Low fitness linked to higher psoriasis risk later in life
January 12, 2021
Science Daily/University of Gothenburg
In a major register-based study, scientists at University of Gothenburg, Sweden, have now demonstrated a connection between inferior physical fitness in young adults and elevated risk of the autoimmune disease psoriasis. For the male recruits to compulsory military training who were rated as the least fit, the risk of developing psoriasis later was 35 percent higher than for the fittest.
The study was based on data on more than 1.2 million men conscripted, aged 18, into the Swedish Armed Forces between the years 1968 and 2005. During the enrollment process, all these young men underwent the same fitness test on an exercise bicycle. The researchers divided the data, according to how fit the men were, into three levels (low, medium, and high fitness). They then merged the data with other registers, using Sweden's National Patient Register to obtain diagnostic codes for psoriasis and the joint disease psoriatic arthritis. The men who had already received one of these diagnoses before conscription were excluded from the study.
Later in life, between the ages of 37 and 51, just over 23,000 of the conscripts developed psoriasis or psoriatic arthritis. In the low-fitness group, 2.5 percent developed one or both of these diseases, while only 1.7 percent in the high-fitness group did so. In calculating this risk differential, the scientists adjusted for other risk factors, such as body mass index (BMI).
Association not causal
Thus, the less fit the men were when they were recruited, the higher the proportion of them who later fell ill with psoriasis or psoriatic arthritis. In the low-fitness group, the risk of developing psoriasis was 35 percent higher, and that of developing psoriatic arthritis 44 percent higher, than in the high-fitness group.
"We show that there's an association between lower fitness and raised risk of developing psoriasis and psoriatic arthritis, but we don't show a causal connection. So we can't say that these health conditions can be prevented by exercising," says the study's first author Marta Laskowski, a doctoral student in dermatology at the University of Gothenburg and resident physician (specialist trainee) at Sahlgrenska University Hospital.
Group in need of monitoring
The group of men who were least fit was also the smallest: just under 48,000 or 3.9 percent of all the conscripts in the study. This is a group that healthcare services should try to monitor regularly.
"Low fitness was already known to boost the risk of incurring cardiovascular disease, and psoriasis as such is linked to raised cardiovascular disease risk, too. The results from our study confirm the reasons for assessing people's fitness early in life, to identify individuals at a higher risk for adverse health outcomes later in life," Laskowski says.
Previous research has indicated that, in general, people with psoriasis are less fit than those without it who engage in an equal amount of physical activity. However, the reasons for this difference have not been fully clarified.
"One weakness of our study is that we weren't been able to monitor the trends of the men's fitness during the intervening years, between their conscription and the disease onset. We're also lacking data on smoking, which is a known risk factor for psoriasis," Laskowski explains.
Scaly skin patches
Some 300,000 Swedes have psoriasis in a mild, moderate, or severe form. It is a chronic, systemic inflammatory disease that affects women as often as men. What triggers its onset is not entirely clear, but heredity is known to play a large part in combination with external factors. The most common type, plaque psoriasis, causes reddened, flaking, and itchy skin lesions ("plaques").
Psoriasis sufferers also often have other diseases. Some 30 percent get the inflammatory joint condition known as psoriatic arthritis. Examples of other known comorbidities are obesity, cardiovascular disease, diabetes, and depression.
In recent years, treatment options have substantially improved. Today, besides ointments with local effects, there are drugs that have systemic effects. Recent years have also seen the emergence of efficacious biological agents that modulate the signaling cascade in the inflammatory process that drives psoriasis.
https://www.sciencedaily.com/releases/2021/01/210112110116.htm
Unlocking PTSD: New study reveals why trauma-focused psychotherapy treatment works
January 27, 2021
Science Daily/University of Texas at Austin
Trauma-focused psychotherapy is widely considered the best available treatment for posttraumatic stress disorder (PTSD). However, the ways in which this method affects the brain to promote recovery from PTSD are not well understood. In a new study published today in Biological Psychiatry, researchers used neuroimaging to examine how the brain areas responsible for generating emotional responses to threats are changed by psychotherapy.
"We know that psychotherapy works. But we don't have a lot of good data to explain how it works, how the brain is changed by going through this process," said Greg Fonzo, Ph.D., lead author of the study and an assistant professor in the Department of Psychiatry and Behavioral Sciences at Dell Medical School at The University of Texas at Austin. "That's what we sought to find out."
Posttraumatic stress disorder may occur in people who have experienced or witnessed a traumatic event such as war or combat, sexual assault, a natural disaster or terrorist act. Symptoms can include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.
Trauma-focused psychotherapy is a treatment that helps people recover from a traumatic event, using techniques such as "in vivo exposure," which involves directly facing a feared object, situation or activity in real life, and "imaginal exposure," which involves facing the trauma memory. A person who is afraid of crowds, for example, may be repeatedly exposed to large gatherings.
