Effect of a low-carbohydrate diet on pain and quality of life in female patients with lipedema: a randomized controlled trial.

OBJECTIVE: The primary objective of this study was to evaluate the effect of a low-carbohydrate diet (LCD) compared with a control diet on pain in female patients with lipedema. The secondary objectives were to compare the impact of the two diets on quality of life (QoL) and investigate potential associations of changes in pain with changes in body weight, body composition, and ketosis. METHODS: Adult female patients with lipedema and obesity were randomized to either the LCD or control diet (energy prescription: 1200 kcal/day) for 8 weeks. Body weight and body composition, pain (Brief Pain Inventory measured pain), and QoL (RAND 36-Item Health Survey [RAND-36], Impact of Weight on Quality of Life [IWQOL]-Lite, and Lymphoedema Quality of Life [LYMQOL]) were measured at baseline and at postintervention. RESULTS: A total of 70 female patients (age, mean [SD], 47 [11] years; BMI 37 [5] kg/m2) were included. The LCD group had greater weight loss (-2.8 kg; 95% CI: -4.1 to -1.0; p < 0.001) and larger reduction in pain now (-1.1; 95% CI: -1.9 to -0.3; p = 0.009) compared with the control group. No association was found between changes in pain now and weight loss. Both groups experienced improvements in several QoL dimensions. CONCLUSIONS: Diet-induced weight loss in women with lipedema can improve QoL. An energy-restricted LCD seems to be superior to a standard control diet in reducing pain.

Associations between postprandial triglyceride concentrations and sex, age, and body mass index: cross-sectional analyses from the Tromsø study 2015-2016.

Introduction: Elevated serum triglyceride concentrations increase the risk of developing atherosclerosis, the leading cause of cardiovascular disease. Postprandial triglyceride concentrations have shown to be a stronger predictor of cardiovascular disease compared to fasting triglycerides. It is therefore clinically relevant to study patterns of postprandial triglyceride concentrations in a general adult population. Aims: The aim of this cross-sectional analysis was to examine postprandial triglyceride concentrations in women and men, and the association with age, body mass index and menopausal status. Methods: Non-fasting blood samples from 20,963 women and men aged 40 years and older, attending the seventh survey of the Tromsø Study (2015-2016), were analyzed for postprandial triglyceride concentrations using descriptive statistics and linear regression models. Self-reported time since last meal before blood sampling was categorized into 1-h intervals with 7+ hours considered fasting. Results: Men had higher triglyceride concentrations compared to women. The pattern of postprandial triglyceride concentrations differed between the sexes. In women, the highest triglyceride concentration (19% higher compared to fasting level, p < 0.001) was found 3-4 h postprandially compared to 1-3 h in men (30% higher compared to fasting level, p < 0.001). In women, all subgroups of age and BMI had higher triglyceride concentrations than the reference group (age 40-49 years and BMI < 25 kg/m2), but no linear trend for age was observed. In men, triglyceride concentrations were inversely associated with age. Body mass index was positively associated with triglyceride concentration in both women (p < 0.001) and men (p < 0.001), although this association was somewhat modified by age in women. Postmenopausal women had significantly higher triglyceride concentrations compared to premenopausal women (p < 0.05). Conclusion: Postprandial triglyceride concentrations differed in groups of sex, age, body mass index, and menopausal status.

Relationship between Ketones, Ghrelin, and, Appetite on Isocaloric Diets with Varying Carbohydrate Quality and Amount: Results from a Randomized Controlled Trial in People with Obesity (CARBFUNC).

