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Atrial fibrillation linked to high mortality and hospitalization rates, UQ study shows

Forty-five per cent of patients admitted to hospital for atrial fibrillation (AF) in Australia and New Zealand die within a decade, according to University of Queensland research.

A team led by Dr. Linh Ngo from UQ's Faculty of Medicine analyzed data from more than 250,000 patients admitted for AF and atrial flutter – a closely related condition – to all public and most private hospitals in Australia and New Zealand between 2008 and 2017.

AF is the most common heart rhythm disorder and the leading cause of heart-related hospitalizations globally, causing symptoms like palpitations, dizziness, and chest pain.

The disorder is closely associated with stroke, but we know much less about the risk of recurrent hospitalizations and other consequences such as heart failure or death.

Unfortunately, we found only 55.2 per cent of patients hospitalized with atrial fibrillation survived beyond a decade."

Dr. Linh Ngo from UQ's Faculty of Medicine

Dr Ngo said while some of those deaths were attributable to co-existing conditions, the research showed AF reduced a patient's life expectancy on average by 2.6 years.

"At 10 years, one in 10 patients had suffered a stroke, one in 6 were hospitalized for heart failure, and 41.2 per cent had been readmitted due to recurrent atrial fibrillation or flutter," she said. 

Co-author and cardiologist Associate Professor Isuru Ranasinghe from the Prince Charles Hospital said the research revealed at 10 years, less than 7 per cent of patients had catheter ablation procedure, one of the most effective treatments for patients with symptomatic atrial fibrillation.

"It may mean this procedure was underused in Australian and New Zealand hospitals," Dr Ranasinghe said.

"Clinicians currently primarily focus on preventing the risk of stroke, but these findings emphasize the need to consider atrial fibrillation as a chronic disease with multiple serious downstream consequences.

"There needs to be a greater focus on preventing recurrent hospitalizations and heart failure.

"The literature also suggests many patients at high risk of a stroke fail to receive blood thinning medications, so current preventative efforts are far from ideal.

"Better patient education in areas such as blood pressure control and weight loss, as well as appropriate preventative therapy in hospital and primary care could improve the outcomes for people with AF."

The research paper is published in European Heart Journal.

'The hypomanic state can be really beautiful': What life is really like when you have bipolar disorder 

Model and Bipolar UK ambassador Rosie van Amerongen, 26, explains her experience of living with the mental health condition

'At the time, it seemed completely rational. I’d already visited Angel tube station that morning (its name was a sign from God, obviously), and proposed to a complete stranger in Costa Coffee, saving his number as ‘love of my life’ in my phone.

'So when I found myself at Stansted Airport's baggage drop, that, too, felt logical. As I jumped, my left arm hit the fire alarm; sirens wailed, security descended and I was jolted out of my mania to realise I had no idea where I was.

'I can laugh about it now. But at the time, aged 22, I’d never been more afraid. Shortly after, I was sectioned and placed in hospital under the Mental Health Act. For the first month, I didn’t recognise my own parents; I can’t remember the first six weeks at all. I do know that I thought I was Susan Boyle for a while. I also thought I could speak Arabic.

'It was there I was diagnosed with bipolar disorder – a condition which leaves you with a greater mood scale than the average person. On a scale of one to 10, the average person’s mood will vary between a four and a six. People prone to depression might go down to a three.

'But someone with bipolar can go from zero to 10, switching between those moods rapidly. If I’m triggered by something, I can drop down to a suicidal, delusional mindset very quickly. I can only describe it as being like a panic attack; it makes no sense and comes on suddenly.

'I have type 1 bipolar disorder, which means I’m more prone to periods of hypomania (from what I understand, type 2 refers to those who are prone to depressive episodes). I’ll often experience feelings of hypomania for up to five hours at a time. This is different to psychosis or mania, the kind I was experiencing at Stansted Airport that day and hope never to experience again. You hallucinate with mania and often need to be sectioned.

'Hypomania, on the other hand, feels like your mind is moving at 100 miles an hour; you don’t have time to stop, think and worry, you’re just so excited with life. It’s like the opposite of anxiety.

'When I finally left hospital, three months after my first manic episode, I had to speak to a doctor three times a week. It meant I was chatting to a medical professional more than I was my own friends; a sense of isolation made worse by the fact that I couldn’t even begin to describe what had happened to me. How do you explain what it’s like to be so ill that you’re physically restrained in hospital?

'For the first few years after my diagnosis, on top of an anti-psychotic, I also took lithium – a drug which suppresses both hypomania and mania. But it left me feeling numb and muted and, for me, that feeling was worse. I’ve always found that a hypomanic state can be really beautiful.

People often draw parallels between hypomania and how you feel on hallucinogenic drugs. It heightens all of my senses and makes me feel incredibly connected to people; that sense of connection in turn heightens my capacity for empathy, which makes me much more considerate of other people’s feelings. 

