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Tag Archives: Mortality

Getting More Exercise than Guidelines Suggest May Further Lower Death Risk

Doubling to quadrupling the minimum amount of weekly physical activity recommended for U.S. adults may substantially lower the risk of dying from cardiovascular disease and other causes, new research finds.

The study, published in the American Heart Association journal Circulation, found people who followed the minimum guidelines for moderate or vigorous long-term, leisure physical activity lowered their risk of dying from any cause by as much as 21%. But adults who exercised two to four times the minimum might lower their mortality risk by as much as 31%.

“Our study provides evidence to guide individuals to choose the right amount and intensity of physical activity over their lifetime to maintain their overall health,” study author Dong Hoon Lee said in a news release. Lee is a research associate in the department of nutrition at the Harvard T.H. Chan School of Public Health in Boston.

“Our findings support the current national physical activity guidelines and further suggest that the maximum benefits may be achieved by performing medium to high levels of either moderate or vigorous activity or a combination.”

The American Heart Association recommends adults get at least 150 minutes per week of moderate-intensity aerobic exercise, 75 minutes per week of vigorous aerobic exercise, or a combination of both. That advice is based on federal guidelines for physical activity.

For the new research, a team analyzed 30 years of medical records and mortality data for over 100,000 adults enrolled in two large studies: the all-female Nurses’ Health Study and all-male Health Professionals Follow-Up Study. The data included self-reported measures of leisure time physical activity intensity and duration. Participants were an average 66 years old.

In the study, moderate physical activity was defined as walking, lower-intensity exercise, weightlifting and calisthenics. Vigorous activity included jogging, running, swimming, bicycling and other aerobic exercises.

Going above and beyond the recommended minimums reaped greater longevity rewards, especially for moderate physical activity. Extra moderate-intensity exercise – 300 to 600 minutes per week – was associated with a 26%-31% lower risk of death from any cause compared with almost no long-term moderate-intensity exercise. By comparison, people who hit just the minimum goals for moderate physical activity had a lower risk of 20%-21%.

For vigorous physical activity, getting 150 to 300 minutes a week was linked to a 21%-23% lower risk of death from any cause compared to getting none. That compared to a 19% lower risk for people who just met the minimum exercise target.

People who reported meeting the recommendation for moderate physical activity had a 22%-25% lower risk of dying from cardiovascular disease, while those who exercised two to four times the recommendation had a 28%-38% lower risk, the analysis found. Those reporting the recommended amount of vigorous physical activity were 31% less likely to die from cardiovascular disease, while those who doubled to quadrupled the recommended target had a 27%-33% lower risk.

Engaging in more than 300 weekly minutes of vigorous or 600 weekly minutes of moderate physical activity did not provide any further reduction in death risk, the study found. But it also did not harm cardiovascular health. Prior research has suggested long-term, high-intensity endurance activities – such as marathons, triathlons and long-distance bicycle races – may increase the risk for cardiovascular problems, including sudden cardiac death.

“This finding may reduce the concerns around the potential harmful effect of engaging in high levels of physical activity observed in several previous studies,” Lee said.

Donna K. Arnett, incoming executive vice president for academic affairs and provost at the University of South Carolina, said in the release that the findings fit with what is already known about the heart health benefits of regular physical activity.

“We have known for a long time that moderate and intense levels of physical exercise can reduce a person’s risk of both atherosclerotic cardiovascular disease and mortality,” said Arnett, who helped write guidelines for cardiovascular disease prevention from the AHA and American College of Cardiology. She was not involved in the new research.

“We have also seen that getting more than 300 minutes of moderate-intensity aerobic physical activity or more than 150 minutes of vigorous-intensity aerobic physical exercise each week may reduce a person’s risk of atherosclerotic cardiovascular disease even further, so it makes sense that getting those extra minutes of exercise may also decrease mortality,” she said.


Source: American Heart Association

Loss of Male Sex Chromosome With Age Leads to Earlier Death for Men

Approximately 40% of men will lose their male sex chromosome in certain cells by age 70, and that can lead to deadly heart failure, a new study finds.

The loss of the male sex chromosome as many men age causes the heart muscle to scar and can lead to deadly heart failure, new research from the University of Virginia School of Medicine shows. The finding may help explain why men die, on average, several years younger than women.