BACKGROUND: Low-carbohydrate high-fat (LCHF) diets may suppress the increase in appetite otherwise seen after diet-induced fat loss. However, studies of diets without severe energy restriction are lacking, and the effects of carbohydrate quality relative to quantity have not been directly compared. OBJECTIVES: To evaluated short- (3 mo) and long-term (12 mo) changes in fasting plasma concentrations of total ghrelin, ß-hydroxybutyrate (ßHB), and subjective feelings of appetite on 3 isocaloric eating patterns within a moderate caloric range (2000-2500 kcal/d) and with varying carbohydrate quality or quantity. METHODS: We performed a randomized controlled trial of 193 adults with obesity, comparing eating patterns based on "acellular" carbohydrate sources (e.g., flour-based whole-grain products; comparator arm), "cellular" carbohydrate sources (minimally processed foods with intact cellular structures), or LCHF principles. Outcomes were compared by an intention-to-treat analysis using constrained linear mixed modeling. This trial was registered at clinicaltrials.gov as NCT03401970. RESULTS: Of the 193 adults, 118 (61%) and 57 (30%) completed 3 and 12 mo of follow-up. Throughout the intervention, intakes of protein and energy were similar with all 3 eating patterns, with comparable reductions in body weight (5%-7%) and visceral fat volume (12%-17%) after 12 mo. After 3 mo, ghrelin increased significantly with the acellular (mean: 46 pg/mL; 95% CI: 11, 81) and cellular (mean: 54 pg/mL; 95% CI: 21, 88) diets but not with the LCHF diet (mean: 11 pg/mL; 95% CI: -16, 38). Although ßHB increased significantly more with the LCHF diet than with the acellular diet after 3 m (mean: 0.16 mmol/L; 95% CI: 0.09, 0.24), this did not correspond to a significant group difference in ghrelin (unless the 2 high-carbohydrate groups were combined [mean: -39.6 pg/mL; 95% CI: -76, -3.3]). No significant between-group differences were seen in feelings of hunger. CONCLUSIONS: Modestly energy-restricted isocaloric diets differing in carbohydrate cellularity and amount showed no significant differences in fasting total ghrelin or subjective hunger feelings. An increase in ketones with the LCHF diet to 0.3-0.4 mmol/L was insufficient to substantially curb increases in fasting ghrelin during fat loss.

Relationships between Dota 2 expertise and decision-making ability.

Esports is an often time-consuming activity that has become increasingly popular with billions of players all over the world. The objective of this study was to investigate if there is a relationship between skill level in the strategy video game Dota 2, a game that places many demands on decision making to be successful, and decision making under ambiguity and experience as measured by performance in the Iowa Gambling Task (IGT), a task known to have ecological validity. Two indicators of players' performance in Dota 2, namely match-making rating (MMR) and Medal, were used as predictors of performance in the IGT in path models. Results showed that Medal was a significant predictor of performance in IGT, while MMR score was borderline significant. The cognitive reflection task, included in the models as an indicator of the ability to engage in conscious, analytical, rational, and logical thinking, was a significant predictor of performance in IGT, and was significantly and positively related to MMR. The findings from this study give insight into the cognitive demands related to performance in Dota 2. Although results suggest that strategy video gaming may be a factor that contributes to increased decision making abilities, a reversed relationship is also possible, whereby individuals who are better at decision making are also more likely to become successful in Dota-2. More studies, preferably longitudinal, are needed to replicate the findings of this study and to establish the directionality between factors.

Associations Between Intake of Fermented Dairy Products and Blood Lipid Concentrations Are Affected by Fat Content and Dairy Matrix - The Tromsø Study: Tromsø7.

Introduction: Dairy fat is rich in saturated fatty acids known to increase serum low-density lipoprotein cholesterol (LDL-C) concentration, an important risk factor for cardiovascular disease (CVD). However, intake of fermented dairy products has been associated with reduced CVD risk in observational studies. How intakes of different fermented dairy products are associated with blood lipid concentrations may provide a possible explanation for the suggested reduced CVD risk. Aim: To examine the associations between different types of fermented dairy products, with various fat contents and dairy matrix structures, and blood lipid concentrations in a general population. Methods: In 11,377 women and men aged between 40-99 participating in the population-based Tromsø Study 2015-2016, multivariable linear regression was used to examine associations between total intake of fermented dairy products, intake of yogurt (including regular-fat, low-fat, and semi-solid yogurt), cheese (including regular-fat and low-fat), and liquid fermented dairy, and serum concentrations of total cholesterol, LDL-C, high-density lipoprotein cholesterol (HDL-C), and triglycerides. Dietary data was collected using a validated food frequency questionnaire. Analyses were adjusted for potential confounding factors, and cheese intake analyses were stratified by self-reported use of cholesterol-lowering drugs. Results: Cheese intake was positively associated with HDL-C [regression coefficient 0.02 mmol/l (95 % CI 0.01, 0.03)], and inversely associated with LDL-C [regression coefficient-0.03 mmol/l (95 % CI-0.04,-0.01)] and triglycerides [relative change -1.34 % (95 % CI: -2.29 %, -0.37 %)] per 25 g/day among non-users of cholesterol-lowering drugs, while no associations were found among users. Total intake of fermented dairy was inversely associated with triglycerides [relative change -1.11 % (95 % CI: -1.96 %, -0.24 %)] per 250 g/day, while no associations were found for yogurt intake. Intake of low-fat cheese was more favorably associated with blood lipids compared to regular-fat cheese, and semi-solid yogurt was inversely associated with LDL-C and triglycerides, while intake of liquid fermented dairy was not associated with any of the blood lipids. Conclusion: This study highlights the importance of investigating specific types of dairy products separately, based on fat content and dairy matrix, when examining effects on blood lipid concentrations, and stratifying statistical models by use of cholesterol-lowering drugs when relevant.

