Issue 108: From Jordan's Desk - Bone Fat?

It sounds like a contradiction in terms, but having too much fat in the bones can lead to thinning bones. What’s more is that this negates previous research which suggested that carrying extra weight and fat protected women against bone thinning and loss.

Here’s the skinny on the bone fat: Women with too much fat around the middle may compromise their bone health and be at greater risk for osteoporosis. Doctors at Massachusetts General Hospital studied 50 premenopausal women with an average body mass index (BMI) of 30. The women’s bone marrow fat and bone mineral density were also measured to determine their bone mass and bone loss.

The researchers were particularly interested in visceral fat—a kind of fat that exists below the muscle tissue in the stomach—compared to fat that is located just under the skin called subcutaneous fat. Visceral fat is believed to be the more dangerous of two, as it has been implicated in greater risk of heart disease. In this case, the doctors wanted to see if there was a difference in osteoporosis risk dependent upon which kind of fat the women had more of.

The doctors used imaging tests to discover that the study’s participants who had more visceral fat also had more bone marrow fat and less bone mineral density—which translated into a greater risk for osteoporosis. Interestingly, the researchers found no significant link between subcutaneous fat or total fat and bone marrow fat or bone mineral density.

Dr. Miriam Bredella, a radiologist at Massachusetts General and assistant professor of radiology at Harvard Medical School, was the lead author of the study. She says, “Our results show that having a lot of belly fat is more detrimental to bone health than having more superficial fat or fat around the hips.”

There may be more to the story, though. Dr. Leanne Chrisman, a family medicine doctor at University Hospitals Case Medical Center in Ohio says, “The people who consume the most unhealthy carbohydrates and fats are the ones going to be the most obese, and they’re also the ones who are the most likely not to exercise. Weight-bearing exercise is associated with improved bone marrow densities. A lack of exercise is associated with being obese and low bone mass.” Additionally, says Chrisman, the more visceral fat you have, the more difficult it is for you to absorb nutrients that are crucial for good bone health, like calcium and vitamin D.

Lead study author, Dr. Bredella sums it up: “It is important for the public to be aware that excess belly fat is a risk factor for bone loss, as well as heart disease and diabetes."

So, if you need one more reason to lose that tummy…now you have it.

Are positive emotions good for your health in old age?

The notion that feeling good may be good for your health is not new, but is it really true? A new article published in Current Directions in Psychological Science, a journal of the Association for Psychological Science, reviews the existing research on how positive emotions can influence health outcomes in later adulthood.

"We all age. It is how we age, however, that determines the quality of our lives," said Anthony Ong of Cornell University, author of the review article. The data he reviews suggest that positive emotions may be a powerful antidote to stress, pain, and illness.

There are several pathways through which a positive attitude can protect against poor health later in life. For example, happier people might take a proactive approach to aging by regularly exercising and budgeting time for a good night's sleep. Alternately, these people may avoid unhealthy behaviors, such as smoking.The benefits of these healthy lifestyle choices may become more important in older adults, as their bodies become more susceptible to disease.

An optimistic outlook has also been shown to combat stress—a known risk factor for a lot of disease. Studies have found that people with stronger positive emotions have lower levels of chemicals associated with inflammation related to stress. Also, by adopting a positive attitude people may even be able to undo some of the physical damage caused by stress.

Ong, a developmental psychologist, became interested in the study of positive emotion during graduate school when he learned about what researchers call the paradox of aging: Despite the notable loss of physical function throughout the body, a person's emotional capacity seemed to stay consistent with age. Ong speculates that if positive emotions are indeed good for our health then, "one direct, measureable consequence of this should be the extended years of quality living."

Eating More Fruit and Vegetables Is Linked to a Lower Risk of Dying from Ischemic Heart Disease

A European study investigating the links between diet and disease has found that people who consume more fruit and vegetables have a lower risk of dying from ischaemic heart disease -- the most common form of heart disease and one of the leading causes of death in Europe. However, the authors point out that a higher fruit and vegetable intake occurs among people with other healthy eating habits and lifestyles, and that these factors could also be associated with the lower risk of dying from IHD.

The study is published online on January 19 in the European Heart Journal.

Data analysed from the European Prospective Investigation into Cancer and Nutrition (EPIC) Heart study has shown that people who ate at least eight portions of fruit and vegetables a day had a 22% lower risk of dying from IHD than did those who consumed fewer than three portions a day. A portion weighed 80 grams, equal to a small banana, a medium apple, or a small carrot.

Dr Francesca Crowe of the Cancer Epidemiology Unit at the University of Oxford, UK, and the first author of the paper by the EPIC study collaborators, said: "This study involved over 300,000 people in eight different European countries, with 1,636 deaths from IHD. It shows a 4% reduced risk of dying from IHD for each additional portion of fruit and vegetables consumed above the lowest intake of two portions. In other words, the risk of a fatal IHD for someone eating five portions of fruit and vegetables a day would be 4% lower compared to someone consuming four portions a day, and so on up to eight portions or more."

