Fitness

Essential Amino Acids: Definition, Benefits, and Food Sources

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Essential amino acids are organic compounds that your body needs to function. You can get them from certain foods.

Essential Amino Acids

This video breaks down the benefits and food sources of how to add the essential amino acids to your diet.

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Amino acids, often referred to as the building blocks of proteins, are compounds that play many critical roles in your body.

You need them for vital processes such as building proteins, hormones, and neurotransmitters.

Amino acids are concentrated in protein-rich foods such as meat, fish, and soybeans.

Some people also take certain amino acids in supplement form as a natural way to boost athletic performance or improve mood.

They’re categorized as essential, conditionally essential, or nonessential depending on several factors.

In this article you’ll find all the basics about essential amino acids, including how they function, food sources rich in essential amino acids, and the potential benefits of taking a supplement.

Egg being cracked into a frying pan with one hand
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What are essential amino acids?

Amino acids are organic compounds composed mainly of nitrogen, carbon, hydrogen, and oxygen.

Your body needs 20 different amino acids to grow and function properly. While all 20 of these are important for your health, only 9 are classified as essential (1Trusted Source).

These are histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine.

Although your body can make nonessential amino acids, it cannot make essential amino acids, so you have to get them from your diet.

The best sources of essential amino acids are animal proteins such as meat, eggs, and poultry. However, some plant foods, such as the soy products edamame and tofu, contain all nine essential amino acids. This means they are “complete” protein sources (2Trusted Source, 3Trusted Source).

After you eat protein, your body breaks it down into amino acids and then uses them for various processes, such as building muscle and regulating immune function (1Trusted Source).

Conditionally essential amino acids

Several nonessential amino acids are classified as conditionally essential.

These are essential only under specific circumstances, such as during illness, pregnancy, infancy, or trauma.

For example, arginine is considered nonessential, but your body can’t make as much as you need when you’re healing from a serious injury or fighting certain diseases, such as cancer (4Trusted Source).

That’s why, in certain situations, people may take arginine supplements to meet their bodies’ needs.

Additionally, certain amino acids, including glycine and arginine, are considered conditionally essential during pregnancy because a pregnant person needs more of these amino acids to support their own health and the health of the fetus (5Trusted Source, 6Trusted Source).

SUMMARY

Your body can’t produce the nine essential amino acids, so you need to get them from your diet. Conditionally essential amino acids are nonessential amino acids that become essential in certain circumstances, such as illness or pregnancy.

How many essential amino acids are there?

There are nine essential amino acids, each of which performs a number of important jobs in your body:

  1. Phenylalanine: Your body turns this amino acid into the neurotransmitters tyrosine, dopamine, epinephrine, and norepinephrine. It plays an integral role in the structure and function of proteins and enzymes and the production of other amino acids (7).
  2. Valine: This is one of three branched-chain amino acids (BCAAs) on this list. That means it has a chain branching off from one side of its molecular structure. Valine helps stimulate muscle growth and regeneration and is involved in energy production (8).
  3. Threonine: This is a principal part of structural proteins such as collagen and elastin, which are important components of your skin and connective tissue. It also plays a role in fat metabolism and immune function (9).
  4. Tryptophan: Often associated with drowsiness, tryptophan is a precursor to serotonin, a neurotransmitter that regulates your appetite, sleep, and mood (10).
  5. Methionine: This amino acid plays an important role in metabolism and detoxification. It’s also necessary for tissue growth and the absorption of zinc and selenium, minerals that are vital to your health (11).
  6. Leucine: Like valine, leucine is a BCAA that is critical for protein synthesis and muscle repair. It also helps regulate blood sugar levels, stimulates wound healing, and produces growth hormones (12).
  7. Isoleucine: The last of the three BCAAs, isoleucine is involved in muscle metabolism and is heavily concentrated in muscle tissue. It’s also important for immune function, hemoglobin production, and energy regulation (13).
  8. Lysine: Lysine plays major roles in protein synthesis, calcium absorption, and the production of hormones and enzymes. It’s also important for energy production, immune function, and collagen and elastin production (14).
  9. Histidine: Your body uses this amino acid to produce histamine, a neurotransmitter that is vital to immune response, digestion, sexual function, and sleep-wake cycles. It’s critical for maintaining the myelin sheath, a protective barrier that surrounds your nerve cells (15).

As you can see, essential amino acids are at the core of many vital processes.

Although amino acids are most recognized for their role in muscle development and repair, your body depends on them for so much more.

That’s why essential amino acid deficiencies can negatively affect your entire body, including your nervous, reproductive, immune, and digestive systems.

People can have different amino acid needs based on stage of life, chronic illness, and acute health issues such as an infection or a surgery.

However, most people get all the amino acids they need through their diet.

SUMMARY

All nine essential amino acids perform important roles in your body. They’re involved in many processes, including tissue growth, energy production, immune function, and nutrient absorption.

Health benefits of taking essential amino acid supplements

While essential amino acids can be found in a wide array of foods, taking concentrated doses in supplement form has been linked to several health benefits.

May help with mood

Tryptophan is necessary for the production of serotonin, a chemical that acts as a neurotransmitter in your body.

Serotonin is an essential regulator of mood, sleep, and behaviors.