Testing the Foreign Language Effect on Cognitive Reflection in Older Adults.

An increasing number of people around the world communicate in more than one language, resulting in them having to make decisions in a foreign language on a daily basis. Interestingly, a burgeoning body of literature suggests that people's decision-making is affected by whether they are reasoning in their native language (NL) or their foreign language (FL). According to the foreign language effect (FLe), people are less susceptible to bias in many decision-making tasks and more likely to display utilitarian cost-benefit analysis in moral decision-making when reasoning in a FL. While these differences have often been attributed to a reduced emotionality in the FL, an emerging body of literature has started to test the extent to which these could be attributable to increased deliberation in the FL. The present study tests whether increased deliberation leads to a FLe on cognitive reflection in a population of older adults (Mage = 65.1), from the successful aging project in Umeå, Sweden. We explored whether performance on a 6-item version of the cognitive reflection test (CRT) adapted to Swedish would differ between participants for whom Swedish was their NL and those for whom Swedish was their FL. The CRT is a task designed to elicit an incorrect, intuitive answer. In order to override the intuitive answer, one requires engaging in deliberative, analytical thinking to determine the correct answer. Therefore, we hypothesized that if thinking in a FL increases deliberation, then those performing the task in their FL would exhibit higher accuracy rates than those performing in their NL. Our results showed that age and level of education predicted performance on the task but performance on the CRT did not differ between the NL and the FL groups. In addition, in the FL group, proficiency in the FL was not related to performance in the CRT. Our results, therefore, do not provide evidence that thinking in a FL increases deliberation in a group of older adults performing a logical reasoning task that is not typically associated with an emotional connotation.

Physical activity and cognitive function: between-person and within-person associations and moderators.

In the present study, we decomposed between- and within-person effects and examined moderators of the longitudinal physical activity-cognition association. Participants (N = 1722) were drawn from the Betula study and we included four waves of data across 15 years. Bayesian multilevel modeling showed that self-reported physical activity did not predict changes in cognitive function. Physical activity positively predicted cognitive performance at baseline, and the relations were stronger for more active (compared to less active) older adults. Physical activity had a positive within-person effect on cognitive function. The within-person effect of physical activity on episodic memory recall was stronger for participants who on average engaged in less physical activity. The within-person effect on verbal fluency was stronger for participants with more education. Our results suggest that preserving cognitive functioning in old age might be more a matter of what you do in old age than reflecting what you did earlier in life.

Biological and environmental predictors of heterogeneity in neurocognitive ageing: Evidence from Betula and other longitudinal studies.

Individual differences in cognitive performance increase with advancing age, reflecting marked cognitive changes in some individuals along with little or no change in others. Genetic and lifestyle factors are assumed to influence cognitive performance in ageing by affecting the magnitude and extent of age-related brain changes (i.e., brain maintenance or atrophy), as well as the ability to recruit compensatory processes. The purpose of this review is to present findings from the Betula study and other longitudinal studies, with a focus on clarifying the role of key biological and environmental factors assumed to underlie individual differences in brain and cognitive ageing. We discuss the vital importance of sampling, analytic methods, consideration of non-ignorable dropout, and related issues for valid conclusions on factors that influence healthy neurocognitive ageing.

Intake of Fermented Dairy Products Induces a Less Pro-Inflammatory Postprandial Peripheral Blood Mononuclear Cell Gene Expression Response than Non-Fermented Dairy Products: A Randomized Controlled Cross-Over Trial.

SCOPE: It is aimed to investigate how intake of high-fat meals composed of different dairy products with a similar fat content affects postprandial peripheral blood mononuclear cell (PBMC) expression of inflammation-related genes, as well as circulating inflammatory markers and metabolites. METHODS AND RESULTS: Healthy subjects (n = 47) consume four different high-fat meals composed of either butter, cheese, whipped cream, or sour cream in a randomized controlled cross-over study. Fasting and postprandial PBMC gene expression, plasma metabolites, and circulating inflammatory markers are measured. Using a linear mixed model, it is found that expression of genes related to lymphocyte activation, cytokine signaling, chemokine signaling, and cell adhesion is differentially altered between the four meals. In general, intake of the fermented products cheese and sour cream reduces, while intake of the non-fermented products butter and whipped cream increases, expression of these genes. Plasma amino acid concentrations increase after intake of cheese compared to the other meals, and the amino acid changes correlate with several of the differentially altered genes. CONCLUSION: Intake of fermented dairy products, especially cheese, induces a less inflammatory postprandial PBMC gene expression response than non-fermented dairy products. These findings may partly explain inconsistent findings in studies on health effects of dairy products.

