Age Related Macular Degeneration – The Link to Fast-Acting Carbohydrates

Age Related Macular Degeneration – The Link to Fast-Acting Carbohydrates. A study this year confirms earlier findings linking high consumption of fast-acting carbohydrates over time with age-related macular degeneration (AMD).

Scientists funded by the Agricultural Research Service (ARS) reported this month that consuming a "high glycemic-index" diet over a long period of time is associated with a higher risk of developing the early stages of a major eye disease, age-related macular degeneration, or AMD.

Consuming higher-than-average amounts of carbohydrates that cause blood sugar levels to spike and fall rapidly could be a risk factor for central vision loss with aging.

The study was led by Chung-Jung Chiu and Allen Taylor at the Jean Mayer USDA Human Nutrition Research Center on Aging in Boston, Mass., and is part of the Nutrition and Vision Project, a substudy of the federally funded Nurses' Health Study.

The researchers analyzed dietary intake and other data from more than 4,000 men and women aged 55 to 80 participating in the Age-Related Eye Disease Study, or AREDS.

Diets high in carbohydrates that are quickly digested and absorbed, resulting in a rapid rise in blood sugar levels, are considered high-glycemic-index diets. Examples of such "fast carbohydrate" foods are white bread, rice, potatoes and pasta, and also sugars and corn syrups.

Carbohydrates leading to a more gradual rise and fall in blood sugar levels comprise low-glycemic-index diets. Such "slow carbohydrate" foods include whole-grain versions of bread, rice and pasta.

Central vision loss is one of the first signs of age-related macular degeneration (AMD), a disease that is one of the leading causes of blindness among the elderly.

The macula is a yellow pigmented spot, one-eighth-inch wide, in the center of the retina toward the back of the eye. AMD is one of the leading causes of irreversible vision loss among those aged 40 or older in the United States.

Study participants were 526 women aged 53 to 73 years who did not have a history of age-related maculopathy, the early form of AMD. The scientists assessed the participants for macular disease and classified the results. They then compared the results with long-term dietary information that had been collected using questionnaires over a 10-year period prior to the macular disease assessment.

When ranked into three groups from highest to lowest in terms of dietary glycemic index, the participants who were ranked highest were well over two times more likely to have macular pigment abnormalities as those ranked lowest. An abnormal level of macular pigment is an early indicator of macular degeneration. The macula is responsible for the maximum ability to receive light and distinguish images.

Consuming a diet high in fast carbohydrates is also suspected of being involved in the vision loss that sometimes occurs in people with diabetes. The researchers theorize that the type of damage to eye tissue produced by fast carbohydrates could be similar in both age-related macular degeneration and diabetic eye disease.

Replacing fast carbohydrates with whole grains may soon prove to be an early dietary intervention to slow its progression.

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

Related articles:

The Glycemic Index: Good Carb, Bad Carb

The Dangers of Diabetes Patients Not Understanding Disease Risks

Adapted with permission from New Findings on Link Between Diet (April 27, 2006 ) and Vision Loss and Fast-Acting Carbs May Hasten Vision Loss Over Time (October 29, 2007), By Rosalie Marion Bliss, United States Department Of Agriculture, USDA, Agricultural Research Service (ARS)

References:

Chung-Jung Chiu, Larry D Hubbard, Jane Armstrong, Gail Rogers, Paul F Jacques, Leo T Chylack, Jr, Susan E Hankinson, Walter C Willett, and Allen Taylor. Dietary glycemic index and carbohydrate in relation to early age-related macular degeneration. Am. J. Clinical Nutrition, Apr 2006; 83: 880 - 886.

Chung-Jung Chiu, Roy C Milton, Gary Gensler, and Allen Taylor. Dietary carbohydrate intake and glycemic index in relation to cortical and nuclear lens opacities in the Age-Related Eye Disease Study. Am. J. Clinical Nutrition, May 2006; 83: 1177 - 1184.

Type 2 Diabetes - Cinnamon and Blood Sugar Levels

Type 2 Diabetes - Cinnamon and Blood Sugar Levels - Several compounds isolated from cinnamon may one day become the key natural ingredients in a new generation of products aimed at lowering blood sugar levels in people with type 2 diabetes. The polyphenolic polymers in cinnamon bark have antioxidant effects, which may provide synergistic benefits to persons with various forms of diabetes.

