GLP-1 drugs could help prevent 34,000 heart attacks and strokes in the US each year, research suggests

Is your competent? doctor closely following this research?

GLP-1 drugs could help prevent 34,000 heart attacks and strokes in the US each year, research suggests

By Deidre McPhillips, CNN

5 minute read

Published 7:00 AM EDT, Wed September 18, 2024

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A new analysis using artificial intelligence and real-world data found that GLP-1 drugs could reduce the risk of heart attack and stroke in millions of people, including those with mild or moderate heart disease.

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CNN  — 

Certain blockbuster weight-loss drugs have been found to protect the heart in significant ways, and new research suggests that the cardiovascular benefits could extend to an even broader set of patients than clinical trial data has shown – helping prevent tens of thousands of heart attacks and strokes each year in the United States.

Clinical trial data from drugmaker Novo Nordisk showed that people using Wegovy had a 20% lower risk of a cardiac event than those who got a placebo. In March, the US Food and Drug Administration approved a change that added cardiovascular benefits to Wegovy’s label, making it the first weight-loss drug to be cleared to reduce the risk of heart attack, stroke or heart-related death in people at higher risk of these conditions.

Related article GLP-1 pills are coming, and they could revolutionize weight-loss treatment

Wegovy is part of a class of drugs called GLP-1 receptor agonists, and its active ingredient, semaglutide, is also approved to treat type 2 diabetes as Ozempic.

Novo Nordisk’s trial was limited to people living with obesity who had a previous heart attack or stroke, or symptoms of peripheral artery disease such as clogged arteries in the arms or legs.

New research from Dandelion Health, a platform that uses real-world data and clinical AI to advance personalized care, found that GLP-1 drugs could also serve as primary prevention, significantly reducing risk for people with mild or moderate cardiovascular disease who hadn’t had a cardiac event.

With the help of artificial intelligence, researchers analyzed real-world medical records for a set of patients who were similar to those enrolled in the Novo Nordisk clinical trial but without the history of a major adverse cardiovascular event.

Tracking years of medical history – with a particular focus on electrocardiogram readings, or measures of the heart’s electrical activity – the researchers used an AI model to predict the benefits that GLP-1s could have in reducing the risk of heart attack or stroke and then validated those predictions against actual events.

They found that GLP-1s reduced the risk of heart attack or stroke by 15% to 20%, in line with findings from the clinical trial – but for a broader population, with benefits that could extend to 44 million additional people.

Related article Trial confirms heart benefits of Wegovy, but is weight loss responsible – or something else?

With these results, they also estimate that if everyone in this broader population of potentially eligible patients took GLP-1s, it could result in 34,000 fewer heart attacks and strokes each year.

“In clinical research, you take the moderate to severe patients because you require fewer patients to prove out the efficacy. But there’s this huge danger that you will consistently miss the impact of medication on broader populations because you just can’t afford the time or money to study them. This is just a natural flaw of clinical research,” said Elliott Green, co-founder and chief executive officer of Dandelion Health.

Broadening the scope of analysis – with help from AI – helps capture a group of patients that researchers from Dandelion Health considered “clinically silent.”

Experts say GLP-1 drugs have already transformed cardiovascular care, and the ability to use them as a primary prevention method could dramatically shift the landscape even more.

“I think about these drugs not as weight loss drugs or even drugs for obesity but as health promoters. They improve health,” said Dr. Harlan Krumholz, a cardiologist and scientist at Yale University and Yale New Haven Hospital who was not involved in the new analysis.

But for people who are unsure about using the medications to treat obesity, extra evidence of the benefits they have for the heart could make all the difference, he said.

“We could reframe the discussion,” Krumholz said. “It’s about trying to get them in a lower-risk category and helping them live a longer and healthier life.”

Dr. Brendan Everett, a cardiologist at Brigham and Women’s Hospital and associate professor at Harvard Medical School, has prescribed GLP-1s for some of his patients.

“I am a preventive cardiologist who wants people to be well and has watched this epidemic of obesity and what we call cardiometabolic disease consume the United States over the past two or three decades,” he said. “If you want to deliver good care to your patients, you have to at least think about [GLP-1s] and know how to use them. So increasingly, I am treating obesity for the sake of treating obesity.”

GLP-1s have created an “absolute paradigm shift” in caring for people with cardiovascular disease, he said. Expanding use to those with mild or moderate disease could be beneficial, as long as the costs and goals for prevention are clearly understood.