New genetically-modified purple tomato made with DNA created by scientists 

Anew genetically engineered purple tomato will be the first of its kind available to US gardeners after 20 years of research created a powerful new superfood.

A new seed is available to green fingers, and it is purple on the outside with plum-coloured fruit inside. It was created by Norfolk Plant Sciences (NPS) over 20 years to hack color genes from a snapdragon flower into the fruit. The snap-dragon cross-breeding means the tomato is high in anthocyanin, a substance good for your health. 

Named the Purple Tomato, it is the first genetically modified (GMO) crop available directly to gardeners, after last year, some farmers started growing and selling the fruit.

NPS hoped to change US perception on GMO products. A 2020 Pew Research study showed that most Americans see GMOs as having a more negative impact on their health than non-GMO foods. Only 7% see GMO products as healthier than other foods.

An artist's impression of bacillus bacteria© Getty Images/Science Photo Library RF

Nathan Pumplin, CEO of Norfolk Healthy Produce, a subsidiary of Norfolk Plant Sciences said: "We aim to show with this product and with this company that there's a lot of benefits that can go to consumers through biotechnology, better taste, better nutrition as prime examples."

Cathie Martin, the lead scientist behind the Purple Tomato set out over two decades ago to create a transgenic tomato, using DNA from another unrelated organism.

Martin isolated the gene responsible for the purple colour of the snapdragon flower© Getty Images/iStockphoto

Landing on the edible flower the purple snapdragon, she wanted to develop a tomato with high levels of anthocyanins, the compounds that give blueberries and blackberries, eggplant and purple cabbage their color and mean they are superfoods. Anthocyanins are antioxidants and may have anti-cancer and anti-inflammatory effects. 

Pumplin said: "It's normal for tomatoes to make these healthy antioxidants. They typically don't make them very much in the fruit, though. So what Cathie [Martin] did was put the on switch into tomato."

Martin isolated the gene responsible for the purple colour of the snapdragon flower that turned on and off the purple colour and inserted it into the tomato. So, the purple tomato has, per weight, as much anthocyanin as superfoods like a blueberries. Martin found that mice who ate a diet supplemented with purple tomatoes lived 30% longer than those who didn't.

Pumplin said: "It really is a great example of understanding how the natural world functions and building on that to meet our needs." Pumplin explains.

Kathleen Hefferon, a microbiologist at Cornell University said the push for GMO- foods is a trend and they are easier to grow. She said:"There was a real push of trying to achieve food security for a lot of populaces in developing countries and usually that involved making these staple crops that grew better, such as rice and corn and wheat and things like this.

"People have interest in their quality of life, for longevity and things like this. I think there has been just a health trend in that regard and it's going to continue.” 

Pili Nuts Nutrition Facts and Health Benefits

Touted as the highest fat nut on the planet, pili nuts are being promoted by ketogenic and paleo diet followers and vegans who look for natural food sources high in fat and low in carbs. But what about those who like to incorporate nuts as a part of a healthy balanced diet that is not particularly high in fat or low in carbs? Are these nuts still good for you? 

Pili nuts, also known as Pacific almonds, are nuts that come from the fruit of the pili tree, native to Northern Australia, the Pacific Islands and Southeast Asia. The majority of large scale cultivation is in the Philippines. The nuts are teardrop shaped and protected by a hard shell and an outer coating that sticks to the shell. 

In addition to their high fat profile, they contain high amounts of Vitamin E, thiamin, phosphorous, manganese and magnesium compared to other nuts and unlike other nuts, contain all of the essential amino acids to be a complete protein source. They are also a source of a variety of other minerals including potassium, copper, zinc, calcium, and iron. Their high-fat content gives them a rich buttery flavor and a texture that is ideal for using as a non-dairy alternative for nut "milks" and yogurts. 

The flavor of pili nuts is delicate in flavor similar to sunflower seeds when eaten raw but after roasting, becomes chewy on the outside with a rich, buttery flavor that is slightly sweet and bitter at the same time.

Pili Nut Nutrition Facts

The nutrition profile of pili nuts is similar in many ways to other tree nuts but is higher in fat and calories per serving; vitamin and mineral content is also slightly higher for some key nutrients. Portion control needs to be considered, especially for those mindful about weight management or with weight loss goals. 

This nutrition information, for a 30-gram serving of roasted unsalted pili nuts was determined by gathering data aggregated from the USDA, Nuts.com, and Pili Hunters brand.  

Carbs

A 30-gram serving of roasted unsalted pili nuts contains only 1g of carbohydrates. Compared to other tree nuts, pili nuts are the lowest in carbohydrates; the majority of the carbohydrates they do contain come from fiber. These nuts can be incorporated into a balanced diet and, due to their low carbohydrate content, are particularly ideal for those on a low-carb or ketogenic diet. 

