Few pro athletes suffer heart disease after mild COVID, says study

There are few cases of inflammatory heart disease among professional athletes who suffer mild cases of COVID-19, according to a study authored by medical experts from Major League Baseball (MLB), the National Basketball Association (NBA) and other major North American sports leagues.

Medical personnel from MLB and the NBA, along with the National Football League (NFL), National Hockey League (NHL), Major League Soccer (MLS) and the Women's National Basketball Association (WNBA) pooled data from athletes from May through October 2020, as professional sports in North America slowly returned to action after coronavirus-linked lockdowns.

The retrospective study, the first of its kind among the six leagues and published by JAMA Cardiology on Thursday, showed that five of 789 athletes who tested positive for COVID-19 during that time were found to have inflammatory heart disease after mandatory "return-to-play" cardiac testing.

"It does show that in this population of athletes it is safe to return and that inflammatory heart disease is relatively uncommon," said Dr. Gary Green, medical director for MLB, who confirmed that all were able to return to play.

None of the people in the study were hospitalized due to COVID-19 infection and none would have been classified as "seriously ill," Green told Reuters.

More than half a million people in the United States have died from the novel coronavirus, as government officials scramble to roll out vaccines and stem the spread of the highly contagious virus.

"The study was sort of designed to answer the uncertainty that there was surrounding this issue about whether cardiac inflammation was present in people who had mild or asymptomatic forms of COVID-19 illness," said Dr. David Engel, the consulting cardiologist for the NBA and a co-author of the study.

Numerous professional athletes have opted out of playing since the COVID-19 pandemic first took hold in North America, amid concerns over the long-term impact of the virus.

Boston Red Sox pitcher Eduardo Rodriguez missed the 2020 season after contracting the novel coronavirus and subsequently being diagnosed with myocarditis. He since said he plans to play in 2021.

"Being athletic doesn't necessarily protect them anymore than if they were sort of an age-matched non-athlete," said Engel. "The cardiac inflammation that you can see with COVID-19 or really with any virus poses a unique risk to athletes because myocarditis, if it's present, it can cause a lethal or a dangerous arrhythmia when the heart is stimulated."

The report offered little insight into the impact of the novel coronavirus on female athletes, with the WNBA the only North American women's league included in the study. Just 12 WNBA players tested positive for COVID-19 during the study's timeframe. 

-reuters-

The 4-second workout

Four seconds of high-intensity exertion repeated periodically throughout the day may counteract some of the unhealthy metabolic consequences of sitting for hours, according to a surprising and timely new study of the potentially large benefits of diminutive workouts.

The study relied on a specialized type of stationary bicycle that few of us will have available at home, but its implications remain broadly applicable and suggest that even a few minutes — or seconds — of exercise each day could help substantially to bolster our health.

For most of us, sitting is our default posture and was, even before the shelter-at-home edicts took effect across the globe. Epidemiological studies indicate that most American adults sit for a least 10 hours a day, a total that is likely to have risen now that many of us are home all day.

The health effects of this inactivity can be considerable, with studies linking prolonged sitting to increased risks for heart disease, Type 2 diabetes and other metabolic disruptions. In particular, multiple hours of sitting can contribute to a later rise in the bloodstream of fatty acids, known as triglycerides, probably in part because muscles at rest produce less than contracting muscles do of a substance that breaks up triglycerides. High levels of triglycerides, in turn, are linked to an increased risk of heart disease and other metabolic problems.


In theory, exercise should help fight this problem, since it entails muscular contractions. But some experiments hint that one workout may not be enough. In studies conducted at the University of Texas at Austin in recent years, healthy young people who sat all day for the sake of science showed higher-than-normal levels of triglycerides in their blood the next day after a fatty meal. The sitting had left their metabolisms less able to break up and clear away the fat.

Even when the young people interrupted another full day of sitting with a 1-hour run, they continued to experience difficulties with fat metabolism the next day. The researchers speculated that the long hours of sitting may have changed the volunteers’ physiologies in ways that rendered them “resistant” to the expected, beneficial metabolic effects of physical activity.

Those studies had deployed a single moderately paced workout, however. Recently, the researchers began to wonder whether more-frequent, brief spurts of exercise throughout the day, especially if they were intense, may better stave off the undesirable effects of sitting.

