GEORGIA

Has limited use of the vaccine following the death of a nurse from anaphylactic shock, and vaccinations will continue only in full-fledged medical centres, Russian news agency TASS reported on March 19.

GERMANY

Sticking to its guidance from March 31 to limit use of the vaccine to those aged over 60. On April 1, Germany’s vaccine commission recommended people under 60 who have had a first shot of the vaccine should receive a different product for their second dose.

HUNGARY

Continuing the vaccine’s rollout.

ICELAND

Resumed use on March 25 after suspending it on March 11.

INDONESIA

Resumed using the vaccine on March 22 but warned against its use in people with a low blood platelet count.

IRELAND

On April 12, the country said it was restricting use of the vaccine to those over 60.

ITALY

Has recommended the vaccine be used only for people over 60, the country’s top health adviser said.

LATVIA

Announced it was restarting administering the shots from March 19.

LITHUANIA

Restarted use on March 19.

MEXICO

Drug regulator Cofepris said on April 7 it did not “at this time” plan to limit the vaccine’s use but was investigating the information raised by Britain.

NETHERLANDS

Limited use of the vaccine to people over 60, the Dutch government said on April 8.

NORTH MACEDONIA

Health minister said on March 31 the vaccine would be limited to people aged over 60 as a precautionary measure.

PHILIPPINES

Suspended use of the vaccine for people under 60 on April 8.

ROMANIA

Has resumed use of the vaccine after temporarily stopping vaccinating people with one batch of the vaccine on March 11.

SOUTH KOREA

Resumed use of the shot for people aged 30 or older on April 12. On April 7, it had suspended providing the AstraZeneca shot to people under 60.

SPAIN

From April 8, it was giving the vaccine only to people over 60.

SWEDEN

Resumed use of the vaccine on March 25 for people aged 65 and older.

THAILAND

Began use on March 15 after delaying rollout the week before.

COUNTRIES WHERE ASTRAZENECA VACCINE USE SUSPENDED

CAMEROON

Suspended administration of the vaccine it was scheduled to receive on March 20 as part of the global vaccines sharing scheme COVAX, the health ministry said.

DENMARK

In a world first, Denmark decided to stop using the AstraZeneca vaccine altogether after initially suspending use of the shot.

NORWAY

Authorities said on March 26 Norway would delay a decision on use of the vaccine, with a decision expected by April 15.

J&J VACCINE DELAYS AND RESTRICTIONS

UNITED STATES

On April 13, U.S. federal health agencies recommended pausing use of J&J’s COVID-19 vaccine for at least a few days after six women under the age of 50 developed rare blood clots after receiving the shot.

EUROPEAN UNION

The company said it would delay the rollout of the vaccine to Europe, after regulators said they were reviewing rare blood clots.

Widespread use in the EU had not yet started after the company began delivering the doses in the week beginning April 12. The European drug regulator recommended storing doses already received until its safety committee issues an expedited recommendation

SOUTH AFRICA

Suspended use of J&J’s vaccine on April 13.

(Reporting by Pushkala Aripaka, Yadarisa Shabong, Manas Mishra, Vishwadha Chander, Amruta Khandekar and Mrinalika Roy in Bengaluru; editing by Josephine Mason, Alison Williams, Timothy Heritage, Larry King, Barbara Lewis)

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Ontario hospitals may have to withhold care as COVID-19 fills ICUs

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By Allison Martell and Anna Mehler Paperny

TORONTO (Reuters) – Doctors in the Canadian province of Ontario may soon have to decide who can and cannot receive treatment in intensive care as the number of coronavirus infections sets records and patients are packed into hospitals still stretched from a December wave.

Canada‘s most populous province is canceling elective surgeries, admitting adults to a major children’s hospital and preparing field hospitals after the number of COVID-19 patients in ICUs jumped 31% to 612 in the week leading up to Sunday, according to data from the Ontario Hospital Association.

The sharp increase in Ontario hospital admissions is also straining supplies of tocilizumab, a drug often given to people seriously ill with COVID-19.

Hospital care is publicly funded in Canada, generally free at the point of care for residents. But new hospital beds have not kept pace with population growth, and shortages of staff and space often emerge during bad flu seasons.

Ontario’s hospitals fared relatively well during the first wave of the pandemic last year, in part because the province quickly canceled elective surgeries.

The College of Physicians and Surgeons of Ontario told doctors last Thursday that the province was considering “enacting the critical care triage protocol,” something that was not done during earlier waves of the virus. Triage protocols help doctors decide who to treat in a crisis.

“Everybody’s under extreme stress,” said Eddy Fan, an ICU doctor at Toronto’s University Health Network. He said no doctor wants to contemplate a triage protocol but there are only so many staff.

“There’s going to be a breaking point, a point at which we can’t fill those gaps any longer.”

In a statement, the health ministry said Ontario has not activated the protocol. A September draft suggested doctors could withhold life-sustaining care from patients with a less than 20% chance of surviving 12 months. A final version has not been made public.

Ontario’s Science Advisory Table had been forecasting the surge for months, said member and critical care physician Laveena Munshi. During a recent shift she wanted to call the son of a patient only to discover he was in an ICU across the street.

“The horror stories that we’re seeing in the hospital are like ones out of apocalyptic movies,” she said. “They’re not supposed to be the reality we’re seeing one year into a pandemic.”

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