Mild cognitive impairment: Reducing blood pressure can lower risk

A recent study in older people suggests that reducing blood pressure to levels below the usual standard can lessen the risk of mild cognitive impairment, which is a condition that often precedes dementia.

Scientists at the Wake Forest School of Medicine in Winston-Salem, NC, led a randomized clinical trial involving just under 9,400 adults in their 50s or older with high blood pressure.

The objective of the trial, as the investigative team notes in the JAMA study paper, was to "evaluate the effect of intensive blood pressurecontrol on risk of dementia."

The older adults received either intensive blood pressure control or standard treatment.

The purpose of intensive control was to bring systolic blood pressure below 120 millimeters of mercury (mm Hg), while that of standard treatment was to lower it to under 140 mm Hg.

Systolic blood pressure is the pressure in the arteries when the heart contracts. It is usually the first number in a blood pressure measurement, as in "140 mm Hg over 80 mm Hg," for instance.

The results revealed that significantly fewer of those who received intensive blood pressure control went on to develop mild cognitive impairment (MCI), compared with those on the standard treatment.

"In the study," says lead investigator Dr. Jeff D. Williamson, who is a professor of gerontology and geriatric medicine at the Wake Forest School of Medicine, "we found that just 3 years of lowering blood pressure not only dramatically helped the heart but also helped the brain."

The trial did not show the same result for dementia: Intensive blood pressure control did not reduce the incidence of dementia, compared with standard control.

Dr. Williamson comments that while there was a "15 percent reduction in dementia in the intensively controlled group, we were disappointed that the results did not achieve statistical significance for this outcome."

However, the authors suggest that low numbers and the study finishing earlier than planned could be reasons for this.

Dementia and MCI

Dementia is a general term for illnesses that affect the brain and in which there is a decline in behavior, thinking, memory, and the ability to carry out everyday tasks.

Alzheimer's, which is a disease that progressively destroys brain tissue, is the main cause of dementia.

According to the World Health Organization (WHO) around 60–70 percent of the 50 million people worldwide who are living with dementia have Alzheimer's.

Many people who have a disability or who cannot care for themselves have dementia. Although it typically affects older people, it is not a normal consequence of aging.

MCI is a condition in which the affected individuals and the people around them notice some loss of mental capacity. This can include, for example, forgetting important appointments, losing the thread of a conversation, and having difficulties reasoning and making decisions.

However, the changes that occur with MCI are not so severe that they prevent the person from taking care of themselves and getting on with everyday life.

MCI affects around 15–20 percent of those aged 65 or older. Having MCI raises the risk of developing dementia, especially if the symptoms suggest problems with memory.

Not everyone who has MCI, however, will develop dementia. The condition can remain stable or, in some cases, even reverse.

Experts are not sure what causes MCI but strongly suspect that many cases are due to changes in the brain wrought by diseases such as Alzheimer's and other forms of dementia.

Being of older age, having a family history of dementia, and having conditions that increase the risk of developing cardiovascular disease are the strongest risk factors for MCI.

There are currently no approved drugs in the United States for the treatment of MCI. Also, drugs approved for the relief of Alzheimer's disease have not done much to stop or prevent MCI from progressing to dementia.

Degrees of blood pressure control

High blood pressure affects more than half of the over-50s and more than three-quarters of those over the age of 65.

Previous studies that have followed groups of people over time have suggested that blood pressure is a "modifiable risk factor" for dementia and MCI.

The investigation that Dr. Williamson and colleagues undertook was part of the Systolic Blood Pressure Intervention Trial (SPRINT) run by the National Institutes of Health (NIH).

The data came from 9,361 individuals aged 50 or older whose systolic blood pressure was at least 130 mm Hg. They all had at least one further risk factor for cardiovascular disease but no history of stroke, diabetes, or polycystic kidney disease.

Recruitment took place between 2010 and 2013 at 102 centers in the U.S., including Puerto Rico. The average age of the cohort was 68 years, 28 percent of the cohort were aged 75 or older, 35.6 percent were female, 30 percent were African-American, and 10.5 percent were Hispanic.

Source: Medical News Today

Is green tea good for BPH?