So, for the new study, published in April in Medicine & Science in Sports & Exercise, the Texas scientists recruited eight healthy young people and asked them to spend a full day at the lab, rising only to eat or visit the bathroom. The next morning, the volunteers returned or a high-fat breakfast of melted ice cream and half and half, while the scientists monitored their bodies’ metabolic response during the next 6 hours.

Then, on a separate day, the volunteers sat again, except for a few seconds each hour, when they sprinted.

These sprints took place on an unusual type of stationary bicycle with a heavy flywheel and no resistance that has been used at the physiology lab to test the leg and lung power of professional athletes. In those tests, athletes generated a tsunami of power and achieved all-out exertion within about two seconds of pedaling.

The scientists reasoned that if athletes needed two seconds of pedaling to reach maximum exertion, the rest of us probably would require, say, twice as much. So, they asked their volunteers to clamber on the bikes and sprint as hard as possible for four seconds, then stop pedaling, rest for 45 seconds, and sprint again, repeating that sequence 5 times.

The volunteers completed these brief interval sessions once every hour for 8 hours, for a total of 160 seconds of actual exercise that day. Otherwise they sat, then returned the next day to down the unctuous breakfast shake.

Their metabolic responses differed this time, though, the researchers found. The volunteers arrived at the lab with lower blood levels of triglycerides to start with and burned more fat during the next 6 hours, so their triglycerides remained about 30 percent lower throughout the 6 hours of monitoring than on the morning after nonstop sitting.

The results suggest that frequent, intense and extremely abbreviated exercise “can undo” some effects of being sedentary, said Ed Coyle, a professor of kinesiology and health education at the University of Texas, who conducted the study with his graduate student Anthony Wolfe and others. (Coyle has equity in the company that manufactures the bicycles at his lab but said his stake did not influence the design of the study or reporting of results.)

This was a small, short-term study, and its results are limited. They do not tell us if the desirable metabolic outcomes after sprinting linger past the next day or whether 4-second intervals represent the right dose of exercise or merely the teensiest. The study also relied on an uncommon type of bicycle. Standard stationary bicycles or spin-class versions would likely require us to sprint for more than four seconds to reach an all-out exertion level, Coyle said. So would racing up and down stairs or jogging in place.

But the underlying theory of the study remains achievable, he adds. When you find yourself sitting for most of the day, try to rise frequently and move, preferably intensely, as often as possible and for as many seconds as you can manage.

2020 The New York Times Company

Half of statins patients don't hit 'healthy' cholesterol levels

PARIS, France - Millions of patients around the world taking statins to lower the risk of heart disease fail to achieve the recommended levels of cholesterol reduction after two years of treatment, new research said Monday.

Statins -- a class of medicines designed to reduce cholesterol linked to heart disease and strokes -- are among the most commonly prescribed drugs in the United States and Britain.

The cholesterol-lowering industry is worth billions of dollars, but guidelines over who should take statins are often unclear.

A team of researchers in Britain reviewed public health records of 165,000 patients taking the medicine and found that fewer than one in two reached the recommended "healthy" 40 percent cholesterol reduction within two years.

"Statins do work and are effective, but some trials have highlighted there have been variations in responses among some patients," said Ralph Kwame Akyea, research associate at the University of Nottingham's Faculty of Medicine and Health Sciences.

"But we've shown there are some people not reaching this (safe cholesterol level) and the reducing of their risk is lower," he told AFP.

Akyea's study, published in the journal Heart, found that people on average started taking statins aged 62. It found nearly 23,000 cases of cardiovascular disease within six years of statin treatment among patients. 

In total, 51 percent of patients had an insufficient drop in cholesterol even while taking the drugs. 

Akyea stressed that the study -- the largest of its kind to date -- could not establish why some patients responded positively to statins while others didn't.

"Probably some people would have stopped taking their medication, maybe they had side effects," he said. 

"There might also be a role played by genetic variation. Not everyone responds to the medication and there are currently studies looking at the genetics of drug response."

MILLIONS MORE PATIENTS EXPECTED

Recent changes to prescription guidelines are set to see statins given to more than 55 million people in the US and 12 million people in Britain in the next few years.