An analysis published last month in the Health Affairs journal suggests that Medicare coverage of these weight-loss drugs could increase Part D spending by $3 billion, even if just 5% of eligible patients were prescribed one. But preventing heart attacks and strokes can reduce health care spending in other ways; research from last year found that heart attacks cost hospitals an average of about $19,000.

Clinical trials with randomized controls, such as the one conducted by Novo Nordisk, are the gold standard for assessing medication safety and efficacy. AI-driven findings are subject to greater scrutiny before they can be used in a more formal drug approvals, but the new research highlights some valuable benefits that work like this can provide.

The analysis by Dandelion Health captured a more diverse population than the Novo Nordisk trial did, including a more balanced ratio of men and women and nearly three times larger share of patients who were not White.

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The new report also found a signal faster: The AI model identified decreased cardiovascular risk in patients in less than two years after they started using GLP-1s; the Novo Nordisk trial took more than three years to complete.

Opportunities to improve cardiovascular health in the US are significant. Heart disease is the leading cause of death in the US, and stroke is fifth.

And as GLP-1 drugs continue to soar in popularity, experts say that additional data could help health care providers better ensure that the currently limited supply is getting to those who need it most.

Dr. Jody Dushay, an endocrinologist at Beth Israel Deaconess Medical Center and an assistant professor of medicine at Harvard Medical School, told CNN in March that she hoped the expanded approval of Wegovy to include cardiovascular benefits would improve insurance coverage, particularly as generic weight-loss drug alternatives can carry heart risks. She added that it “might also help prioritize use of [the drugs] among those with highest-risk obesity,” those who also have cardiovascular disease.

CNN’s Meg Tirrell contributed to this report.

Five-year effects of cognitive training in individuals with mild cognitive impairment

 Do you really think your doctor and hospital are competent enough to know about this AND implement this for stroke survivors?

Five-year effects of cognitive training in individuals with mild cognitive impairment

Sylvie Belleville, Marc Cuesta, Nathalie Bier, Catherine Brodeur, Serge Gauthier, Brigitte Gilbert, Sébastien Grenier, Marie-Christine Ouellet, Chantal Viscogliosi, Carol Hudon

First published: 06 September 2024

https://doi.org/10.1002/dad2.12626

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Abstract

INTRODUCTION

In a 5-year follow-up study, we investigated the enduring effects of cognitive training on older adults with mild cognitive impairment (MCI).

METHODS

A randomized controlled single-blind trial involved 145 older adults with MCI, assigned to cognitive training (MEMO+), an active control psychosocial intervention, or a no-contact condition. Five-year effects were measured on immediate and delayed memory recall, the Montreal Cognitive Assessment screening test (MoCA), self-reported strategy use, and daily living difficulties.

RESULTS

At follow-up, participants who received cognitive training showed a smaller decline in delayed memory and maintained MoCA scores, contrasting with greater declines in the control groups. Cognitive training participants outperformed controls in both delayed memory and MoCA scores at the 5-year time point. No significant group differences were observed in self-reported strategy use or difficulties in daily living.

DISCUSSION

Cognitive training provides long-term benefits by mitigating memory decline and slowing clinical symptom progression in older adults with MCI.

Highlights

• Cognitive training reduced the 5-year memory decline of persons with MCI.
• Cognitive training also reduced decline on the Montreal Cognitive Assessment (MoCA).
• No intervention effect was found on strategy use or activities of daily living.

1 INTRODUCTION

Alzheimer's disease (AD) has a long prodromal phase, offering a valuable opportunity to implement strategies aimed at slowing the progression of mild cognitive symptoms into dementia.^1-3 Among these strategies, cognitive training emerges as a promising approach to counter cognitive decline in individuals with mild cognitive impairment (MCI),^4-7 many of whom find themselves in the prodromal phase of AD. Cognitive training equips older adults with compensatory strategies that mitigate the impact of cognitive difficulties in their daily lives. Furthermore, it contributes to cognitive reserve, providing additional protection against dementia.^8-10

