OREGON STATE UNIVERSITY

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Mechanism outlined by which inadequate vitamin E can cause brain damage

 

The study this story is based on is available online: http://bit.ly/1DtAIyU

 

CORVALLIS, Ore. – Researchers at Oregon State University have discovered how vitamin E deficiency may cause neurological damage by interrupting a supply line of specific nutrients and robbing the brain of the “building blocks” it needs to maintain neuronal health.

The findings – in work done with zebrafish – were just published in the Journal of Lipid Research. The work was supported by the National Institutes of Health.

The research showed that zebrafish fed a diet deficient in vitamin E throughout their life had about 30 percent lower levels of DHA-PC, which is a part of the cellular membrane in every brain cell, or neuron. Other recent studies have also concluded that low levels of DHA-PC in the blood plasma of humans are a biomarker than can predict a higher risk of Alzheimer’s disease.

Just as important, the new research studied the level of compounds called “lyso PLs,” which are nutrients needed for getting DHA into the brain, and serve as building blocks that aid in membrane repair. It showed the lyso PLs are an average of 60 percent lower in fish with a vitamin E deficient diet.

The year-old zebrafish used in this study, and the deficient levels of vitamin E they were given, are equivalent to humans eating a low vitamin E diet for a lifetime. In the United States, 96 percent of adult women and 90 percent of men do not receive adequate levels of vitamin E in their diet.

DHA is a polyunsaturated fatty acid, or PUFA, increasingly recognized as one of the most important nutrients found in omega-3 fatty acids, such as those provided by fish oils and some other foods.

“This research showed that vitamin E is needed to prevent a dramatic loss of a critically important molecule in the brain, and helps explain why vitamin E is needed for brain health,” said Maret Traber, the Helen P. Rumbel Professor for Micronutrient Research in the College of Public Health and Human Sciences at OSU and lead author on this research.

“Human brains are very enriched in DHA but they can’t make it,” said Traber, who also is a principal investigator in the Linus Pauling Institute at OSU. “They get it from the liver. The particular molecules that help carry it there are these lyso PLs, and the amount of those compounds is being greatly reduced when vitamin E intake is insufficient. This sets the stage for cellular membrane damage and neuronal death.”

DHA is the needed nutrient, Traber said, but it’s lyso PLs which help get it into the brain. It’s the building block.

“You can’t build a house without the necessary materials,” Traber said. “In a sense, if vitamin E is inadequate, we’re cutting by more than half the amount of materials with which we can build and maintain the brain.”

Some other research, Traber said, has shown that the progression of Alzheimer’s disease can be slowed by increased intake of vitamin E, including one study published last year in the Journal of the American Medical Association. But that disease is probably a reflection of years of neurological damage that has already been done, she said. The zebrafish diet used in this study was deficient in vitamin E for the whole life of the fish – as is vitamin E deficiency in some humans.

Vitamin E in human diets is most often provided by dietary oils, such as olive oil. But many of the highest levels are in foods not routinely considered dietary staples – almonds, sunflower seeds or avocados.

“There’s increasingly clear evidence that vitamin E is associated with brain protection, and now we’re starting to better understand some of the underlying mechanisms,” Traber said.

Other collaborators on this research included Jan Stevens from the OSU College of Pharmacy and Robert Tanguay from the College of Agricultural Sciences.

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Maret Traber, 541-737-7977

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Sunflowers
Vitamin E source

High cholesterol, triglycerides can keep vitamin E from reaching body tissues

CORVALLIS, Ore. – In the continuing debate over how much vitamin E is enough, a new study has found that high levels of blood lipids such as cholesterol and triglycerides can keep this essential micronutrient tied up in the blood stream, and prevent vitamin E from reaching the tissues that need it.

The research, just published in the American Journal of Clinical Nutrition, also suggested that measuring only blood levels may offer a distorted picture of whether or not a person has adequate amounts of this vitamin, and that past methods of estimating tissue levels are flawed.

The findings are significant, the scientists say, because more than 90 percent of the people in the United States who don’t take supplements lack the recommended amount of vitamin E in their diet.

Vitamin E is especially important in some places such as artery walls, the brain, liver, eyes and skin, but is essential in just about every tissue in the body. A powerful, fat-soluble antioxidant, it plays important roles in scavenging free radicals and neurologic function. In the diet, it’s most commonly obtained from cooking oils and some vegetables.

