This study evaluated the association between migraine without aura (MO) and migraine with aura (MA) and 3 types of structural brain abnormalities detected by MRI: white matter abnormalities (WMAs), infarct-like lesions (ILLs), and volumetric changes in gray and white matter (GM, WM) regions. In this systematic review, the results showed that six population-based and 13 clinic-based studies were identified. The studies suggested that structural brain changes, including WMAs, silent ILLs, and volumetric changes in GM and WM regions, were more common in migraineurs than in control groups. The results were strongest for MA. The meta-analysis of WMAs showed an association for MA (OR 1.68; 95% CI 1.07-2.65; p = 0.03) but not for MO (OR 1.34; 95% CI 0.96- 1.87; p = 0.08). The association of ILLs was greater for MA (OR 1.44; 95% CI 1.02-2.03; p = 0.04) than for MO, but no association was found for MA (p = 0.52) and MO (p = 0.08) compared to controls. The authors conclude that the data suggest that migraine may be a risk factor for structural changes in the brain. They argue additional longitudinal studies are needed to determine the differential influence of MO and MA. Neurology. 2013 August. PMID: 23986301

This follow-up study compared ten men and 25 external controls who had biopsy-proven low-risk prostate cancer and had chosen to undergo active surveillance. Eligible participants were enrolled between 2003 and 2007 from previous studies and selected according to the same criteria. Men in the intervention group followed a program of comprehensive lifestyle changes (diet, activity, stress management, and social support), and the men in the control group underwent active surveillance alone. The authors took blood samples at 5 years and compared relative telomere length and telomerase enzymatic activity per viable cell with those at baseline, and assessed their relation to the degree of lifestyle changes. The results showed that relative telomere length increased from baseline by a median of 0.06 telomere to single-copy gene ratio (T/S) units (IQR-0.05 to 0.11) in the lifestyle intervention group, but decreased in the control group (-0.03 T/S units, –.05 to 0.03, difference p=0.03). Adherence to lifestyle changes was significantly associated with relative telomere length after adjustment for age and the length of follow-up. The authors conclude that a comprehensive lifestyle intervention was associated with increases in relative telomere length after 5 years of follow-up. Lancet Oncol. 2013 September. PMID: 24051140

This study investigated whether diverticulitis might lead to IBS. The authors compared the incidence of IBS and functional bowel and related affective disorders among patients with diverticulitis. They performed a retrospective study of patients followed up for an average of 6.3 years at a Veteran’s Administration medical center. Patients with diverticulitis were identified based on International Classification of Diseases, 9th revision codes, selected for the analysis based on chart review and matched with patients without diverticulosis. They excluded patients with prior IBS, or prior functional bowel disorders, or mood disorders. They identified patients who were diagnosed with IBS or functional bowel disorders after the diverticulitis attack and controls who developed these disorders during the study period. The results showed that cases were 4.7-fold more likely to be diagnosed later with IBS, 2.4-fold more likely to be diagnosed later with a functional bowel disorder, and 2.2-fold more likely to develop a mood disorder than controls. The authors conclude that patients with diverticulitis could be at risk for later development of IBS and functional bowel disorders. Diverticulitis appears to predispose patients to long-term gastrointestinal and emotional symptoms after resolution of inflammation. Clin Gastroenterol Hepatol. 2013 March. PMID: 23524129

This study investigated if acute sleep deprivation affects food purchasing choices in a mock supermarket. On the morning after one night of total sleep deprivation (TSD) or after one night of sleep, 14 normal-weight men were given a fixed budget (300 SEK-approximately 50 USD). They were instructed to purchase as much as they could out of a possible 40 items, including 20 high-caloric foods (>2 kcal/g) and 20 low-caloric foods (<2 kcal/g). The prices of the high-caloric foods were then varied (75%, 100% (reference price), and 125%) to determine if TSD affects the flexibility of food purchasing. Before the task, participants received a standardized breakfast, thereby minimizing the potential confound produced by hunger. In addition, morning plasma concentrations of the orexigenic hormone ghrelin were measured under fasting conditions. The results showed that independent of both type of food offered and price condition, sleep-deprived men purchased significantly more calories (+9%) and grams (+18%) of food than they did after one night of sleep. Morning plasma ghrelin concentrations were also higher after TSD. However, this increase didn’t correlate with the effects of TSD on food purchasing. The authors conclude acute sleep loss alters food purchasing. Obesity (Silver Spring). 2013 August. PMID: 23908148

