Eating more plant foods may lower heart disease risk in young adults, older women

Woman holding crate of fresh vegetable

Eating more nutritious, plant-based foods is heart-healthy at any age, according to two research studies published today in the Journal of the American Heart Association, an open access journal of the American Heart Association.

In two separate studies analyzing different measures of healthy plant food consumption, researchers found that both young adults and postmenopausal women had fewer heart attacks and were less likely to develop cardiovascular disease when they ate more healthy plant foods.

The American Heart Association Diet and Lifestyle Recommendations suggest an overall healthy dietary pattern that emphasizes a variety of fruits and vegetables, whole grains, low-fat dairy products, skinless poultry and fish, nuts and legumes and non-tropical vegetable oils. It also advises limited consumption of saturated fat, trans fat, sodium, red meat, sweets and sugary drinks.

One study, titled "A Plant-Centered Diet and Risk of Incident Cardiovascular Disease during Young to Middle Adulthood," evaluated whether long-term consumption of a plant-centered diet and a shift toward a plant-centered diet starting in young adulthood are associated with a lower risk of cardiovascular disease in midlife.

"Earlier research was focused on single nutrients or single foods, yet there is little data about a plant-centered diet and the long-term risk of cardiovascular disease," said Yuni Choi, Ph.D., lead author of the young adult study and a postdoctoral researcher in the division of epidemiology and community health at the University of Minnesota School of Public Health in Minneapolis.

Choi and colleagues examined diet and the occurrence of heart disease in 4,946 adults enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Participants were 18- to 30-years-old at the time of enrollment (1985-1986) in this study and were free of cardiovascular disease at that time. Participants included 2,509 Black adults and 2,437 white adults (54.9% women overall) who were also analyzed by education level (equivalent to more than high school vs. high school or less). Participants had eight follow-up exams from 1987-88 to 2015-16 that included lab tests, physical measurements, medical histories and assessment of lifestyle factors. Unlike randomized controlled trials, participants were not instructed to eat certain things and were not told their scores on the diet measures, so the researchers could collect unbiased, long-term habitual diet data.

After detailed diet history interviews, the quality of the participants diets was scored based on the A Priori Diet Quality Score (APDQS) composed of 46 food groups at years 0, 7 and 20 of the study. The food groups were classified into beneficial foods (such as fruits, vegetables, beans, nuts and whole grains); adverse foods (such as fried potatoes, high-fat red meat, salty snacks, pastries and soft drinks); and neutral foods (such as potatoes, refined grains, lean meats and shellfish) based on their known association with cardiovascular disease.

Participants who received higher scores ate a variety of beneficial foods, while people who had lower scores ate more adverse foods. Overall, higher values correspond to a nutritionally rich, plant-centered diet.

"As opposed to existing diet quality scores that are usually based on small numbers of food groups, APDQS is explicit in capturing the overall quality of diet using 46 individual food groups, describing the whole diet that the general population commonly consumes. Our scoring is very comprehensive, and it has many similarities with diets like the Dietary Guidelines for Americans Healthy Eating Index (from the U.S. Department of Agriculture's Food and Nutrition Service), the DASH (Dietary Approaches to Stop Hypertension) diet and the Mediterranean diet," said David E. Jacobs Jr., Ph.D., senior author of the study and Mayo Professor of Public Health in the division of epidemiology and community health at the University of Minnesota School of Public Health in Minneapolis.

Researchers found:

• During 32 years of follow-up, 289 of the participants developed cardiovascular disease (including heart attack, stroke, heart failure, heart-related chest pain or clogged arteries anywhere in the body).
• People who scored in the top 20% on the long-term diet quality score (meaning they ate the most nutritionally rich plant foods and fewer adversely rated animal products) were 52% less likely to develop cardiovascular disease, after considering several factors (including age, sex, race, average caloric consumption, education, parental history of heart disease, smoking and average physical activity).
• In addition, between year 7 and 20 of the study when participants ages ranged from 25 to 50, those who improved their diet quality the most (eating more beneficial plant foods and fewer adversely rated animal products) were 61% less likely to develop subsequent cardiovascular disease, in comparison to the participants whose diet quality declined the most during that time.
• There were few vegetarians among the participants, so the study was not able to assess the possible benefits of a strict vegetarian diet, which excludes all animal products, including meat, dairy and eggs.

