X-Message-Number: 30848 Date: Sat, 5 Jul 2008 22:08:41 -0700 (PDT) From: Subject: more on BMI plus a boost for pomegranate Message #30845 From: > Doug, the BMI relates only height and weight. Surely the build or bone structure enters too. A broad person and a narrow person of the same height and weight cannot have the same responses. < I wouldn't be surprised that at a given BMI, an elderly person with more lean tissue would fare better. Nonetheless the lifespan advantage of a higher BMI in the elderly is a well established finding. It might seem that I'm going out on a limb in recommending modest weight gain in thin or even normal weight elderly subjects. However, from where I'm perched, that limb appears to be impressively strong, since the dangers of a low or even normal BMI in this population has been well documented in the medical literature. I would expect this longevity benefit to accrue exclusively to weight gainers consuming more calories from healthy foods only, such as to give four examples; nuts, extra virgin olive oil, dark chocolate, and pomegranate juice. Check out PMID: 9343002 below to see the oh-so-not-very-surprising effect of donuts on mortality. BTW, if I had to choose one food that I consider to be the most underrated from a longevity standpoint, I would choose pomegranate. See below for some of the reasons for why I am so impressed by this food. J Nutr Health Aging. 2008 Feb;12(2):127-31. Body mass index, dementia, and mortality in the elderly. Luchsinger JA, Patel B, Tang MX, Schupf N, Mayeux R. Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY 10032, USA. OBJECTIVES: To explore the association between body mass index and mortality in the elderly taking the diagnosis of dementia into account. DESIGN: Cohort study. SETTING: cohort study of aging in Medicare recipients in New York City. PARTICIPANTS: 1,452 elderly individuals 65 years and older of both genders. MEASUREMENTS: We used proportional hazards regression for longitudinal multivariate analyses relating body mass index (BMI) and weight change to all-cause mortality. RESULTS: There were 479 deaths during 9,974 person-years of follow-up. There were 210 cases of prevalent dementia at baseline, and 209 cases of incident dementia during follow-up. Among 1,372 persons with BMI information, the lowest quartile of BMI was associated with a higher mortality risk compared to the second quartile (HR=1.5; 95% CI: 1.1,2.0) after adjustment for age, gender, education, ethnic group, smoking, cancer, and dementia. When persons with dementia were excluded, both the lowest (HR=1.9; 95% CI=.3,2.6) and highest (HR=1.6; 95% CI: 1.1,2.3) quartiles of BMI were related to higher mortality. Weight loss was related to a higher mortality risk (HR=1.5; 95% CI: 1.2,1.9) but this association was attenuated when persons with short follow-up or persons with dementia were excluded. CONCLUSION: The presence of dementia does not explain the association between low BMI and higher mortality in the elderly. However, dementia may explain the association between weight loss and higher mortality. PMID: 18264640 J Gen Intern Med. 2008 Jan;23(1):19-24. Epub 2007 Oct 23. Body mass index is inversely related to mortality in elderly subjects. Weiss A, Beloosesky Y, Boaz M, Yalov A, Kornowski R, Grossman E. Geriatric Department, Beilinson Hospital, The Rabin Medical Center, Petach-Tikva, Israel. PURPOSE: To study the long-term effect of being overweight on mortality in very elderly subjects. METHODS: The medical records of 470 inpatients (226 males) with a mean age of 81.5 +/- 7 years and hospitalized in an acute geriatric ward between 1999 and 2000 were reviewed for this study. Body mass index (BMI) at admission day was subdivided into quartiles: <22, 22-25, 25.01-28, and > or =28 kg/m(2). Patients were followed-up until August 31, 2004. Mortality data were taken from death certificates. RESULTS: During a mean follow-up of 3.46 +/- 1.87 years (median 4.2 years [range 1.6 to 5.34 years]), 248 patients died. Those who died had lower baseline BMI than those who survived (24.1 +/- 4.2 vs 26.3 +/- 4.6 kg/m(2); p < .0001). The age-adjusted mortality rate decreased from 24 to 9.6 per 100 patient-years from the highest to lowest BMI quartile (p < .001). BMI was associated with all-cause and cause-specific mortality even after controlling for sex. A multivariate Cox proportional hazards model identified that even after controlling for male gender, age, renal failure, and diabetes mellitus, which increased the risk of all-cause