Akyea and his team suggested that better guidance and monitoring was needed to ensure those given statins were taking the correct doses for the prescribed amount of time. 

Writing in a linked editorial, Marcio Bittencourt, from Sao Paulo's University Hospital, said the study's results were "clearly alarming". 

He stressed, however, that statins had been shown to significantly reduce the likelihood of heart attacks and strokes in a large percentage of at-risk patients. 

"Patients and society should be educated on the scientific evidence documenting the benefits of lipid lowering therapy," said Bittencourt. 

"Anti-statin propaganda based on pseudoscience should be strongly disavowed."

pg/mh/pvh

source: news.abs-cbn.com

Coffee-drinkers less likely to die from certain diseases

People who report drinking three to five cups of coffee per day are less likely to die prematurely from heart disease, suicide, diabetes or Parkinson's disease, US researchers said.

Both caffeinated and decaffeinated coffee were shown to have benefits, said the study by researchers at the Harvard University Chan School of Public Health published in the November 16 edition of the journal Circulation.

The study compared people who don't drink coffee, or drank less than two cups daily, to those who reported drinking "moderate" amounts of coffee, or up to five cups daily.

The study did not prove a cause-and-effect for coffee and the reduced likelihood of certain diseases, but uncovered an apparent link that aligns with previous research, and that scientists would like to probe further.

"Bioactive compounds in coffee reduce insulin resistance and systematic inflammation," said first author Ming Ding, a doctoral student in the Department of Nutrition.

"That could explain some of our findings. However, more studies are needed to investigate the biological mechanisms producing these effects."

No protective effect was found against cancer in this study. Some previous research has pointed to a link between coffee consumption and a lower risk of certain cancers.

The study was based on data gathered from three large, ongoing surveys including some 300,000 nurses and other health professionals who agree to answer questionnaires about their own medical conditions and habits at regular intervals over the course of 30 years.

"In the whole study population, moderate coffee consumption was associated with reduced risk of death from cardiovascular disease, diabetes, neurological diseases such as Parkinson's disease, and suicide," said the findings.

Researchers also accounted for potential confounding factors such as smoking, body mass index, exercise, alcohol consumption, and diet. But the fact that the research relied on surveys, which use self-reported behavior, could raise questions about its reliability.

And experts warned that coffee -- a substance adored by many devotees -- may not be right for everyone.

"Regular consumption of coffee can be included as part of a healthy, balanced diet," said senior author Frank Hu, professor of nutrition and epidemiology at Harvard.

"However, certain populations such as pregnant women and children should be cautious about high caffeine intake from coffee or other beverages."

source: www.abs-cbnnews.com

Smoking worsens diabetes complications

People with type 2 diabetes who smoke have significantly higher risks of heart disease, stroke, and death than diabetic non-smokers, a new study shows.

They also had higher risks of clogged arteries, heart failure, and reduced blood flow to the limbs.

The risks were lower for diabetics who quit smoking, but still moderately higher than risks among never smokers, the researchers write in the journal Circulation.

Lead author An Pan told Reuters Health by email that smoking is still common among people with diabetes, despite efforts to discourage it.

“We wanted to know whether smoking was related to total mortality and cardiovascular events among diabetic patients, and whether smoking cessation would reduce the risks,” said Pan, who is a professor at Huazhong University of Science and Technology in China.

According to the Centers for Disease Control and Prevention, smoking can worsen the health risks that go along with diabetes, such as heart and kidney disease, nerve damage, and blindness.

Pan’s team pooled the data from 89 earlier studies of smoking among adults with type 2 diabetes and found that diabetic smokers were around 1.5 times more likely to experience clogged arteries, stroke, overall heart disease, and heart failure.

In addition, smokers were more than twice as likely to suffer from peripheral artery disease, or reduced blood flow to the limbs, than patents who did not smoke.

Former smokers had 1.2 times the risk of clogged arteries and 1.1 times the risk of overall heart disease, compared to never-smokers.

Using the risk estimates from their review and global rates of deaths from diabetes, the researchers estimated that smoking accounted for 14.6 percent of deaths in diabetic men and 3.3 percent of deaths in diabetic women worldwide.

Dr. Wael Al-Delaimy, division chief of global health at the University of California, San Diego, said part of the problem may be the care diabetes patients receive.