"A nutritionally rich, plant-centered diet is beneficial for cardiovascular health. A plant-centered diet is not necessarily vegetarian," Choi said. "People can choose among plant foods that are as close to natural as possible, not highly processed. We think that individuals can include animal products in moderation from time to time, such as non-fried poultry, non-fried fish, eggs and low-fat dairy."

Because this study is observational, it cannot prove a cause-and-effect relationship between diet and heart disease.

 

Lightning and subvisible discharges produce molecules that clean the atmosphere

Lightning strike

 Lightning bolts break apart nitrogen and oxygen molecules in the atmosphere and create reactive chemicals that affect greenhouse gases. Now, a team of atmospheric chemists and lightning scientists have found that lightning bolts and, surprisingly, subvisible discharges that cannot be seen by cameras or the naked eye produce extreme amounts of the hydroxyl radical -- OH -- and hydroperoxyl radical -- HO2.

The hydroxyl radical is important in the atmosphere because it initiates chemical reactions and breaks down molecules like the greenhouse gas methane. OH is the main driver of many compositional changes in the atmosphere.

"Initially, we looked at these huge OH and HO2 signals found in the clouds and asked, what is wrong with our instrument?" said William H. Brune, distinguished professor of meteorology at Penn State. "We assumed there was noise in the instrument, so we removed the huge signals from the dataset and shelved them for later study."

The data was from an instrument on a plane flown above Colorado and Oklahoma in 2012 looking at the chemical changes that thunderstorms and lightning make to the atmosphere.

But a few years ago, Brune took the data off the shelf, saw that the signals were really hydroxyl and hydroperoxyl, and then worked with a graduate student and research associate to see if these signals could be produced by sparks and subvisible discharges in the laboratory. Then they did a reanalysis of the thunderstrom and lightning dataset.

"With the help of a great undergraduate intern," said Brune, "we were able to link the huge signals seen by our instrument flying through the thunderstorm clouds to the lightning measurements made from the ground."

The researchers report their results online today (April 29) in Science First Release and the Journal of Geophysical Research -- Atmospheres.

Brune notes that airplanes avoid flying through the rapidly rising cores of thunderstorms because it is dangerous, but can sample the anvil, the top portion of the cloud that spreads outward in the direction of the wind. Visible lightning happens in the part of the anvil near the thunderstorm core.

"Through history, people were only interested in lightning bolts because of what they could do on the ground," said Brune. "Now there is increasing interest in the weaker electrical discharges in thunderstorms that lead to lightning bolts."

Most lightning never strikes the ground, and the lightning that stays in the clouds is particularly important for affecting ozone, and important greenhouse gas, in the upper atmosphere. It was known that lightning can split water to form hydroxyl and hydroperoxyl, but this process had never been observed before in thunderstorms.

What confused Brune's team initially was that their instrument recorded high levels of hydroxyl and hydroperoxyl in areas of the cloud where there was no lightning visible from the aircraft or the ground. Experiments in the lab showed that weak electrical current, much less energetic than that of visible lightning, could produce these same components.

While the researchers found hydroxyl and hydroperoxyl in areas with subvisible lightning, they found little evidence of ozone and no evidence of nitric oxide, which requires visible lightning to form. If subvisible lightning occurs routinely, then the hydroxyl and hydroperoxyl these electrical events create need to be included in atmospheric models. Currently, they are not.

According to the researchers, "Lightning-generated OH (hydroxyl) in all storms happening globally can be responsible for a highly uncertain but substantial 2% to 16% of global atmospheric OH oxidation."