Studies have indicated that cognitive training can yield immediate cognitive benefits in individuals with MCI.^{5, 11-13} However, long-term effects of cognitive training in this population and its efficacy in mitigating the progression of cognitive symptoms remain largely unknown. In the context of normal aging, the ACTIVE trial¹⁴ stands out as one of the few studies that examined the long-term benefits of cognitive training, including follow-up assessments up to 10 years post-intervention.^{15, 16} Participants randomized to memory, reasoning, or processing speed training outperformed a no-contact control group in the targeted cognitive domains. Notably, those in the reasoning and processing speed groups maintained superior performance 5¹⁵ and 10 years¹⁶ post-training. Nevertheless, the ACTIVE trial exclusively involved healthy older adults, and to our knowledge, no study has assessed the long-term benefits of cognitive training on cognition in individuals with MCI beyond an 18-month follow-up.¹³ Demonstrating that cognitive training can reduce symptom progression holds significant potential, particularly in the absence of disease-modifying treatments. It could serve as an accessible tool to support cognition in older adults at risk of dementia.

Over the past 15 years, we have developed and validated the MEMO+ program (Méthode d'Entrainement pour une Mémoire Optimale, Training Method for Optimal Memory^{5, 17, 18}). This program teaches memory encoding strategies that utilize the remaining cognitive capacities of individuals with MCI, helping them in compensating for their everyday memory challenges. A prior randomized controlled trial involving 145 older adults with MCI demonstrated the program's short-term efficacy in improving episodic memory, showing enhanced delayed memory compared to a no-contact control group.⁵, while a psychosocial intervention (active control) did not. Participants also reported using more memory strategies in daily life, as measured by the Multifactorial Memory Questionnaire-Strategies (MMQ).¹⁹ Enhanced delayed memory and strategy use effects were still observed 6-months post-intervention. Furthermore, increased activation in frontal, temporal, and parietal brain regions was observed,¹⁸ suggesting enhanced recruitment of both specialized and alternative brain regions.

RESEARCH IN CONTEXT

1. Systematic review: There is a paucity of published data on the long-term effect of non-pharmacological interventions, such as cognitive training.

2. Interpretation: Following a 5-year follow-up, individuals with mild cognitive impairment who underwent cognitive training exhibited significantly less memory decline and outperformed the control groups on the Montreal Cognitive Assessment (MoCA). No intervention effects were observed on self-reported strategy use or difficulties in instrumental activities of daily living at the 5-year timepoint.

3. Future directions: Cognitive training shows promise for providing long-term benefits to older adults with mild cognitive impairment; however, larger studies are needed, and efforts should focus on identifying those who benefit and on developing approaches that facilitate effective transfer.

The main objective of the present study was to assess the long-term benefits of the MEMO+ cognitive training program. To accomplish this objective, we contacted participants from the initial MEMO+ study 5 years after training. We conducted assessments focusing on delayed memory, which was identified as the primary outcome sensitive to MEMO+ training in the initial study. Additionally, we investigated potential maintenance of self-reported difficulties in activities of daily living (ADL), of global cognition with the Montreal Cognitive Assessment (MoCA)²⁰ and of strategy use with the MMQ questionnaire. Given that the participants had MCI at study entry, we hypothesized that there would be a decline in delayed memory and MoCA scores at the 5-year follow-up, along with an increase in self-reported difficulties in ADL. However, we anticipated a significant Intervention × Time interaction, indicating that participants randomized to the MEMO+ program would exhibit less memory decline and fewer self-reported difficulties in ADL than those in the no-contact condition. Furthermore, we expected MEMO+ participants to continue reporting greater use of memory strategies on the MMQ than participants in the no-contact condition. Finally, based on the hypothesis that cognitive training has a protective effect, we anticipated that MEMO+ participants would better maintain their performance on the MoCA compared to participants in the no-contact condition.

More at link.

Adelaide To Host World Leaders In Stroke Care

 This is absolutely fucking appalling! 'CARE' NOT RECOVERY OR RESULTS! This is why survivors need to be in charge; stroke medical 'professionals' are incompetent at solving stroke, they are not even trying!

Adelaide To Host World Leaders In Stroke Care

The world's brightest minds(Really? I bet you don't have survivors there!) in stroke prevention, treatment, rehabilitation, research and lived experience will converge at the Adelaide Convention Centre next week for a major international conference.

The Asia Pacific Stroke Conference, jointly hosted by the Australian and New Zealand Stroke Organisation and the Asia Pacific Stroke Organisation, will bring together leading experts and consumers in stroke to showcase research and share ideas that could improve the care of stroke patients worldwide.