"At first, that patient will obviously experience fear or whatever negative emotion is triggered by being in a crowd," said Fonzo, who also holds a courtesy appointment in the Department of Psychology at UT Austin. "But it's like looking at a fire from behind a window. It appears to be a dangerous situation, but the person is actually quite safe. After a while, the fire will burn out, and the person recognizes there was no actual danger. And so that process eventually promotes new learning in the brain."
Fonzo and his colleagues used functional magnetic resonance imaging (fMRI) scans to identify how brain networks communicate with one another before and after treatment. Specifically, they measured the degree of communication or "traffic," known as functional connectivity, between areas of the brain responsible for emotion and regions of the cortex in charge of logic and thinking.
"What we discovered was a reduction in traffic between these brain regions among patients who had undergone trauma-focused psychotherapy," said Fonzo. "In fact, greater connectivity changes were associated with bigger symptom reductions. This restructuring of brain communication may be a unique signature of PTSD recovery."
Fonzo said these findings could change the way doctors treat people who suffer from PTSD.
"Now that we have a better understanding of the brain mechanisms underlying psychotherapy, we may be able to use this information to develop new and better treatments for people with PTSD," said Fonzo.
https://www.sciencedaily.com/releases/2021/01/210127093223.htm
Could playing host to hookworms help prevent aging?
February 2, 2021
Science Daily/eLife
Parasitic worms could hold the key to living longer and free of chronic disease, according to a review article published today in the open-access eLifejournal.
The review looks at the growing evidence to suggest that losing our 'old friend' helminth parasites, which used to live relatively harmlessly in our bodies, can cause ageing-associated inflammation. It raises the possibility that carefully controlled, restorative helminth treatments could prevent ageing and protect against diseases such as heart disease and dementia.
"A decline in exposure to commensal microbes and gut helminths in developed countries has been linked to increased prevalence of allergic and autoimmune inflammatory disorders -- the so-called 'old friends hypothesis'," explains author Bruce Zhang, Undergraduate Assistant at the UCL Institute of Healthy Ageing, London, UK. "A further possibility is that this loss of 'old friend' microbes and helminths increases the sterile, ageing-associated inflammation known as inflammageing."
Inflammageing is increasingly thought to be a contributory factor to the major diseases of later life, including heart disease, dementia, cancer, chronic obstructive pulmonary disease, osteoporosis, age-related eye disease and -- more recently -- symptom severity during SARS-CoV-2 (COVID-19) infections.
One theory is that changes in the gut microbiome might cause inflammageing, but until now little consideration has been given to the role of organisms comprising the macrobiome -- the ecosystem of macro-organisms -- including helminth parasites such as flukes, tapeworms and nematodes.
Helminths have infected humans throughout our evolutionary history, and as a result have become master manipulators of our immune response. Humans, in turn, have evolved levels of tolerance to their presence.
In their article, Zhang and co-author David Gems, Professor of Biogerontology and Research Director at the UCL Institute of Healthy Ageing, review the evidence for helminth therapy in two areas: treating known inflammatory disorders, such as coeliac disease, and stopping or reversing inflammageing as part of the ageing process.
They reveal how the loss of helminths has so far been linked to a range of inflammatory diseases, including asthma, atopic eczema, inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis and diabetes. Some studies have shown that natural infection with helminths can alleviate disease symptoms, for example in multiple sclerosis and eczema, while other studies in animal models suggest that intentional infection with helminths could have benefits against disease.
The safer, and perhaps more palatable, option is the concept of using helminth-derived proteins to achieve the same therapeutic benefits. This was tested recently in mice and shown to prevent the age-related decline in gut barrier integrity usually seen with a high-calorie diet. It also had beneficial effects on fat tissue, which is known to be a major source of inflammageing.
The authors speculate that if helminths have anti-inflammageing properties, you would expect to see lower rates of inflammageing-related disease in areas where helminth infection is more common. There is some evidence to support this. For example, in a region in Eastern India endemic for lymphatic filariasis caused by filarial worms, not a single person with rheumatoid arthritis (RA) tested positive for circulating filarial antigens, whereas a much higher proportion (40%) of people without RA tested positive for the nematode. Other epidemiological studies have shown protection from helminths against type 2 diabetes and blocked arteries.
"It goes without saying that improvements in hygiene and elimination of helminth parasites have been of incalculable benefit to humanity, but a cost coupled to this benefit is abnormalities of immune function," Gems concludes. "In the wake of successes during the last century in eliminating the evil of helminths, the time now seems right to further explore their possible benefits, particularly for our ageing population -- strange as this may sound."
https://www.sciencedaily.com/releases/2021/02/210202113730.htm
'Attitude of gratitude' keeps older people in Japan feeling hopeful as they age
January 21, 2021
Science Daily/University of Exeter
Older people in Japan have an "attitude of gratitude" which keeps them feeling hopeful despite the challenges of aging, a new study says.
Feeling thankful and grateful for the care and support they have had during their life helps pensioners in the country to be more optimistic, even when they experienced difficulties and were anxious about getting older, an expert found.