Some experts have suggested that recommended levels of vitamin E should be lowered. But because of these absorption issues, the recommended level of 15 milligrams per day is about right, said Maret Traber, the lead author of this study. Inadequate vitamin E intake remains a significant societal problem, she said.

“This research raises particular concern about people who are obese or have metabolic syndrome,” said Traber, who is the Helen P. Rumbel Professor for Micronutrient Research in the College of Public Health and Human Sciences at Oregon State University, and a principal investigator in OSU’s Linus Pauling Institute.

“People with elevated lipids in their blood plasma are facing increased inflammation as a result,” Traber said. “Almost every tissue in their body is under oxidative attack, and needs more vitamin E. But the vitamin E needed to protect these tissues is stuck on the freeway, in the circulatory system. It’s going round and round instead of getting to the tissues where it’s needed.”

This research was done with 41 men and women, including both younger and older adults, who obtained vitamin E by eating deuterium-labeled collard greens, so the nutrient could be tracked as it moved through the body. Of some interest, it did not find a significant difference in absorption based solely on age or gender. But there was a marked difference in how long vitamin E stayed in blood serum, based on higher level of lipids in the blood – a more common problem as many people age or gain weight.

The study also incorporated a different methodology, using a stable isotope instead of radioactive tracers, than some previous research, to arrive at the estimates of vitamin E that made it to body tissues. Using the stable isotope methodology that these researchers believe is more accurate, they concluded that only 24 percent of vitamin E is absorbed into the body, instead of previous estimates of 81 percent measured by the use of radioactive vitamin E.

“In simple terms, we believe that less than one third the amount of vitamin E is actually making it to the tissues where it’s most needed,” Traber said.

Vitamin E in the blood stream is not completely wasted, Traber noted. There, it can help protect LDL and HDL cholesterol from oxidation, which is good. But that doesn’t offset the concern that not enough of this micronutrient may be reaching tissues, she said.

Collaborators on this study were from the USDA Human Nutrition Center on Aging at Tufts University, and the Children’s Nutrition Research Center at the Baylor College of Medicine. The work was supported by the USDA Agricultural Research Service and the National Institutes of Health.

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Maret Traber, 541-737-7977

Beyond prevention: sulforaphane may find possible use for cancer therapy

CORVALLIS, Ore. – New research has identified one of the key cancer-fighting mechanisms for sulforaphane, and suggests that this much-studied phytochemical may be able to move beyond cancer prevention and toward therapeutic use for advanced prostate cancer.

Scientists said that pharmacologic doses in the form of supplements would be needed for actual therapies, beyond the amount of sulforaphane that would ordinarily be obtained from dietary sources such as broccoli. Research also needs to verify the safety of this compound when used at such high levels.

But a growing understanding of how sulforaphane functions and is able to selectively kill cancer cells indicate it may have value in treating metasticized cancer, and could work alongside existing approaches.

The new findings on the unique abilities of sulforaphane were recently published in the journal Oncogenesis, by researchers from Oregon State University and the Texas A&M Health Science Center. The work was supported by the National Institutes of Health.

“There’s significant evidence of the value of cruciferous vegetables in cancer prevention,” said Emily Ho, professor and director of the Moore Family Center for Whole Grain Foods, Nutrition and Preventive Health in the OSU College of Public Health and Human Sciences, and lead author on this research.

“However, this study is one of the first times we’ve shown how sulforaphane can affect a histone methylation and alter gene expression in metasticized prostate cancer cells,” said Ho, who is also a principal investigator in OSU’s Linus Pauling Institute. “It begins a process that can help to re-express tumor suppressors, leading to the selective death of cancer cells and slowing disease progression.”

The evidence now shows that sulforaphane should have therapeutic value against some forms of cancer, Ho said, including late-stage, metasticized disease. Its multiple impacts on metabolic processes might also make it a valuable adjunct to existing therapies, helping them to work better.

No clinical trials have yet been done to test the value of sulforaphane in cancer therapy, although a trial is under way using sulforaphane supplements in men with high risk for prostate cancer. Results from that may help demonstrate the safety of higher-dosage supplements and set the stage for therapeutic trials, Ho said.