Benign prostatic hyperplasia is the medical term for an enlarged prostate. There is continuing research into alternative ways to manage the condition, including by drinking green tea.

Polyphenols are the active ingredients in green tea that may be responsible for helping manage benign prostatic hyperplasia or BPH.

Polyphenols are chemical compounds found in a category called phytochemicals, which occur naturally in plants.

Various studies have shown that the prostate absorbs polyphenols more easily than other tissues in the body. This suggests that the prostate should be receptive to polyphenols when used in the management of BPH.

Why manage BPH with green tea?

Green tea has increased in popularity and is now the second most consumed beverage in the world.

As a beverage, green tea is an alternative to coffee and soft drinks, with the added health benefits from the polyphenol compounds present.

Polyphenols are plentiful in plant foods, and are:

• antioxidants
• anti-inflammatory
• anti-carcinogenic

What are the active ingredients in green tea?

Green tea's active ingredients include:

• epigallocatechin (EGC)
• gallic acid
• chlorogenic acid
• caffeic acid
• other polyphenols

In recent animal trials and in vitro studies in laboratories, one particular polyphenol called epigallocatechin-3-gallate (EGCG) appears to have promising results. EGCG reduced the over-production of cells and even prevented the onset of BPH.

What do the studies say?

It is worth noting that most studies into green tea have been done outside the human body, for example, in lab cultures or animals. These studies also use concentrated versions of polyphenols, not the green tea itself, or other whole foods.

Overall, specific polyphenols, some of which occur in green tea, have been found to treat the causes and symptoms of BPH. This suggests that green tea could assist in managing BPH alongside medications and other treatments.

Other health benefits of green tea

Green tea has a wide variety of health benefits due to its anti-inflammatory and antioxidant properties.

Obesity and diabetes

The benefits of green tea are not only due to anti-inflammatory and antioxidant properties. The drink may help in the treatment of obesity and non-insulin dependent diabetes mellitus.

Studies suggest that green tea might help with weight management, alongside exercise and improvement of diet. More studies are needed, however, to confirm the positive effects conclusively.

Metabolic syndrome

Green tea may also be able to assist in glucose control in people with metabolic syndrome.

Furthermore, some studies suggest there is a link between metabolic syndrome and diseases of the prostate.

Metabolic syndrome causes an increase in free radicals in the body. This increases oxidative stress, which is considered a risk factor for developing BPH.

Increasing intake of polyphenol-containing foods such as green tea may help manage metabolic syndrome and other conditions at the same time.

Medical News Today

What are the treatment options for BPH?

An enlarged prostate can affect a person's ability to urinate, which can impact on their quality of life. Treatment options for an enlarged prostate include watchful waiting, medication, minimally invasive procedures, and surgery. Certain lifestyle changes can also help to prevent or improve symptoms.

In this article, we look at treatment options, lifestyle changes, and promising natural treatments for an enlarged prostate.

What is an enlarged prostate?

The prostate is a small gland that sits between the penis and the bladder. It functions as part of the male reproductive system.

If the prostate becomes enlarged, it can place pressure on the bladder and the urethra, which is the tube that carries urine from the bladder out through the penis. The medical term for an enlarged prostate is benign prostatic hyperplasia, or BPH.

BPH is a common health condition in older people. In the United States, according to the National Institute of Diabetes and Digestive and Kidney Diseases, BPH affects:

• around 50 percent of men aged 51–60 years
• up to 90 percent of men over the age of 80

Common symptoms of BPH include:

• needing to urinate more than eight times a day
• being unable to delay urination
• waking up frequently at night to urinate
• straining to urinate or having difficulty starting urination
• having a weak or intermittent urine stream
• being unable to empty the bladder completely, which is called urinary retention
• urinating accidentally, or urinary incontinence
• dribbling after urinating

Treatment options

BPH is a progressive condition, which means that if a person does not get treatment, their symptoms may get worse over time. Treatment options for BPH include:

Watchful waiting

The primary stage of BPH treatment is usually called watchful waiting. During watchful waiting, the affected individual will be:

• learning about BPH
• making positive lifestyle changes, such as becoming more physically active
• taking no further action until their symptoms change

A doctor will also work with the individual and keep a close eye on their condition. Many people with an enlarged prostate remain at this level of care for some time.