Australian and New Zealand Stroke Organisation (ANZSO) President Professor Timothy Kleinig, who is also Conference Chair, said the event provides an exciting opportunity to showcase the latest innovations being made in stroke treatment and care, both in Australia and across the world.

"The theme of this year's conference is 'Transcending Borders' which aims to bridge borders between countries, research and implementation, pre-hospital care, medical neuro-interventional and surgical specialties, and between health professionals and those who use the services," Professor Kleinig said.

"We're thrilled to have the best stroke minds in Adelaide from across the world who are driving advancements in the treatment of stroke and challenging the norms to move forward with new and innovative treatments."

Some of the research being showcased at the event, which is expected to attract over 600 attendees, includes: advances in brain imaging in acute stroke, using virtual reality and video gaming as possible aids to stroke treatment, the benefits of physical activity and sleep on post-stroke fatigue, advancements in mental health supports for survivors of stroke and families, and new pathways to streamline hospital to rehabilitation care transition.

More than 40,000 Australians experience a stroke event every year, and nearly half a million survivors of stroke live in the community. Globally, around one in four people will experience a stroke in their lifetime. New data will be released at the conference on the cost of stroke to the Australian community and economy by Stroke Foundation.

Stroke Foundation Chief Executive Officer, Dr Lisa Murphy, said the conference provides an exciting opportunity for the stroke sector to share ideas and research that will change the game when it comes to stroke prevention, treatment and enhanced recovery.

"This is a huge opportunity to have Australasian leading stroke experts and innovators come together in Adelaide, share ideas, showcase the latest advancements in stroke care, and highlights the real-world impacts for survivors of stroke, their carers, families and the broader society," Dr Murphy said.

"We hope exciting new progress comes out of the conference and has a direct impact on the Australian health system."

/Public Release. This material from the originating organization/author(s) might be of the point-in-time nature, and edited for clarity, style and length. Mirage.News does not take institutional positions or sides, and all views, positions, and conclusions expressed herein are solely those of the author(s).View in full here.

The ‘obesity paradox’: Weight gain during hospitalization for stroke may improve survival

 

My doctor obviously knew nothing about weight gain post stroke. He didn't reference body metabolism slowing down after age 50 and  my limited exercise ability which I used to do to excess allowing me to eat as I wanted. This incompetence led me to a 30 lb. weight gain which I'm still working to conquer.  

How to Increase Metabolism After 50 - WebMD

The latest here:

The ‘obesity paradox’: Weight gain during hospitalization for stroke may improve survival

Key takeaways:

• Those who survived hospitalization for intracerebral hemorrhage logged a mean 2.6 kg change in weight.
• There were no differences between outcome groups when the researchers accounted for hospitalization length.

ORLANDO, Fla. — For individuals hospitalized with intracerebral hemorrhage, increased caloric intake that led to an increase in weight was associated with higher odds of survival after 3 months, according to a poster.

“Although overweight patients are likely to have [intracerebral hemorrhage], they are also more likely to survive in comparison to patients who are underweight or normal weight,” Natasha Gupta, BA, a doctoral student at the University of Cincinnati College of Medicine, said at the American Neurological Association annual meeting.

According to new research, stroke survival outcomes following hospitalization for intracerebral hemorrhage were linked to caloric intake and mean weight change. Image: Adobe Stock

Although data associating weight and survival rates for intracerebral hemorrhage (ICH) are limited, Gupta and colleagues hypothesized that, since ICH is a high-caloric event, patients with obesity or overweight may have a caloric reserve that allows them to survive stroke occurrence better. As such, increased caloric intake may improve survival rates regardless of weight, according to Gupta and colleagues.

The researchers examined data on spontaneous ICH cases from the Genetic and Environmental Risk Factors for Hemorrhaging Stroke study as well as the Ethnic/Racial Variations of Intracranial Hemorrhage study, conducted between 2008 and 2021.

The analysis included 86 individuals who were fed exclusively by tube and then underwent a 3-month follow-up examination. Patient weight was logged at initial hospital admission, during admission and at discharge, while malnutrition levels were estimated by serum albumin levels taken at admission. In addition, data on IV fluids as well as caloric intake were collected throughout the hospital stay.

The primary outcome metric was patient survival, which the researchers defined as either “good” (patient survived hospitalization) or “bad” (patient discharge to either hospice care or death).

According to the results, at the 3-month follow-up exam, 68 patients survived (mean age, 65.5 years; 23.5% Black) and 18 died (mean age, 73.3 years, 94.4% white).