This prospective study used longitudinal data from the Avon Longitudinal Study of Parents and Children to examine the associations between acute adverse events at seven time points prior to age eight and inflammation at ages 10 and 15. Inflammatory markers at age 10 included interleukin-6 (IL-6; N=4655) and C-reactive protein (CRP; N=4647), and CRP was measured again at age 15 (N=3286). We further evaluated whether body mass index (BMI), depression, or cigarette smoking mediated associations between adverse events and inflammation. The results showed that adverse events in middle childhood (occurring between ages six to eight), as well as cumulative adversity from birth to eight years, were associated with higher levels of IL-6 and CRP at age 10. Adverse events reported in early childhood (1.5years) or middle childhood, and cumulative adversity from birth through eight years predicted increased levels of CRP at age 15, and these associations persisted after adjustment for CRP at age 10. Some, but not all, of these associations were mediated by BMI. The authors conclude that exposure to adverse events prior to age eight is associated with elevated inflammation at age 10 and in mid-adolescence. Psychoneuro- endocrinology. 2013 February. PMID: 22727478

This study examined the relationship between vitamin D deficiency and osteoporosis, risk of cancer, and cardiovascular disease. In a systematic literature review using the Medline and EMBASE databases, the authors identified 195 studies conducted in forty-four countries involving more than 168,000 participants. Mean population-level 25(OH)D values varied considerably across the studies (range 4·9-136·2 nmol/l), with 37.3 % of the studies reporting mean values below 50 nmol/l. The highest 25(OH)D values were observed in North America. Although age-related differences were observed in the Asia/ Pacific and Middle East/Africa regions, they were not observed elsewhere and sex-related differences were not observed in any region. Substantial heterogeneity between the studies precluded drawing conclusions on overall vitamin D status at the population level. Exploratory analyses suggested that newborns and institutionalized elderly from several regions worldwide appeared to be at a generally higher risk of exhibiting lower 25(OH)D values. The authors conclude substantial details on worldwide patterns of vitamin D status at the population level and within key subgroups are needed to inform public health policy development to reduce risk for potential health consequences of an inadequate vitamin D status. Br J Nutr. 2013 August. PMID: 23930771

(Provigil)

This study analyzed the association between hormone replacement therapy (HRT) and break cancer risk as modified by patient factors. The authors analyzed 1642824 screening mammograms with 9300 breast cancer cases in postmenopausal women aged 45 years or older derived from the Breast Cancer Surveillance Consortium, a longitudinal registry of mammography screening in the United States. Multiple imputation methods were used to accommodate missing data for HRT use (14%) and other covariables. The results showed HRT use was associated with greater than 20% increased risk in white (OR = 1.21; 95% CI = 1.14 to 1.28), Asian (OR = 1.58; 95% CI = 1.18 to 2.11), and Hispanic women (OR = 1.35; 95% CI = 1.09 to 1.67) but not black women (OR = 0.91; 95% CI = 0.72 to 1.14). In women with low/normal BMI and extremely dense breasts, HRT use was associated with the highest breast cancer risk (OR = 1.49; 95% CI = 1.21 to 1.83), compared with nonusers. The authors also found that in overweight/ obese women with less-dense breasts, no excess risk was associated with HRT use (adjusted ORs = 0.96 to 1.03). J Natl Cancer Inst. 2013 September. PMID: 24003037

This systematic review synthesized the studies on the association between adherence to the Mediterranean diet and cognitive function or dementia. The authors conducted a systematic review of 11 electronic databases (including Medline) of published articles up to January 2012. Reference lists, selected journal contents, and relevant websites were also searched. Study selection, data extraction, and quality assessment were performed independently by two reviewers using predefined criteria. Studies were included if they examined the association between a Mediterranean diet adherence score and cognitive function or dementia. The results showed there were twelve eligible papers (11 observational studies and one randomized controlled trial) were identified, describing seven unique cohorts. Despite methodological heterogeneity and limited statistical power in some studies, there was a reasonably consistent pattern of associations. Higher adherence to Mediterranean diet was associated with better cognitive function, lower rates of cognitive decline, and reduced risk of Alzheimer disease in nine out of 12 studies, whereas results for mild cognitive impairment were inconsistent. The authors conclude that published studies suggest a greater adherence to Mediterranean diet is associated with slower cognitive decline and lower risk of developing Alzheimer disease. Epidemiology. 2013 July. PMID: 23680940

Published in Nature, this study describes the idea of an impending global metabolic health crisis provoked by an obesity epidemic. The authors report the human gut microbial composition in a population sample of 123 non-obese and 169 obese Danish individuals. The authors found two groups of individuals that differ by the number of gut microbial genes and thus gut bacterial richness. The results show that they contain known and previously unknown bacterial species at different proportions; individuals with a low bacterial richness (23% of the population) are characterized by more marked overall adiposity, insulin resistance and dyslipidemia and a more pronounced inflammatory phenotype when compared with high bacterial richness individuals. The obese individuals among the lower bacterial richness group also gain more weight over time. Only a few bacterial species are sufficient to distinguish between individuals with high and low bacterial richness, and even between lean and obese participants. The author conclude that their classifications based on the variation in the gut microbiome identify subsets of individuals in the general white adult population who may be at an increased risk of progressing to adiposity- associated co-morbidities. Nature. 2013 August. PMID: 23985870