Fats

While pili nuts are the lowest in carbohydrates of any tree nut, they are conversely the highest in fat. A 30-gram serving of roasted unsalted pili nuts contains 24g total fat and 8g of saturated which means over 90% of the calories come from fat and 40% of the total fat comes from saturated fat. The remaining percentage of fat comes from heart-healthy monounsaturated and polyunsaturated. Nearly 50% of the total fat is monounsaturated and about 10% from polyunsaturated fat. While several pili nut brands tout their high omega-3 content, research to date does not validate those claims. 

Protein

Pili nuts are one of the few plant sources that are a complete source of protein, providing all of the essential amino acids the body needs through diet. Most plant foods only contain some of the essential amino acids but pili nuts, similar to quinoa and soy, contain all nine, making them an ideal food for those on a vegan diet. A 30-gram serving of roasted unsalted pili nuts provides 3g of protein, which means 5% of the calories come from protein. This is comparable to other tree nuts such as pecans, cashews, brazil nuts, walnuts, and pistachios which all contain 3-4g protein per ounce. 

Vitamins and Minerals

Pili nuts contain a variety of vitamins and minerals but are notably high in Vitamin E, copper, thiamin, manganese, magnesium, and phosphorous, as well as a source of zinc, iron, calcium and potassium and other B-vitamins. A 30-gram serving of roasted unsalted pili nuts provides 60-70% of the daily value for Vitamin E which is optimally absorbed by the inherent fat in the nuts. 

Pili nuts also contain one of the highest amounts of magnesium of all common tree nuts. A 30-gram serving provides 85mg magnesium (19% of the daily value). Magnesium is an essential mineral for muscle and nerve function, energy production, blood sugar levels, bone health, and can help foster stable blood pressure and better sleep. 

Health Benefits

In addition to being a protein powerhouse, pili nuts have plenty of benefits to offer.

Supports Heart Health

Pili nuts contain high amounts of monounsaturated fats and Vitamin E, both of which are recognized for lowering the risk of heart disease. Pili nuts also contain a significant portion of saturated fat which is known to raise unhealthy LDL cholesterol but the proportion of monounsaturated fats is greater than the proportion of saturated fat. Furthermore, if the rest of one's diet is low in saturated fat (i.e. plant-based), and pili nuts are consumed in moderation, one can still reap the benefits of the healthy fats that they contain. 

Stabilizes Blood Sugar

The low carb content of pili nuts makes them an ideal food to incorporate into a diet for managing diabetes or high blood sugar. The high magnesium content may also be helpful in lower fasting blood glucose and regulating blood sugar levels. 

Supports Bone Health

Pili nuts contain manganese, phosphorous, calcium, magnesium, and potassium—all of which are important minerals to support bone health. Magnesium is essential for calcium and Vitamin D regulation in the body. Along with calcium, manganese and phosphorous are essential for bone-building and mineralization of bones. Potassium plays an important role in reducing any potential calcium loss from your bones. 

Helps Support the Immune System

The high Vitamin E content in pili nuts helps support the immune system as an antioxidant that helps fight off free radicals and reduce systemic inflammation. A little bit goes a long way: a 30-gram portion of pili nuts provides over 60% of the daily recommended intake of Vitamin E. 

Provides Plant-Based Source of Protein

While pili nuts are not incredibly high in protein, they still offer some (almost half as much as an egg) and provide a quality source. Unlike other nuts, they provide all of the essential amino acids so are a good source of plant-based protein for those on vegan and vegetarian diets. 

Allergies

Those with allergies to tree nuts may also be allergic to pili nuts. 

Adverse Effects

Those on a low-fat or low-calorie diet need to be mindful of the portion of pili nuts consumed due to their high fat content and thus, high calorie content. 

Varieties

There are three pili nut cultivars in the Philippines: 'Katutubo', 'Mayon', and 'Oas'. 'Poamoho' is the only cultivar in Hawaii. The majority of pili nuts found in the US are sustainably sourced from the Philippines. Pili nut harvesting is from May to October, peaking in June to August but, similar to other nuts, are available year-round once packaged and sold. 

Pili nuts can come in a variety of forms similar including dry roasted, unsalted, sprouted, and in nut butter form. Some companies make entire product lines using pili nuts such as Pili Hunters which offers snack packs of sprouted pili nuts in a variety of flavors as well as pili nut butter. Due to its high fat content, oil can also be produced from the pili nut kernel and has a similar fatty acid profile to olive oil. Pili nuts are also being manufactured into yogurt (i.e. Lavva brand) as a non-dairy alternative due to their creamy consistency. 

Lastly, pili shoots from the pili tree and pulp from the pili fruit are edible; the young shoots can be used in salads and the pulp is eaten once boiled and is similar to sweet potato in texture but with the fat content similar to an avocado. 

Storage and Food Safety

Pili nuts are best stored in a cool dry place for up to 6 months. For longer shelf life, store in the refrigerator. Pili nuts can safely be consumed raw as well as roasted.