“The physician caring for the diabetes patient might be focusing on cardiovascular risk factors or diabetes complications and diet and weight control while neglecting smoking as another important risk factor,” Al-Delaimy told Reuters by email.

Pan said some smokers may be reluctant to quit due to concerns about gaining weight in the short term. However, he noted, “The long-term benefits clearly overweigh the short-term side effects.”

Pan advises diabetic patients who are smokers “to seek professional help to quit smoking.”

Al-Delaimy agreed, saying, “If you are a patient suffering from diabetes and smoking cigarettes, or if you know a family member, friend or anyone else who is diabetic and smoking, there is still opportunity to substantially decrease further complications and suffering or even early death by quitting smoking.”

source: www.abs-cbnnews.com

Depressed adolescents face increased heart disease risk

Adolescents with major depression or bipolar disease face an increased risk of early heart disease and may need early intervention to prevent it, according to a scientific statement from the American Heart Association (AHA).

“We expect that the statement itself will come as quite a surprise to most,” said Dr. Benjamin I. Goldstein from Sunnybrook Health Sciences Center in Toronto, who chaired the committee that issued the report.

“This is precisely what makes the statement so important and potentially impactful; it takes a largely unrecognized and under-appreciated body of evidence, and positions it squarely on center stage,” Goldstein told Reuters Health in an email.

Goldstein and his coauthors say major depression affects nearly 9 percent of U.S. adolescents. Bipolar disorder, the fourth most disabling condition, affects about 2.6 percent of U.S. adolescents.

The National Institute of Mental Health explains on its web site that people with major depression have persistent severe symptoms that interfere with their ability to work, sleep, study, eat, and enjoy life. In bipolar disorder, which is less common, people have mood changes that go back and forth between extreme highs (e.g., mania) to extreme lows (e.g., depression).

In developing the new scientific statement, Goldstein and his colleagues evaluated the existing data at the behest of the AHA’s Council on Cardiovascular Disease in the Young.

Although research on the association between these mood disorders and heart disease is limited, what is available shows a significant increase in traditional heart disease risk factors in adolescents with major depression or bipolar disorder, the team reported in the journal Circulation.

These risk factors include obesity, high blood pressure, and unhealthy cholesterol levels.

Childhood maltreatment, sleep disorders, physical inactivity, and smoking – factors common in adolescents with depression and bipolar disorder – can also contribute to an increased heart disease risk.

Even the treatments (antidepressants and mood-stabilizing medications) can cause weight gain and other metabolic changes that increase the risk of heart disease, the statement points out.

Based on the available data, the authors say, these adolescents should be considered to be at moderate risk for early heart disease.

Prevention efforts should focus on maintaining a healthy weight and blood pressure, healthy levels of cholesterol, and blood sugar in the normal range. The first step in achieving these targets is intensive lifestyle management that emphasizes regular physical activity, a healthy-heart diet, and, if necessary, weight loss.

“When considering cardiovascular risk among youth with mood disorders, screen more and take action earlier and at lower thresholds,” Goldstein advised.

Dr. Viola Vaccarino from Rollins School of Public Health at Emory University in Atlanta, who wasn’t involved in developing the statement, told Reuters Health, “It is time to end the traditional separation between mental health and physical health. Stigma from mental disorders remains widespread and results in low recognition and management of psychiatric problems outside of mental health clinics. But cardiovascular disease and depression are linked conditions; they both rank highest as causes of disability in the United States, and (are) also rapidly growing worldwide.”

“Cardiovascular disease is a chronic, progressive condition that starts in youth, even if the disease becomes clinically manifest later in life,” Vaccarino concluded. “This is why identification of risk conditions such as depression early in life provides an important opportunity for cardiovascular disease prevention.”

source: www.abs-cbnnews.com

This cholesterol is good for you

MANILA – Not all cholesterol is bad for you.

Speaking on radio DZMM Tuesday, Dr. Kurt Glen Jacoba of the Philippine Heart Center said there is a form of cholesterol that may be good for the body.

Low density lipoprotein, the "bad" cholesterol, can clog arteries and blood vessels.

Meanwhile, high density lipoprotein (HDL) can eliminate the bad cholesterol from the system.