While low serotonin levels have been linked to depressed mood and sleep disturbances, several studies have shown that taking tryptophan supplements may help reduce symptoms of depression and boost mood (16Trusted Source, 17Trusted Source, 18Trusted Source, 19Trusted Source).

A review that included 11 high quality studies found that taking 0.14–3 grams (g) of tryptophan per day could help decrease anxiety and increase positive mood in generally healthy people (18Trusted Source).

May improve exercise performance and recovery

Many people take valine, leucine, and isoleucine, the three essential BCAAs, to alleviate fatigue, improve athletic performance, and stimulate muscle recovery after exercise.

In a small 2017 study, resistance-trained athletes took BCAAs at a dose of 0.039 g per pound (lb) — 0.087 g per kilogram (kg) — of body weight, with a 2:1:1 ratio of leucine, isoleucine, and valine.

Those who took the BCAAs showed improved performance and muscle recovery and decreased muscle soreness compared with those who took a placebo (20Trusted Source).

A review of eight studies found that taking BCAAs was superior to rest for promoting muscle recovery and reducing soreness after exhaustive exercise (21Trusted Source).

What’s more, another review that included nine studies found that taking BCAAs helped reduce muscle damage and soreness after resistance exercise in active men (22Trusted Source).

Taking BCAAs has also been shown to reduce the rating of perceived exertion — how intensely a person feels they are working during exercise — in people performing high intensity exercise (23Trusted Source).

May be helpful for wound healing and surgery

Taking amino acid supplements may be helpful for people who are healing after surgery (24Trusted Source, 25Trusted Source).

A study in 243 people with pelvis or long bone fractures found that those who took conditionally essential amino acids for 2 weeks after surgery had lower rates of death and medical complications than those who received standard nutrition (25Trusted Source).

A review of 20 studies looking at the effects of taking BCAAs in people with cancer undergoing surgery found that those who took BCAAs around the time of surgery had reduced postoperative complications from infections and fluid accumulation in the abdomen (26Trusted Source).

What’s more, according to results from one study, taking essential amino acid supplements may help reduce loss of muscle volume in older adults recovering from knee replacement surgery (27Trusted Source).

SUMMARY

Taking certain essential amino acids in supplement form may help improve mood, support exercise performance and recovery, and help improve health outcomes after surgery.

Food sources and recommended intake

Because your body cannot produce essential amino acids, it’s important to get them through your diet.

Many foods are rich in essential amino acids, making it easy to meet your daily needs (28Trusted Source).

Here are the daily required intakes for the essential amino acids, according to the World Health Organization. These are for adults per 2.2 lb (1 kg) of body weight (29):

  • Histidine: 10 milligrams (mg)
  • Isoleucine: 20 mg
  • Leucine: 39 mg
  • Lysine: 30 mg
  • Methionine: 10.4 mg
  • Phenylalanine combined with the nonessential amino acid tyrosine: 25 mg
  • Threonine: 15 mg
  • Tryptophan: 4 mg
  • Valine: 26 mg

To find out how much you should consume per day, you can multiply the numbers given above by your weight in kilograms. For example, a person who weighs 60 kg (132 lb) should consume 1,200 mg (1.2 g) of isoleucine per day.

Meeting these requirements is very easy with most diets, so there’s usually no need to track your intake of individual amino acids.

For example, one 174-g piece of braised chicken breast provides 55.9 g of complete protein, easily meeting or exceeding the needs listed above (30Trusted Source).

Food sources

Foods that contain all nine essential amino acids are referred to as complete proteins.

The following foods are complete protein sources:

  • meat
  • seafood
  • poultry
  • eggs
  • dairy products

Soy and pea protein are plant-based complete protein sources (2Trusted Source, 3Trusted Source, 31Trusted Source).

Other plant-based sources of protein, such as beans, nuts, and certain grains, are considered incomplete proteins because they lack one or more of the essential amino acids.

However, if you’re following a plant-based diet, you can still ensure proper intake of all nine essential amino acids by eating a variety of plant proteins each day.

For example, choosing a variety of plant-based proteins, such as beans, nuts, seeds, whole grains, and vegetables, can ensure that you meet your essential amino acid needs, even if you choose to exclude animal products from your diet.

SUMMARY

Many animal and plant foods, such as meat, eggs, quinoa, and soy, contain all nine essential amino acids and are considered complete proteins.

How to supplement with essential amino acids

Most people get enough essential amino acids through their diet.

However, there are some benefits to taking essential amino acid supplements. For example, athletes often take them to enhance exercise performance and recovery.

One review that included 10 high quality studies found that doses of BCAAs of up to 115.6 mg per lb (255 mg per kg) per day could help reduce delayed onset muscle soreness in trained individuals after exercise (32Trusted Source).

Additionally, people may choose to take individual amino acids, rather than blends, to support certain aspects of health, such as mood.

A review that included 11 high quality studies found that taking 0.14–3 g of tryptophan per day could help improve mood in healthy people (18Trusted Source).

As you can see, dosing varies depending on the type of amino acid you’re taking and what your goal is.

Amino acid supplements are considered safe for most people. However, they’re usually not necessary if you’re getting enough protein in your diet.

