The co-benefits of climate change mitigation strategies on cardiovascular health: a systematic review.

Background: Climate change is a significant threat to global human health and a leading cause of premature death. Global warming, leading to more extreme weather (in particular extreme heat events), and air pollution has been associated with increased cardiovascular disease (CVD) morbidity and mortality. According to the Global Burden of Disease Study 2019, 62% of the deaths attributable to climate change were from CVD. Climate change mitigation is a slow, steady process, and the concept of co-benefits has arisen to promote climate action. This systematic review examines how numerous mitigation strategies, such as plant-based diets, increasing green spaces, increasing active transport, using renewable energy sources, and smoking cessation, may have the co-benefit of reducing CVD. Methods: A mixed methods systematic review with narrative synthesis was conducted on four databases, according to the PRISMA guidelines. The articles retrieved (published between 2012 and 2022) had a mitigation strategy as the exposure, and CVD related morbidity or mortality reduction as an outcome. Findings: The review found that renewable energy has a stronger association with cardiovascular co-benefits compared to emission reduction targets. Multimodal transport is more beneficial for both the climate and cardiac health than zero emission vehicles. Diet modification, such as Mediterranean and plant-based-diets, is positively associated with CVD reduction. Proximity to green spaces and reducing urbanisation may also improve cardiac health. Interpretation: This systematic review demonstrates that implementing four mitigation strategies - increasing renewable energy use, active transport, green spaces, and plant-based diets; could lead to the co-benefit of reducing CVD morbidity and mortality. Furthermore, it illustrates the importance of plant-based diets and active transport to improve cardiovascular health. Funding: This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Functional Evaluation of Fermented Rice Bran and Extracted Rice Bran Oil Addressing for Human Health Benefit.

Rice bran (RB) and rice bran oil (RBO) are exploring as prominent food component worldwide and their compositional variation is being varied among the world due to regional and production process. In this study, Fermented Rice Bran (FRB) was produced by employing edible gram-positive bacteria (Lactobacillus acidophilus, Lactobacillus bulgaricus and Bifidobacterium bifidum) at 125×10 5 spore g -1 of rice bran, and investigated to evaluate nutritional quality. The Crude Rice Bran Oil (CRBO) was extracted from RB and its quality was also investigated compared to market available rice bran oil (MRBO) in Bangladesh. We found that fermentation of rice bran with lactic acid bacteria increased total proteins (29.52%), fat (5.38%), ash (48.47%), crude fiber (38.96%), and moisture (61.04%) and reduced the carbohydrate content (36.61%). We also found that essential amino acids (Threonine, valine, leucine, lysine, histidine and phenylalanine) and non-essential amino acids (alanine, aspartate, glycine, glutamine, serine and tyrosine) were increased in FRB except methionine and proline. Moreover, total phenolic content, tannin content, flavonoid content and antioxidant activity were increased in FRB. The RBO analysis showed that γ-oryzanol content (10.00 mg/g) were found in CRBO compared to MRBO (ranging 7.40 to 12.70 mg/g) and Vitamin-E content 0.20% were found higher in CRBO compared to MRBO (ranging 0.097 to 0.12%). The total saturated (25.16%) and total unsaturated fatty acids (74.44%) were found in CRBO whereas MRBO contained total saturated (22.08 to 24.13%) and total unsaturated fatty acids (71.91 to 83.29%) respectively. The physiochemical parameters (density, refractive index, iodine value) were found satisfactory in all sample except acid value and peroxide value higher in CRBO. Heavy metal concentration was found within an acceptable range in both CRBO and MRBO. Thus FRB and RBO could be value added food supplement for human health.

Short-term changes in endogenous estrogen levels and consumption of soy isoflavones affect working and verbal memory in young adult females.

Estrogen is known to modulate certain cognitive functions, most notably improving working memory and verbal memory. Soy foods contain isoflavones, phytoestrogens structurally similar to estrogen that weakly bind to estrogen receptors. We investigated the effects of natural variations in estrogen levels and short-term dietary supplementation with soy isoflavones on cognitive function in 28 young women. Performance was examined across a range of cognitive tasks on three occasions during separate menstrual cycles: during a menses phase (low estrogen), during a luteal phase (highest estrogen), and once during a menses phase after a 3-day phytoestrogen-rich dietary intervention. Soy supplementation during menses led to an improvement in working memory and verbal memory. The menstrual cycle effects were mixed, with high estrogen improving performance on a verbal memory task but not on working memory. Our results suggest that soy phytoestrogens may improve working memory through estrogen-independent mechanisms.

Frontotemporal Dementia Differential Diagnosis in Clinical Practice: A Single-Center Retrospective Review of Frontal Behavioral Referrals.

Background and Objectives: Many neurodegenerative syndromes present with impairment of frontal networks, especially frontoinsular networks affecting social and emotional cognition. People presenting with frontal network impairments may be considered for a frontotemporal dementia (FTD) diagnosis. We sought to examine the diagnostic mix of patients referred with frontal network impairments to a single cognitive neurology service. Methods: A retrospective review was conducted of all patients seen between January 2010 and December 2019 at the Eastern Cognitive Disorders Clinic, a quaternary cognitive neurology clinic in Melbourne, Australia. Patients were included if they met the following criteria: (1) were referred for suspected FTD or with a preexisting diagnosis of a FTD syndrome, (2) were referred for 'frontal behaviors' (i.e., disinhibition, disorganization, poor judgment, loss of empathy, apathy) and/or had an informant report of behavior change, and (3) had available referral documents and clinical consensus diagnosis. Referral diagnosis was compared against final diagnosis adjudicated by a consensus multidisciplinary team. Case details including age of symptom onset, Cambridge Behavioural Inventory-Revised scores, psychiatric history, and Charlson Comorbidity Index were compared against the final diagnosis. Results: In total, 161 patients aged 42-82 years (mean = 64.5, SD = 9.0; 74.5% men) met inclusion criteria. The commonest final diagnosis was a FTD syndrome (44.6%: 26.7% behavioral variant FTD (bvFTD), 9.3% progressive supranuclear palsy, 6.2% semantic dementia, 1.2% corticobasal syndrome, and 1.2% FTD/motor neuron disease). A primary psychiatric disorder (PPD) was the next commonest diagnosis (15.5%), followed by vascular cognitive impairment (VCI, 10.6%), Alzheimer disease (AD, 9.9%), and other neurologic diagnoses (6.2%). A final diagnosis of bvFTD was associated with higher rates of medical comorbidities and more eating behavior abnormalities compared with a diagnosis of PPD. Screening cognitive tests and preexisting psychiatric history did not distinguish these 2 groups. Discussion: A broad spectrum of neurologic and psychiatric disorders may present with impairments to frontal networks. Almost half of patients referred had a final FTD syndrome diagnosis, with bvFTD the commonest final diagnosis. People with PPD, VCI, and AD present with similar clinical profiles but are distinguishable using MRI and FDG-PET imaging. Medical and psychiatric comorbidities are common in people with bvFTD.