“Pag titingnan mo yung molecules ng dalawa, ang difference lang is that yung bad cholesterol, yung LDL, meron siyang konting protein, pero maraming cholesterol. Yung good cholesterol, mas madaming protein, less yung cholesterol,” he explained.

Jacoba said the clogging of arteries and other blood vessels may lead to cardiovascular diseases and heart problems.

Heart disease is one of the leading causes of death in the Philippines.

The cardiologist explained that the best way to know your cholesterol level is to give a blood sample to a laboratory after adequate fasting.

A doctor, however, may see telltale signs of high cholesterol levels by looking at a person’s eyes using an instrument.

Whitish accumulations on the eye may indicate high cholesterol.

If your fingertips take some time to return to their normal color after you pinch them, this may also mean that some of your capillaries are clogged because of cholesterol.

Jacoba said HDL cholesterol may be obtained from the omega fatty acids in fish.

Exercise may also help reduce the amount of cholesterol in the body.

Those prone to cholesterol problems are also advised to avoid fatty foods.

When frying dishes, it may be better to use corn oil or olive oil.

Or, if it is possible, don’t fry the dishes. Steaming and other ways of cooking food are better for your health, he said. “Madami naming luto ang Pilipino na masarap eh,” he added.

source: www.abs-cbnnews.com

Doctors issue warning on 'dad bod' trend

MANILA – “Dad bod” is not the way to go.

This was the statement made by some healthcare experts amid the “dad bod” trend among men over 25 who have noticeable bellies and still get to catch women’s interest.

According to healthcare experts, they are worried that the continuing fad might increase the number of obese males in the Philippines.

According to the National Statistical Coordination Board (NSCB), there are 20.9% of obese men in the country.

“Some men most probably rejoiced when they heard that women get attracted to men who are flabbier,” said Carmie de Leon, vice president for sales and marketing of Healthway Medical. “But this rings the bell for healthcare experts.”

De Leon said it is alarming “that different health conditions are already surfacing beyond what our eyes can see.”

Dr. Helen Dy-Eduvas of Healthway Medical, for her part, added that having a huge belly is not a sign of good health since “they become candidates for acquiring a heart disease, Type 2 diabetes, insulin resistance, and even cancer.”

“When your waistline gains girth, your abdominal fat breaks down easily into fatty acids that flow directly into the liver and into your muscles,” said Dy-Eduvas. “The most affected part will be your cardiovascular system. When this happens, men will risk themselves to acquire the deadliest disease in the country.”

De Leon said it is normal for men to desire to always be at their best “but confidence should not be dependent on what people think or say.”

source: www.abs-cbnnews.com

Obesity, heart disease linked to childhood bullying

Victims of childhood bullying are more likely to be overweight or obese as adults and have a higher risk of developing heart disease, diabetes and other illnesses, according to a study by British psychiatrists.

Researchers found that just over a quarter of women who were occasionally or frequently bullied as children were obese at age 45, compared to 19 percent of those who had never been bullied.

And both men and women who were bullied as children had higher levels of fat around their middle -- a known risk factor for heart disease.

"Bullying is bad for your physical health, whether you're a man or a woman," said Andrea Danese, who worked on the study at the Institute of Psychiatry, Psychology & Neuroscience at King’s College London.

Louise Arseneault, who led the research, said its findings should remind teachers, parents and carers to think about the victims, not just worry about how to stop the bullies.

Bullying is characterized by repeated hurtful actions by other children, against which the victims find it difficult to defend themselves, she told reporters. Unfortunately, bullying was "part of growing up for many children", she said.

"We tend to neglect the victims and their suffering," she added. "(Yet) for some children, they will be marked for the rest of their lives."

Arseneault's findings, published on Wednesday in the journal Psychological Medicine, come from the British National Child Development Study which has data on all children born in England, Scotland and Wales during one week in 1958.

It included 7,102 children whose parents gave information on their child's exposure to bullying at age 7 and 11. Some 28 percent had been bullied occasionally and 15 percent were bullied frequently. The children were then followed up at age 45, when measures of blood inflammation and obesity were recorded.

Besides obesity, the results showed that being bullied also led to higher levels of blood inflammation by the age 45.

Some 20 percent of those who were frequently bullied had high levels of a substance called C-reactive protein (CRP). High CRP raises heart disease risk by increasing atherosclerosis, where arteries get clogged up with fatty deposits.