Mental Demands at Work and Risk of Dementia.

High mental demands at work was examined as a possible protective factor to reduce the risk of dementia in 1,277 initially dementia-free participants, aged 60 years and older. The cohort was followed for a mean of 13.6 years. During follow-up, 376 participants developed all-cause dementia (Alzheimer's disease = 199; vascular dementia = 145). The association between mental demands at work and dementia was analyzed with Cox hazard models, adjusted for a range of covariates. The results revealed no significant association between mental demands at work and incidence of dementia. Based on the measures used in this study, it was concluded that high mental demands at work may not reduce the risk of dementia later in life.

Decision-making competence in older adults: A rosy view from a longitudinal investigation.

Cross-sectional studies have suggested age-related differences in decision-making competence, but these differences may also reflect cohort-related effects. We present a longitudinal study of age-related changes over 5 years in older adults (aged 60-85) for 3 important aspects of decision-making competence: resistance to framing, applying decision rules, and resistance to sunk costs. The findings show small age-related longitudinal declines in resistance to framing but no decline in applying decision rules or resistance to sunk costs. The results also indicate that individuals' decision-making competence after 5 years is significantly related to their initial decision-making competence assessment and that the contribution of crystallized abilities to decision making in older adults is greater than previously thought. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Dairy products influence gut hormone secretion and appetite differently: A randomized controlled crossover trial.

Little is known about how dairy products with different nutrient contents and food matrices affect appetite sensation and gut hormone secretion. The objective of this study was to investigate how appetite sensation and gut hormone secretion in healthy adults are affected by meals with the same amount of fat but from different dairy products. Forty-seven healthy adults (70% women) were recruited to a randomized controlled crossover study with 4 dairy meals consisting of butter, cheese, whipped cream, or sour cream, corresponding to 45 g (approximately 60 energy percent) of fat. Plasma samples were collected for analysis of cholecystokinin (CCK), pancreatic polypeptide (PP), peptide YY (PYY), and ghrelin concentrations at 0, 2, 4, and 6 h after the meals and analyzed as the incremental area under the curve (iAUC0-6h) in a mixed model. Hunger, satiety, and appetite sensations were measured with a visual analog scale (VAS) immediately after finishing the meals and at 4 and 6 h postprandially. Intake of cheese induced a higher level of plasma PP-iAUC0-6h compared with butter or whipped cream, and a higher level of plasma CCK-iAUC0-6h compared with whipped cream. Intake of whipped cream increased VAS appetite at 4 h compared with cheese or sour cream, and at 6 h compared with cheese or butter. No significant meal effect was found for hunger, satiety, plasma PYY, or plasma ghrelin concentration. Intake of cheese increased postprandial plasma PP and CCK concentrations and decreased appetite compared with whipped cream but not with sour cream. These findings encourage further investigations of how different dairy products affect gut hormone secretion and appetite sensation.

Sedentary behavior as a potential risk factor for depression among 70-year-olds.

BACKGROUND: Sedentary behavior has previously been associated with the risk of depression. In addition, older adults have been proven to be more sedentary and more depressed than other age groups. However, studies using objective measures of sedentary behavior and taking physical activity into account are lacking. Thus, the purpose of this population-based study was to examine how total sedentary time and length of sedentary bouts were associated with the risk of depression among 70-year-olds. METHODS: The present study used data from the Healthy Ageing Initiative (n = 3,633), an ongoing cross-sectional research project in Umeå, Sweden. Sedentary behavior was measured objectively with the ActiGraph GT3X+ accelerometer, and depression was measured with the Geriatric Depression Scale. Several covariates, including physical activity, were included in logistic regression analyses. RESULTS: Results from two hierarchical logistic regression models showed that a greater percentage of the day spent sedentary [odds ratio (OR) = 1.031, p = 0.010] and longer average length of sedentary bouts (OR = 1.116, p = 0.045) increased the risk of depression. LIMITATIONS: Limitations include of possible underrepresentation of severely depressed participants, and possible observer effects. CONCLUSIONS: The present study verified the relationship between sedentary behavior and depression and provides new information about the risks associated with increased length of sedentary bouts.  These findings may be important to consider in the development of future recommendations for the prevention of depression among older adults.