Medication

When BPH becomes more advanced, a doctor may recommend medication. Medication can help to control the growth of the prostate and reduce the symptoms of BPH. Common medications for BPH include:

Alpha blockers. These can relax prostate muscles and improve the functioning of the urinary system.

Phosphodiesterase-5 (PDE5) inhibitors. Doctors primarily prescribe these for erectile dysfunction. However, PDE5 inhibitors can also relax muscles in the urinary tract to help relieve symptoms of BPH.

5-alpha-reductase inhibitors. These may help to limit the growth of the prostate gland in people with BPH.

Combination medications. A doctor may recommend the concurrent use of two or more different types of medication to help improve BPH symptoms.

Minimally invasive procedures

When medication alone does not relieve the symptoms of BPH, the next level of treatment typically involves minimally invasive procedures. During these procedures, a doctor will insert an instrument into a person's urethra or rectum to either destroy excess prostate tissue or widen the urethra.

Surgery

If medication and minimally invasive procedures are unable to improve the symptoms of BPH sufficiently, a doctor may recommend surgery. A person may also require surgery if their symptoms become severe or if complications develop. Potential complications include:

• pain or severe difficulty with urination
• recurrent urinary tract infections
• blood in the urine
• sexual dysfunction
• stones in the bladder
• kidney damage

Surgery is not uncommon for people with BPH. According to the Urology Care Foundation, around 150,000 men in the U.S. undergo transurethral resection of the prostate (TURP) for BPH each year. TURP is the most common type of surgery for BPH in the U.S., but there are now several other surgical options.

Some procedures can take place under local anesthetic on an outpatient basis, but others are likely to require full anesthesia and a hospital stay.

Medical News Today

The truth about 'Blue Monday'

Each year around this time, the internet starts going abuzz with warnings about the dreaded "Blue Monday," the so-called most depressing day of the year. Where did the Blue Monday concept originate, and is it a real phenomenon?

A quick internet search will reveal that today, the 21st of January, is supposedly Blue Monday, the worst day of the year, when doom and gloom govern the general mood.

Blue Monday does not fall on the same date each year, but it has to be a Monday (of course), and it has to be in January, and it is usually the third Monday of the first month of the year.

Truth be told, today, as I write this article, I am not in the best of shapes. Fighting off a stubborn and painful cold, stressed by pressing deadlines, and worried about the challenges that the week ahead may present, I am tempted to say that the Blue Monday label is fitting for a day like today.

But then again, I had the flu last week as well, and stress-inducing deadlines are a common occurrence in my line of work, so why not call every less-than-perfect Monday a "Blue" Monday? What makes today so uniquely gloomy? Or perhaps a better question would be: "Is the third Monday of January truly the gloomiest day of the year?"

In this Spotlight feature, we find out where the concept of Blue Monday originated, how this date is calculated, and whether or not there is any truth to the idea.

A forgotten marketing campaign

According to reports from various online sources, Blue Monday originated with psychologist Cliff Arnall in 2005, when he came up with the concept as part of a marketing campaign for the now-defunct company Sky Travel.

In order to determine which day in January Blue Monday would fall on each year, Arnall came up with a complex formula that takes into account a variety of factors, including: weather, level of debt, monthly salary, time elapsed since Christmas, how long a person has failed to keep their New Year's resolutions, motivational levels, and need to take action.

The premise is that the gloomiest day of the year would be marked by bad weather, guilt over not being able to keep up with the goals set for the year, money worries, and the contrast between the recent holiday cheer and the harsh return to mundane reality.

While all of these variables may seem like valid factors when it comes to calculating the worst day of the year, specialists have pointed out, time and again, that these variables are impossible to determine, making the equation utterly unscientific.

There is no way to measure "time since failure to keep New Year's resolution" for every single person on the planet, and January weather is vastly different among countries and continents.

In fact, as I write this, the weather in New York is -14°C (7°F), but in Brighton, United Kingdom — where the Medical News Today office is based — we are enjoying a balmy 5°C (41°F), while the inhabitants of Sydney, Australia are bracing for an "intense hot spell."

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What is the best diet for osteoarthritis?

