Medical Bulletin 30/ April/ 2024

Here are the top medical news for the day:

Is calcium consumption at different times associated with cardiovascular disease?

In a recent study published in BMC Public Health, researchers investigated whether the quantity of calcium consumed at breakfast and dinner was associated with cardiovascular disease (CVD) in the general population.

Cardiovascular disease (CVD) is a leading global cause of death and a prevalent chronic condition. Calcium, essential for various bodily functions, plays a key role in preventing and managing CVD by regulating blood vessels, muscle function, nerve activity, hormone production, fat levels, blood pressure, and lipids. Recent research indicates that calcium intake can influence physiological variations in circadian pacemaker-type neuronal cells and alter the expression of the biological clock genes.

In the study involving 36,164 participants from the National Health and Nutrition Examination Surveys (2013–2018), researchers examined how calcium intake timing affects cardiovascular disease risk. They categorised participants based on calcium intake during night and morning meals. The study focused on self-reported cardiovascular disease endpoints and considered various factors like age, sex, smoking, physical activity, and more. Using dietary replacement models, they analysed the impact of shifting 5.0% of calcium from dinner to morning consumption. Exclusions were made for specific demographics and dietary habits, and data were collected via 24-hour diet recalls at a testing facility.

The results showed that replacing 5.0% of calcium intake from dinner with breakfast reduced cardiovascular disease (CVD) risk by 6.0% while maintaining total calcium intake. The circadian clock regulated various cardiovascular functions such as endothelial function, thrombus formation, blood pressure, and heart rate. Sleep enhanced calcium retention capacity. Circadian rhythms affect the inflammatory pathway, metabolism, and immune system adaptation.

The study suggested that individuals with high calcium intake during both dinner and breakfast were at higher risk of cardiovascular disease, emphasizing the importance of distributing calcium intake across meals. Additionally, there was a positive correlation found. Substituting 5.0% of calcium from dinner with an equivalent amount at breakfast decreased CVD risk by 6.0%.

Reference:Zhang, T., Zhuang, S., Yu, Y., et al., (2024) Association of dietary calcium intake at dinner versus breakfast with cardiovascular disease in U.S. adults: the national health and nutrition examination survey, 2003–2018. BMC Public Health. doi:https://doi.org/10.1186/s12889-024-18587-7.https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-024-18587-7

Food additive emulsifiers linked to increased risk of type 2 diabetes, finds study

In a recent study published in The Lancet Diabetes & Endocrinology, researchers investigated the association between food additive emulsifier exposure and risk of type 2 diabetes (T2D).

Food additives, including emulsifiers, are extensively used to produce ultra-processed foods to enhance texture and prolong shelf-life. These additives, which can be found in a wide range of products like chocolate, ice cream, and pastries, have been linked to cardiovascular disease, metabolic disorders, and inflammation, as well as chronic conditions like T2D, obesity, and hypertension. Previous studies have observed a correlation between high intake of ultra-processed foods and increased T2D risk.

In the study, participants from the general population provided detailed information via questionnaires on lifestyle, health, diet, anthropometrics, and physical activity. Dietary data, including emulsifier intake, were collected through three 24-hour dietary records every six months. Emulsifier intake was quantified using food composition databases. Type 2 diabetes (T2D) cases were identified through self-reports, health questionnaires, and mortality registries. The analysis examined the link between emulsifier intake and T2D risk, considering factors like age, sex, BMI, smoking, and dietary habits.

Participants completed 5.7 dietary records on average, with nearly all exposed to emulsifiers. Mean daily energy intake, excluding alcohol, was 1,846.2 kcal, and average emulsifier intake was 4,191.9 mg/day. Primary sources were ultra-processed fruits and vegetables, cakes and biscuits, and dairy products.

The results showed that several emulsifiers correlated positively with type 2 diabetes risk, with total carrageenans showing the highest association (3% increase per 100 mg/day). Other emulsifiers linked to higher T2D risk included carrageenan gum, xanthan gum, Tripotassium phosphate, and others.

The study results indicated that a total of seven individual emulsifiers and one group of emulsifiers were positively associated with the risk of T2Dand demonstrated the need to reevaluate regulations that govern the use of these additives for strengthened consumer protection.

Reference:Salame, C., Javaux, G., Sellem, L., et al. (2024). Food additive emulsifiers and the risk of type 2 diabetes: analysis of data from the NutriNet-Santé prospective cohort study. The Lancet Diabetes & Endocrinology. doi:10.1016/S2213-8587(24)00086-X

Does creatine improve cognitive performance?

According to a study published in the journal Scientific Reports, researchers discovered that a high single dose of creatine can temporarily improve cognitive performance that is reduced by sleep deprivation.

Creatine, a naturally occurring compound found in the body and obtained through diet, is known for its role in providing energy for muscle cells during high-intensity exercise. However, its benefits extend beyond physical performance.Beyond its traditional function in ATP production for muscle cells, creatine's neuroprotective properties and influence on brain energy metabolism make it a good choice for addressing sleep-related cognitive impairment. By supporting ATP synthesis in brain cells, creatine may help sustain cognitive function under conditions of sleep deprivation-induced stress.

In the study, 15 participants underwent overnight sleep deprivation and engaged in cognitive tasks throughout. Sleep deprivation induces alterations in brain metabolism that enhance the cellular uptake of creatine. Before the experiment, participants received a high single dose of creatine. Three hours post-creatine ingestion, a noticeable enhancement in both brain metabolism and cognitive performance was observed among the participants. This effect peaked after four hours and endured for up to nine hours. Notably, improvements were particularly evident in processing capacity and short-term memory.

“The findings indicate that a single high dose of creatine enhances cognitive function and alters brain energy reserves during sleep deprivation. Previously, it wasn't feasible to demonstrate this short-term effect due to limited creatine absorption by neuronal cells in the central nervous system (CNS). The experimental conditions induced a "stressed" state in the brain, facilitating increased creatine uptake in cells. However, caution is advised against consuming such high doses of creatine at home due to potential kidney strain and health risks. Future research exploring cognitive benefits at lower doses could position creatine as a potential alternative to coffee during extended work periods,” saidDr. Ali Gordjinejad, coordinator of the study from the Institute of Neuroscience and Medicineat Forschung-szentrumJülich.

Reference:Gordji-Nejad, A., Matusch, A., Kleedörfer, S. et al. Single dose creatine improves cognitive performance and induces changes in cerebral high energy phosphates during sleep deprivation. Sci Rep 14, 4937 (2024). https://doi.org/10.1038/s41598-024-54249-9