Nonetheless, amino acid supplements may offer certain benefits for specific groups of people.

If you’re interested in taking essential amino acid supplements, speak with a healthcare professional who is knowledgeable about dietary supplements, such as your doctor or a registered dietitian.

They can recommend specific dosing and tell you how best to take your supplement, depending on your health goals. Additionally, they can help you choose a supplement from a reputable brand that offers products tested by third-party organizations.

SUMMARY

Dosing of amino acid supplements depends on the specific amino acid and your reason for using it. If you’re interested in taking essential amino acid supplements, consult a qualified healthcare professional.

The bottom line

There are nine essential amino acids, which you must get through your diet — histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine.

They’re vital for functions throughout your body, including protein synthesis, tissue repair, and nutrient absorption.

Some may also help prevent muscle loss, support recovery after surgery, and improve mood, sleep, and athletic performance.

These vital compounds are found in many animal- and plant-based foods, so most people can meet their daily needs by eating a healthy, balanced diet. You can also take essential amino acid supplements if needed.

Perspire with purpose: Discover the science behind sweating

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Sweating stands as a powerful “incentive” behind many human inventions.  From the creation of air conditioning and deodorants to the popularity of shorts and moisture-wicking fabrics, numerous innovations have emerged to address the challenges posed by perspiration.  Simply put, manufacturers tend to put a negative spin on the act of sweating.

Unfortunately, while sweating is known to play a pivotal role in cooling our bodies, its broader benefits often remain overlooked.  Beyond merely evaporating water to reduce body heat, sweating offers a range of systemic advantages that enhance our overall well-being.

In the following exploration, we’ll delve deeper into the multifaceted benefits of sweating and consider why embracing it might be a valuable addition to our lives.

The sweaty secret to detoxifying your body from heavy metals and toxins

When your pores expand to release sweat, their function extends beyond temperature regulation.  The skin accumulates various toxic substances, making it a conduit for exposure to pathogens and harmful compounds.

Although the epidermis acts as a protective barrier, preventing many toxins from entering our system, some inevitably penetrate.  Whether through ingestion or everyday encounters, sweat plays a vital role in expelling a significant portion of these toxins.  Notably, heavy metals, like cadmium, are more concentrated in sweat than in blood or urine, suggesting sweating as a primary elimination route for such contaminants.

Given that heavy metals and toxins can build up in tissues, leading to pervasive and lasting harm, effective detoxification methods become crucial.  This becomes especially pertinent for those residing or working in environments predisposed to heavy metal exposure.

Can sweating improve immune function?

While sweat itself and the act of sweating do not boost your immune system to fight off a cold, there is an innately immune-boosting aspect to perspiration.  Your sweat glands release antimicrobial compounds that inhibit the growth of bacteria, fungi, and viruses on the surface of the skin.  Dermatitis, for instance, is often caused by a mild fungal infection and sweating can help alleviate the itchiness and occurrence of types of dermatitis.

Additionally, the method by which you are sweating – specifically if you are exercising – does actually have immune-boosting effects.  Exercise helps move blood and lymphatic fluid and can help mobilize your body’s immune system in response to an infection.

How to get the most out of sweating

One of the easiest ways to increase your sweating is to exercise.  Physical activity has innumerable health benefits, from cardiovascular strengthening to improved immune function, mental clarity, libido, anti-aging effects, longevity, anti-cancer effects, and so on.  If you want to start getting the benefits of a good sweat today, try walking, cycling or even playing some pickleball.   The key here is to have fun and dress warm enough (in layers) to generate a good sweat.  Keep in mind, when dressed in layers, your exercise intensity can be mild and still generate plenty of sweat.

Saunas are another way to get a good sweat in every day.  Most gyms or bathhouses have saunas or some type of sweat room you can utilize for your health.  Some studies suggest that the act of sweating helps make your blood vessels more pliable, able to react and dilate better when blood flow is occluded.  There is even ample evidence that saunas can help reduce the risk of dementia and other neurodegenerative diseases later on in life.

Even something as simple as adding spiciness to your food – such as hot peppers or cayenne – can induce sweating, add flavor, and have positive health benefits.

Embrace the sweat!

While sweating might feel bothersome, especially on scorching summer days prompting multiple showers, it offers health advantages that often go unnoticed.  Instead of feeling vexed by those damp shirts, consider the benefits: you’re expelling toxins and creating an environment hostile to microbes on your skin.

Understanding the connection between weight loss and heart health – a timeline

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Due to its complex nature many people find weight management a challenge and see their weight fluctuate or yo-yo’ throughout their life.

Weight gain can happen for a variety of reasons and will vary by person, but common factors can include genetics, significant life events, certain medications, and lifestyle changes.

If you have recently tried and failed to lose weight it may seem hard to find the motivation to begin this process again. While it may seem difficult to achieve at first, maintaining behaviour changes over the long term, is vital, as even limited weight loss can have a significant and long- lasting impact on the heart.

The purpose of this article is therefore to address the different stages of weight loss and how they can have a direct impact on heart health.

Why maintaining a healthy weight is so important for your cardiovascular health

Adults with a BMI over 27.5 or 30 kg/m2 (depending on ethnicity) are classified as living with obesity and this is associated with increased cardiovascular risk, and higher chances of a stroke or heart condition.