M

any people find that making changes to their diet can help with osteoarthritis symptoms, which include pain, stiffness, and swelling.

Osteoarthritis is the most common form of arthritis, affecting over 30 million adults in the United States. It develops when the cartilage in the joints breaks down over time.

The condition can affect any joint in the body, but people often notice it in their knees, hands, hips,

or spine.

This article will look at which foods people with osteoarthritis should include in their diet and which they should avoid. We also bust some common food myths regarding arthritis.

How can diet help with osteoarthritis?

Consuming a balanced and nutritious diet may help prevent further damage to the joints.

It is not possible for specific foods or nutritional supplements to cure osteoarthritis, but, according to the Arthritis Foundation, certain diets can improve people's symptoms.

Some foods have anti-inflammatory capabilities which can help reduce symptoms while other foods may amplify them.

The right diet can help to improve osteoarthritis in the following ways:

Reducing inflammation and preventing damage

A balanced, nutritious diet will give the body the tools it needs to prevent further damage to the joints, which is essential for people with osteoarthritis.

Some foods are known to reduce inflammation in the body, and following an anti-inflammatory diet can improve symptoms. Eating enough antioxidants, including vitamins A, C, and E, may help to prevent further damage to the joints.

Reducing cholesterol

People with osteoarthritis are more likely to have high blood cholesterol, and reducing cholesterol may improve the symptoms of this disease. On the right diet, people can quickly improve their cholesterol levels.

Maintaining a healthy weight

Being overweight can put extra pressure on the joints, and excess fat stores in the body can cause further inflammation. Maintaining a healthy weight can lessen the symptoms of osteoarthritis.

Keeping to a healthy weight can be difficult for some people, especially those who have a medical condition that reduces their mobility, such as osteoarthritis. A doctor or dietitian will be able to provide advice.

Eight foods to eat and why

Including specific foods in the diet can strengthen the bones, muscles, and joints and help the body to fight inflammation and disease.

People with osteoarthritis can try adding the following eight foods to their diet to ease their symptoms:

1. Oily fish

Salmon contains lots of omega-3 fatty acids, which have anti-inflammatory properties.

Oily fish contain lots of healthful omega-3 fatty acids. These polyunsaturated fats have anti-inflammatory properties so they may benefit people with osteoarthritis.

People with osteoarthritis should aim to eat at least one portion of oily fish per week. Oily fish include:

·         sardines

·         mackerel

·         salmon

·         fresh tuna

Those who prefer not to eat fish can take supplements that contain omega-3 instead, such as fish oil, krill oil, or flaxseed oil.

Other sources of omega-3 include chia seeds, flaxseed oil, and walnuts. These foods can also help to fight inflammation.

2. Oils

In addition to oily fish, some other oils can reduce inflammation. Extra virgin olive oil contains high levels of oleocanthal, which may have similar properties to nonsteroidal anti-inflammatory drugs (NSAIDs).

Avocado and safflower oils are healthful options and may also help to lower cholesterol.

3. Dairy

Milk, yogurt, and cheese are rich in calcium and vitamin D. These nutrients increase bone strength, which may improve painful symptoms.

Dairy also contains proteins that can help to build muscle. People who are aiming to manage their weight can choose low-fat options.

4. Dark leafy greens

Dark leafy greens are rich in Vitamin D and stress-fighting phytochemicals and antioxidants. Vitamin D is essential for calcium absorption and can also boost the immune system, helping the body to fight off infection.

Dark leafy greens include:

·         spinach

·         kale

·         chard

·         collard greens

5. Broccoli

Broccoli contains a compound called sulforaphane, which researchers believe could slow the progression of osteoarthritis.

This vegetable is also rich in vitamins K and C, as well as bone-strengthening calcium.

6. Green tea

Polyphenols are antioxidants that experts believe may be able to reduce inflammation and slow the rate of cartilage damage. Green tea contains high levels of polyphenols.

7. Garlic

Scientists believe that a compound called diallyl disulfide that occurs in garlic may work against the enzymes in the body that damage cartilage.

8. Nuts

Nuts are good for the heart and contain high levels of calcium, magnesium, zinc, vitamin E, and fiber. They also contain alpha-linolenic acid (ALA), which boosts the immune system.