Dozens of studies have examined the health value of cruciferous vegetables such as broccoli, cauliflower, and cabbages, and many of them ultimately focused on the role of sulforaphane, one compound found in these foods. Broccoli sprouts contain some of the highest dietary levels of the sulforaphane precursor.

The new study identified a particular enzyme in prostate cancer cells, SUV39H1, that is affected by exposure to sulforaphane. Aside from potential dietary approaches, the researchers said that this establishes SUV39H1 as a new therapeutic target, in general, for advanced cancer.

Prostate cancer is one of the most commonly diagnosed cancers in the United States, and existing therapies include surgical removal of the prostate, radiation therapy, hormones or other approaches. Although often slow growing, prostate cancer can be much more aggressive if it metasticizes to other areas of the body, at which point survival rates decrease dramatically. In the U.S. it’s the fifth leading cause of cancer death.

In laboratory studies, sulforaphane has shown toxicity to a number of human cancer cell lines, including prostate, breast, ovarian, colon and pancreatic cancer, and in animal studies it decreased metastases of prostate cancer.

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Emily Ho, 541-737-9559

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Broccoli

Broccoli

Vitamin E intake critical during “the first 1000 days”

CORVALLIS, Ore. – Amid conflicting reports about the need for vitamin E and how much is enough, a new analysis published today suggests that adequate levels of this essential micronutrient are especially critical for the very young, the elderly, and women who are or may become pregnant.

A lifelong proper intake of vitamin E is also important, researchers said, but often complicated by the fact that this nutrient is one of the most difficult to obtain through diet alone. Only a tiny fraction of Americans consume enough dietary vitamin E to meet the estimated average requirement.

Meanwhile, some critics have raised unnecessary alarms about excessive vitamin E intake while in fact the diet of most people is insufficient, said Maret Traber, a professor in the College of Public Health and Human Sciences at Oregon State University, principal investigator with the Linus Pauling Institute and national expert on vitamin E.

“Many people believe that vitamin E deficiency never happens,” Traber said. “That isn’t true. It happens with an alarming frequency both in the United States and around the world. But some of the results of inadequate intake are less obvious, such as its impact on the nervous system and brain development, or general resistance to infection.”

Some of the best dietary sources of vitamin E – nuts, seeds, spinach, wheat germ and sunflower oil - don’t generally make the highlight list of an average American diet. One study found that people who are highly motivated to eat a proper diet consume almost enough vitamin E, but broader surveys show that 90 percent of men and 96 percent of women don’t consume the amount currently recommended, 15 milligrams per day for adults.

In a review of multiple studies, published in Advances in Nutrition, Traber outlined some of the recent findings about vitamin E. Among the most important are the significance of vitamin E during fetal development and in the first years of life; the correlation between adequate intake and dementia later in life; and the difficulty of evaluating vitamin E adequacy through measurement of blood levels alone.

Findings include:

  • Inadequate vitamin E is associated with increased infection, anemia, stunting of growth and poor outcomes during pregnancy for both the infant and mother.
  • Overt deficiency, especially in children, can cause neurological disorders, muscle deterioration, and even cardiomyopathy.
  • Studies with experimental animals indicate that vitamin E is critically important to the early development of the nervous system in embryos, in part because it protects the function of omega-3 fatty acids, especially DHA, which is important for brain health. The most sensitive organs include the head, eye and brain.
  • One study showed that higher vitamin E concentrations at birth were associated with improved cognitive function in two-year-old children.
  • Findings about diseases that are increasing in the developed world, such as non-alcoholic fatty liver disease and diabetes, suggest that obesity does not necessarily reflect adequate micronutrient intake.
  • Measures of circulating vitamin E levels in the blood often rise with age as lipid levels also increase, but do not prove an adequate delivery of vitamin E to tissues and organs.
  • Vitamin E supplements do not seem to prevent Alzheimer’s disease occurrence, but have shown benefit in slowing its progression.
  • A report in elderly humans showed that a lifelong dietary pattern that resulted in higher levels of vitamins B,C, D and E were associated with a larger brain size and higher cognitive function.
  • Vitamin E protects critical fatty acids such as DHA throughout life, and one study showed that people in the top quartile of DHA concentrations had a 47 percent reduction in the risk of developing all-cause dementia.