If you would like to read more about the link between obesity and heart disease, please click here to view our previous feature ‘Does obesity cause heart disease and how can you reduce your risk?’.

Starting your weight loss journey

If you are worried about the impact of your weight on your cardiovascular health, it is vital you speak to a healthcare professional who can work with you to find the most effective and sustainable approach personalised for you.

There is not one diet or exercise programme that works for everyone, and speaking to a doctor or healthcare professional specialised in obesity care significantly improve the likelihood of successful weight loss.

When you lose 1-5% of your body weight you can expect to see benefits to your cardiovascular health. This level of weight loss has been shown after one year to have a significant impact on the heart and is linked with reduced blood pressure and cholesterol.

Further weight loss

For those living with obesity, using weight management medication like pharmacotherapy, or undergoing surgery can increase weight loss to over 10% of your bodyweight, and in some cases up to 40% with bariatric surgery.

If you do manage to lose over 10% of your body weight, there are even larger health benefits. A 10-year study conducted in 2004, found that those living with overweight or obesity who lost 10% of their body weight in the first year, saw a 21% decrease in the chances of a heart attack or a stroke, a reduction that was not seen in those that lost less than this amount. This weight loss also has benefits to cholesterol levels and blood pressure levels mentioned earlier.

Maintaining your weight after a period of weight loss

While losing any amount of weight is a fantastic achievement, sustaining weight loss is also a vital step to a healthier heart.

Studies have shown that up to 80% of people who have lost a significant amount of weight gain almost all of this back within 2 to 5 years. This can be due to lifestyle changes, but also the body metabolism slowing down following any form of diet and entering ‘fasting mode’.

To help keep the weight off long term it is vital to continue to seek support from healthcare professionals who will be able to advise you on how best to keep the weight off and provide a support network.

While it may seem a difficult task at first there are many resources and forms of support to help you lose weight and the benefits to your heart make the fight to control the disease of obesity potentially lifesaving and one worth winning.

Sustained Weight Loss Linked to Lower Renal Risk in Diabetes

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Patients with overweight/obesity and type 2 diabetes who lose ≥ 7% of their body weight and maintain it for longer may lower their risk for kidney outcomes.

METHODOLOGY:

  • Researchers conducted a post hoc analysis of the Look AHEAD trial including 3601 adults with a body mass index of > 25 kg/m2 and a diagnosis of type 2 diabetes. The mean age was 59 years, and 2140 (59%) were women.
  • Body weight time in target range (TTR), a new indicator of weight management, was defined as the proportion of time during the first 4 years when weight was within the weight-loss target of ≥ 7% from baseline.
  • Body weight TTR during the first 4 years was assessed in three evenly divided categories ranging from > 0% to < 100%, using 0% as the reference group.
  • Patients were randomly assigned to an intensive lifestyle intervention group of reduced caloric intake and increased physical activity or a control diabetes support and education group that focused on exercise, diet, and social support.
  • The primary outcome was the composite kidney outcome, defined as ≥ 30% decrease in estimated glomerular filtration rate to < 60 mL/min/1.73 m2, end-stage kidney disease, or self-reported kidney failure.

TAKEAWAY:

  • During a median follow-up of 8 years, composite kidney outcome was reported in 435 participants.
  • During the first 4 years, body weight TTR was inversely associated with the subsequent risk for composite kidney outcome (adjusted hazard ratio [aHR], 0.81; P < .001).
  • The inverse association between body weight TTR and composite kidney outcome was stronger in the intense intervention group (aHR, 0.77; 95% CI, 0.66-0.89) but not significant in the control group.
  • Compared with participants having a body weight TTR of 0%, the aHRs of composite kidney outcomes were 0.73 (95% CI, 0.54-1.00) for a TTR of > 0% to < 29.9%, 0.71 (95% CI, 0.52-0.99) for a TTR of 29.9% to < 69.7%, and 0.54 (95% CI, 0.36-0.80) for a TTR of 69.7% to < 100%.

IN PRACTICE:

“Even a single-digit sustained weight loss can bring significant renal benefits,” the authors wrote, emphasizing the importance of weight control through caloric restriction and physical activity in patients with overweight/obesity and type 2 diabetes.

SOURCE:

Xianhui Qin of the Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China, was the corresponding author of this study, which was published online on December 11, 2023, in Diabetes Care.

LIMITATIONS:

The participants’ body weight was measured annually, and body weight TTR was computed using the results of at least three body weight measurements taken over the first 4 years. Because weight change is a gradual process, these data may not accurately reflect the actual time spent within the target weight range. Given the novelty of the body weight TTR concept, the authors noted, the findings are hypothesis generating and should be interpreted with greater caution.

Are Immune Therapies for Type 1 Diabetes Worthwhile?

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The oral Janus kinase inhibitor baricitinib (Olumiant) preserved beta-cell function in people with new-onset type 1 diabetes over 48 weeks, new phase 2 data show. 

But, as with the intravenously administered monoclonal antibody teplizumab (Tzield), there were no significant improvements in A1c and all study participants continued to require exogenous insulin. Both drugs are currently on the US market — baricitinib for rheumatoid arthritis, alopecia areata, and COVID-19 and teplizumab for delaying the onset of type 1 diabetes in those with preclinical (stage 2) disease. 

