Author: Théophile Niyitegeka

{Eating potassium-rich foods like sweet potatoes, avocados, spinach, beans, bananas — and even coffee — could be key to lowering blood pressure, according to Alicia McDonough, PhD, professor of cell and neurobiology at the Keck School of Medicine of the University of Southern California (USC).}

“Decreasing sodium intake is a well-established way to lower blood pressure,” McDonough says, “but evidence suggests that increasing dietary potassium may have an equally important effect on hypertension.”

Hypertension is a global health issue that affects more than one billion people worldwide. The World Health Organization estimates that hypertension is responsible for at least 51 percent of deaths due to stroke and 45 percent of deaths due to heart disease.

McDonough explored the link between blood pressure and dietary sodium, potassium and the sodium-potassium ratio in a review article published in the April 2017 issue of the American Journal of Physiology — Endocrinology and Metabolism. The review looked at population, interventional and molecular mechanism studies that investigated the effects of dietary sodium and potassium on hypertension.

McDonough’s review found several population studies demonstrating that higher dietary potassium (estimated from urinary excretion or dietary recall) was associated with lower blood pressure, regardless of sodium intake. Interventional studies with potassium supplementation also suggested that potassium provides a direct benefit.

McDonough reviewed recent studies in rodent models, from her own lab and others, to illustrate the mechanisms for potassium benefit. These studies indicated that the body does a balancing act that uses sodium to maintain close control of potassium levels in the blood, which is critical to normal heart, nerve and muscle function.

“When dietary potassium is high, kidneys excrete more salt and water, which increases potassium excretion,” McDonough says. “Eating a high potassium diet is like taking a diuretic.”

Increasing dietary potassium will take a conscious effort, however. McDonough explains that our early ancestors ate primitive diets that were high in fruits, roots, vegetables, beans and grains (all higher in potassium) and very low in sodium. As a result, humans evolved to crave sodium — but not potassium. Modern diets, however, have changed drastically since then: processed food companies add salt to satisfy our cravings, and processed foods are usually low in potassium.

“If you eat a typical Western diet,” McDonough says, “your sodium intake is high and your potassium intake is low. This significantly increases your chances of developing high blood pressure.” When dietary potassium is low, the balancing act uses sodium retention to hold onto the limited potassium, which is like eating a higher sodium diet, she says.

But how much dietary potassium should we consume? A 2004 Institute of Medicine report recommends that adults consume at least 4.7 grams of potassium per day to lower blood pressure, blunt the effects of dietary sodium and reduce the risks of kidney stones and bone loss, McDonough says. Eating ¾ cup of black beans, for example, will help you achieve almost 50 percent of your daily potassium goal.

McDonough recommends developing public policies to increase intake of dietary potassium from plant-based sources. She also advocates adding potassium content to nutrition labels to help raise consumers’ awareness of economical sources of potassium.

Source:Science Daily

{University of Queensland School of Public Health researcher Akilew Adane said women who gained more than 2.5 per cent of their body weight each year had almost triple the risk of gestational diabetes compared to women who maintained a stable weight.}

“Women with only a small weight gain each year (1.5 to 2.5 per cent of body weight) doubled their risk of gestational diabetes,” Mr Adane said.

“Surprisingly, even women who were underweight or in the normal BMI range had an increased risk of gestational diabetes when they gained weight — even if they remained within the healthy weight category.

“Women with small weight gains within the healthy BMI range doubled their risk of gestational diabetes compared to women whose weight remained stable.”

Obesity is a known risk factor for gestational diabetes, which can lead to large babies, birth complications and long-term health risks for mothers and children.

Mr Adane said researchers set out to see what impact weight change had in the years leading up to pregnancy.

They tracked more than 3000 participants from the Women’s Health Australia study (also known as the Australian Longitudinal Study on Women’s Health).

The women, aged between 18 and 23 when they joined the study in 1996, have answered regular surveys on their weight, physical activity, lifestyle, health issues, and pregnancies ever since.

“It’s important for women and their clinicians to be aware that, even in the healthy BMI range, gaining a kilogram or two a year can be a health risk,” Mr Adane said.

“For instance, a 60-kilogram, 166-centimetre woman is in a healthy BMI range, but if she gains 1.14kg each year for seven years (about two per cent of her body weight) her risk of gestational diabetes would double compared to a woman whose weight remained stable.

“It’s likely that women who continue to gain weight through early adulthood may experience a modest, progressive insulin resistance, which is further exacerbated by pregnancy, even though their weight is still within the normal range.”

The research is published in Diabetes Research and Clinical Practice and will be presented at the 15th World Congress of Public Health this week.

Source:Science Daily

{In a clinical trial conducted among adults in 11 hospitals, researchers have shown that a hand-held EEG device approved in 2016 by the U.S. Food and Drug Administration that is commercially available can quickly and with 97 percent accuracy rule out whether a person with a head injury likely has brain bleeding and needs further evaluation and treatment.}

According to the Centers for Disease Control and Prevention, about 2.5 million Americans each year show up to the emergency room with suspected head injuries. Most of these people receive a CT scan, and more than 90 percent of the scans show no structural brain injury, creating needless radiation exposure and medical costs estimated at about $1,200 per scan.

In a report on their clinical trial, described online March 31 in Academic Emergency Medicine, the researchers say the new device — which measures electrical activity in the brain and then uses an algorithm to decide if a patient is likely to have brain bleeding — can help with clinical decision-making and triage of patients, and could reduce the need for CT scans.