“It’s important all of your life, but the most compelling evidence about vitamin E is about a 1000-day window that begins at conception,” Traber said. “Vitamin E is critical to neurologic and brain development that can only happen during that period. It’s not something you can make up for later.”

Traber said she recommends a supplement for all people with at least the estimated average requirement of vitamin E, but that it’s particularly important for all children through about age two; for women who are pregnant, nursing or may become pregnant; and for the elderly.

This research was supported in part by the National Institutes of Health.

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Maret Traber, 541-737-7977

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Sunflowers

High in vitamin E

Few surfers are deterred by ocean bacteria that makes them sick

CORVALLIS, Ore. – Health warnings issued when beaches have high levels of bacteria do not keep many surfers out of the water, according to a new study by Oregon State University.

Nearly three in 10 surfers admit they knowingly surf during health advisories – nearly the same amount that chooses not to surf during periods of elevated bacteria. About 40 percent of surfers said they were unaware if they had ever surfed during an active health advisory.

The data can help public officials better warn surfers of potential health risks, said Anna Harding, co-author of the study and professor in OSU's College of Public Health and Human Sciences.

"Beach advisories for bacteria are not having their intended effect of dissuading surfers,” Harding said. “The lack of awareness about advisories – and willingness to take risks surfing in water that may be contaminated – suggests the need to educate surfers about behaviors that make them vulnerable to illness."

More than 500 surfers from the Pacific Northwest provided information for OSU's study and spanned a wide range of ages, incomes, surfing frequency and other demographics.

Of those surveyed by OSU, nearly 40 percent reported ear infections or discharge at some point during surfing; 30 percent, a sore throat or cough; 16 percent experienced diarrhea; 10 percent, fever; and 7 percent had vomited. Results were consistent across experience levels and were not lessened by showering after surfing.

Surfing during and after rain also led to higher rates of waterborne illnesses. Surfers are attracted to large waves that accompany a storm, but rain can send fecal bacteria from stormwater outfalls into the Pacific Ocean, as well as flush harmful microbes from animal feces present in streams and rivers onto beaches.

Surfers cannot avoid swallowing water – which can include harmful bacteria – during wipeouts, Harding said. They ingest 10 times more ocean water than swimmers, about 170 milliliters a day, or half a can of soda, she added.

Health advisories are posted online and on signs around the West Coast. But not every beach entrance has a warning sign, and many surfers do not notice them, said Dave Stone, co-author of the study and an environmental and molecular toxicology professor in OSU's College of Agricultural Sciences.

Beach sampling by states is intermittent, tends to lag behind current conditions and cannot cover all waters, Stone added.

"The best thing surfers can do is pay attention to the weather and where stormwater outfalls are located," said Stone, a toxicologist with OSU Extension. “They should also bookmark beach advisory websites with the latest information.”

"Surfers can go far in minimizing their exposure to microbes just by choosing when and where to surf," he added.

When an advisory is issued for a particular beach, water contact is discouraged and state websites advise beachgoers to avoid any activities during which they might swallow water, such as swimming, surfing, diving, and kayaking.

Using earplugs during surfing also leads to higher rates of ear infections, OSU researchers found. Generic earplugs tend to let water and bacteria inside the ear, Stone said, and then trap it inside the canal

OSU's study was funded by Oregon Sea Grant and is available online in the Journal of Water and Health.

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Anna Harding, 541-737-3830

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Oregon beach sign, Brookings

Beach signs

Motor skill deficiencies linked to autism severity in new research

CORVALLIS, Ore. – An Oregon State University researcher has found a relationship between motor skill deficiencies and the severity of the symptoms of autism spectrum disorder in very young children.

The findings, believed to the be the first to show a direct relationship between motor skills and autism severity, indicate that development of fine and gross motor skills should be included in treatment plans for young children with autism, said Megan MacDonald, an assistant professor in OSU’s College of Public Health and Human Sciences.

“Recognizing those deficits really early gives us more time to help children catch up to their peers in regards to motor skill,” said MacDonald, who is an expert on the movement skills of children with autism.

The research was based on a study of the development and motor skills of 159 children ages 12 months to 33 months old, including 110 children with an autism diagnosis. Results were published this week in “Adapted Physical Activity Quarterly.” 

The motor skill deficiencies among the children with autism were not related to intellectual ability, MacDonald said. She found that the children with autism were nearly a year behind their typical peers in fine motor skills, such as holding a spoon or grasping a small toy. They also were about six months behind in their gross motor skills, including activities like running and jumping.