Dr Iza Kavedzija, from the University of Exeter, observed people in their 80s and 90s in the course of long-term ethnographic fieldwork in a merchant neighbourhood in the city of Osaka. Her research is published in the journal Anthropology and Aging.
Dr Kavedzija found many members of the older community cultivated a "quiet hope," even though they had concerns for the future, such as getting dementia like their parents or becoming a burden to their children. They said they believed things would work out "somehow" (nantonaku). They accepted the uncertainty ahead, but remained actively engaged in their wider community. This gave them a sense of security, and offered them some confidence for the future.
Dr Kavedzija said: "As people move through life, through their later years, many experience a sense of loss. But this time for them also offers opportunities to reflect more on life, with a heightened realisation of their interconnections with others. If one habitually invokes the involvement of others and their role in one's life, one is reminded how much other people have helped them, in countless small and more substantive ways. The same events seem different when one focuses on how others have helped."
"An attitude of gratitude was embedded in older peoples' recollections of the past, but also allowed them to think about the present in a hopeful way. A world in which one has received much good will from others is a different place than one in which one has experienced loss, even if the facts of life are the same."
"Gratitude in Japan can be seen to a large extent as a recognition of how much one relies on others as one moves through life. Gratitude highlights feelings of interdependence in the social world."
Many people said they wouldn't be the person they were without others who played a significant part in their life. A phrase they liked to use was arigatai, "I am grateful," and sometimes kansha, "gratitude." This gratitude might exist for having been able to lead a full life, for having had a good husband who supported the family, for having understanding in-laws, or simply for an opportunity to work.
Dr Kavedzija said: "While people in Japan might hesitate to say they are happy, gratitude is mentioned frequently. Through appreciation, dependence on others is not seen as simply a burden or a potential source of embarrassment, but also as moving and deeply meaningful. Meaningful relationships and encounters with others comprise a valuable foundation for what Japanese people call ikigai, or that which makes life worth living."
https://www.sciencedaily.com/releases/2021/01/210121131633.htm
NAD+ can restore age-related muscle deterioration
January 20, 2021
Science Daily/Ecole Polytechnique Fédérale de Lausanne
Scientists have discovered that Alzheimer's-like protein aggregates underly the muscle deterioration seen in aging. But the aggregates can be reversed by boosting the levels of nicotinamide adenine dinucleotide (NAD+), which turns on the defense systems of mitochondria in cells and restores muscle function.
The older we grow, the weaker our muscles get, riddling old age with frailty and physical disability. But this doesn't only affect the individual, it also creates a significant burden on public healthcare. And yet, research efforts into the biological processes and biomarkers that define muscle aging have not yet defined the underlying causes.
Now, a team of scientists from lab of Johan Auwerx at EPFL's School of Life Sciences looked at the issue through a different angle: the similarities between muscle aging and degenerative muscle diseases. They have discovered protein aggregates that deposit in skeletal muscles during natural aging, and that blocking this can prevent the detrimental features of muscle aging. The study is published in Cell Reports.
"During age-associated muscle diseases, such as inclusion body myositis (IBM), our cells struggle to maintain correct protein folding, leading these misfolded proteins to precipitate and forming toxic protein aggregates within the muscles," explains Auwerx. "The most prominent component of these protein aggregates is beta-amyloid, just like in the amyloid plaques in the brains of patients with Alzheimer's disease."
In the study, the scientists identify amyloid-like protein aggregates in aged muscles from different species, from the nematode C. elegans all the way to humans. In addition, they also found that these aggregates also impair mitochondrial function. Although aggregated proteins have been suggested to contribute to brain aging, this is the first time that they have been shown to contribute to muscle aging and to directly damage mitochondria. "These abnormal proteotoxic aggregates could serve as novel biomarkers for the aging process, beyond the brain and muscle," says Auwerx.
But can the formation of the protein aggregates be reversed? To answer this, the researchers fed worms the vitamin nicotinamide riboside and the antitumor agent Olaparib, both of which boost the levels of nicotinamide adenine dinucleotide (NAD+), a biomolecule that is essential for maintaining mitochondrial function, and whose levels decline during aging.
In the worms, the two compounds turned on the defense systems of the mitochondria, even when provided at advanced age. Turning on the so-called "mitochondrial quality control system" reduced the age-related amyloid protein aggregates and improved the worms' fitness and lifespan.
The scientists then moved on to human muscle tissue, taken from aged subjects and IBM patients. Turning on the same mitochondrial quality control systems produced similar improvements in protein and mitochondrial homeostasis. The encouraging results led the researchers to test nicotinamide riboside in aged mice. The treatment also activated the mitochondrial defense systems and reduced the number and size of amyloid aggregates in different skeletal muscle tissues.