In 2004 ARS scientists and colleagues isolated and characterized several polyphenolic polymer compounds from cinnamon bark that could one day become natural ingredients in products aimed at lowering blood sugar levels.

The newly identified chemical structures were recently named in a patent application and described in the Journal of Agricultural and Food Chemistry. ARS chemist Richard A. Anderson co-authored the study with colleagues at the Beltsville (Maryland) Human Nutrition Research Center and two universities.

Impaired sugar and fat metabolism is present in millions of people and may lead to type-2 diabetes and cardiovascular diseases. In test tube assays using fat cells, the polyphenolic polymers were found to increase sugar metabolism a whopping 20-fold.

Insulin is a hormone made by the pancreas to regulate sugar metabolism. In people with type-2 diabetes, either the pancreas doesn't make enough insulin or the body is unable to use it correctly. Both conditions lead to unhealthy blood levels of sugar that would otherwise provide energy to muscles.

During a decade of efforts to find natural compounds that could help maintain normal blood sugar levels, the scientists tested several components of cinnamon. The newly characterized chemical structures are closely related to a previously reported chemical derivative of cinnamon, MHCP—methylhydroxychalcone polymer. The researchers also tested scores of other plant extracts, but none displayed insulin-enhancing activity near that of cinnamon.

"These new compounds increase insulin sensitivity by activating key enzymes that stimulate insulin receptors, while inhibiting the enzymes that deactivate them," says Anderson, who is with the Nutrient Requirements and Functions Laboratory.

"Polyphenols are known for their antioxidant, anticancer, and anti-inflammatory functions, but they have not been commonly known to improve insulin function," he says. "The polyphenolic polymers in cinnamon bark have antioxidant effects, which may provide synergistic benefits to persons with various forms of diabetes."

Last year, the researchers reported that less than a half-teaspoon of cinnamon daily for 40 days reduced by about 20 percent the blood sugar, cholesterol and triglyceride levels of 60 volunteers in Pakistan with Type 2 diabetes. But table cinnamon made from cinnamon bark contains fat-soluble compounds. Those compounds may accumulate in the body if ingested consistently as more than a spice over long periods of time.

Table cinnamon is made from cinnamon bark and contains both water-soluble and fat-soluble compounds. Fat-soluble compounds may accumulate in the body if ingested over a long period. At this time, there is no data on potential effects of long-term ingestion of table cinnamon. But the newly defined chemical structures noted above are isolated from water extracts of cinnamon and appear to be nontoxic in any quantity, according to Anderson.

He is with the BHNRC's Nutrient Requirements and Functions Laboratory in Beltsville.

"Insulin Imitators: Polyphenols Found in Cinnamon Mimic Job of Hormone" was published in the April 2004 issue of Agricultural Research magazine.

Source: Rosalie Marion Bliss, United States Department Of Agriculture, USDA, Agricultural Research Service Information Staff. Used with permission.

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ADHD – Are Sleep Disorders, Apnea Linked?

ADHD – Are Sleep Disorders, Apnea Linked? Breathing Problems During Sleep May Affect Mental Development in Infants and Young Children.

Children who have problems breathing during sleep tend to score lower on tests of mental development and intelligence than do other children their age, according to two studies funded by the National Institutes of Health (NIH). Both studies appear in the October issue of Journal of Pediatrics.

The first study, funded by the National Institute of Child Health and Human Development (NICHD), found that at one year of age, infants who have multiple, brief breathing pauses (apnea) or slow heart rates during sleep scored lower on mental development tests than did other infants of the same age.

The second study was funded primarily by the National Heart, Lung, and Blood Institute (NHLBI). Results show that 5-year-old children who had frequent snoring, loud or noisy breathing during sleep, or sleep apneas observed by parents scored lower on intelligence, memory, and other standard cognitive tests than other children their age. They were also more likely to have behavioral problems. (SEE ADHD Articles and News).

“The findings from these studies support other research that has shown that breathing problems during sleep are associated with serious health consequences in children,” said Carl E. Hunt, M.D., director of the NIH National Center on Sleep Disorders Research (NCSDR). “However, at this point we don’t know if the sleep problems during these episodes cause the decline in test scores or if the sleep episodes and the lower test scores are both related to some common underlying mechanism.”