“It’s not that big a deal if we’re talking about older kids, but for kids between 1 and 3 years old, those are substantial deficits, almost one-third of their life,” MacDonald said. “At that age, they’re like little sponges – we can teach them motor skills.”

Most autism treatment plans for young children focus on social communication because the disability has such a significant effect in that area. Research has shown that successful social communication interventions can improve IQ, language, play skills and more for children with autism.

Incorporating fine and gross motor skill development into early interventions could provide a similar boost, MacDonald said. She also recommends that parents consider adaptive physical education programs, which are designed around a child’s abilities and needs.

MacDonald said she hopes the new research will help build awareness about the importance of motor skill development and the need to include adapted physical education and physical and occupational therapy in treatment plans. Future research will look at different types of motor skill interventions to see if there are some that work better than others, she said.

Co-authors of the study are Catherine Lord of Weill Cornell Medical College and New York Presbyterian Hospital in White Plains, N.Y., and Dale A. Ulrich of the School of Kinesiology at the University of Michigan.

The research was funded in part by a grant to MacDonald from the Blue Cross Blue Shield Foundation of Michigan. Study co-author Lord received funding from the Simons Foundation, First Words; the National Institute of Child Health and Human Development and the National Institute of Mental Health.

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Megan MacDonald, 541-737-3273, Megan.MacDonald@oregonstate.edu

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Megan MacDonald

Religion, spirituality influence health in different but complementary ways

CORVALLIS, Ore. – Religion and spirituality have distinct but complementary influences on health, new research from Oregon State University indicates.

“Religion helps regulate behavior and health habits, while spirituality regulates your emotions, how you feel,” said Carolyn Aldwin, a gerontology professor in the College of Public Health and Human Sciences at OSU.

Aldwin and colleagues have been working to understand and distinguish the beneficial connections between health, religion and spirituality. The result is a new theoretical model that defines two distinct pathways.

Religiousness, including formal religious affiliation and service attendance, is associated with better health habits, such as lower smoking rates and reduced alcohol consumption. Spirituality, including meditation and private prayer, helps regulate emotions, which aids physiological effects such as blood pressure. 

The findings were published recently in the journal “Psychology of Religion and Spirituality.” Co-authors were Crystal L. Park of the University of Connecticut, and Yu-Jin Jeong and Ritwik Nath of OSU. The research was supported by a grant from the John Templeton Foundation.

“No one has ever reviewed all of the different models of how religion affects health,” said Aldwin, the Jo Anne Leonard endowed director of OSU’s Center for Healthy Aging Research. “We’re trying to impose a structure on a very messy field.”

There can be some overlap of the influences of religion and spirituality on health, Aldwin said.  More research is needed to test the theory and examine contrasts between the two pathways. The goal is to help researchers develop better measures for analyzing the connections between religion, spirituality and health and then explore possible clinical interventions, she said.

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Contact: Carolyn Aldwin, 541-737-2024; Carolyn.aldwin@oregonstate.edu

OSU selects public health leader, ecologist for Distinguished Professor Awards

CORVALLIS, Ore. – The leader behind what will become Oregon’s first accredited school of public health and a terrestrial ecologist who identified a new paradigm in wildlife research have been named 2014 recipients of the Distinguished Professor Award by Oregon State University.

Marie Harvey, a professor in OSU’s College of Public Health and Human Sciences, and William Ripple, a professor in the College of Forestry, will receive their awards this spring and give public lectures on campus.

The Distinguished Professor title is the highest designation Oregon State gives to its faculty.

Sabah Randhawa, OSU provost and executive vice president, said the two faculty members chosen for the honor share similar traits of innovative leadership, internationally recognized scholarship and service to the university and their respective fields.

“Marie Harvey and Bill Ripple exemplify what we hope all of our faculty will strive to become as they develop their careers,” Randhawa said. “They both have revolutionized their fields, drawing respect and admiration not only from their colleagues on campus, but from around the world.”

Harvey is widely known for her pioneering work in reproductive and sexual health, shifting the research from an exclusive focus on women to one that examines the relationship dynamics of couples as it applies to both pregnancy and disease prevention. That shift, along with Harvey’s work in diversity and equity, prompted the American Public Health Association to present her with its Lifetime Achievement Award.