"Drugs that boost mitochondrial quality control could therefore be tested in the clinic to reverse these age-related proteotoxic aggregates and rejuvenate tissues," says Mario Romani, the first author of the study.
https://www.sciencedaily.com/releases/2021/01/210119114405.htm
Mediterranean-style diet linked to better thinking skills in later life
February 10, 2021
Science Daily/University of Edinburgh
People who eat a Mediterranean-style diet -- particularly one rich in green leafy vegetables and low in meat -- are more likely to stay mentally sharp in later life, a study shows.
Closely adhering to a Mediterranean diet was associated with higher scores on a range of memory and thinking tests among adults in their late 70s, the research found.
The study found no link, however, between the Mediterranean-style diet and better brain health.
Markers of healthy brain ageing -- such as greater grey or white matter volume, or fewer white matter lesions -- did not differ between those regularly eating a Mediterranean diet and those who did not.
These latest findings suggest that this primarily plant-based diet may have benefits for cognitive functioning as we get older, researchers say.
Researchers at the University of Edinburgh tested the thinking skills of more than 500 people aged 79 and without dementia.
The participants completed tests of problem solving, thinking speed, memory, and word knowledge, as well as a questionnaire about their eating habits during the previous year.
More than 350 of the group also underwent a magnetic resonance imaging (MRI) brain scan to gain insights into their brain structure.
The team used statistical models to look for associations between a person's diet and their thinking skills and brain health in later life.
The findings show that, in general, people who most closely adhered to a Mediterranean diet had the highest cognitive function scores, even when accounting for childhood IQ, smoking, physical activity and health factors. The differences were small but statistically significant.
The individual components of the diet that appeared to be most strongly associated with better thinking skills were green leafy vegetables and a lower red meat intake.
Researchers say the latest findings add to the evidence that a healthier lifestyle, of which diet is one aspect, is associated with better thinking skills in later life.
Dr Janie Corley, of the University of Edinburgh's School of Philosophy, Psychology and Language Sciences, said: "Eating more green leafy vegetables and cutting down on red meat might be two key food elements that contribute to the benefits of the Mediterranean-style diet. In our sample, the positive relationship between a Mediterranean diet and thinking skills is not accounted for by having a healthier brain structure, as one might expect. Though it's possible there may be other structural or functional brain correlates with this measure of diet, or associations in specific regions of the brain, rather than the whole brain, as measured here."
https://www.sciencedaily.com/releases/2021/02/210210133340.htm
Excess body weight linked with worse heart health even in people who exercise
January 22, 2021
Science Daily/European Society of Cardiology
Physical activity does not undo the negative effects of excess body weight on heart health. That's the finding of a large study published today in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC).
"One cannot be 'fat but healthy'," said study author Dr. Alejandro Lucia of the European University, Madrid, Spain. "This was the first nationwide analysis to show that being regularly active is not likely to eliminate the detrimental health effects of excess body fat. Our findings refute the notion that a physically active lifestyle can completely negate the deleterious effects of overweight and obesity."
There is some evidence that fitness might mitigate the negative effects of excess body weight on heart health. It has been suggested that in adults and children, being "fat but fit" might be associated with similar cardiovascular health to being "thin but unfit." Dr. Lucia said: "This has led to controversial proposals for health policies to prioritise physical activity and fitness above weight loss. Our study sought to clarify the links between activity, body weight, and heart health."
The study used data from 527,662 working adults insured by a large occupational risk prevention company in Spain. The average age of participants was 42 years and 32% were women.
Participants were categorised as normal weight (body mass index [BMI] 20.0-24.9 kg/m2), overweight (BMI 25.0-29.9 kg/m2), or obese (BMI 30.0 kg/m2 or above). Additionally, they were grouped by activity level: 1) regularly active, defined as doing the minimum recommended for adults by the World Health Organization (WHO); 2) insufficiently active (some moderate to vigorous physical activity every week but less than the WHO minimum); 3) inactive (no exercise). Cardiovascular health was determined according to three major risk factors for heart attack and stroke, namely diabetes, high cholesterol, and high blood pressure.
Approximately 42% of participants were normal weight, 41% were overweight, and 18% were obese. The majority were inactive (63.5%), while 12.3% were insufficiently active, and 24.2% were regularly active. Some 30% had high cholesterol, 15% had high blood pressure, and 3% had diabetes.
The researchers investigated the associations between each BMI and activity group and the three risk factors. At all BMI levels, any activity (whether it met the WHO minimum or not) was linked with a lower likelihood of diabetes, high blood pressure or high cholesterol compared to no exercise at all. Dr. Lucia said: "This tells us that everyone, irrespective of their body weight, should be physically active to safeguard their health."
At all weights, the odds of diabetes and hypertension decreased as physical activity rose. "More activity is better, so walking 30 minutes per day is better than walking 15 minutes a day," he said.
However, overweight and obese participants were at greater cardiovascular risk than their peers with normal weight, irrespective of activity levels. As an example, compared to inactive normal weight individuals, active obese people were approximately twice as likely to have high cholesterol, four times more likely to have diabetes, and five times more likely to have high blood pressure. Dr. Lucia said: "Exercise does not seem to compensate for the negative effects of excess weight. This finding was also observed overall in both men and women when they were analysed separately."