More than 10 percent of young children have habitual snoring, the mildest form of sleep-disordered breathing (SDB). One to three percent of children have obstructive sleep apnea, a more severe form of SDB in which breathing stops briefly and repeatedly during sleep.

Sleep-disordered breathing is thought to be more common in toddlers and younger children than in older children because the younger ones are more likely to have large tonsils and adenoids, which can briefly block the airways in the back of the throat during sleep.

African American children are twice as likely to develop SDB compared to white children.

Children who are overweight or obese are also more likely to develop sleep-disordered breathing.

In the first study, researchers evaluated 256 full-term and preterm infants at one year of age with a standardized test that measured physical and mental development. The infants were part of the multi-center Collaborative Home Infant Monitoring Evaluation (CHIME) study.
The CHIME study sought to identify factors that could put infants at risk for sudden infant death syndrome (SIDS).

Participants included healthy infants as well as those at increased risk of SIDS because they had a history of prematurity, a life-threatening event during sleep, or a sibling who had died from SIDS. The infants’ breathing, heart rates, and blood oxygen levels were monitored electronically at home for the first 4-6 months of age.

The researchers found that infants who totaled more than five episodes of abnormally slowed heart rate or apnea during the period they were monitored scored lower on the mental development test at one year of age than did infants who experienced fewer or no such episodes. The episodes were often associated with drops in oxygen levels.

The lower mental development scores persisted even after data were adjusted to correct for other factors known to affect mental development in preterm infants. The study also found that full-term infants who experienced the abnormal episodes scored lower on the tests than did other full term infants, according to Hunt, the lead author, who conducted the research while at the Medical College of Ohio in Toledo.

The second study involved 205 children at 5 years of age. Researchers at Boston University School of Medicine compared neurocognitive function and behavior of 61 children with SDB symptoms to 144 children without symptoms.

Symptoms of sleep-disordered breathing, as reported by parents, included frequent snoring; heavy, loud, or noisy breathing during sleep; or observed apneas during sleep. An overnight sleep test (polysomnogram) was also performed to objectively measure the severity of sleep-disordered breathing.

The study found that children with sleep-disordered breathing symptoms scored lower on standard tests measuring executive function (attention and planning), memory, and general intelligence. These children also had significantly more behavioral problems than children without sleep-disordered breathing symptoms, based on parental survey scores.

“One of the more remarkable findings in this study was that the neurocognitive effects were significant even among the children who had mild symptoms of sleep-disordered breathing but no actual sleep apneas,” said Daniel Gottlieb, M.D., M.P.H., lead author of the study. “Parents need to be aware that their child’s snoring could signal serious problems.”

The mild sleep-disordered breathing symptoms associated primarily with snoring in these children result in frequent arousals and fragmented sleep, leading to poor sleep quality and hence to sleep deprivation.

Today’s findings are similar to other studies of children and adults that link poor sleep or sleep deprivation to problems with school (or job) performance, difficulties with memory and concentration, increased risk of injuries, and trouble controlling impulses, emotions, and behavior, especially in children.

“Unfortunately, the effects of poor sleep are often overlooked or misinterpreted in children. Rather than appearing sleepy like adults who are sleep deprived, children may in fact seem to be more active or even hyperactive,” comments Hunt.

In an accompanying editorial, Hunt notes that brain development is not complete until at least late childhood, and hence children may be uniquely vulnerable to sleep-disordered breathing symptoms and their consequences, especially if such symptoms begin during infancy or early childhood. Brain areas, such as the prefrontal cortex, which regulate executive function, might be particularly susceptible to damage from sleep-disordered breathing, writes Hunt.

In addition, other researchers have reported that the effects of sleep-disordered breathing appear to have long-term consequences for children. For example, a University of Louisville study found that young children who snored loudly and frequently were more likely to have lower grades in middle school – even several years after the breathing problem was treated or resolved.

“These two new studies point to the need for parents and pediatricians to be on the watch for what might appear to be less serious breathing problems in their babies and young children when they sleep,” notes Hunt. “If we can identify these children before the effects on mental development have occurred, the challenge then will be to identify possible ways to intervene and prevent any reduced potential for doing their best in school.”