“I am very pleased that Marie Harvey is being honored with the Distinguished Professor title,” said Tammy Bray, dean of OSU’s College of Public Health and Human Sciences. “In addition to her scholarly contributions to the field of public health, I most appreciate her leadership and partnership with me in the effort to transform our college to become the first accredited school of public health in Oregon.”

Harvey has been a faculty member at OSU since 2003 and associate dean of the college since 2011. Her title is Distinguished Professor of Public Health.

Ripple began his career studying old-growth forests and spotted owls and evolved his research to look at the impact of predators. His work led to a new field called “trophic cascades” – or how large predators exert powerful influences on ecosystem structure and function. Examples include the influence of wolves in Yellowstone Park on everything from the composition of hardwood forests to streamside erosion.

His prominence as an ecologist has led to consulting efforts with the National Academy of Sciences, The White House, President Clinton’s Forest Summit, the U.S. Fish and Wildlife Service and others. Ripple will be Distinguished Professor of Ecology.

“Bill Ripple has been a fantastic teacher and researcher in the College of Forestry and well deserves being named a Distinguished Professor,” said Thomas Maness, dean of the college. “He is an internationally known leader in the ecology of top predators and his studies on the impact of gray wolves in Yellowstone, along with co-author (OSU professor emeritus) Robert Beschta, have been featured in numerous scientific journals and in popular media. They have directly impacted conservation research and policies.”

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 Sabah Randhawa, 541-737-2111; Sabah.Randhawa@oregonstate.edu

Aging men: More uplifts, fewer hassles until the age of 65-70

CORVALLIS, Ore. – A new study of how men approach their golden years found that how happy individuals are remains relatively stable for some 80 percent of the population, but perceptions of unhappiness – or dealing with “hassles” – tends to get worse once you are about 65-70 years old.

The reasons vary, researchers say, but may be because of health issues, cognitive decline or the loss of a spouse or friends.

“In general, life gets better as you age in the sense that older adults on average have fewer hassles – and respond to them better – than younger adults,” said Carolyn Aldwin, a gerontology professor in the College of Public Health and Human Sciences at Oregon State University and lead author on the study. “And they also experienced more uplifts – a least, until their mid-70s.”

“But once you turn 70, how you react to these hassles changes and may be dependent on your resources or your situation in life,” added Aldwin, the Jo Anne Leonard endowed director of OSU’s Center for Healthy Aging Research.

Results of the study, which was funded by the National Institutes of Health and the Department of Veterans Affairs, are being published in the journal Psychology and Aging.

The researchers used data from the Veterans Affairs Normative Aging Study, which looked at 1,315 men ages 53 to 85 years of age – predominantly comprised of white males who were initially in good health at entry into the study in the 1960s. This particular study aimed to take a fresh look at the emotional reactions of older adults and evaluate whether three previously established, yet contradictory models of aging had validity.

One of those models, known as the hedonic treadmill model, suggests that how happy or unhappy you are is relatively stable through your life, outside of a few up-or-down blips. A second theory posits that in general things get better as you age, while the third says your life will spiral downhill rapidly once you turn 80.

The new study, led by researchers from Oregon State and Boston University, found some support for all three models, depending on whether you looked at hassles or uplifts – and the age of the men. How men appraised their uplifts was stable, the researchers say, supporting the hedonic treadmill theory. But how they appraised hassles depended on their age: Appraisals got better through their 60s, but then started to become more severe in their 70s.

Nonetheless, Aldwin noted, some men respond more intensely to life’s ups and downs than others, but both the perception and intensity of these events is highly variable among individuals.

“What we found was that among 80 percent of the men in the study, the hassles they encounter from their early 50s on tended to decline until they reached about 65 to 70 years of age, and then they rose,” Aldwin pointed out. “Conversely, about 20 percent of the men perceived experiencing more uplifting events until they turned 65-70 and they begin to decline.”

The study drew from the perceptions of the men over events in their lives that were big and small, positive and negative. Self-regulation – or how they respond to those events – varied, Aldwin said.

“Some older people continue to find sources of happiness late in life despite dealing with family losses, declining health, or a lack of resources,” she said. “You may lose a parent, but gain a grandchild. The kids may leave the house, but you bask in their accomplishments as adults. You find value in gardening, volunteering, caregiving or civic involvement.”