“Before our study, there were no objective, quantitative measures of mild head injury other than imaging,” says lead investigator Daniel Hanley Jr., M.D., the Legum Professor of Neurological Medicine and director of the Brain Injury Outcomes Program at the Johns Hopkins University School of Medicine. “This work opens up the possibility of diagnosing head injury in a very early and precise way.

“This technology is not meant to replace the CT scan in patients with mild head injury, but it provides the clinician with additional information to facilitate routine clinical decision-making,” says Hanley. “If someone with a mild head injury was evaluated on the sports or battlefield, then this test could assist in the decision of whether or not he or she needs rapid transport to the hospital. Alternatively, if there is an accident with many people injured, medical personnel could use the device to triage which patients would need to have CT scans and who should go first. Those showing a ‘positive’ for brain injury would go first.”

The study only looked at adults and didn’t assess how well the device could predict traumatic brain injuries in children or teens.

The study, Hanley says, was designed to test the accuracy and effectiveness of AHEAD 300, a device developed by BrainScope Company Inc. of Bethesda, Maryland, that is now available to a limited audience through a centers of excellence program. Throughout its eight years of development, the company has tested this and prior generations of the device in multiple human trials. The point of the device is to assess the likelihood that a patient has more than 1 milliliter of bleeding in the brain and needs immediate evaluation by medical personnel.

To begin, the researchers recruited 720 adults who came to 11 Emergency Departments across the nation between February and December 2015 with a closed head injury, meaning the skull was intact. Participants were between 18 and 85 years old, and 60 percent were men. Upon entry to the Emergency Department, each physician performed standard clinical assessments for head injuries used at their site. A trained technician then administered the Standardized Assessment of Concussion and the Concussion Symptom Inventory to characterize the patient’s symptoms, and then used the AHEAD 300 device to measure electroencephalogram (EEG) data — essentially tracking and recording brain wave patterns — from patients while they reclined quietly for five to 10 minutes. The device includes a disposable headset that records the EEG data from five regions on the forehead and feeds the signals back to the hand-held AHEAD 300 device in real time. In addition, the technician entered certain clinical/demographic information into the device, including age; the Glasgow Coma Scale score, which rates how conscious a person is; and if there was a loss of consciousness related to the injury.

The device was programmed to read approximately 30 specific features of brain electrical activity, which it uses an algorithm to analyze, and how the patient’s pattern of brain activity compared to the same pattern of brain activity considered normal. For example, it looked for how fast or slow information traveled from one side of the brain to the other, or whether electrical activity in both sides of the brain was coordinated or if one side was lagging.

The accuracy of the device was tested using CT scans from the participants. The presence of any blood within the intracranial cavity was considered a positive finding, indicating brain bleeding. After 72 to 96 hours, the researchers followed up with phone calls to the patients and/or looked at medical records after 30 days to further confirm the accuracy of each participant’s injury status.

Of the 720 patients, 564 turned out not to have traumatic brain injuries, and 156 did have them, as determined by independently measured and judged CT scan assessments.

On the basis of AHEAD 300 classification, the researchers sorted patients into “yes” or “no” categories, indicating likely traumatic brain injury with over 1 millimeter of bleeding or not. Of 564 patients without brain bleeding, as confirmed with CT scans, 291 patients were scored on the AHEAD 300 as likely not having a brain injury. Of the 156 patients with confirmed brain bleeding, 144, or 92 percent, were assessed as likely to have an injury by the AHEAD 300 classification. Of those confirmed with brain bleeding via CT scan, 12 participants, or 8 percent, had some intracranial bleeding, and five participants, or 3 percent, had more than 1 milliliter of blood in the brain.

Because many of the incorrect yes/no classifications don’t contain information about how close a patient is to the cutoff, the researchers then created three categories to sort patients by — “yes,” “no” and “maybe” — to see if this boosted the accuracy of the device. The maybe category included a small number of patients with greater-than-usual abnormal EEG activity that was not statistically high enough to be definitely positive. When the results were recalculated on the three-tier system, the sensitivity of detecting someone with a traumatic brain injury increased to 97 percent, with 152 of 156 traumatic head injuries detected, and 99 percent of those had more than or equal to 1 milliliter of bleeding in the brain. None of the four false negatives required surgery, returned to the hospital due to their injury or needed additional brain imaging.

The trial results also show the device predicted the absence of potentially dangerous brain bleeding 52 percent of the time in the participants tested with the yes/no classification. Using the yes/no/maybe classification, the device classified 281 patients as having a brain injury, correctly predicting whether someone didn’t have a head injury 39 percent of the time. The researchers say these predictive capabilities improve on the clinical criteria currently used to assess whether to do a CT scan — known as the New Orleans Criteria and the Canadian Head CT rules — and predicted the absence of brain bleeding more than 70 percent of the time in those people with no more than one symptom of brain injury, such as disorientation, headache or amnesia.

As with a typical EEG, the test doesn’t cause any type of sensation or risk. There is a small chance of skin irritation from the discs that read the electrical activity.

Although an exact cost hasn’t been set by BrainScope, the maker of the device, the company says it will be a fraction of the cost of a CT scanner, which starts at $90,000 and goes up to $2.5 million depending on the capabilities, and it will be cheaper and significantly faster to administer. In September 2016, the device was cleared by the Food and Drug Administration for use in a clinical setting.

Source:Science Daily