"These results are highly uncertain, partly because we do not know how these measurements apply to the rest of the globe," said Brune. "We only flew over Colorado and Oklahoma. Most thunderstorms are in the tropics. The whole structure of high plains storms is different than those in the tropics. Clearly we need more aircraft measurements to reduce this uncertainty."

Other researchers at Penn State include Patrick J. McFarland, undergraduate; David O. Miller, doctoral recipient; and Jena M. Jenkins, doctoral candidate, all in meteorology and atmospheric science.

Mars has right ingredients for present-day microbial life beneath its surface, study finds

Mars illustration

 As NASA's Perseverance rover begins its search for ancient life on the surface of Mars, a new study suggests that the Martian subsurface might be a good place to look for possible present-day life on the Red Planet.

The study, published in the journal Astrobiology, looked at the chemical composition of Martian meteorites -- rocks blasted off of the surface of Mars that eventually landed on Earth. The analysis determined that those rocks, if in consistent contact with water, would produce the chemical energy needed to support microbial communities similar to those that survive in the unlit depths of the Earth. Because these meteorites may be representative of vast swaths of the Martian crust, the findings suggest that much of the Mars subsurface could be habitable.

"The big implication here for subsurface exploration science is that wherever you have groundwater on Mars, there's a good chance that you have enough chemical energy to support subsurface microbial life," said Jesse Tarnas, a postdoctoral researcher at NASA's Jet Propulsion Laboratory who led the study while completing his Ph.D. at Brown University. "We don't know whether life ever got started beneath the surface of Mars, but if it did, we think there would be ample energy there to sustain it right up to today."

In recent decades, scientists have discovered that Earth's depths are home to a vast biome that exists largely separated from the world above. Lacking sunlight, these creatures survive using the byproducts of chemical reactions produced when rocks come into contact with water.

One of those reactions is radiolysis, which occurs when radioactive elements within rocks react with water trapped in pore and fracture space. The reaction breaks water molecules into their constituent elements, hydrogen and oxygen. The liberated hydrogen is dissolved in the remaining groundwater, while minerals like pyrite (fool's gold) soak up free oxygen to form sulfate minerals. Microbes can ingest the dissolved hydrogen as fuel and use the oxygen preserved in the sulfates to "burn" that fuel.

In places like Canada's Kidd Creek Mine, these "sulfate-reducing" microbes have been found living more than a mile underground, in water that hasn't seen the light of day in more than a billion years. Tarnas has been working with a team co-led by Brown University professor Jack Mustard and Professor Barbara Sherwood Lollar of the University of Toronto to better understand these underground systems, with an eye toward looking for similar habitats on Mars and elsewhere in the solar system. The project, called Earth 4-D: Subsurface Science and Exploration, is supported by the Canadian Institute for Advances Research.

For this new study, the researchers wanted to see if the ingredients for radiolysis-driven habitats could exist on Mars. They drew on data from NASA's Curiosity rover and other orbiting spacecraft, as well as compositional data from a suite of Martian meteorites, which are representative of different parts of the planet's crust.

The researchers were looking for the ingredients for radiolysis: radioactive elements like thorium, uranium and potassium; sulfide minerals that could be converted to sulfate; and rock units with adequate pore space to trap water. The study found that in several different types of Martian meteorites, all the ingredients are present in adequate abundances to support Earth-like habitats. This was particularly true for regolith breccias -- meteorites sourced from crustal rocks more than 3.6 billion years old -- which were found to have the highest potential for life support. Unlike Earth, Mars lacks a plate tectonics system that constantly recycle crustal rocks. So these ancient terrains remain largely undisturbed.

The researchers say the findings help make the case for an exploration program that looks for signs of present-day life in the Martian subsurface. Prior research has found evidence of an active groundwater system on Mars in the past, the researchers say, and there's reason to believe that groundwater exists today. One recent study, for example, raised the possibility of an underground lake lurking under the planet's southern ice cap. This new research suggests that wherever there's groundwater, there's energy for life.