UVA researcher Kenneth Walsh, PhD, says the new discovery suggests that men who suffer Y chromosome loss – estimated to include 40% of 70-year-olds – may particularly benefit from an existing drug that targets dangerous tissue scarring. The drug, he suspects, may help counteract the harmful effects of the chromosome loss – effects that may manifest not just in the heart but in other parts of the body as well.

On average, women live five years longer than men in the United States. The new finding, Walsh estimates, may explain nearly four of the five-year difference.

“Particularly past age 60, men die more rapidly than women. It’s as if they biologically age more quickly,” said Walsh, the director of UVA’s Hematovascular Biology Center. “There are more than 160 million males in the United States alone. The years of life lost due to the survival disadvantage of maleness is staggering. This new research provides clues as to why men have shorter lifespans than women.”

Y CHROMOSOME LOSS AND HEART HEALTH

While women have two X chromosomes, men have an X and a Y. But many men begin to lose their Y chromosome in a fraction of their cells as they age. This appears to be particularly true for smokers. The loss occurs predominantly in cells that undergo rapid turnover, such as blood cells. (Loss of the Y chromosome does not occur in male reproductive cells, so it is not inherited by the children of men who exhibit Y chromosome loss.) Scientists previously observed that men who suffer Y chromosome loss are more likely to die at a younger age and suffer age-associated maladies such as Alzheimer’s disease. Walsh’s new research, however, is believed to be the first hard evidence that the chromosome loss directly causes harmful effects on men’s health.

Walsh, of UVA’s Division of Cardiovascular Medicine and Robert M. Berne Cardiovascular Research Center,and his team used cutting-edge CRISPR gene-editing technology to develop a special mouse model to better understand the effects of Y chromosome loss in the blood. They found that the loss accelerated age-related diseases, made the mice more prone to heart scarring and led to earlier death. This wasn’t the result of just inflammation, the scientists determined. Instead, the mice suffered a complex series of responses in the immune system, leading to a process called fibrosis throughout the body. This tug-of-war within the immune system, the researchers believe, may accelerate disease development.

The scientists also looked at the effects of Y chromosome loss in human men. They conducted three analyses of data compiled from the UK Biobank, a massive biomedical database, and found that Y chromosome loss was associated with cardiovascular disease and heart failure. As chromosome loss increased, the scientists found, so did the risk of death.

POTENTIAL TREATMENT

The findings suggest that targeting the effects of Y chromosome loss could help men live longer, healthier lives. Walsh notes that one potential treatment option might be a drug, pirfenidone, that has already been approved by the federal Food and Drug Administration for the treatment of idiopathic pulmonary fibrosis, a form of lung scarring. The drug is also being tested for the treatment of heart failure and chronic kidney disease, two conditions for which tissue scarring is a hallmark. Based on his research, Walsh believes that men with Y chromosome loss could respond particularly well to this drug, and other classes of antifibrotic drugs that are being developed, though more research will be needed to determine that.

At the moment, doctors have no easy way to determine which men suffer Y chromosome loss. Walsh’s collaborator Lars A. Forsberg, of Uppsala University in Sweden, has developed an inexpensive polymerase chain reaction (PCR) test, like those used for COVID-19 testing, that can detect Y chromosome loss, but the test is largely confined to his and Walsh’s labs. Walsh, however, can foresee that changing: “If interest in this continues and it’s shown to have utility in terms of being prognostic for men’s disease and can lead to personalized therapy, maybe this becomes a routine diagnostic test,” he said.

“The DNA of all our cells inevitably accumulate mutations as we age. This includes the loss of the entire Y chromosome within a subset of cells within men. Understanding that the body is a mosaic of acquired mutations provides clues about age-related diseases and the aging process itself,” said Walsh, a member of UVA’s Department of Biochemistry and Molecular Genetics. “Studies that examine Y chromosome loss and other acquired mutations have great promise for the development of personalized medicines that are tailored to these specific mutations.”

The researchers have published their findings in the journal Science.


Source: University of Virginia

The Surprising Link Between COVID-19 Deaths and … Internet Access

Keren Landman wrote . . . . . . . . .