Scientists have not yet determined safe and effective ways to reduce cardiorespiratory episodes in infants. In children, however, treatment for sleep-disordered breathing typically involves having the tonsils and adenoids surgically removed. (SEE ADHD Improved When Tonsils Removed).

In more severe cases, or for children who cannot have surgery, a machine known as continuous positive airway pressure (CPAP), which forces air into the air passages while the patient is sleeping, can be as effective in children as it is in adults with sleep apnea.

The health consequences associated with sleep-disordered breathing in children are gaining increasing recognition. In April 2002, the American Academy of Pediatrics established clinical practice guidelines on obstructive sleep apnea in children. The guidelines call for all children to be screened for snoring and for children diagnosed with obstructive sleep apnea to be treated.

Related Articles:

ADHD Improved When Tonsils Removed

ADHD: Fish oil increases attention, reduces hyperactivity, restlessness and impulsivity

ADHD – Is your child deficient in magnesium?

Reference:
NHLBI National Heart, Lung, and Blood Institute

Develop a Healthy Body Image instead of a Distorted Body Image

Develop a Healthy Body Image instead of a Distorted Body Image. Professor Barbara Lohse – “Body image is very complex. It's more that just weight. It's not about body image; it's about your whole image.”

K-State professor says body image may be body mirage.

MANHATTAN - A Kansas State University professor says that it is the mind that makes people who they are physically, socially and emotionally - not body image. But, according to Barbara Lohse, associate professor of human nutrition, a trend toward inaccurate body images is a cause for concern - not only for young children and teenagers, but also to those of all ethnicities, genders and ages.

Lohse said when people think about "body image," they automatically think of weight. However, body image consists of all aspects of the body. She said there are so many other attributes included in body image, such as height, shape of ears, face and nose. But according to Lohse, "People tend to focus on weight because it's something that can be changed yourself. Inaccurate body image is a huge problem," she said. "Body image is very complex. It's more that just weight."

Lohse said people are focusing on what they think about their looks rather than how they actually look. A person could be extremely tall and thin, and look great in the media's perspective, but in reality they might have nutrient deficiencies or eating disorders. On the other hand, a person could be extremely large because they consume a lot of calories, but in reality they eat the right foods and are very healthy. Lohse said the issue has been approached in the wrong direction.

"People think if they change their body first, then all other aspects of their life will improve. Really, if you focus on all other aspects of your life, like your job, activities, friends and family situations to become happier, then your body image will improve," she said.

Lohse's personal campaign is to focus on the "personal image" rather than "body image." For example, she wants her students to measure success based on friends, grades, activities, financial and life adjustments, and other happiness qualities. Lohse's "Weigh to Diet" publication online says that, rather than dieting for weight loss, the goal is to achieve well-being through eating, physical activity and self-acceptance.

HUGS, an adult weight management program mentioned in Lohse's publication, has a Health focus, centered on Understanding lifestyle behaviors, Group support and Self-esteem building. Lohse said if someone has a poor body image, it stunts everything else.

"If you have confidence in yourself, body image will improve intellectually without having to concentrate on it," she said.

Most importantly, Lohse wants people to have emotional intelligence and self-control. She suggests striving to be a "reasonable adventurer," or someone who has intelligence, close friendships, value judgment independence, toleration to ambiguity, a wide variety of interests and a sense of humor.

"It's not about body image; it's about your whole image, what kind of person you are and your abilities. Body image is just a hook to hang all your problems on," she said.
Lohse said it's also important to talk with children about what they see on television, and clarify body image inaccuracies. She said it's vital as a parent to be emotionally healthy yourself.

For more information about body image, read Lohse's "Weigh to Diet" publication online at http://www.oznet.ksu.edu/library/fntr2/MF2596.pdf or visit the HUGS Web site at http://www.hugs.com
Lohse can be reached at or by e-mail at [email protected]

Used with permission.

Kids and Calcium, Eat your Cereal!

Kids and Calcium, Eat your Cereal! Increasing a child's calcium intake can be as simple as reaching for a box of cereal.