mortality, elevated BMI decreased the all-cause mortality risk. CONCLUSIONS: In very elderly subjects, elevated BMI was associated with reduced mortality risk. PMID: 17955304 J Am Geriatr Soc. 2001 Jul;49(7):968-79. High body mass index does not predict mortality in older people: analysis of the Longitudinal Study of Aging. Grabowski DC, Ellis JE. Department of Health Care Organization and Policy, The University of Alabama at Birmingham, Birmingham, Alabama, USA. OBJECTIVE: To determine the excess mortality associated with obesity (defined by body mass index (BMI)) in older people, with and without adjustment for other risk factors associated with mortality and for demographic factors. DESIGN: Retrospective cohort analysis of the Longitudinal Study of Aging (LSOA). SETTING: Nationally representative sample of community-dwelling older people. PARTICIPANTS: Seven thousand five hundred and twenty-seven participants age 70 and older in 1984. MEASUREMENTS: We used Cox regression to calculate proportional hazards ratios for mortality over 96 months. We tested the hypothesis that increased BMI (top 15%) increased mortality rates in older people. RESULTS: Death occurred in 38% of the cohort: 54% of the thin (lowest 10% of the population, BMI <19.4 kg/m(2)), 33% of the obese (highest 15%, BMI> 28.5 kg/m(2)), and 37% of the remaining participants (normal) died. Adjustment for demographic factors, health services utilization, and functional status still demonstrated reduced mortality in obese older people (hazard ratio 0.86, 95% confidence interval (CI) = 0.77-0.97) compared with normal. After adjustment, thin older people remained more likely to die (hazard ratio 1.46, 95% CI = 1.30-1.64) than normal older people. Sensitivity analyses for income, mortality during the first two years of follow-up, and medical comorbidities did not substantively alter the conclusions. CONCLUSION: Obesity may be protective compared with thinness or normal weight in older community-dwelling Americans. PMID: 11527490 [Yes, Homer Simpson's favorite food is associated with increased mortality, but nuts reduce it.] Arch Intern Med. 1997 Oct 27;157(19):2249-58. Risk factors for all-cause and coronary heart disease mortality in the oldest-old. The Adventist Health Study. Fraser GE, Shavlik DJ. School of Public Health, Center for Health Research, Loma Linda University, Calif., USA. BACKGROUND: The oldest-old population (> or = 84 years of age) is growing rapidly and consumes a disproportionate amount of health care dollars. Risk factors for disease have not been extensively studied in this group. METHODS: A cohort study of non-Hispanic white Seventh-Day Adventists from California allowed follow-up for mortality from 1976 through 1988. Associations between traditional risk factors, consumption of selected foods, and both coronary heart disease (CHD) and all-cause mortality were evaluated in the oldest-old portion of this population, using proportional hazards regression analyses. RESULTS: We observed 364 cases of CHD and 1387 total deaths during 11,828 person-years of follow-up. Men had higher risk of both all-cause mortality and mortality from CHD. The relative risks (RRs) associated with diabetes mellitus were 1.51 (95% confidence interval [CI], 1.24-1.84; P < .001) for all deaths and 1.95 (95% CI, 1.38-2.76; P < .001) for mortality from CHD. The apparent effects of hypertension were small unless subjects were currently taking antihypertensive medications. Compared with those with no regular vigorous activity, subjects who exercised at least 3 times each week had RRs of death of 0.80 (95% CI, 0.70-0.91; P < .001) and 0.74 (95% CI, 0.56-0.97; P < .05) for mortality from CHD. Subjects who consumed nuts 5 times per week had RRs of death of 0.82 (95% CI, 0.70-0.96; P < .01) and 0.61 (95% CI, 0.45-0.83; P < .001) for death from CHD compared with those consuming nuts less than weekly. In men, regular consumption of donuts appeared hazardous for both all-cause mortality (RR, 1.40; 95% CI, 1.05-1.88) and mortality from CHD (RR, 2.10; 95% CI, 1.15-3.81), and consumption of beef 4 times weekly was associated with a 2-fold RR for CHD compared with vegetarians, but there was no increase in risk for women. CONCLUSIONS: Even in the oldest-old, certain traditional risk factors and dietary habits are associated with mortality. PMID: 9343002 [If optimal health is one's goal, pomegranate rules.] Neurobiol Dis. 2006 Dec;24(3):506-15. Epub 2006 Sep 28. Pomegranate juice decreases amyloid load and improves behavior in a mouse