A multivariate analysis revealed a significant correlation between weight gain during hospitalization and survival outcomes. Those who survived their ICH-related hospital stay recorded a mean difference of 2.6 kg, while those who were discharged to hospice or died recorded a difference of –0.3 kg.

Those who survived also consumed a higher median caloric intake over the course of the hospitalization compared with those in hospice or who were deceased (1,831.4 vs. 1611.6)

However, when the researchers accounted for length of hospital stay, no significant differences were found between outcome groups with respect to association between caloric intake and survival. Additionally, data did not reveal any association between serum albumin levels and survival rates.

Gupta hypothesized that since individuals with obesity or who are overweight produce a higher level of estrogen, which is known to have neuroprotective effects, survival rates in ICH are better than those of lower weight.

“It is possible that greater calories were needed to be able to see that difference in survival,” Gupta noted. “It is also possible that there are other explanations in the obesity paradox.”

Sources/Disclosures

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Source:

Gupta N, et al. Caloric intake during hospital stay and impact on the survival among patients with intracerebral hemorrhage. Presented at: American Neurological Association annual meeting; Sept. 14-17, 2024; Orlando.

Disclosures: Gupta reports no relevant financial disclosures. The study was funded by grants from the NIH.

Cross-step detection using center-of-pressure based algorithm for real-time applications

 What OBJECTIVE method is your doctor and therapist using to determine EXACTLY your gait disabilities? So they can provide EXACT REHAB PROTOCOLS! Oh, you don't have a functioning stroke doctor or therapist because they are doing nothing to objectively determine your problems or have fixes for them? So why are you seeing them if they are that incompetent?

Cross-step detection using center-of-pressure based algorithm for real-time applications

• Matjaž Zadravec &
• Zlatko Matjačić 

Journal of NeuroEngineering and Rehabilitation volume 21, Article number: 161 (2024) Cite this article

• Metrics details

Abstract

Background

Gait event detection is crucial for assessment, evaluation and provision of biofeedback during rehabilitation of walking. Existing online gait event detection algorithms mostly rely on add-on sensors, limiting their practicality. Instrumented treadmills offer a promising alternative by utilizing the Center of Pressure (CoP) signal for real-time gait event detection. However, current methods have limitations, particularly in detecting cross-step events during perturbed walking conditions.

Methods

We present and validate a CoP-based algorithm to detect gait events and cross-steps in real-time, which combines thresholding and logic techniques. The algorithm was evaluated on CoP datasets from healthy participants (age range 21–61 years), stroke survivors (age range 20–67 years), and people with unilateral transtibial amputation (age range 28–63 years) that underwent perturbation-based balance assessments, encompassing different walking speeds. Detected gait events from a simulated real-time processing operation were compared to offline identified counterparts in order to present related temporal absolute mean errors (AME) and success rate.

Results

The proposed algorithm demonstrated high accuracy in detecting gait events during native gait, as well as cross-step events during perturbed walking conditions. It successfully recognized the majority of cross-steps, with a detection success rate of 94%. However, some misclassifications or missed events occurred, mainly due to the complexity of cross-step events. AME for heel strikes (HS) during native gait and cross-step events averaged at 78 ms and 64 ms respectively, while toe off (TO) AME were 126 ms and 111 ms respectively. A statistically significant difference in the algorithm's success rate score in detecting gait events during cross-step intervals was observed across various walking speeds in a sample of 12 healthy participants, while there was no significant difference among groups.

Conclusion

The proposed algorithm represents an advancement in gait event detection on instrumented treadmills. By leveraging the CoP signal, it successfully identifies gait events and cross-steps in the simulated real-time processing operation, providing valuable insights into human locomotion. The algorithm's ability to accommodate diverse CoP patterns enhance its applicability to a wide range of individuals and gait characteristics. The algorithm's performance was consistent across different populations, suggesting its potential for diverse clinical and research settings, particularly in the domains of gait analysis and rehabilitation practices.