Two years into the pandemic, researchers are still trying to understand what makes some people more likely than others to die from Covid-19. Although we know some of the risk factors — like age and underlying disease — others are less obvious. Identifying them could ease our current pain, protect communities from future epidemics, and point us toward some of the societal fractures we should most urgently try to mend.

One of the more surprising answers to this question is one that appears to have a relatively straightforward solution: internet access.

This March, researchers at the University of Chicago published a study in the journal JAMA Network Open that showed one of the factors most consistently associated with a high risk of death due to Covid-19 in the US was the lack of internet access, whether broadband, dial-up, or cellular. This was regardless of other demographic risk factors like socioeconomic status, education, age, disability, rent burden, health insurance coverage, or immigration status.

The study authors estimated that for every additional 1 percent of residents in a county who have internet access, between 2.4 and six deaths per 100,000 people could be prevented, depending on the makeup of the region.

The findings held more surprises. The trend held true not just in rural areas with sparse internet access, but also in urban areas, where most homes can be wired for broadband internet. That is, people who could get internet access in cities but either don’t or can’t are also at increased risk of dying from Covid-19.

“We believe this finding suggests that more awareness is needed,” the study authors wrote in the paper. “Populations with limited internet access remain understudied and are often excluded in pandemic research.”

Still, questions remain. Why does internet access seem to be protective? And would increasing it yield meaningful improvements in public health?

The answers to those questions matter because while the American marketplace has generally treated internet access as a luxury, the Covid-19 pandemic has revealed that the ability to get online might be a matter of life or death.

America’s internet inequality, explained

Internet access has been inequitable for almost as long as there’s been an internet.

In 2000, when the Pew Research Center first began gathering data on Americans’ internet use, its researchers found large gaps: older Americans, low-income people, minorities, people with less education, and those who live in rural areas were less likely to be online.

While some of those gaps have since narrowed, most of them stubbornly remain. More than a quarter of Americans still don’t have home broadband internet, and the proportion without access is twice as high for those without any college education and those who earn less than $30,000 a year. Only 63 percent of rural homes have broadband access, as do about half of those living on tribal lands — even if they have a computer.

These inequities were not created by chance. In the US, private internet service providers developed the infrastructure for broadband internet access where it was profitable. As a consequence, many of the country’s most marginalized communities have the fewest, most expensive, and lowest-quality choices when it comes to an internet service provider.

As those access gaps persisted over the years, more and more health services came online. That left those without access unable to use telemedicine, or even easily look up information about health conditions. Over the last few years, researchers have started to see internet access, and in particular high-speed broadband, as a critical component of health — something vital for connecting people not only with health care, but also with food, housing, education, and income, all of which are considered social determinants of health.

Then, as Covid-19 pushed routine health care provider visits into the telehealth space, people without internet access — many of them already medically underserved — found health care even harder to access. Home broadband drew a sharper line than ever before between haves and have-nots; access to internet bandwidth suddenly determined access to educational instruction, economic stability, food pantry sign-ups, vaccine availability and safety information, human contact, and so many other resources.

Before the pandemic, broadband internet access was only occasionally described as a social determinant of health, but over the past two years, its centrality has crystallized. “Broadband internet access acts as a gateway to information and services,” said Natalie Benda, a health care informatics researcher who co-authored an editorial on the subject in the American Journal of Public Health.

Having broadband internet access means having access to education and financial stability, which on their own contribute to our well-being. The connections are so strong, Benda said, that the Federal Communications Commission is now framing broadband internet access as a “super” determinant of health.

There’s a huge amount of observational data showing broadband internet access tracks with other factors that predict health, like income, race, and education. However, there is almost no experimental data linking internet access with health outcomes themselves.

The pandemic provided an opportunity to accelerate our understanding of just how internet access is related to health because it exacerbated many of the existing inequalities underlying health disparities.

Linking internet access to Covid-19 mortality

Prior to the pandemic, the investigators might not have thought to include internet access as a variable, said Qinyun Lin, one of the study’s co-authors. However, another study had linked home broadband internet to Chicago-area Covid-19 mortality; that finding, combined with the team’s own pandemic experiences of retreating to life online, led them to consider internet access as essential in the Covid-19 context. The authors drew on census data on households without access to any form of internet, whether broadband, dial-up, satellite, or cellular. (Note: The study does not directly compare the impact of having broadband versus dial-up or any other category.)

