Welcome to the February 2019 edition of Thorne’s Research Extracts. This is Thorne’s monthly research update on diet, nutrient, botanical, and lifestyle approaches to good health. Knowing that busy practitioners can’t always focus on the latest research, our medical team of NDs, MDs, PhDs, RDs, and MS (Biol) has summarized the essence of the most interesting studies.

In this issue: (1) smelling foods can decrease cravings, (2) exercise reduces fall risk in elderly, (3) the Mediterranean Diet and rheumatoid arthritis, and (4) sleep and atherosclerosis.

Long exposure to the smell of “indulgent” foods can reduce cravings

Most people recognize a close relationship between smell and taste. When it comes to cravings, we usually assume that smelling a food we love or desire makes us crave it even more. In fact, restaurants use the appealing smell of food that people crave to draw in diners. If you have walked by a Cinnabon® in your local mall, then you have had this experience.

Researchers in this current study wanted to determine whether the duration of exposure to an “indulgent” smell – in this case cookies – would have an impact on craving.

In a controlled environment, 61 individuals were exposed for varying lengths of time to the smell of cookies and strawberries. They were then offered the choice of either food they most desired to eat. An exposure of 30 seconds or less was highly correlated with selecting the cookie – but a longer exposure of two minutes led most participants to select the strawberries.

This research group has conducted similar studies in uncontrolled environments (school cafeterias and supermarkets) with similar outcomes. Their theory is that a brief exposure to an “indulgent food aroma” stimulates reward pathways just enough to produce a craving – but that a longer exposure actually satisfies that craving. 

This could be because the very close relationship between smell and taste allows for some redundancy in how human reward systems respond.

While food companies might use this knowledge to draw in customers to consume more indulgent foods, this awareness of time being associated with aromas could be leveraged to support weight management and help those who specifically struggle with food cravings.

Contributed by Jacqueline Jacques, ND


Regular exercise including balance training reduces fall risk for older adults

In a meta-analysis drawing from five databases, researchers evaluated the results from 46 randomized controlled trials (22,709 individuals) with an age mean of 73.1 years and an exercise group versus a control group for at least one year (mean, 17 months).

The active groups engaged in moderate-intensity exercise an average of 50 minutes a day three times a week. The majority of the trials used multi-component exercise with a balance component, and it was this mode that corresponded with the most significant results. Data was compiled for six outcomes – mortality, hospitalization, fallers (1 fall), multiple fallers (2 or more falls), injurious fallers, and fractures.  

Significant associations were found between long-term exercise and reduction in risk of falling (12%) and risk of injury with a fall (26%).

There was a non-significant association between exercise and reduced risk of fracture. Risk for multiple falls, of hospitalization, and of mortality were not significantly affected by exercise in the study results.

There was an association between exercise 2-3 times/week and decreased mortality, while exercise more than 3 times/week was actually associated with increased risk for falling.  

The authors propose moderate-intensity, multi-component exercise with balance training, at a frequency of 2-3 times/week for 30-60 minutes to be the most effective for protecting older adults from falls, but noted there might be a need to attenuate this for the most at-risk population.   

Contributed by Sheena Smith, MS (Biol) 


  • de Souto-Barreto P, Rolland Y, Vellas B, Maltais M. Association of long-term exercise training with risk of falls, fractures, hospitalizations, and mortality in older adults: a systematic review and meta-analysis. JAMA Intern Med 2018 Dec 28.  doi:10.1001/jamainternmed.2018.5406 

Mediterranean Diet – a winner again and research keeps mounting

The Mediterranean Diet stands out as one of the most extensively researched diets for prevention of numerous chronic conditions, including cardiovascular disease, diabetes, obesity, metabolic syndrome, cancer, inflammatory bowel disease, and cognitive dysfunction.

The diet is so-named because it is the primary diet eaten by the inhabitants of the countries surrounding the Mediterranean Sea.

For the second year in a row, the Mediterranean Diet tied for first place in the 2018 U.S. News & World Report Best Overall Diet category and ran away with the top honor for the easiest-to-follow diet. 

New evidence supports the use of the Mediterranean Diet to decrease the risk of developing rheumatoid arthritis (RA). In this population-based study, 1,721 patients with incident RA were compared with 3,667 matched controls. 

he extent to which the Mediterranean Diet was followed was determined on a scale of 0-9 based on a 124-item food frequency questionnaire. The group with the highest adherence to the diet had a 21% decreased risk of developing RA compared to the group with the lowest adherence.

After the results were analyzed, statistical significance was only evident in men at high risk for developing the disease because they were rheumatoid factor positive.

Contributed by Kathi Head, ND


Inadequate sleep increases cardiovascular risk

It is indisputable that good sleep is important for good health. It seems like the more we look, the more connections we see between poor sleep and a range of chronic health conditions. A new study now adds more weight to the body of research that connects poor sleep with cardiovascular disease.

Seven days of sleep monitoring was performed on 4,000 participants who were part of the Progression of Early Subclinical Atherosclerosis (PESA) trial (https://clinicaltrials.gov/ct2/show/NCT01410318). Researchers also used ultrasound and CT to evaluate atherosclerosis and coronary calcification.

Both decreased sleep quantity (less than 6 hours/night) and sleep quality (frequent waking) were connected to a significant increase in the presence of atherosclerotic disease.

Those in either group were about 30% more likely to have atherosclerosis compared to individuals with healthier sleep patterns.

Interestingly, the small subset of women who slept more than eight hours per night also had an increased risk for atherosclerosis – suggesting we still have more to learn about what optimal sleep might be when it comes to heart health.

Contributed by Jacqueline Jacques, ND


  • Domínguez F, Fuster V, Fernández-Alvira J, et al. Association of sleep duration and quality with subclinical atherosclerosis. J Am Coll Cardiol 2019;73(2):134-144.