Introduction

Gait analysis plays a crucial role in understanding human locomotion and assessing the effectiveness of rehabilitation therapies [1,2,3]. Accurate and reliable real-time detection of gait events, such as heel strikes (HS) and toe offs (TO), is essential for monitoring various gait parameters as well as for providing real-time biofeedback during gait training. Such immediate feedback allows researchers and clinicians to evaluate data in real-time, as well as to make on-the-fly adjustments and interventions. In rehabilitation, it is crucial to tailor exercises to an individual's gait pattern and abilities to maximize the effectiveness of the training. This ensures that the exercises are both appropriate and beneficial for the individual's specific needs. Real-time gait event detection also plays a key role in prosthetics, enabling responsive control for artificial limbs and resulting in a more natural walking experience. Additionally, it is essential for fall detection systems for the elderly, triggering timely preventive measures. Overall, real-time gait event detection enhances customization and optimization in rehabilitation programs, ensuring effective and personalized treatment. Conventionally, online gait event detection algorithms rely on various sensors (Inertial Measurement Units – IMU, pressure insoles, angular sensors or optical tracking systems) attached to the lower limbs or body to capture the kinematics of movement [4,5,6,7]. Particularly, IMU systems, whether using a single or multiple units, have the capability to detect gait events, though their success depends on several factors such as the quality of the IMU units, signal processing techniques, individual's gait behaviour or suitable sensor positioning [8, 9]. However, these methods can be often burdensome for participants, have potential issues with synchronization and often limit the practicality of the procedure setup, especially for everyday use in a clinical environment [10].

In recent years, instrumented treadmills equipped with force transducers to measure Center of Pressure (CoP) during walking, including single or split-belt treadmill variations, have gained popularity as a valuable tool for gait analysis and training [11,12,13,14]. Here, the CoP represents the point where the vertical ground reaction force is applied and can provide valuable insights into gait dynamics [15,16,17,18]. Leveraging the CoP signal, researchers have developed real-time algorithms for detecting gait events and gait subphases without the need for additional human add-on sensors [16, 19,20,21]. Additionally, force signals from the instrumented split-belt treadmills have been used by the researchers to employ a thresholding method based on force data for detecting gait events [22, 23]. However, it's important to note that this technique is applicable solely during native (unperturbed) gait, where each leg makes contact with each belt of the treadmill. Conversely, in the case of a cross-step, both feet are in contact with only one belt, rendering the conventional method ineffective.

Two related studies have examined the CoP-based algorithm, one involving healthy participants and the other focusing on subjects with amputations [16, 20]. In the both studies, participants performed their native gait, revealing asymmetrical butterfly-shaped CoP signals assessed in people with amputations [20] as opposed to the unimpaired gait in healthy subjects [16]. The acquired signals were analyzed to assess specific gait characteristics such as step length, width, time, and durations of double and single support. However, these studies did not include analysis and evaluation of perturbed walking conditions.

One particular challenge for real-time gait event detection algorithms is accurate identification of stepping responses during perturbation-based balance training (PBT). PBT has emerged as a valuable approach for improving balance control and reducing the risk of falls in the elderly and neurologically impaired [24,25,26]. During PBT, individuals experience controlled perturbations that challenge their stability, leading to different reactive balance strategies. These strategies involve adjustments in step length and width to regain dynamic stability. Among these adjustments, cross-steps have been identified as reactive balance responses following outward perturbations, where individuals cross their legs during the gait cycle to stabilize the body and restore equilibrium [27,28,29]. Therefore, accurately detecting cross-steps poses a significant challenge to traditional algorithms, as cross-steps disrupt the expected "butterfly-shaped" pattern of CoP movement following externally or internally elicited perturbation [27, 28]. While these studies have explored gait abnormalities caused by pathology or varying step widths and lengths, the specific scenario of crossing legs during walking has not been thoroughly investigated. Consequently, there is a gap in contemporary methods that can reliably examine cross-step events. Currently, the lack of real-time algorithms capable of detecting and quantifying cross-steps without the need for wearable sensors is a notable limitation hindering the use of real-time biofeedback during gait training.

The aim of this study was to develop a real-time algorithm that utilizes the CoP signal from a single-belt instrumented treadmill to accurately detect HS and TO events during both native and perturbed gait, specifically addressing cross-step events. We conducted extensive experiments to evaluate the algorithm's reliability and accuracy on diverse populations, including healthy participants, subjects with unilateral transtibial amputations, and individuals after stroke, across different walking speeds.

More at link.

Drinking 1 to 3 cups of coffee a day may protect heart health, new study finds

I'm doing a 12 cup pot of coffee a day to lessen my chance of dementia and Parkinsons. Tell me EXACTLY how much coffee to drink for that and I'll change. Yep, that is a lot more than the 400mg. limit. I think I'm in this category:  I never get the jitters or flushed skin.