In Lin’s study, internet access was the only factor associated with higher mortality rates in rural, urban, and suburban areas (the study also included measures of socioeconomic status, education, age, and other demographic risk factors). The effect was strong: In rural areas, a 1 percent decrease in a county’s internet access was associated with 2.4 deaths per 100,000 people. But the effect was even stronger in urban areas, where the same difference in access was associated with nearly six deaths per 100,000 people.

The investigators weren’t surprised to find that low internet access was associated with high death rates, said study coordinator and co-author Susan Paykin. But they were surprised by how strong the association was, and surprised by its presence in both rural and urban areas.

None of the other demographic variables the team examined — including socioeconomic status — were significant across all three types of communities, said Paykin. There’s a lot of attention and research put into broadband gaps in rural areas, “but I think that misses a lot of what’s clearly going on in suburban and urban communities,” she said. That means lack of internet access isn’t just a rural infrastructure problem. It’s likely a problem of affordability in cities as well.

Questions remain about the why of it all

Internet access doesn’t boost your immune system or filter your air — so what’s the mechanism explaining the robust relationship between low digital connectivity and high Covid-19 death rates?

The absence of internet access in a household can signify a variety of other factors that are known to increase the risk of dying from Covid-19: old age, housing problems, or difficulty accessing quality health care. But Lin’s study accounted for these characteristics in the analysis, suggesting the lack of internet access was the real source of risk.

Lin hypothesizes that it’s all about lacking information. “If they have limited access to the internet, they rely more on their personal network or their local network to get Covid-19-related information,” she said. That may lead to being influenced by low-quality information sowing distrust in vaccines, for example. But her study wasn’t designed to show why Covid-19 deaths were more common in counties where internet access was more scarce, she says, and more research is needed to answer this question.

New funding for broadband expansion will solve some access problems but not the root cause of them

The good news here is that internet access is a problem the US government has actually allocated money to solve.

In November, Congress passed an infrastructure bill that included $65 billion in funding for broadband internet expansion. Two-thirds of the funding will support the creation of infrastructure, largely in rural parts of each state, and an additional large chunk will pay for $30 monthly subsidies to help low-income households pay for internet access.

Smaller amounts have been earmarked for programs to teach new users the tech skills they need to use the internet, programs to expand access in tribal communities, and other initiatives.

That means a lot of the new money “gets funneled toward rural areas without access to what we consider basic broadband today,” said Ry Marcattilio-McCracken, a senior researcher with the Institute for Local Self-Reliance’s Community Broadband Networks Initiative.

In many ways, that’s a good thing: Because rural communities have not been profitable areas of development for the telecommunications monopolies that serve them, infrastructure to support rural access to even the lowest-speed broadband internet has been woefully underdeveloped.

But the bill doesn’t do as much to address disparities in areas that have good infrastructure but low affordability, said Marcattilio-McCracken. Residents of many cities cannot afford an $80 monthly bill for broadband internet, even with the $30 subsidies the new funding would provide. And because the bill disincentivizes competition, urban residents will not have new internet service providers to choose from any time soon.

One of the most promising solutions to urban internet insecurity — and one the Biden administration initially wrote into the bill — is the creation of cooperative community networks. These municipally run internet service providers are able to provide higher download speeds, lower prices, and better service to city residents — plus, they are relatively uncomplicated to set up, and as easy to sign up for as, say, city-run electrical utilities, Marcattilio-McCracken said.

They do require startup funding, he said, but ultimately, these providers prioritize access over profit. “They’ve got a whole different set of motives in building an operating infrastructure, and it means building more resilient communities,” Marcattilio-McCracken said.

“Broadband internet access should be a public utility,” Benda said, especially considering the research linking access to health. It’s a need, not a privilege; that means making it as accessible and adjustable as water or electricity use, she said.

Will expanding access improve health? It’s an experiment worth conducting.

Researchers know the lack of internet access is associated with poor health outcomes, but one thing still remains to be seen: Does expanding access work as an intervention to improve health?