Scientists at the ARS Children's Nutrition Research Center (CNRC) at Baylor College of Medicine have completed a study involving 27 Houston-area children, ages 6 to 9. They found that ready-to-eat cereals fortified with a moderate amount of calcium can help kids meet their calcium needs without decreasing iron absorption.

"We've been interested in strategies to evaluate the effects of adding specific nutrients to foods, because that's a major approach used in the United States and globally these days," says Dr. Steven A. Abrams, who led the study. "Children often don't take in enough calcium, so identifying and fortifying foods that kids commonly eat, such as breakfast cereals, can be helpful in meeting intake requirements. We're looking at whether or not this is an effective approach."

In 1997, the Food and Nutrition Board of the Institute of Medicine evaluated dietary requirements for calcium and related nutrients. In general, the board recommended higher intakes than previous standards.

Fortifying food products with additional calcium has become a widespread practice. It's now commonplace for many foods—especially beverages, like orange juice, and grain products, like cereal—to be fortified so that each serving provides at least 100 milligrams (mg) of calcium.

During the CNRC study, which was published in the Journal of Pediatrics, children were given two 1-ounce servings of cereal each day for 2 weeks. One of the servings was eaten at breakfast with milk; the other was eaten at lunch, as a snack, without milk.

Half the children received cereal fortified with 156 mg of calcium per ounce, while the others were given a non-fortified cereal containing 39 mg per ounce.

Calcium fortification was done by adding calcium carbonate to the dry-mix cereal before cooking.

At the end of the study, Abrams concluded that all the children absorbed about the same amount of iron per day. But those who ate the fortified cereal also absorbed about 50 mg more calcium, which is about equivalent to drinking an extra 2 ounces of milk.

"Breakfast is obviously a key meal, in terms of both children's school performance and their intake of important micronutrients. A nutritious breakfast cereal with milk can contribute a tremendous part of the vitamins and minerals a child needs," says Abrams. "A cereal-and-milk breakfast represents a major portion of a child's micronutrient intake for a day."

According to Dr. Abrams, increasing the amount of one nutrient in the diet can sometimes work against the absorption of others, but not in this case.

"We were pleased that increasing calcium absorption did not harm iron absorption," says Abrams.

Adequate calcium intake is thought to be essential to reducing the risk of bone fractures among children and preventing osteoporosis, or brittle bones, later in life.

This has been more recently supported by researchers reporting in the July 2005 edition of the American Journal Of Clinical Nutrition. They found that the long-term iron status of 113 adolescent (12-14 year old) girls does not seem to be compromised by high calcium intakes. (Am J Clin Nutr. 2005 Jul;82(1):98-102).

"Many scientists consider osteoporosis to be a 'pediatric-preventable' disease, so achieving maximum calcium absorption during childhood and adolescence is a key public health goal," says Abrams. "Anything we can do to enhance that in childhood and adolescence may be valuable."

Source: Alfredo Flores, USDA, Agricultural Research Service News & Events
Used with permission. 9/21/2004.

Related articles: Eating less fat may be unhealthy for children

Copyright 2007 Kevin Flatt. Disclaimer: The information contained in this article is presented for information purposes only and is in no way intended to replace professional medical care or attention by a qualified practitioner. It cannot and should not be used as a basis for diagnosis or choice of treatment.

Dealing with Depression during Pregnancy – Part 1

This article on Dealing with Depression during Pregnancy will be published on this site in 7 parts.

Background Information - Pregnancy and Severe Depression

Canadian researchers, reporting in BMC Women's Health September 2007, explored the experiences of 19 women in Ontario who were diagnosed with depression during their pregnancy.

Part of the aim of this research was to explore women’s experiences of depression during pregnancy. It is concerned with the women’s personal experiences, how they make sense of those experiences, and how those meanings relate to their management of the disorder.

The model that emerged from their analysis was becoming the best mom that I can.

From the women's perspective, becoming the best mom that I can was the process of “doing everything I could” to implement control over the perceived threat to their pregnancy and their ability to care for the baby after birth.

Becoming the best mom that I can explains the complex process of the women’s journey as they travel from the depths of despair, where the depression is perceived to threaten their pregnancy and their ability to care for the coming baby, to arrive at knowing the self and being in a better place.