Danese said the effects of childhood bullying on the risk of poor health in adulthood are relatively small compared to factors such as smoking, diet and exercise, but stressed that because obesity and bullying are both common, tackling them could have a significant health impact.

source: www.abs-cbnnews.com

Why olive oil lowers blood pressure

WASHINGTON -- The secret to the Mediterranean diet may be in the salad.

Eating unsaturated fats, like those in olive oil, along with leafy greens and other vegetables creates a certain kind of fatty acid that lowers blood pressure, scientists said Monday.

These nitro fatty acids are formed when consuming spinach, celery and carrots that are filled with nitrates and nitrites, along with avocado, nuts and olive oils that contain healthy fats.

Nitro fatty acids appear to inhibit an enzyme known as soluble epoxide hydrolase, which regulates blood pressure, said the research in the Proceedings of the National Academy of Sciences, a peer-reviewed US journal.

The study was based on experiments in lab mice, and was funded by the British Heart Foundation.

"The findings of our study help to explain why previous research has shown that a Mediterranean diet supplemented with extra-virgin olive oil or nuts can reduce the incidence of cardiovascular problems like stroke, heart failure and heart attacks," said Philip Eaton, professor of cardiovascular biochemistry at King's College London.

While most experts agree that the Mediterranean diet -- which consists of lots of vegetables, fish, grains, red wine and fatty nuts and oils -- brings health benefits, there has been little scientific consensus about how or why.

Some have touted red wine as a driving force behind the ability of Europeans to eat high fat cheeses and meats while maintaining better overall health than Americans.

But research published last week found that a key antioxidant in red wine, resveratrol, did not help people in Italy live longer or avoid cancer or heart disease.

source: www.abs-cbnnews.com

Could too much calcium be bad for your heart?

NEW YORK - In a new analysis from the National Institutes of Health, men who took calcium tablets were more likely to die of heart disease over more than a decade than those who didn't get extra calcium in supplement form.

"The effect of supplemental or dietary calcium on heart disease has always been a bit of an unanswered story," said Howard Sesso, a preventive medicine researcher at Brigham and Women's Hospital and Harvard Medical School in Boston.

"It could be that when you take supplements, maybe you're taking doses that far exceed what you need," he added. But it's still unclear how that might raise cardiovascular risks.

The new findings are based on a study of close to 400,000 middle-aged Americans initiated in 1995 to 1996.

Study volunteers answered questions about their lifestyle, general health and diet, including use of supplements. Researchers then tracked how many of them died, and from what causes, over the next 12 years.

About half of men and more than two-thirds of women said they took calcium supplements or multivitamins containing calcium at the outset.

During the study period, almost 12,000 people - or about 3% - died of cardiovascular disease.

Qian Xiao from the National Cancer Institute and her colleagues found men who took 1,000 milligrams of calcium per day or more were 20% more likely to die of heart-related causes than those who passed on calcium supplements. That was after the researchers took into account men's age, race and weight, as well as other measures of diet and lifestyle.

However, there was no link between calcium supplements and heart disease deaths in women. And calcium from food and beverages wasn't tied to heart problems in men or women, the research team wrote Monday in JAMA Internal Medicine.

It's possible that calcium build-up in the arteries and veins may affect cardiovascular risks in some people, Xiao wrote in an email to Reuters Health.

No cause-effect link

But Sesso, who wasn't involved in the new study, told Reuters Health he wasn't sure why, biologically, calcium supplements would be linked to a higher risk of heart problems in men but not women.

The findings don't prove a cause-and-effect link between the supplements and heart problems. It's possible there were certain differences between men who did or didn't take extra calcium that the research team couldn't measure.

"Although we observed an increased risk of death from heart disease in men who reported taking supplements containing calcium, we cannot say for sure that it was a result of using those supplements," Xiao said.

According to Sesso, the study won't change the fact that calcium supplements are typically recommended for reasons not related to heart disease - such as to prevent fracture risk in older adults who don't get enough calcium through food.

Eating a balanced diet and keeping a healthy weight are as or more important than any supplement when it comes to cardiovascular health, Sesso said.

"If you have a good diet in the first place, a supplement might not be adding all that much," he said.

source: abs-cbnnews.com