In the coming years, the expansion of broadband will at least provide a natural experiment to test this question. Regardless, the pandemic has shown that increasing access is essential for so many reasons.

Improving internet access now would have positive effects that last beyond the pandemic, Paykin said. Telehealth and online learning for children and adults are likely here to stay. “This almost surely won’t be our last pandemic,” she said, nor our last public health emergency. Whatever challenges may come, increased broadband internet access seems likely to help people through them.


Source : Vox

Study: A Literature Review and Meta-Analysis of the Effects of Lockdowns on COVID-19 Mortality

Jonas Herby, Lars Jonung, and Steve H. Hanke wrote . . . . . . . . .

Abstract

This systematic review and meta-analysis are designed to determine whether there is empirical evidence to support the belief that “lockdowns” reduce COVID-19 mortality. Lockdowns are defined as the imposition of at least one compulsory, non-pharmaceutical intervention (NPI).

NPIs are any government mandate that directly restrict peoples’ possibilities, such as policies that limit internal movement, close schools and businesses, and ban international travel. This study employed a systematic search and screening procedure in which 18,590 studies are identified that could potentially address the belief posed. After three levels of screening, 34 studies ultimately qualified. Of those 34 eligible studies, 24 qualified for inclusion in the meta-analysis.

They were separated into three groups: lockdown stringency index studies, shelter-in-placeorder (SIPO) studies, and specific NPI studies. An analysis of each of these three groups support the conclusion that lockdowns have had little to no effect on COVID-19 mortality. More specifically, stringency index studies find that lockdowns in Europe and the United States only reduced COVID-19 mortality by 0.2% on average. SIPOs were also ineffective, only reducing COVID-19 mortality by 2.9% on average. Specific NPI studies also find no broad-based evidence of noticeable effects on COVID-19 mortality.

While this meta-analysis concludes that lockdowns have had little to no public health effects, they have imposed enormous economic and social costs where they have been adopted. In consequence, lockdown policies are ill-founded and should be rejected as a pandemic policy instrument.


Read the full report . . . . .

Feelings of Fatigue Predict Death in Older Adults

How fatigued certain activities make an older person feel can predict the likelihood death is less than three years away, according to research published today in the Journal of Gerontology: Medical Sciences by University of Pittsburgh epidemiologists. It is the first study to establish perceived physical fatigability as an indicator of earlier mortality.

Older people who scored the highest in terms of how tired or exhausted they would feel after activities were more than twice as likely to die in the following 2.7 years compared to their counterparts who scored lower. Fatigability was assessed for a range of activities using the novel Pittsburgh Fatigability Scale.

“This is the time of year when people make—and break—New Year’s resolutions to get more physical activity,” said lead author Nancy W. Glynn, Ph.D., associate professor in the Department of Epidemiology at Pitt’s Graduate School of Public Health. “I hope our findings provide some encouragement to stick with exercise goals. Previous research indicates that getting more physical activity can reduce a person’s fatigability. Our study is the first to link more severe physical fatigability to an earlier death. Conversely, lower scores indicate greater energy and more longevity.”

Glynn and her colleagues administered the Pittsburgh Fatigability Scale to 2,906 participants aged 60 or older in the Long Life Family Study, an international study that follows family members across two generations. Participants ranked from 0 to 5 how tired they thought or imagined that certain activities—such as a leisurely 30-minute walk, light housework or heavy gardening—would make them.

Follow-up for this work concluded at the end of 2019, to avoid any increased mortality impact from the COVID-19 pandemic, which gave the team an average of 2.7 years of data on each participant. After accounting for a variety of factors that influence mortality, such as depression, pre-existing or underlying terminal illness, age and gender, the team found that participants who scored 25 points or higher on the Pittsburgh Fatigability Scale were 2.3 times more likely to die in the 2.7 years after completing the scale, compared to their counterparts who scored below 25.

“There has been research showing that people who increase their physical activity can decrease their fatigability score,” said Glynn, a physical activity epidemiologist. “And one of the best ways to increase physical activity—which simply means moving more—is by setting manageable goals and starting a routine, like a regular walk or scheduled exercise.”

