Four years ago, Stanley Hazen, MD, PhD, Chair of Cellular and Molecular Medicine, and colleagues made a landmark discovery linking intestinal bacteria to heart disease. His team found that when our digestive systems digest the nutrients carnitine and choline (abundant in red meat and eggs, respectively), a bacterial waste product called TMAO is formed. They showed that high levels of TMAO are associated with higher rates of heart attack, stroke and cardiac death.

Now, Dr. Hazen’s team has discovered a naturally occurring TMAO inhibitor called DMB, which is found in some cold-pressed extra virgin olive oils and grape seed oils. DMB blocks the production of TMAO and reduces atherosclerosis (hardening of the arteries) in mice fed a diet containing high levels of choline. The discovery was published in the December 17, 2015, issue of the prestigious journal Cell.

This exciting discovery opens the door to preventing diet-induced heart disease by targeting the intestinal, or “gut,” bacteria. Heart disease is the number one killer in the United States, a fact which is commonly associated with the typical “Western” diet. Therefore, a therapeutic intervention may help save the lives of some of the nearly 400,000 Americans who die each year of heart disease.

Interestingly, although DMB targets a bacterial pathway, it is not an antibiotic. Therefore, its use will not contribute to antibiotic overuse or resistance, which is a worldwide health crisis.

“Many chronic diseases like atherosclerosis, obesity and diabetes are linked to gut microbes,” said Dr. Hazen. “These studies demonstrate the exciting possibility that we can prevent or retard the progression of diet-induced heart diseases starting in the gut. This opens the door in the future for new types of therapies for atherosclerosis, as well as other metabolic diseases.

Newswise —

Vascular surgery appears to be safer than stenting for patients over 70 years of age with carotid stenosis, or a blockage of the carotid arteries in the neck, according to new findings published today in the Lancet.

The international study, led by investigators at the University of Alabama at Birmingham, looked at the two standard methods for treating plaque buildup in the carotid arteries: a surgical procedure called carotid endarterectomy against carotid artery stenting.

The surgical procedure, or CEA, involves surgeons’ opening up the artery to remove plaque. It is an invasive surgery first done in 1946. Stenting is a newer, less invasive procedure in which a catheter is threaded through blood vessels, usually from the groin, to the affected area in the artery. A balloon is used to open the blocked artery, and a mesh stent is placed to hold it open.

“Stenting was hailed as a less invasive alternative to surgery, one that avoided many of the hazards and risks inherent in a surgical procedure,” said George Howard, Dr.P.H., professor in the Department of Biostatistics in the UAB School of Public Health and the study’s first author. “What we find, however, is that the risk of stroke in patients over the age of 70 is twice that with stenting than with the surgical CEA procedure.”

The study looked at data from four randomized controlled trials within the Carotid Stenosis Trialists’ Collaboration with patients with symptomatic carotid stenosis. Collectively, 4,754 patients were followed. Age was not associated with increased stroke risk for either surgery or stenting in patients under age 70; but stent patients over 70 had an increased risk, particularly in the immediate time frame of the procedure.

“These findings are very conclusive — stenting has a higher risk for stroke over carotid surgery in the older patient, older than 70,” Howard said. “This study should help drive decision-making and establish appropriate practice guidelines in the treatment of carotid stenosis.”

Howard says the stenting procedure itself seems to be causing the increased risk.

“The risk appears centered on the periprocedural period, the time during and immediately after the procedure,” Howard said. “The risk does not appear to continue in the months or years following the procedure.”

Howard acknowledges that advances in stenting, such as the routine use of closed-cell stents, which seem to be associated with lower rates of procedural stroke and the development of novel protection systems, might allow safe stenting for elderly people in the future.

“But for now, stenting in an older population needs to be done with great caution,” he said.

In addition to investigators at UAB, the international study included investigators from Cardiovascular Associates of the Southeast, Birmingham, Alabama; Clinic for Radiology and Neuroradiology, UKSH Campus Kiel, Kiel, Germany; Department of Radiology, University Medical Center Utrecht, Utrecht, Netherlands; Nuffield Department of Surgical Sciences, John Radcliffe Hospital, Oxford, U.K.; Department of Vascular Surgery, Medical University of Innsbruck, Innsbruck, Austria; Department of Vascular and Endovascular Surgery, Vascular Center, Klinikum rechts der Isar der Technischen Universität München, Munich, Germany; Department of Neurology, Hôpital Sainte-Anne, Université Paris-Descartes, DHU Neurovasc Sorbonne Paris Cité, INSERM U894, Paris, France; Clinical Trial Service Unit and Epidemiological Studies Unit, Oxford University, Oxford, U.K.; Department of Neurology and Stroke Center, University Hospital Basel, Basel, Switzerland; Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, University College London, London, U.K.; and Department of Vascular Surgery, University of Paris, XII, Hôpital Henri Mondor, Paris.