Aging is neither exclusively rosy nor depressing, Aldwin said, and how you react to hassles and uplifts as a 55- to 60-year-old may change as you enter what researchers call “the fourth age,” from 75 to 100, based on your perceptions and/or your life experiences.

“Who falls into these groups and why can begin to tell us what kind of person ultimately may be happy late in life and who may not,” Aldwin said. “Once we find that out, we can begin interventions.”

The researchers on the study, who included Yu-Jin Jeong and Heidi Igarashi of OSU, and Avron Spiro III of Boston University, hope to expand their research beyond the limited VA sample and look at the mental health outlook for aging women, minorities and persons with varied economic and health backgrounds.

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Carolyn Aldwin, 541-737-2024; Carolyn.aldwin@oregonstate.edu

Study finds home births comparatively safe – for low-risk women, infants

CORVALLIS, Ore. – The largest study ever conducted in the United States of planned home births found that 93.6 percent of the 16,924 women in the study had spontaneous vaginal births, and only 5.2 percent required a cesarean section for delivery.

Both mortality figures and the cesarean rate are lower than those reported at U.S. hospitals, which is to be expected the researchers say because the women in the study were primarily healthy and the pregnancies low-risk. Importantly, however, the numbers reported in this study are consistent with other large home birth studies conducted in Canada and Europe.

Results of the study are being published this week in the Journal of Midwifery and Women’s Health. A companion article provides evidence of data validity.

“Given our findings, especially in light of other observational studies published in the last decade, I think it’s time to start shifting the discourse around home birth in this country,” said Melissa Cheyney, a medical anthropologist at Oregon State University and lead author on the study. “We need to start focusing on who might be a good candidate for a home or birth center birth and stop debating whether women should be allowed to choose these options.

“Home birth is not for every woman and risk factors need to be weighed,” she added. “But the evidence strongly suggests that a healthy woman with an uncomplicated delivery and a single, term baby in a head-down position can safely give birth outside the hospital.”

Home births are on the rise in the United States – up about 40 percent in the last nine years – but still constitute only 1.2 percent of all deliveries. In contrast, 8 percent of women in Great Britain and 29 percent of women in the Netherlands give birth outside of an obstetric unit.

The study resulted from an analysis of data collected by the Midwives Alliance of North America Statistics Project, commonly referred to as MANA Stats. Most of the nearly 17,000 women in the study were attended by Certified Professional Midwives, who provided detailed reports on outcomes. Among the findings:

  • Of the 1,054 women who had previously given birth by cesarean section, 87 percent had a successful vaginal birth;
  • More than 89 percent of the women successfully gave birth at home, while only 11 percent of them required transport for medical treatment. Of those receiving additional medical care, the majority were for “failure to progress,” usually indicating that labor was proceeding slowly and that augmentation of the labor may have been needed.
  • Only 1.5 percent of the babies had a low Apgar score, a measure of how healthy the newborn is in the first five minutes following birth.

“One of the biggest risk factors we did find is with breech births, which have a higher mortality rate than do head-down babies,” said Cheyney, an associate professor in OSU’s College of Liberal Arts who also is a practicing certified professional midwife. “Most breeches are known prior to birth and many breech babies may successfully be turned to a head-down position prior to delivery.

“But this kind of information is important for mothers, physicians and midwives to discuss as they engage in shared decision-making.”

Women in this nationwide study were predominately white and married, and 58 percent were college-educated, according to Marit Bovbjerg, a postdoctoral research associate in epidemiology in Oregon State’s College of Public Health and Human Sciences and a co-author on the study.

The study also found that 98 percent of the newborns were breastfeeding six weeks after birth, and 86 percent exclusively so – one of the strongest measures of future health and at a rate much higher than the national average.

The study was supported by the Foundation for the Advancement of Midwifery, the Transforming Birth Fund, and the MANA Board of Directors. Other authors on the paper include Courtney Everson, a doctoral student at OSU; Wendy Gordon, a faculty member in the Bastyr University Midwifery Department; Darcy Hannibal, a research associate at the University of California, Davis; and Saraswathi Vedam, an associate professor in the University of British Columbia faculty of medicine.

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Melissa Cheyney, 541-737-4515; melissa.cheyney@oregonstate.edu