Can you have flare-ups of osteoarthritis?

Osteoarthritis may flare up from time to time, particularly after eating trigger foods. Learn more about how to prevent and treat a flare-up here.

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What about the Mediterranean diet?

Studies have suggested that the Mediterranean diet can reduce the inflammation that contributes to the symptoms of osteoarthritis.

As well as helping to reduce the pain associated with osteoarthritis, eating a Mediterranean-style diet offers many other health benefits, including weight loss.

Following a Mediterranean diet may also reduce the risk of:

·         heart disease and stroke

·         muscle weakness in older age

·         Alzheimer's disease

·         Parkinson's disease

·         premature death

The diet consists of fruit and vegetables, whole grains, legumes, fish, yogurt, and healthful fats, such as olive oil and nuts.

People can make simple changes to their diet to make it more like the Mediterranean one. These may include:

·         eating high-fiber, starchy foods, such as sweet potatoes, potatoes, beans, lentils, and whole-grain bread and pasta

·         eating plenty of fruit and vegetables

·         including fish in the diet

·         eating less meat

·         choosing products made from vegetable and plant oils, such as olive oil

·         selecting wholemeal options over those containing refined flour

Three types of food to avoid and why

People should avoid processed sugars as they may contribute to inflammation.

When someone is living with osteoarthritis, their body is in an inflammatory state.

While foods with anti-inflammatory properties may reduce symptoms, some foods contain substances that actively contribute to this inflammation. It is best to avoid or restrict these dietary choices.

The types of food to avoid are those that include the following:

1. Sugar

Processed sugars can prompt the release of cytokines, which act as inflammatory messengers in the body. The sugars that manufacturers add to sweetened beverages, including soda, sweet tea, flavored coffees, and some juice drinks, are the most likely to worsen inflammatory conditions.

2. Saturated fat

Foods high in saturated fat, such as pizza and red meat, can cause inflammation in the fat tissue. As well as contributing to the risk of developing obesity, heart disease, and other conditions, this can make arthritis inflammation worse.

3. Refined carbohydrates

Refined carbohydrates, such as white bread, white rice, and potato chips, fuel the production of advanced glycation end (AGE) oxidants. These can stimulate inflammation in the body.

Busting three arthritis food myths

Many people claim that certain types of food can make osteoarthritis worse, but there is not always scientific evidence to support their theories.

Below, we discuss three common myths:

1. Citrus fruits cause inflammation

Some people believe that they should avoid citrus fruits because the acidity is inflammatory. However, this is not the case. In fact, citrus fruits have anti-inflammatory benefits, as well as being rich in vitamin C and antioxidants.

Grapefruit juice can, however, interact with some medicines that doctors use to treat arthritis. People who are undergoing treatment should check with a doctor before incorporating it into their diet.

2. Avoiding dairy helps with osteoarthritis

There are also claims that avoiding dairy can help with osteoarthritis. Although milk, cheese, and other dairy products can be problematic for some people, these foods can have anti-inflammatory effects in others.

People who have inflammatory symptoms relating to gout may find skimmed and low-fat milk protective against this condition.

An elimination diet can help people to determine whether or not their symptoms improve or worsen with dairy intake.

3. Nightshade vegetables cause inflammation

Tomatoes, potatoes, eggplants, and peppers all contain the chemical solanine, which some blame for arthritis pain. However, the Arthritis Foundation say that there is no scientific evidence for this. Adding these nutritious vegetables to the diet can have many benefits for chronic health conditions.

Takeaway

There is evidence that certain foods and nutrients can improve the symptoms of osteoarthritis. They do this by fighting inflammation, providing nutrition, and boosting bone, muscle, and immune system function.

People may also benefit from avoiding or restricting foods that contribute to inflammation.

Being overweight or obese places extra pressure on the joints, which can make the symptoms of osteoarthritis worse.

Eating a balanced diet rich in plants, fiber, and anti-inflammatory fats, such as those that the Mediterranean diet includes, can help people living with osteoarthritis to maintain a healthy weight.

This will help to ease symptoms, such as pain and swelling.

Source: MedicalNewsToday