Recruitment was conducted through a reproductive mental health program located in a major urban centre in southern Ontario. Purposely recruiting women from the reproductive mental health program and including only women with a psychiatrist diagnosed depression maximized the opportunity of interviewing women who could provide the best and clearest examples of the phenomenon of interest.

In order to reground the self and regain control of their lives, the women had to recognize the problem, overcome shame and embarrassment, identify an understanding healthcare provider, and consider the consequences of the depression and its management.

When confronting and confining the threat of depression, the women employed strategies of overcoming barriers, gaining knowledge, and taking control. As a result of counselling, medication, or a combination of both, women felt that they had arrived at a better place.

Recruitment was a two-step process. First, healthcare providers at the program contacted potential participants by letter alerting them to the study and asking those interested in participating to telephone the first author Heather A Bennett.

Second, women who contacted Heather Bennett were provided an explanation of the study, invited to ask questions, and an appointment was made to meet with women who wished to participate.

In this way, the women could be reassured that their healthcare provider would not know of their decision regarding participation in this study.

Potential participants were provided with a verbal explanation of the study and given the opportunity to ask questions during the initial telephone contact. Women who agreed to participate were given as much time as they required at the beginning of the meeting to read the study information sheet/informed consent form, to ask questions, and satisfy themselves as to the conditions and implications associated with their participation in this study.

Informed consent was obtained in writing prior to the start of the interview. Confidentiality was maintained by assigning each participant a code number. Nineteen women who had experienced depression during pregnancy, as diagnosed by a psychiatrist, participated in the study.

The 19 participants were between 25 and 47 years of age (average age = 36), of varied ethnic backgrounds, and of relatively high socioeconomic status (SES) compared with the general Canadian population. Twelve were university educated, 7 had completed college, and the majority had an annual household income in excess of $75,000 (CDN). Nine women had one child at the time of the interview, nine had two children and one had three children (two women had twins).

Seventeen sought mental health care during pregnancy and two delayed seeking care until the postpartum period. Fifteen women reported that they had experienced at least one episode of depression during their lifetime. Eight women were taking antidepressants prior to conception; three discontinued medication when planning their pregnancy and two upon confirmation of pregnancy. Four of the five who discontinued resumed antidepressants during pregnancy, the fifth resumed in the postpartum.

The pregnancy of interest, that is the pregnancy during which the woman was depressed, occurred on average 1 year (range = 0 to 2.5 years) prior to the interview. This relatively short time period between the pregnancy and the interview served to decrease the likely hood of recall error.

For many women, the idea that depression could occur during pregnancy was contradictory to their vision of the pregnant self. The challenge for a pregnant woman who is diagnosed with depression, is that effective care for her may jeopardize her baby’s future health. This provides a dilemma for about-to-be parents and their healthcare providers.

Improved awareness of depression during pregnancy on the part of healthcare professionals is needed to improve the women’s understanding of this disorder and their ability to recognize and seek help with depression should it occur during the prenatal period.

Major depressive disorder (MDD) is a chronic, recurrent illness associated with considerable disability, impaired quality of life and high economic costs. This serious illness interferes with a person’s ability to work, study, sleep, eat and enjoy themselves. It may appear once in a person’s life, but more often occurs several times. It is common in most countries, with annual rates in the adult population ranging from 7% to 13%. Depression is twice as prevalent in women as in men, and has been identified as a leading cause of disease burden for women aged 15 to 44 years globally.

The mean age of onset of depression for females ranges from the early 20s to early 30s, coinciding with the childbearing years of a woman’s life. The notion that pregnancy is a time of joyful expectation, a satisfying and fulfilling experience for all women, has been exposed as a myth. It is now clear that some women develop depression during pregnancy, while others with a history of depression are at risk for its recurrence. Indeed, an estimated 13% of pregnant women experience this disorder.

Part 2 will be published soon.

The researchers were Heather Bennett, Heather Boon, Sarah Romans and Paul Grootendorst. The above is a partially modified reproduction of their research. Also their references have been omitted for ease of reading.

Reference:

Bennett HA, Boon HS, Romans SE, Grootendorst P. Becoming the best mom that I can: women's experiences of managing depression during pregnancy – a qualitative study. BMC Women's Health 2007, 7:13 (11 September 2007). © 2007 Bennett et al., licensee BioMed Central Ltd.
This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.