A randomized, placebo-controlled trial examined baricitinib vs placebo in 91 people with type 1 diabetes onset during the previous 100 days. Published in The New England Journal of Medicine (NEJM) on December 7, 2023, the research was performed by Michaela Waibel, PhD, of St. Vincent’s Institute of Medical Research, Melbourne, Australia, and colleagues. 

A phase 3 teplizumab trial, of two 12-day courses or placebo given to 328 young people with new-onset type 1 diabetes, was also published in the December 7, 2023, issue of NEJM. That study appeared online on October 18, 2023, and was reported by Medscape Medical News. 

In an editorial in the same issue, Johnny Ludvigsson, MD, PhD, of Crown Princess Victoria Children’s Hospital and the Division of Pediatrics, Linköping University, Linköping, Sweden, writes that the two trials together “indicate that, finally, we have promising treatments that may soon be offered to patients with type 1 diabetes at the onset of their disease. With sufficient health care resources, these treatments will be pragmatically feasible.”

Ludvigsson also points out that even though thus far, these interventions aren’t cures and patients must still administer exogenous insulin, preserved residual beta-cell secretion of even small amounts of insulin can help minimize glucose fluctuations and thereby potentially reduce the risk for long-term complications. 

However, he questions whether clinicians, patients, or their parents will see these treatments as justified because other options for improving glycemia are available. “For patients with type 1 diabetes, immunologic interventions to preserve β-cell function arrive in parallel with glucose sensors, smart insulin pumps, and even closed-loop systems…immunologic interventions can be expected to be accepted and successful if clinicians are able to explain the great value for the patient of residual insulin secretion.”

At the same time, he notes, “the interventions to preserve β-cell function must be proved to be safe and to not cause serious adverse events in both the short and the long term. If patients with type 1 diabetes, who already have a chance for a good-quality, long life with modern conventional treatment, are to start receiving such therapy, it should not add to their already heavy burden.”

In the baricitinib study, 60 patients were randomly assigned to receive the drug at 4 mg/da and 31 to receive matched oral placebo. The primary outcome, mean C-peptide level determined by area under the curve during a 2-hour mixed meal tolerance test at week 48, was 0.65 nmol/L/min with baricitinib vs 0.43 nmol/L/min with placebo — a significant difference (P = .001). 

There were no significant differences in daily insulin dose or A1c, but the mean coefficient of variation in glucose levels, as measured by continuous glucose monitoring, was lower with baricitinib: 29.6% vs 33.8% with placebo. 

Waibel and colleagues write, “We speculate that the initiation of baricitinib earlier, when the C-peptide level is higher, either immediately after the diagnosis of symptomatic clinical type 1 diabetes or during presymptomatic stage 2 or stage 3A disease identified through the screening of relatives of patients with type 1 diabetes or through the screening of the general population, may be more effective in decreasing the need for injected insulin.”

Adverse event frequency and severity didn’t differ between the two groups, and there were no severe treatment-associated adverse events.

In the teplizumab trial, participants randomly assigned to receive teplizumab had significantly higher stimulated C-peptide levels than did those assigned to placebo at week 78, with a difference of 0.13 pmol/mL (P <  .001).

There were no significant differences in other endpoints, including insulin doses required to meet glycemic goals, A1c, time in range, or significant hypoglycemic events. 

And with teplizumab, despite premedication in anticipation of discomfort and adverse events, some patients still experienced headache, gastrointestinal symptoms, rash, lymphopenia, and mild cytokine release syndrome. Two patients had severe cytokine release syndrome that resolved within a week but led to treatment discontinuation. 

Ludvigsson concludes, “As clinicians, we need to learn how best to combine therapies to preserve β cells and to control type 1 diabetes. Furthermore, we must learn to which patient a certain immunologic therapy should be given, and for how long. With increasing knowledge from treatment trials involving patients with early stage 3 (clinical) diabetes, we should learn whether such therapy can contribute to a cure and possibly prevent clinical disease if used in earlier stages of type 1 diabetes.”

Even Vigorous Exercise Appears Safe for Patients With Hypertrophic Cardiomyopathy: LIVE-HCM

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People with hypertrophic cardiomyopathy (HCM), whether or not they are competitive athletes, needn’t be routinely advised against vigorous exercise or upping the intensity of their daily activity, suggests a prospective study of patients with clinically evident or a genetic predisposition to HCM.

Patients with HCM have traditionally been advised against activities that require intense exercise, including recreational or competitive sports, so as not to worsen their already elevated risk of ventricular arrhythmias or sudden death.

But such cautions, applied to everyone with HCM, are probably unfounded and may unnecessarily deprive such patients of the health benefits of exercise and its other rewards, say researchers reporting results from the LIVE-HCM study.

Risk for the study’s clinical primary endpoint over 3 years was similar for those of the 1660 patients who self-reported engaging in vigorous exercise, as defined on a questionnaire, and those who exercised “non-vigorously,” that is, at low to moderate levels. It was also similar for those in the vigorous-exercise group who engaged or did not engage in high-intensity competitive sports.