Genetics determine how much coffee you can drink before it goes wrong

 

How coffee protects against Parkinson’s Aug. 2014  

Coffee May Lower Your Risk of Dementia Feb. 2013 

And this: Coffee's Phenylindanes Fight Alzheimer's Plaque December 2018

10+ years for your competent? doctor to come up with EXACT AMOUNTS OF COFFEE TO DRINK DAILY. Your incompetent doctors didn't do that, did they?

Drinking 1 to 3 cups of coffee a day may protect heart health, new study finds

The latest study should be a comfort for caffeine drinkers, but isn't necessarily a sign to start a new habit, said Dr. Gregory Marcus, professor of medicine at the University of California, San Francisco.

Alexander Spatari/Moment RF/Getty Images

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CNN  — 

A morning cup of coffee may do more than just perk you up, according to new research.

Moderate amounts of caffeine intake — defined as one to three cups of coffee or tea a day — were associated with a lower risk of developing cardiometabolic multimorbidity, said the study’s lead author, Dr. Chaofu Ke, associate professor of epidemiology and biostatistics at Soochow University in Suzhou, China.

Cardiometabolic multimorbidity, or CM, is the coexistence of at least two cardiometabolic diseases such as heart disease, stroke, diabetes and high blood pressure.(That's me)

“Coffee and caffeine consumption may play an important protective role in almost all phases of CM development,” Ke said.

Researchers analyzed data from more than 360,000 people in the UK Biobank, a large biomedical database and research resource that follows people long-term. Those involved did not have cardiometabolic diseases at the outset.

Related article Coffee drinkers get more steps but also less sleep, study finds

The information included the participants’ self-reported caffeine consumption through coffee or black or greentea and the cardiometabolic diseases they developed through their primary care data, hospital records and death certificates, according to the study published Tuesday in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.

Moderate caffeine consumers had a reduced risk of new onset cardiometabolic multimorbidity. The risk was reduced by 48.1% if they had one to three cups a day, or 40.7% if they had 200 to 300 milligrams of caffeine daily, compared with people who didn’t drink or drank less than one cup, Ke said.

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The study had a large sample size and used multiple biomarkers to support the findings, making it a strong look at how caffeine affects heart health, said Dr. Gregory Marcus, associate chief of cardiology for research and professor of medicine at the University of California, San Francisco. He was not involved in the research.

“These observations add to the growing body of evidence that caffeine, and commonly consumed natural substances that contain caffeine such as tea and coffee, may enhance cardiovascular health,” Marcus said in an email.

What researchers don’t know

The methodology is strong and the results line up with existing data about caffeine and heart health, but there are still questions about the extent of the connection between caffeine and heart health, Marcus said.

“It is important to emphasize that, while these data suggest a relationship between caffeine, tea, and coffee and a reduced risk of a combination of cardiovascular diseases, we need to be careful before we infer true causal effects,” Marcus said.

Because the study is observational, it can only show a connection between caffeine and heart health, he said. Other factors may actually be the cause of the improved heart health, he added.

“It remains possible that the apparent protective effects do not truly exist at all and that the positive associations are all explained by some as yet unknown or unmeasured true determining factor,” Marcus added.

“For example, perhaps those more likely to consume these substances also tend to have a healthier diet or to be more physically active.”

The study also didn’t take into consideration the impact of caffeine from carbonated beverages or energy drinks, meaning that researchers can’t say whether those substances would also have a positive effect, Ke said.

Should you start drinking coffee?

Plenty of literature shows a benefit from caffeine consumption.

Several studies have suggested a lower risk of diabetes, Marcus said. And contrary to popular wisdom, drinking caffeine in coffee is associated with experiencing a lower risk of abnormal heart rhythms, he added, pointing to his and others’ research.

But much of that research is observational, and one study showed a mixed result, with more caffeine linked to additional daily step counts but less sleep, Marcus said.

Related article The hidden danger of energy drinks. A doctor explains

Although the new study should provide comfort to those who already have a coffee or tea habit, it isn’t necessarily a sign to start a regular caffeine routine, Marcus said.

“It is also important to mention that more is not necessarily better,” he said.

“Even if caffeine, coffee, and tea in the amounts described in this study … are indeed healthy, there is also strong evidence that high-dose caffeine, particularly when included in artificial concoctions like energy drinks, may actually cause harmful and even dangerous heart rhythm problems.”