He concluded: "Fighting obesity and inactivity is equally important; it should be a joint battle. Weight loss should remain a primary target for health policies together with promoting active lifestyles."
https://www.sciencedaily.com/releases/2021/01/210121210500.htm
Study compares low-fat, plant-based diet to low-carb, animal-based diet
January 21, 2021
Science Daily/NIH/National Institute of Diabetes and Digestive and Kidney Diseases
People on a low-fat, plant-based diet ate fewer daily calories but had higher insulin and blood glucose levels, compared to when they ate a low-carbohydrate, animal-based diet, according to a small but highly controlled study at the National Institutes of Health. Led by researchers at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the study compared the effects of the two diets on calorie intake, hormone levels, body weight, and more. The findings, published in Nature Medicine, broaden understanding of how restricting dietary carbohydrates or fats may impact health.
"High-fat foods have been thought to result in excess calorie intake because they have many calories per bite. Alternatively, high-carb foods can cause large swings in blood glucose and insulin that may increase hunger and lead to overeating," said NIDDK Senior Investigator Kevin Hall, Ph.D., the study's lead author. "Our study was designed to determine whether high-carb or high-fat diets result in greater calorie intake."
The researchers housed 20 adults without diabetes for four continuous weeks in the NIH Clinical Center's Metabolic Clinical Research Unit. The participants, 11 men and nine women, received either a plant-based, low-fat diet or an animal-based, low-carbohydrate diet for two weeks, immediately followed by two weeks on the alternate diet. The low-fat diet was high in carbohydrates. The low-carbohydrate diet was high in fats. Both diets were minimally processed and had equivalent amounts of non-starchy vegetables. The participants were given three meals a day, plus snacks, and could eat as much as desired.
The main results showed that people on the low-fat diet ate 550 to 700 fewer calories per day than when they ate the low-carb diet. Despite the large differences in calorie intake, participants reported no differences in hunger, enjoyment of meals, or fullness between the two diets. Participants lost weight on both diets, but only the low-fat diet led to a significant loss of body fat.
"Despite eating food with an abundance of high glycemic carbohydrates that resulted in pronounced swings in blood glucose and insulin, people eating the plant-based, low-fat diet showed a significant reduction in calorie intake and loss of body fat, which challenges the idea that high-carb diets per se lead people to overeat. On the other hand, the animal-based, low-carb diet did not result in weight gain despite being high in fat," said Hall.
These findings suggest that the factors that result in overeating and weight gain are more complex than the amount of carbs or fat in one's diet. For example, Hall's laboratory showed last year that a diet high in ultra-processed food led to overeating and weight gain in comparison to a minimally processed diet matched for carbs and fat.
The plant-based, low-fat diet contained 10.3% fat and 75.2% carbohydrate, while the animal-based, low-carb diet was 10% carbohydrate and 75.8% fat. Both diets contained about 14% protein and were matched for total calories presented to the subjects, although the low-carb diet had twice as many calories per gram of food than the low-fat diet. On the low-fat menu, dinner might consist of a baked sweet potato, chickpeas, broccoli and oranges, while a low-carb dinner might be beef stir fry with cauliflower rice. Subjects could eat what and however much they chose of the meals they were given.
"Interestingly, our findings suggest benefits to both diets, at least in the short-term. While the low-fat, plant-based diet helps curb appetite, the animal-based, low-carb diet resulted in lower and more steady insulin and glucose levels," Hall said. "We don't yet know if these differences would be sustained over the long term."
The researchers note that the study was not designed to make diet recommendations for weight loss, and results may have been different if participants were actively trying to lose weight. Further, all meals were prepared and provided for participants in an inpatient setting, which may make results difficult to repeat outside the lab, where factors such as food costs, food availability, and meal preparation constraints can make adherence to diets challenging. The tightly controlled clinical environment, however, ensured objective measurement of food intake and accuracy of data.
"To help us achieve good nutrition, rigorous science is critical ? and of particular importance now, in light of the COVID-19 pandemic, as we aim to identify strategies to help us stay healthy," said NIDDK Director Griffin P. Rodgers, M.D. "This study brings us closer to answering long-sought questions about how what we eat affects our health."
https://www.sciencedaily.com/releases/2021/01/210121131851.htm
Working outdoors linked to lower risk of breast cancer among older women
Outdoor workers are able to make more vitamin D which may be protective
February 1, 2021
Science Daily/BMJ
Working outdoors over many years is linked to a lower risk of breast cancer in women after the age of 50, finds research published online in the journal Occupational & Environmental Medicine.
Outdoor workers are exposed to more sunlight, boosting their levels of vitamin D, which may protect against the disease, say the researchers.
Vitamin D has a well recognised role in maintaining bone and musculoskeletal health, but it may have other roles, including helping to ward off infection and cancer.