Ischaemic heart disease (IHD) is characterised by reduced blood supply to the heart; people suffering from it can develop angina, chest pains and have a heart attack.

The EPIC study started in 1992 and recruited participants from a total of ten European countries* until 2000. For the analysis of IHD deaths, data from eight countries for people aged between 40 and 85 were used. Participants answered questions about their diet at the time of entry to the study and other questions about health, socio-economic status and life-style, such as smoking, drinking and exercise habits. They were followed-up for an average of nearly eight and a half years.

The researchers found that the average intake of fruit and vegetables was five portions a day; people in Greece, Italy and Spain ate more, and those in Sweden ate less.

When analysing the data, the researchers made allowances for confounding factors such as differences in lifestyles and eating habits. However, the study could be limited by errors in measuring correctly people's fruit and vegetable intake as well as other aspects of their diet. In addition, the study had a higher proportion of women, which might not be generalisable to the wider European population.

Dr Crowe said: "The main message from this analysis is that, in this study, people who consume more fruits and vegetables have lower risk of dying from IHD. However, we need to be cautious in our interpretation of the results because we are unsure whether the association between fruit and vegetable intake and risk of IHD is due to some other component of diet or lifestyle.

"If we could understand, by means of well-designed intervention studies, the biological mechanisms that could underlie the association between fruits and vegetables and IHD, this might help to determine whether or not the relation between fruit and vegetables with IHD risk is causal."

In an accompanying editorial, Professor Sir Michael Marmot, director of the University College London (UCL) International Institute for Society and Health, head of the UCL Department of Epidemiology and Public Health, and chairman of the Commission on Social Determinants of Health, writes that it is difficult to reach firm conclusions about causation from results that show a 22% lower risk of dying from IHD (an odds ration of 0.78) in people who eat eight portions of fruit and vegetables a day.

He continues: "Such an odds ratio is, however, of huge practical importance. Cardiovascular disease is the most common cause of death. A reduction of 22% is huge. But... this reduction in mortality comes with consumption of eight portions a day, or 640g. Such a high consumption was found in only 18% of the men and women in these eight cohorts. There would need to be big shift in dietary patterns to achieve this healthy consumption of eight portions a day. It is worth trying to move in that direction. Reductions in cancers of several sites, in blood pressure and stroke, would add to this reduction in fatal CHD. Moving to a diet that emphasises fruit and vegetables is of great importance to public health."

*The ten countries include: Denmark, France, Germany, Greece, Italy, The Netherlands, Norway, Spain, Sweden and the United Kingdom. For the Heart component of the study, data from France and Norway were excluded due to the small number of IHD deaths at the end of the follow-up period.

Healthy gums may lead to healthy lungs

CHICAGO – January 18, 2011 – Maintaining periodontal health may contribute to a healthy respiratory system, according to research published in the Journal of Periodontology. A new study suggests that periodontal disease may increase the risk for respiratory infections, such as chronic obstructive pulmonary disease (COPD) and pneumonia. These infections, which are caused when bacteria from the upper throat are inhaled into the lower respiratory tract, can be severely debilitating and are one of the leading causes of death in the U.S.

The study included 200 participants between the ages of 20 and 60 with at least 20 natural teeth. Half of the participants were hospitalized patients with a respiratory disease such as pneumonia, COPD, or acute bronchitis, and the other half were healthy control subjects with no history of respiratory disease. Each participant underwent a comprehensive oral evaluation to measure periodontal health status.

The study found that patients with respiratory diseases had worse periodontal health than the control group, suggesting a relationship between respiratory disease and periodontal disease. Researchers suspect that the presence of oral pathogens associated with periodontal disease may increase a patient's risk of developing or exacerbating respiratory disease. However, the study authors note that additional studies are needed to more conclusively understand this link.

"Pulmonary diseases can be severely disabling and debilitating," says Donald S. Clem, DDS, President of the American Academy of Periodontology. "By working with your dentist or periodontist, you may actually be able to prevent or diminish the progression of harmful diseases such as pneumonia or COPD. This study provides yet another example of how periodontal health plays a role in keeping other systems of the body healthy."

Periodontal disease is a chronic inflammatory disease that affects the gum tissue and other structures supporting the teeth. Previous research has associated gum disease with other chronic inflammatory diseases such as diabetes, cardiovascular disease, and rheumatoid arthritis.

Dr. Clem stressed the importance of routine oral care in helping to prevent periodontal disease. "Taking good care of your periodontal health involves daily tooth brushing and flossing. You should also expect to get a comprehensive periodontal evaluation every year," he advised. A dental professional, such as a periodontist, a specialist in the diagnosis, treatment and prevention of gum disease, can conduct a comprehensive exam to assess your periodontal disease status.