The cerebellum may have played an important role in the evolution of the human brain

Illustration of human brain, cerebellum highlighted

 The cerebellum -- a part of the brain once recognized mainly for its role in coordinating movement -- underwent evolutionary changes that may have contributed to human culture, language and tool use. This new finding appears in a study by Elaine Guevara of Duke University and colleagues, published May 6th in the journal PLOS Genetics.

Scientists studying how humans evolved their remarkable capacity to think and learn have frequently focused on the prefrontal cortex, a part of the brain vital for executive functions, like moral reasoning and decision making. But recently, the cerebellum has begun receiving more attention for its role in human cognition. Guevara and her team investigated the evolution of the cerebellum and the prefrontal cortex by looking for molecular differences between humans, chimpanzees, and rhesus macaque monkeys. Specifically, they examined genomes from the two types of brain tissue in the three species to find epigenetic differences. These are modifications that do not change the DNA sequence but can affect which genes are turned on and off and can be inherited by future generations.

Compared to chimpanzees and rhesus macaques, humans showed greater epigenetic differences in the cerebellum than the prefrontal cortex, highlighting the importance of the cerebellum in human brain evolution. The epigenetic differences were especially apparent on genes involved in brain development, brain inflammation, fat metabolism and synaptic plasticity -- the strengthening or weakening of connections between neurons depending on how often they are used.

The epigenetic differences identified in the new study are relevant for understanding how the human brain functions and its ability to adapt and make new connections. These epigenetic differences may also be involved in aging and disease. Previous studies have shown that epigenetic differences between humans and chimpanzees in the prefrontal cortex are associated with genes involved in psychiatric conditions and neurodegeneration. Overall, the new study affirms the importance of including the cerebellum when studying how the human brain evolved.

Among COVID-19 survivors, an increased risk of death, serious illness

COVID-19 test concept

As the COVID-19 pandemic has progressed, it has become clear that many survivors -- even those who had mild cases -- continue to manage a variety of health problems long after the initial infection should have resolved. In what is believed to be the largest comprehensive study of long COVID-19 to date, researchers at Washington University School of Medicine in St. Louis showed that COVID-19 survivors -- including those not sick enough to be hospitalized -- have an increased risk of death in the six months following diagnosis with the virus.

The researchers also have catalogued the numerous diseases associated with COVID-19, providing a big-picture overview of the long-term complications of COVID-19 and revealing the massive burden this disease is likely to place on the world's population in the coming years.

The study, involving more than 87,000 COVID-19 patients and nearly 5 million control patients in a federal database, appears online April 22 in the journal Nature.

"Our study demonstrates that up to six months after diagnosis, the risk of death following even a mild case of COVID-19 is not trivial and increases with disease severity," said senior author Ziyad Al-Aly, MD, an assistant professor of medicine. "It is not an exaggeration to say that long COVID-19 -- the long-term health consequences of COVID-19 -- is America's next big health crisis. Given that more than 30 million Americans have been infected with this virus, and given that the burden of long COVID-19 is substantial, the lingering effects of this disease will reverberate for many years and even decades. Physicians must be vigilant in evaluating people who have had COVID-19. These patients will need integrated, multidisciplinary care."

In the new study, the researchers were able to calculate the potential scale of the problems first glimpsed from anecdotal accounts and smaller studies that hinted at the wide-ranging side effects of surviving COVID-19, from breathing problems and irregular heart rhythms to mental health issues and hair loss.

"This study differs from others that have looked at long COVID-19 because, rather than focusing on just the neurologic or cardiovascular complications, for example, we took a broad view and used the vast databases of the Veterans Health Administration (VHA) to comprehensively catalog all diseases that may be attributable to COVID-19," said Al-Aly, also director of the Clinical Epidemiology Center and chief of the Research and Education Service at the Veterans Affairs St. Louis Health Care System.