Beyond tying high fatigability to an earlier death, Glynn said the study demonstrates the value of the Pittsburgh Fatigability Scale, which she and colleagues created in 2014. It has since been translated into 11 languages.

“While the Pittsburgh Fatigability Scale has been widely adopted in research as a reliable, sensitive way to measure fatigability, it is underutilized in hospital settings and clinical trials,” Glynn said. “My ultimate goal is to develop a physical activity intervention targeting a reduction in fatigability as a means to stem the downward spiral of impaired physical function common with the aging process. By reducing fatigability, one can change how they feel, potentially motivating them to do more.”


Source: University of Pittsburgh


Diet High in Processed Meats Could Shorten Your Life

Cara Murez wrote . . . . . . . . .

That piece of sausage you’re about to enjoy? You may want to put it down for something healthier.

New research found an association between eating even small amounts of processed meats, 150 grams (a little over 5 ounces) per week, and a higher risk of major heart disease and death.

But not all meat is bad: The study, which includes data from 21 countries, also found that eating up to 250 grams (just under 9 ounces) per week of unprocessed meat, even red meat, was neutral in terms of cardiovascular disease.

Why are processed meats, such as hot dogs, cold cuts and bacon, considered to be so unhealthy?

“We believe this might be the result of food preservatives, food additives and color because if you compare, cholesterol and saturated fat in unprocessed and also processed are very similar, the difference is in food additives and color and nitrate,” said study author Mahshid Dehghan, an investigator at the Population Health Research Institute of McMaster University and Hamilton Health Sciences in Ontario, Canada.

Most past evidence on meat intake and health outcomes comes from studies that were done in North America, Europe and Japan. The amount and type of meat consumed in those areas differs from some other parts of the world, including South Asia and Africa, , according to the study.

Enter PURE, a long-term study that is tracking dietary habits and health outcomes of more than 164,000 people in countries that include those with low, middle and high incomes. The study launched in 2003. It uses food frequency questionnaires. Researchers also collected other health data.

In the study, unprocessed red meat was beef, lamb, veal and pork. Poultry included all birds. Processed meat was any meat that had been salted, cured or treated with food preservatives or additives.
The increased risk was incurred with even a small amount of processed meat, according to the study.

“I would say it’s about two servings per week. A medium-sized sausage is about 75 grams. Having two sausages per week is associated with this amount of increasing risk,” Dehghan said. “The message of our study is really limiting consumption, very limited amount of once in a while, not very frequent consumption.”

Despite the neutral finding on unprocessed meat, a news release sent with the study cautioned that red meat is a major source of medium- and long-chain saturated fatty acids, which may up the risk of cardiovascular disease.
The association between diet and disease isn’t linear, but is U-shaped, Dehghan said, with both insufficient and excessive amounts of certain foods being bad for you. Meat can be a good source of protein, iron and other essential nutrients, Dehghan explained, but consuming an excessive amount can add other risks.

The authors said more research is needed to improve understanding about meat consumption and health outcomes. For example, what participants with lower meat intake are eating instead may have an impact on health outcomes.

The study was published in the American Journal of Clinical Nutrition.

“When you look at comparing intake in countries who consume very little meat versus countries who do, it’s hard to draw conclusions,” said Connie Diekman, a food and nutrition consultant in St. Louis. “As a registered dietitian, my best message in looking at this study is let’s put this in with the bigger body of research where we know that the amount of meat we consume needs to be reduced versus the amount of plant foods.”

Diekman noted that limitations of the PURE study include that food frequency questionnaires can be inaccurate and that consumption varies a lot between countries.

“The study did point out when you look at those countries with higher consumption, you see more disease risk,” Diekman said.

Foods that contain higher amounts of saturated fats, including some meats, should be consumed in moderation and within an overall eating plan where there are a lot of fruits, vegetables, whole grains and low-fat dairy, she said. The body of evidence suggests that people should limit consuming processed meats.

“The bottom line when we look at animal foods, whether we’re talking the raw meat, the processed meat, the dairy foods, the whole animal line, is we do have more saturated fat in those animal foods and they need to be consumed in moderate amounts,” Diekman said.


Source: HealthDay

Estimated Total Deaths by Pandemic as a Percentage of the Global Population

Source : Deutsche Bank