The primary source of vitamin D is UVB sunlight. However, concerns about skin cancer risk and the increasing use of computers for both work and leisure have decreased the amount of time people spend outdoors.
The rising incidence of breast cancer over the last half of the 20th century has given rise to the suggestion that this might be linked to vitamin D deficiency.
Previous research indicates that higher levels of vitamin D in the blood may be associated with lower risk of breast cancer, but the evidence is inconclusive.
Most studies have relied on limited assessments of vitamin D levels rather than looking at levels over the long term.
Exposure to sunlight can be used as a surrogate marker for levels of vitamin D over the long term, and, as the body makes vitamin D mainly in the middle of the working day (between the hours of 10:00 and 15:00), outdoor workers are exposed to considerably higher levels than those who work indoors.
The researchers identified 38, 375 women under the age of 70 who had been diagnosed with primary breast cancer from the Danish Cancer Registry.
They compared each of them with five women born in the same year and randomly selected from the Danish Civil Registration System.
Full employment history was retrieved from Danish pension fund records and a job exposure matrix was used to assess each woman's occupational exposure to sunlight.
After taking account of potentially influential factors, such as reproductive history, no association emerged between occupational exposure to sunlight and overall breast cancer risk.
But long term occupational exposure was associated with a lower risk of breast cancer after the age of 50.
In these women occupational exposure for 20 or more years was associated with 17% lower odds of a breast cancer diagnosis while the highest level of cumulative exposure was associated with 11% reduced odds.
This is an observational study, and so can't establish cause. What's more, there was no information on dietary vitamin D intake or use of vitamin D supplements, although this might not be critical as other studies have shown that indoor workers have significantly lower levels of serum vitamin D than outdoor workers, say the researchers.
Estimates of sunlight exposure were also crude. And leisure time sunlight exposure plus potentially influential lifestyle factors, such as use of the Pill, hormone replacement therapy, and alcohol, as well as obesity and leisure time physical activity, weren't accounted for.
Nevertheless, the researchers conclude: "This study indicates an inverse association between long-term occupational [sunlight] exposure and late-onset breast cancer. This finding needs further attention in future occupational studies."
https://www.sciencedaily.com/releases/2021/02/210201200013.htm
Light pollution linked to preterm birth increase
January 25, 2021
Science Daily/Lehigh University
Scientists conducted the first study to examine the fetal health impact of light pollution based on a direct measure of skyglow, an important aspect of light pollution. Using an empirical regularity discovered in physics, called Walker's Law, a team from Lehigh University, Lafayette College and the University of Colorado Denver in the U.S., found evidence of reduced birth weight, shortened gestational length and preterm births.
Specifically, the likelihood of a preterm birth could increase by approximately 1.48 percentage points (or 12.9%), according to the researchers, as a result of increased nighttime brightness. Nighttime brightness is characterized by being able to see only one-fourth to one-third of the stars that are visible in the natural unpolluted night sky. The findings have been published in an article in Southern Economic Journal called, "Light pollution, sleep deprivation, and infant health at birth."
One possible biological mechanism underlying the findings, based on the existing literature, is light-pollution-induced circadian rhythm disruption, according to Muzhe Yang, a co-author of the study and a professor of economics in Lehigh's College of Business. Yang says circadian rhythm disruption can cause sleep disorders that subsequently lead to adverse birth outcomes.
"While greater use of artificial light at night (ALAN) is often associated with greater economic prosperity, our study highlights an often neglected health benefit of 'darkness,'" says Yang. "We must realize that the biological clock (i.e., the circadian rhythm) of a human body, like all lives on the earth, needs the 'darkness' as part of the light-dark cycle, in order to effectively regulate physiological functions, such as sleep."
While essential to a modern society, ALAN can disrupt a human body's circadian rhythm and therefore become a "pollutant." The societal benefits of ALAN, for example through increased economic activity, may be offset by ALAN's negative externalities such as adverse health effects, say the authors.
The contribution of ALAN to the alteration of natural nocturnal lighting levels is often referred to as light pollution. Light pollution is considered a worldwide ongoing problem
https://www.sciencedaily.com/releases/2021/01/210125191821.htm
Treating moms with postpartum depression helps their babies' brains
Psychiatric help for mothers with postpartum depression results in healthy changes in the brains of their babies
January 21, 2021
Science Daily/McMaster University
For the study 40 infants of women diagnosed with postpartum depression were matched with 40 infants of non-depressed mothers on infant age, gender and socioeconomic status. The mothers with postpartum depression received nine weeks of group CBT. The infants were all tested before the treatment and nine weeks later, including a questionnaire on the infant behaviour completed by the mother and her partner.
New research from McMaster University has found that psychiatric help for mothers with postpartum depression results in healthy changes in the brains of their babies.
The study, published in the journal Depression and Anxiety this week, found treating mothers who had postpartum depression with cognitive behavioural therapy (CBT) not only helped the moms, but resulted in adaptive changes in the brains and behaviour of their infants.