The composite endpoint, which consisted of death, cardiac arrest, syncope considered likely to be arrhythmic, or appropriate implantable-defibrillator shocks, occurred in fewer than 5% of study patients overall, reported Rachel Lampert, MD, on March 6 at the American College of Cardiology (ACC) Scientific Session/World Congress of Cardiology (WCC) 2023, held live and virtually from New Orleans, Louisiana.

The findings “do not support universal restriction of vigorous exercise in patients with hypertrophic cardiomyopathy.” Rather, they should inform discussion between patients and their physicians regarding safe levels of exercise “in the context of expert assessment and management of HCM using an individualized shared decision-making framework,” said Lampert, director of sports cardiology at Yale School of Medicine, New Haven, Connecticut.

Among the caveats about the trial, she said, were that the patients weren’t a randomly selected sample and received care at experienced HCM centers.

Lampert told theheart.org | Medscape Cardiology that participants were asked at the outset what their physicians had recommended to them about exercise.

About 75% of the patients with overt, clinical HCM, she said, and even a third of the phenotype-negative, genotype-positive participants had been advised not to exercise.

But given these results, “We’re now able now to say to HCM patients — after they have been appropriately evaluated by and talked with HCM experts, so that we know they’ve been assessed and treated appropriately — that you can join that soccer league, you can get all the enjoyment and physical benefits of exercise, because it’s not going to put you at higher risk than you already are.”

Exercise restriction can be an enormous burden for patients with HCM, she added. “We know that restriction from exercise worsens your quality of life. And so, I think that this,” the study’s findings, “will be liberating for that group.”

That vigorous exercise did not appear to raise the patients’ risk for major cardiac events was “really encouraging,” agreed sports cardiologist Eugene H. Chung, MD, MPH, University of Michigan Health, Ann Arbor, who isn’t associated with LIVE-HCM.

For such patients and for any level of exercise, “it’s not as high-risk as we used to think. Therefore, the message is that we should be less restrictive than we have been,” he told theheart.org | Medscape Cardiology.

In the previously published RESET-HCM trial, he noted, HCM patients who engaged in a 4-month moderately intensive exercise training program showed improved cardiovascular fitness with no increase in arrhythmic risk.

“There were essentially no real events over the follow-up period, a moderate level of activity seemed reasonable,” Chung said. Now, LIVE-HCM seems to say that “higher-intensity levels are very reasonable too.”

LIVE-HCM enrolled 1660 patients aged 8 to 60 years who had clinical HCM or a genetic predisposition but not the disease at 42 centers in North America, the United Kingdom, Australia, and New Zealand; 42% were female. Any with exercise-restricting clinical disease, such as advanced heart failure, were excluded.

Participants self-reported their level of regular exercise as vigorous (at least one activity of >6 METS for more than 60 h/y) or moderate (activities between 4 and 6 METS for more than 60 h/y) or low (not meeting criteria for vigorous or moderate exercise), per definitions in the Minnesota Leisure Time Activity Questionnaire.

About 42% and 43% of participants reported vigorous or moderate exercise, respectively; the remainder reported low exercise levels. The primary analysis compared the vigorous-exercise group to those reporting non-vigorous exercise, that is, the moderate- and low-level exercise groups combined. All events were blindly adjudicated.

The primary endpoint rate was 15.3 per 1000 person-years for the 961 patients reporting non-vigorous exercise and 15.9 per 1000 person-years for those reporting vigorous exercise. Their rates for components of the primary endpoint were also similar. Of note, about equal proportions of patients had implantable defibrillators, and all endpoint events occurred in those with clinical HCM.

Of the 699 patients reporting vigorous exercise, 259 said it was in the context of competitive sports: 440 reported vigorous noncompetitive exercise. Their primary endpoint rates per 1000 person-years were similar at 13.1 and 17.6, respectively.

The appropriate doctor-patient discussion regarding HCM and exercise may be evolving to become less about avoiding higher-intensity activity and more about the benefits of exercise, Chung observed. The message, he said, “will be that everyone needs to exercise, and that at whatever level you want to do it, it’s relatively low risk. I think we’re heading in that direction.”

Could Inhaling a Statin Help Ease Asthma, COPD?

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News Picture: Could Inhaling a Statin Help Ease Asthma, COPD?By Ernie Mundell HealthDay Reporter

FRIDAY, Jan. 5, 2024

Drugs already used by millions to lower cholesterol might someday have a new role: Relieving asthma and COPD.

That’s the hope of a new line of research underway at the University of California, Davis.

A study funded by the U.S. National Institutes of Health is seeking to determine whether a “statin inhaler” might reduce the airway inflammation that makes breathing difficult for folks with illnesses like asthma or chronic obstructive pulmonary disease (COPD).

Taking a statin pill has no significant effect on the airways, but “delivering statins directly to the lung via inhalation might achieve better local tissue drug levels, and therefore, better clinical results,” theorized lead investigator Amir Zeki, a professor of internal medicine who specializes in pulmonary, critical care and sleep medicine at UC Davis.

This research is still in its early stages. However, if it pans out it might offer another treatment option to the more than 26.5 million Americans with asthma and the more than 16 million battling COPD.