model of Alzheimer's disease. Hartman RE, Shah A, Fagan AM, Schwetye KE, Parsadanian M, Schulman RN, Finn MB, Holtzman DM. Department of Psychology, Loma Linda University, Loma Linda, CA 92354, USA. Although there are no proven ways to delay onset or slow progression of Alzheimer's disease (AD), studies suggest that diet can affect risk. Pomegranates contain very high levels of antioxidant polyphenolic substances as compared to other fruits and vegetables. Polyphenols have been shown to be neuroprotective in different model systems. We asked whether dietary supplementation with pomegranate juice (PJ) would influence behavior and AD-like pathology in a transgenic mouse model. Transgenic mice (APP(sw)/Tg2576) received either PJ or sugar water control from 6 to 12.5 months of age. PJ-treated mice learned water maze tasks more quickly and swam faster than controls. Mice treated with PJ had significantly less (approximately 50%) accumulation of soluble Abeta42 and amyloid deposition in the hippocampus as compared to control mice. These results suggest that further studies to validate and determine the mechanism of these effects, as well as whether substances in PJ may be useful in AD, should be considered. PMID: 17010630 Nutrition. 2008 Jul-Aug;24(7-8):733-43. Epub 2008 May 19. Consumption of hydrolyzable tannins-rich pomegranate extract suppresses inflammation and joint damage in rheumatoid arthritis. Shukla M, Gupta K, Rasheed Z, Khan KA, Haqqi TM. Division of Rheumatic Diseases, Department of Medicine, Case Western Reserve University/University Hospitals of Cleveland, Cleveland, Ohio, USA. OBJECTIVE: Although consumption of dietary supplements containing pomegranate extract (POMx) by patients with arthritis is on the rise, the efficacy of such preparations in suppressing joint inflammation and damage is not known. The present study was designed to evaluate a standardized preparation of POMx using collagen-induced arthritis (CIA) in mice, a widely used animal model of rheumatoid arthritis. METHODS: CIA-susceptible DBA/1 mice were fed POMx by gavage before and after immunization with chicken type II collagen. Severity of clinical arthritis was scored using a visual scoring system. Arthritic joints were analyzed by histopathology and graded. Lysates were generated from mouse joints and levels of anti-type II collagen immunoglobulin G and inflammatory cytokines interleukin (IL)-1beta, IL-6, and tumor necrosis factor-alpha were quantified by enzyme-linked immunosorbent assay. The effect of POMx on lipopolysaccharide-induced nitric oxide production was determined by Griess reaction and mitogen-activated protein kinase activation was studied by western immunoblotting in mouse macrophages. RESULTS: Consumption of POMx potently delayed the onset and reduced the incidence of CIA in mice. Severity of arthritis was also significantly lower in POMx-fed animals. Histopathology of the arthritic joints from POMx-fed mice demonstrated reduced joint infiltration by the inflammatory cells, and the destruction of bone and cartilage were alleviated. Levels of IL-6 were significantly decreased in the joints of POMx-fed mice with CIA. In mouse macrophages, POMx abrogated multiple signal transduction pathways and downstream mediators implicated in the pathogenesis of rheumatoid arthritis. CONCLUSION: Our studies suggest that inhibition of a spectrum of signal transduction pathways and the downstream pathogenic cellular response by POMx or compounds derived from it may be a useful approach for the prevention of the onset and severity of inflammatory arthritis. PMID: 18490140 J Agric Food Chem. 2008 Feb 13;56(3):1148-57. Epub 2008 Jan 4. Pomegranate phenolics from the peels, arils, and flowers are antiatherogenic: studies in vivo in atherosclerotic apolipoprotein e-deficient (E 0) mice and in vitro in cultured macrophages and lipoproteins. Aviram M, Volkova N, Coleman R, Dreher M, Reddy MK, Ferreira D, Rosenblat M. The Lipid Research Laboratory, Rambam Medical Center, Haifa, Israel. We have analyzed in vivo and in vitro the antiatherogenic properties and mechanisms of action of all pomegranate fruit parts: peels (POMxl, POMxp), arils (POMa), seeds (POMo), and flowers (POMf), in comparison to whole fruit juice (PJ). Atherosclerotic E 0 mice consumed POM extracts [200 microg of gallic acid equivalents (GAE)/mouse/day] for 3 months. Blood samples, peritoneal macrophages (MPM), and aortas were then collected. All POM extracts possess antioxidative properties in vitro. After consumption of