More specifically, after the mothers' treatment, their infants showed healthy changes in their nervous and cardiovascular systems, and they were observed to better regulate their behaviours and emotions by both mothers and fathers.
"In fact, we found that after their moms were treated that their infant's brain activity normalized to the levels seen in our healthy infants," said Ryan Van Lieshout, senior author of the study, a psychiatrist, and associate professor of psychiatry and behavioural neuroscience at McMaster's Michael G. DeGroote School of Medicine.
He added that it is well-known that the children of women with postpartum depression have changes in the functioning of their brains that make it more likely that they will develop emotional and behavioural problems later in life. However, it had not been known before if treating the mother's postpartum depression could reverse these changes.
"We believe that this is the first time that anyone has shown that treating moms' postpartum depression can lead to healthy changes in the physiology of the brains of their infants, a finding that we think provides a lot of good news," he said.
"This study shows that cognitive behavioural therapy, a treatment that is short, cost-effective and preferred by women, could potentially reduce the intergenerational transmission of risk from mother to child."
For the study 40 infants of women diagnosed with postpartum depression were matched with 40 infants of non-depressed mothers on infant age, gender and socioeconomic status. The mothers with postpartum depression received nine weeks of group CBT. The infants were all tested before the treatment and nine weeks later, including a questionnaire on the infant behaviour completed by the mother and her partner.
https://www.sciencedaily.com/releases/2021/01/210121131907.htm
Mouse study finds link between gut disease and brain injury in premature infants
January 6, 2021
Science Daily/Johns Hopkins Medicine
Physicians have long known that necrotizing enterocolitis (NEC), a potentially lethal inflammatory condition that destroys a premature infant's intestinal lining, is often connected to the development of severe brain injury in those infants who survive. However, the means by which the diseased intestine "communicates" its devastation to the newborn brain has remained largely unknown.
Now, working with mice, researchers at Johns Hopkins Medicine and the University of Lausanne in Switzerland have identified that missing link -- an immune system cell that they say travels from the gut to the brain and attacks cells rather than protect them as it normally does.
The team's findings are published Jan. 6, 2021, in the journal Science Translational Medicine.
Seen in as many as 12% of infants weighing less than 3.5 pounds at birth, NEC is a rapidly progressing gastrointestinal emergency in which bacteria invade the wall of the colon and cause inflammation that can ultimately destroy healthy tissue at the site. If enough cells become necrotic (die) so that a hole is created in the intestinal wall, bacteria can enter the bloodstream and cause life-threatening sepsis.
In a 2018 mouse study, researchers at Johns Hopkins Medicine and the Fred Hutchinson Cancer Research Center found that animals with NEC make a protein called toll-like receptor 4 (TLR4) that binds to bacteria in the gut and precipitates the intestinal destruction. They also determined that TLR4 simultaneously activates immune cells in the brain known as microglia, leading to white matter loss, brain injury and diminished cognitive function. What wasn't clear was how the two are connected.
For this latest study, the researchers speculated that CD4+ T lymphocytes -- immune system cells also known as helper T cells -- might be the link. CD4+ T cells get their "helper" nickname because they help another type of immune cell called a B lymphocyte (or B cell) respond to surface proteins -- antigens -- on cells infected by foreign invaders such as bacteria or viruses. Activated by the CD4+ T cells, immature B cells become either plasma cells that produce antibodies to mark the infected cells for disposal from the body or memory cells that "remember" the antigen's biochemistry for a faster response to future invasions.
CD4+ T cells also send out chemical messengers that bring another type of T cell -- known as a killer T cell -- to the area so that the targeted infected cells can be removed. However, if this activity occurs in the wrong place or at the wrong time, the signals may inadvertently direct the killer T cells to attack healthy cells instead.
"We knew from comparing the brains of infants with NEC with ones from infants who died from other causes that the former had accumulations of CD4+ T cells and showed increased microglial activity," says study senior author David Hackam, M.D., Ph.D., surgeon-in-chief at Johns Hopkins Children's Center and professor of surgery at the Johns Hopkins University School of Medicine. "We suspected that these T cells came from the NEC-inflamed regions of the gut and set out to prove it by using neonatal mice as a model of what happens in human infants."
In the first of a series of experiments, the researchers induced NEC in infant mice and then examined their brains. As expected, the tissues showed a significant increase in CD4+ T cells as well as higher levels of a protein associated with increased microglial activity. In a follow up test, the researchers showed that mice with NEC had a weakened blood-brain barrier -- the biological wall that normally prevents bacteria, viruses and other hazardous materials circulating in the bloodstream from reaching the central nervous system. This could, the researchers surmised, explain how CD4+ T cells from the gut could travel to the brain.
Next, the researchers determined that accumulating CD4+ T cells were the cause of the brain injury seen with NEC. They did this first by biologically blocking the movement of the helper T cells into the brain and then in a separate experiment, neutralizing the T cells by binding them to a specially designed antibody. In both cases, microglial activity was subdued and white matter in the brain was preserved.