Zeki’s team is focusing on what’s known as airway smooth muscle (ASM) — tissue which lies within each airway’s wall and helps control airflow.

The inflammation that drives asthma can trigger a tightening of smooth muscle, restricting airways. This “hyperactivity” of smooth muscle also plays a role in COPD, the researchers explained.

Treatments such as asthma bronchodilators already target receptors on specific smooth muscle cells, triggering a healthy relaxation of the muscle. But these meds aren’t always effective.

“Despite their widespread use, current inhaler therapies that treat asthma and COPD remain inadequate in controlling symptoms for many patients, especially those with moderate to severe disease,” Zeki said in a UC Davis news release. “For this reason, we need novel inhaled medications to treat obstructive airway diseases such as asthma via mechanisms of action different from current standard-of-care therapies.”

That’s where the anti-inflammatory properties of statins come in. Studies in the lab have shown that these drugs enhance the cellular function of airways in various ways.

“To our surprise, we have discovered that statins also work as a bronchodilator, in which they directly relax ASM tissue, leading to the opening of airways,” Zeki said.

Statins taken as pills have not shown any benefit against airway disease, however. That’s because the liver breaks down drugs taken as pills, minimizing any benefit that might accrue by the time the drug makes it to an airway.

Using an inhaler to deliver a statin directly to the airway bypasses that issue.

“This allows us to deliver significantly lower doses to the airways with hopefully greater potency,” Zeki said.

Phase 1 and phase 2 clinical trials are planned in which patients with asthma and COPD will try out statin inhalers for safety and effectiveness.

“We have successfully developed a proprietary formulation that is available and ready for first-in-human testing,” Zeki said. “Our aim is to begin with asthma, but we also have plans to investigate COPD as well.”

Combining mindfulness with exercise can provide major mental health boosts, study reveals

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BATH, United Kingdom — If you still haven’t settled on a New Year’s resolution, new research suggests you may want to consider adopting two instead of just one. Scientists at the University of Bath say that while exercise and mindfulness make fantastic, healthy habits all on their own, combining the two activities can lead to an even greater boost in overall well-being and mental health.

Study authors explain any life changes that included a combination of both physical activity and mindfulness were the most effective at lifting mood and improving both health and well-being.

Exercise and mindfulness, of course, both feature their own distinct, established psychological benefits. Now, though, this latest work offers a fresh perspective on their combined effect through a review of existing research studies. This report is one of the first ever to detail how the individual positive effects of each increase when someone combines the two.

“Starting 2024 with a resolution to exercise more can have really positive physical and mental health benefits. But we know that starting out can be tough and that it can also be hard to stick with it over time,” says Masha Remskar from Bath’s Department of Health in a university release. “Mindfulness is an approach that can help us ‘train up’ the psychological strengths we need to exercise and be more in tune with our bodies, as well as make exercising more interesting and help us recognize its benefits.”

“This may be because becoming more mindful prompts us to think differently about our lifestyle, makes us more accepting and less judgmental of our own shortcomings, which can help to build healthy habits. There is a huge potential to use mindfulness to unlock the positive benefits exercise can bring.”

Woman at the gym laughing after finishing a strenuous boxing exercise
Woman laughing at the gym (Photo by Unsplash+ in collaboration with Getty Images)

The research indicates that mindfulness — a variety of meditation that focuses on the present moment free of any interpretations, judgments, or thoughts — can also help “unlock” exercise by helping motivate people to get started in the first place. For example, this technique can help overcome minor pain, discomfort, or feelings of failure when working out becomes difficult.

An analysis of the existing research found mindfulness to be a highly effective method of lowering one’s worries, stress, and anxiety, as well as serving as a catalyst for healthier, happier lives. Researchers saw these mental and physical health benefits tied to mindfulness in people with and without health issues.

This project was put together by psychologist Masha Remskar, an expert in behavior change, mindfulness and exercise based at the University of Bath, in collaboration with the Medito Foundation, a mindfulness non-profit on a mission to build a more mindful world. Medito has developed a free mindfulness meditation app – an alternative to paid-for services like Headspace and Calm. Now, the Medito Foundation hopes their collaboration with the University of Bath will help encourage more people to try both mindfulness and more exercise.

Based on this new report, the research team have already developed and released the first of two mindfulness audio courses intended to help people exercise more. Later this year, they plan to release the second guide, which will focus on sustaining exercise habits.

“Mindfulness mobile apps are a great way to boost our mental wellbeing. Unfortunately, all too often companies put up paywalls, making the benefits of mindfulness inaccessible to some,” adds Steven Yorke, co-founder at Medito.

“This collaboration with the University of Bath has been a great way to expand the range of mindfulness meditations we can offer, and it feels great to be at the cutting edge of mindfulness science while we do this.”

The study is published in the journal Mental Health and Physical Activity.

14 Ways to Shed Pounds After 40

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Age Matters

Age Matters

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If you’re over 40, you may have noticed that it’s easier to gain weight — and harder to lose it — than it used to be. Changes in your activity level, eating habits, and hormones, and how your body stores fat all can play roles. But a few simple steps may help you slim down.