The investigators showed that, after surviving the initial infection (beyond the first 30 days of illness), COVID-19 survivors had an almost 60% increased risk of death over the following six months compared with the general population. At the six-month mark, excess deaths among all COVID-19 survivors were estimated at eight people per 1,000 patients. Among patients who were ill enough to be hospitalized with COVID-19 and who survived beyond the first 30 days of illness, there were 29 excess deaths per 1,000 patients over the following six months.

"These later deaths due to long-term complications of the infection are not necessarily recorded as deaths due to COVID-19," Al-Aly said. "As far as total pandemic death toll, these numbers suggest that the deaths we're counting due to the immediate viral infection are only the tip of the iceberg."

The researchers analyzed data from the national health-care databases of the U.S. Department of Veterans Affairs. The dataset included 73,435 VHA patients with confirmed COVID-19 but who were not hospitalized and, for comparison, almost 5 million VHA patients who did not have a COVID-19 diagnosis and were not hospitalized during this time frame. The veterans in the study were primarily men (almost 88%), but the large sample size meant that the study still included 8,880 women with confirmed cases.

To help understand the long-term effects of more severe COVID-19, the researchers harnessed VHA data to conduct a separate analysis of 13,654 patients hospitalized with COVID-19 compared with 13,997 patients hospitalized with seasonal flu. All patients survived at least 30 days after hospital admission, and the analysis included six months of follow-up data.

The researchers confirmed that, despite being initially a respiratory virus, long COVID-19 can affect nearly every organ system in the body. Evaluating 379 diagnoses of diseases possibly related to COVID-19, 380 classes of medications prescribed and 62 laboratory tests administered, the researchers identified newly diagnosed major health issues that persisted in COVID-19 patients over at least six months and that affected nearly every organ and regulatory system in the body, including:

• Respiratory system: persistent cough, shortness of breath and low oxygen levels in the blood.
• Nervous system: stroke, headaches, memory problems and problems with senses of taste and smell.
• Mental health: anxiety, depression, sleep problems and substance abuse.
• Metabolism: new onset of diabetes, obesity and high cholesterol.
• Cardiovascular system: acute coronary disease, heart failure, heart palpitations and irregular heart rhythms.
• Gastrointestinal system: constipation, diarrhea and acid reflux.
• Kidney: acute kidney injury and chronic kidney disease that can, in severe cases, require dialysis.
• Coagulation regulation: blood clots in the legs and lungs.
• Skin: rash and hair loss.
• Musculoskeletal system: joint pain and muscle weakness.
• General health: malaise, fatigue and anemia.

While no survivor suffered from all of these problems, many developed a cluster of several issues that have a significant impact on health and quality of life.

Among hospitalized patients, those who had COVID-19 fared considerably worse than those who had influenza, according to the analysis. COVID-19 survivors had a 50% increased risk of death compared with flu survivors, with about 29 excess deaths per 1,000 patients at six months. Survivors of COVID-19 also had a substantially higher risk of long-term medical problems.

"Compared with flu, COVID-19 showed remarkably higher burden of disease, both in the magnitude of risk and the breadth of organ system involvement," Al-Aly said. "Long COVID-19 is more than a typical postviral syndrome. The size of the risk of disease and death and the extent of organ system involvement is far higher than what we see with other respiratory viruses, such as influenza."

In addition, the researchers found that the health risks from surviving COVID-19 increased with the severity of disease, with hospitalized patients who required intensive care being at highest risk of long COVID-19 complications and death.

"Some of these problems may improve with time -- for example, shortness of breath and cough may get better -- and some problems may get worse," Al-Aly added. "We will continue following these patients to help us understand the ongoing impacts of the virus beyond the first six months after infection. We're only a little over a year into this pandemic, so there may be consequences of long COVID-19 that are not yet visible."