Newswise

March is Colon Cancer Awareness Month, and the perfect time to think about colon health.

Unfortunately, less than half of people aged 50 and older get tested for colon cancer. But early detection can save lives. Colorectal cancer is the third most commonly diagnosed cancer and the second leading cause of cancer death in the US, yet it has a 90 percent cure rate when detected early, according to the American Cancer Society (ACS).

“We say the best screening is the one that actually gets done,” says Dr. Judy Yee, professor and vice chair of Radiology and Biomedical Imaging at University of California, San Francisco.

CT Colonography (CTC) or “virtual colonoscopy” — a less invasive, safe and sedation-free alternative to the colonoscopy — is increasing colorectal screening rates. CTC uses high-tech, low-dose X-rays to produce moving images of the colon, which doctors examine to detect colorectal cancer and precancerous polyps.

If you’re interested in avoiding a colonoscopy, but want to get the screening needed to verify your colorectal health, consider the following about CTC, an ACS recommended screening test:

• Comprehensiveness: The exam can detect abnormalities outside of the colon, including early-stage cancers in the liver, kidney and lungs, and can pinpoint potentially dangerous conditions, like aneurysms. In this way, it serves as two or even more detection tests in one.

• Accuracy: CTC is just as accurate as a colonoscopy for detecting clinically significant polyps and cancers; however, you don’t have to undergo sedation. There’s no need to take time off work or have someone drive you from the hospital.

• Affordability: This exam costs a fraction of the price of a standard colonoscopy and is covered by several major insurers. Your insurance company can verify whether CTC is covered under your plan.

• Non-Invasive: While a colonoscopy is the standard procedure, there is a small risk of serious complications associated with the test. However, CTC is non-invasive, as no needles or scopes enter the body. Only a small tube is placed in the bottom of the colon to help distend the colon for viewing.

• Improved Screening Rates: Availability of CTC screening significantly boosts colorectal cancer screening rates, according to studies at National Military Medical Centers in Bethesda, MD, and San Diego.

The US Preventive Services Task Force recently released draft recommendations naming CTC as an “alternative screening test,” and Medicare is currently reviewing coverage of this test in order to provide seniors with a lifesaving alternative.

Bottom line: not enough people are getting screened for colon cancer. Whatever screening alternative you prefer, make sure you schedule this vital appointment and encourage loved ones to do the same.

(StatePoint)

Poor physical fitness in middle age may be linked to a smaller brain size 20 years later, according to a study published in the February 10, 2016, online issue of Neurology®, the medical journal of the American Academy of Neurology.

“We found a direct correlation in our study between poor fitness and brain volume decades later, which indicates accelerated brain aging,” said study author Nicole Spartano, PhD, with Boston University School of Medicine in Boston.

For the study, 1,583 people enrolled in the Framingham Heart Study, with an average age of 40 and without dementia or heart disease, took a treadmill test. They took another one two decades later, along with MRI brain scans. The researchers also analyzed the results when they excluded participants who developed heart disease or started taking beta blockers to control blood pressure or heart problems; this group had 1,094 people.

The participants had an average estimated exercise capacity of 39 mL/kg/min, which is also known as peak VO2, or the maximum amount of oxygen the body is capable of using in one minute. Exercise capacity was estimated using the length of time participants were able to exercise on the treadmill before their heart rate reached a certain level. For every eight units lower a person performed on the treadmill test, their brain volume two decades later was smaller, equivalent to two years of accelerated brain aging. When the people with heart disease or those taking beta blockers were excluded, every eight units of lower physical performance was associated with reductions of brain volume equal to one year of accelerated brain aging.

The study also showed that people whose blood pressure and heart rate went up at a higher rate during exercise also were more likely to have smaller brain volumes two decades later. Spartano said that people with poor physical fitness often have higher blood pressure and heart rate responses to low levels of exercise compared to people with better fitness.

Spartano noted that the study is observational. It does not prove that poor physical fitness causes a loss of brain volume; it shows the association.

“While not yet studied on a large scale, these results suggest that fitness in middle age may be particularly important for the many millions of people around the world who already have evidence of heart disease,” she said.

The study was supported by the National Heart, Lung and Blood Institute, the National Institutes of Health and the American Heart Association.