Eat Your Fruits and Veggies

Eat Your Fruits and Veggies

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Fill half your plate with them at every meal. Produce tends to have more nutrients and less fat and calories than meat, dairy products, or grains. And it may help you feel satisfied, even if you eat less. Fresh fruits, like apples and berries, are also great in place of high-fat or high-sugar snacks.

Don’t Skip Breakfast

Don’t Skip Breakfast

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Experts recommend a healthy morning meal like oatmeal or whole wheat toast with fruit. It can help curb that mid-morning hunger that leads you to grab something unhealthy on-the-go or overeat at lunch. Small meals or snacks every few hours can keep your appetite in check all day long.

Eat Less at Night

Eat Less at Night

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If you get most of your daily calories at lunch (before 3 p.m.), you might lose more weight than if you have a big meal later. But the most important thing is still what you eat, not when.

Cook Healthy Meals

Cook Healthy Meals

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A lot of extra fat and calories can come from the way you prepare food. Instead of frying food or cooking it in butter or lots of oil, try grilling, baking, or broiling. This is good advice at restaurants, too: Skip foods that are fried or that come in creamy sauces. 

Don’t Make a Second Trip

Don’t Make a Second Trip

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You tend to be less active as you get older, and you may need a few hundred calories less than you used to. To lose weight, you may need to cut your calories back even more. Smaller portions and tracking your calories with a food diary or an app can help you eat less.

Pay Attention

Pay Attention

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When you’re busy with work, kids, and life, you can be tempted to grab food on-the-go or multitask through a meal. But you’re more likely to overeat — and be hungry again soon after — if you don’t focus on your food. Sit down for meals and tune in to what’s on your plate (not what’s on your TV or computer screen). That helps your brain realize when you’ve had enough.

Lay Off the Soda

Lay Off the Soda

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If you drink sugar-sweetened coffee, tea, soft drinks, or energy drinks, switch to water or another zero-calorie beverage. Your sweet drinks have lots of added sugar, which can make you gain weight and raise your risk for diabetes.

Cut Back on Alcohol

Cut Back on Alcohol

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Beer bellies aren’t always caused by booze. But a “spare tire” is common in middle age, and alcohol can have something to do with it. A glass of beer or wine is about 150 calories, and that can add up if you drink often. Plus, alcohol can make you hungry, so you may eat more while you drink.

Make Time for Exercise

Make Time for Exercise

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Between desk jobs, commutes, and family activities, many 40-somethings don’t have a lot of free time to work out. But it’s important — for your weight and your overall health — to fit in at least 2 1/2 hours of moderate physical activity (like brisk walking or light yard work) every week. Pencil times in to your calendar, and make them a priority.

Build Muscle

Build Muscle

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People naturally lose muscle after 40, especially women after menopause. Because muscle burns more calories than fat, this can slow down your metabolism and make it harder to shake those stubborn pounds. Strength-training exercises — lifting weights or doing body-weight exercises, like push-ups and squats — at least twice a week can help you keep those muscles.

Relax, Don’t Stress

Relax, Don’t Stress

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Stress can make you more likely to binge on unhealthy food, and it makes it harder for your body to break down fat. Try yoga, deep breathing, meditation, going for a walk, or reading a good book. Stress relief is different for everyone, so find what works for you.

Get Good Sleep

Get Good Sleep

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All kinds of things can mess with your sleep after age 40 — health problems, stress, medications, and, for women, menopause. But people who don’t get good-quality sleep are more likely to gain weight. If you skimp on sleep because you’re busy or stressed, try to change your habits and settle into a regular routine.

Have Your Thyroid Checked

Have Your Thyroid Checked

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If you eat healthy and exercise regularly and still can’t lose weight, your thyroid might not be working like it should. This happens in about 5% of people, and it’s most common in women and people over 60. In addition to weight gain, it can also cause fatigue, joint or muscle pain, and depression. Medications can help, so get it checked if you think it might be an issue.

Get Support

Get Support

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For many people, it’s easier to lose weight with others than to do it alone. You might enter a weight-loss contest at work, join a group on social media, or ask a friend to go for early-morning walks or classes at the gym. Other people who share your goals can help keep you accountable and cheer you on as you make progress.

Micronutrients in early life and offspring metabolic health programming: a promising target for preventing non-communicable diseases

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Abstract

Chronic non-communicable diseases are the leading cause of morbidity and mortality worldwide. Developing and implementing effective preventive strategies is the best way to ensure the overall metabolic health status of the population and to counter the global burden of non-communicable diseases. Predisposition to obesity and other non-communicable diseases is due to a combination of genetic and environmental factors throughout life, but the early environment, particularly the environment during the fetal period and the early years of life, is crucial in determining metabolic health, hence the concept of ‘fetal programming’. The origins of this causal link between environmental factors and disease lie in epigenetic mechanisms. Among the environmental factors, diet plays a crucial role in this process. Substantial evidence documented the key role of macronutrients in the programming of metabolic diseases early in life. Recently, the effect of maternal micronutrient intake on offspring metabolic health in later life emerged. The purpose of this narrative review is to bring to light available evidence in the literature on the effect of maternal micronutrient status on offspring metabolic health and underlying epigenetic mechanisms that drive this link to highlight its potential role in the prevention of non-communicable diseases.