Complexity of Primary Lifetime Occupation and Cognitive Processing.

Today, there are a lack of studies focusing on the relationship between occupational complexity and executive functioning. This is noteworthy since executive functions are core aspects of cognitive processing. The present study was aimed to investigate if three occupational complexity factors (with data, people, and things) of main lifetime occupation were related to performance in executive tasks (inhibition, switching, updating). We analyzed cross-sectional data that were available for 225 participants aged 50-75 years. Results from structural equation models showed that higher complexity levels of working with data were related to lower error rates in the updating component of cognitive control. In addition, higher rates of complexity working with people was associated with lower error rates in task-switching, which also persisted after adjustment of fluid intelligence. Complexity with things, however, was not related to performance in the executive tasks. Future studies would benefit from a longitudinal design to investigate if the results from this study also hold in the long term and to further investigate the directionality between factors.

Executive Processes Underpin the Bilingual Advantage on Phonemic Fluency: Evidence From Analyses of Switching and Clustering.

Bilinguals often show a disadvantage in lexical access on verbal fluency tasks wherein the criteria require the production of words from semantic categories. However, the pattern is more heterogeneous for letter (phonemic) fluency wherein the task is to produce words beginning with a given letter. Here, bilinguals often outperform monolinguals. One explanation for this is that phonemic fluency, as compared with semantic fluency, is more greatly underpinned by executive processes and that bilinguals exhibit better performance on phonemic fluency due to better executive functions. In this study, we re-analyzed phonemic fluency data from the Betula study, scoring outputs according to two measures that purportedly reflect executive processes: clustering and switching. Consistent with the notion that bilinguals have superior executive processes and that these can be used to offset a bilingual disadvantage in verbal fluency, bilinguals (35-65 years at baseline) demonstrated greater switching and clustering throughout the 15-year study period.

Sex differences in postprandial responses to different dairy products on lipoprotein subclasses: a randomised controlled cross-over trial.

Men have earlier first-time event of CHD and higher postprandial TAG response compared with women. The aim of this exploratory sub-study was to investigate if intake of meals with the same amount of fat from different dairy products affects postprandial lipoprotein subclasses differently in healthy women and men. A total of thirty-three women and fourteen men were recruited to a randomised controlled cross-over study with four dairy meals consisting of butter, cheese, whipped cream or sour cream, corresponding to 45 g of fat (approximately 60 energy percent). Blood samples were taken at 0, 2, 4 and 6 h postprandially. Lipoprotein subclasses were measured using NMR and analysed using a linear mixed model. Sex had a significant impact on the response in M-VLDL (P=0·04), S-LDL (P=0·05), XL-HDL (P=0·009) and L-HDL (P=0·001) particle concentration (P), with women having an overall smaller increase in M-VLDL-P, a larger decrease in S-LDL-P and a larger increase in XL- and L-HDL-P compared with men, independent of meal. Men showed a decrease in XS-VLDL-P compared with women after intake of sour cream (P<0·01). In men only, XS-VLDL-P decreased after intake of sour cream compared with all other meals (v. butter: P=0·001; v. cheese: P=0·04; v. whipped cream: P=0·006). Meals with the same amount of fat from different dairy products induce different postprandial effects on lipoprotein subclass concentrations in men and women.

Different Features of Bilingualism in Relation to Executive Functioning.

The notion that the long-term practice of managing two languages is beneficial for the executive control system is an ongoing debate. Criticism have been raised that studies demonstrating a bilingual advantage often suffer from small sample sizes, and do not control for fluid intelligence as a possible confound. Taking those suggested factors into account, focusing on older bilingual age groups and investigating the potential effects of linguistic distances, this study aimed to improve the interpretations of the bilinguals' advantages. Measures of inhibition (Flanker, Stroop, Simon task) and switching (Number-letter, Color-Shape, Local-global task) were collected in participants in the ages 50-75 years (n = 193). Despite a large study sample, results did not support any beneficial effects related to improve processing costs in executive functioning. Sub-analyses of the two different language groups (Swedish-Finnish / Swedish-English) intended to investigate the effect of linguistic distances did not change this outcome. Future studies exploring the potential long-term term effects of bilingualism would benefit from identifying tests of cognitive control with greater ecological validity and include other measures of cognitive functioning. Language learning interventions may also be a promising tool for future research.