PJ, POMxl, POMxp, POMa, or POMf by E (0) mice, the atherosclerotic lesion area was significantly decreased by 44, 38, 39, 6, or 70%, respectively, as compared to placebo-treated group, while POMo had no effect. POMf consumption reduced serum lipids, and glucose levels by 18-25%. PJ, POMxl, POMxp, POMf, or POMa consumption resulted in a significant decrement, by 53, 42, 35, 27, or 13%, respectively, in MPM total peroxides content, and increased cellular paraoxonase 2 (PON2) activity, as compared to placebo-treated mice. The uptake rates of oxidized-LDL by E (0)-MPM were significantly reduced by approximately 15% after consumption of PJ, POMxl, or POMxp. Similar results were obtained on using J774A.1 macrophage cell line. Finally, pomegranate phenolics (punicalagin, punicalin, gallic acid, and ellagic acid), as well as pomegranate unique complexed sugars, could mimic the antiatherogenic effects of pomegranate extracts. We conclude that attenuation of atherosclerosis development by some of the POM extracts and, in particular, POMf, could be related to the combined beneficial effects on serum lipids levels and on macrophage atherogenic properties. PMID: 18173244 J Cardiovasc Pharmacol. 2005 Dec;46(6):856-62. Pomegranate flower extract diminishes cardiac fibrosis in Zucker diabetic fatty rats: modulation of cardiac endothelin-1 and nuclear factor-kappaB pathways. Huang TH, Yang Q, Harada M, Li GQ, Yamahara J, Roufogalis BD, Li Y. Herbal Medicines Research and Education Center, Faculty of Pharmacy A15, The University of Sydney, NSW, Australia. The diabetic heart shows increased fibrosis, which impairs cardiac function. Endothelin (ET)-1 and nuclear factor-kappaB (NF-kappaB) interactively regulate fibroblast growth. We have recently demonstrated that Punica granatum flower (PGF), a Unani anti-diabetic medicine, is a dual activator of peroxisome proliferator-activated receptor (PPAR)-alpha and -gamma, and improves hyperglycemia, hyperlipidemia, and fatty heart in Zucker diabetic fatty (ZDF) rat, a genetic animal model of type 2 diabetes and obesity. Here, we demonstrated that six-week treatment with PGF extract (500 mg/kg, p.o.) in Zucker diabetic fatty rats reduced the ratios of van Gieson-stained interstitial collagen deposit area to total left ventricular area and perivascular collagen deposit areas to coronary artery media area in the heart. This was accompanied by suppression of overexpressed cardiac fibronectin and collagen I and III mRNAs. Punica granatum flower extract reduced the up-regulated cardiac mRNA expression of ET-1, ETA, inhibitor-kappaBbeta and c-jun, and normalized the down-regulated mRNA expression of inhibitor-kappaBalpha in Zucker diabetic fatty rats. In vitro, Punica granatum flower extract and its components oleanolic acid, ursolic acid, and gallic acid inhibited lipopolysaccharide-induced NF-kappaB activation in macrophages. Our findings indicate that Punica granatum flower extract diminishes cardiac fibrosis in Zucker diabetic fatty rats, at least in part, by modulating cardiac ET-1 and NF-kappaB signaling. PMID: 16306813 Altern Med Rev. 2008 Jun;13(2):128-44. Therapeutic applications of pomegranate (Punica granatum L.): A Review. Jurenka JS. Associate Editor, Alternative Medicine Review; Technical research assistant, Thorne Research. Correspondence address: Thorne Research, PO Box 25, Dover, ID 83825. Email: The pomegranate, Punica granatum L., is an ancient, mystical, unique fruit borne on a small, long-living tree cultivated throughout the Mediterranean region, as far north as the Himalayas, in Southeast Asia, and in California and Arizona in the United States. In addition to its ancient historical uses, pomegranate is used in several systems of medicine for a variety of ailments. The synergistic action of the pomegranate constituents appears to be superior to that of single constituents. In the past decade, numerous studies on the antioxidant, anticarcinogenic, and anti-inflammatory properties of pomegranate constituents have been published, focusing on treatment and prevention of cancer, cardiovascular disease, diabetes, dental conditions, erectile dysfunction, bacterial infections and antibiotic resistance, and ultraviolet radiation-induced skin damage. Other potential applications include infant brain ischemia, male infertility, Alzheimer's disease, arthritis, and obesity. PMID: 18590349 [I can't think of another food that possesses all the advantages of pomegranate. Nuf said.] Rate This Message: http://www.cryonet.org/cgi-bin/rate.cgi?msg=30848