To further define the role of CD4+ T cells in brain injury, the researchers harvested T cells from the brains of mice with NEC and injected them into the brains of mice bred to lack both T and B lymphocytes. Compared with control mice that did not receive any T cells, the mice that did receive the lymphocytes had higher levels of the chemical signals which attract killer T cells. The researchers also observed activation of the microglia, inflammation of the brain and loss of white matter -- all markers of brain injury.
The researchers then sought to better define how the accumulating CD4+ T cells were destroying white matter -- actually a fat called myelin that covers and protects neurons in the brain, and facilitates communication between them. To do this, they used organoids, mouse brain cells grown in the laboratory to simulate the entire brain. Brain-derived CD4+ T cells from mice with NEC were added to these laboratory "mini-brains" and then examined for several weeks.
Hackam and his colleagues found that a specific chemical signal from the T cells -- a cytokine (inflammatory protein) known as interferon-gamma (IFN-gamma) -- increased in the organoids as the amount of myelin decreased. This activity was not seen in the organoids that received CD4+ T cells from mice without NEC.
After adding IFN-gamma alone to the organoids, the researchers saw the same increased levels of inflammation and reduction of myelin that they had seen in mice with NEC. When they added an IFN-gamma neutralizing antibody, cytokine production was significantly reduced, inflammation was curtailed and white matter was partially restored.
The researchers concluded that IFN-gamma directs the process leading to NEC-related brain injury. Their finding was confirmed when an examination of brain tissues from mice with NEC revealed higher levels of IFN-gamma than in tissues from mice without the disease.
Next, the researchers investigated whether CD4+ T cells could migrate from the gut to the brain of mice with NEC. To do this, they obtained CD4+ T cells from the intestines of infant mice with and without NEC. Both types of cells were injected into the brains of infant mice in two groups -- one set that could produce the protein Rag1 and one that could not. Rag1-deficient mice do not have mature T or B lymphocytes.
The Rag1-deficient mice that received gut-derived helper T cells from mice with NEC showed the same characteristics of brain injury seen in the previous experiments. T cells from both mice with and without NEC did not cause brain injury in mice with Rag1, nor did T cells from mice without NEC in Rag1-deficient mice. This showed that the gut-derived helper T cells from mice with NEC were the only ones that could cause brain injury.
In a second test, gut-derived T cells from mice with and without NEC were injected into the peritoneum -- the membrane lining the abdominal cavity -- of Rag1-deficient mice. Only the intestinal T cells from mice with NEC led to brain injury.
This finding was confirmed by genetically sequencing the same portions from both the brain-derived and gut-derived T lymphocytes from mice with and without NEC. The sequences of the helper T cells from mice with NEC, on average, were 25% genetically similar while the ones from mice without NEC were only 2% alike.
In a final experiment, the researchers blocked IFN-gamma alone. Doing so provided significant protection against the development of brain injury in mice with severe NEC. This suggests, the researchers say, a therapeutic approach that could benefit premature infants with the condition.
"Our research strongly suggests that helper T cells from intestines inflamed by NEC can migrate to the brain and cause damage," says Hackam. "The mouse model in our study was previously shown to closely match what occurs in humans, so we believe that this is the likely mechanism by which NEC-related brain injury develops in premature infants."
Based on these findings, Hackam says measures for preventing this type of brain injury, including therapies to block the action of INF-gamma, may be possible.
https://www.sciencedaily.com/releases/2021/01/210106171334.htm
Gut microbe may promote breast cancers
Short-term exposure to B. fragilis toxin leaves lasting impression in cells, increasing the risk for cancer
January 6, 2021
Science Daily/Johns Hopkins Medicine
A microbe found in the colon and commonly associated with the development of colitis and colon cancer also may play a role in the development of some breast cancers, according to new research from investigators with the Johns Hopkins Kimmel Cancer Center and its Bloomberg~Kimmel Institute for Cancer Immunotherapy. Breast tissue cells exposed to this toxin retain a long-term memory, increasing the risk for disease.
In a series of laboratory experiments, researchers discovered that when enterotoxigenic Bacteroides fragilis (ETBF) was introduced to the guts or breast ducts of mice, it always induced growth and metastatic progression of tumor cells. A description of the work is published in the January 6 issue of the journal Cancer Discovery.
While microbes are known to be present in body sites such as the gastrointestinal tract, nasal passages and skin, breast tissue was considered sterile until recently, says senior study author Dipali Sharma, Ph.D., a professor of oncology at Johns Hopkins Medicine.
The study is a first step to show the involvement of ETBF in breast cancer development, Sharma says. Additional studies are needed to clarify how ETBF moves throughout the body, whether ETBF can be a sole driver to directly trigger the transformation of breast cells in humans, and/or if other microbiota also have cancer-causing activity for breast tissue.
"Despite multiple established risk factors for breast cancer, such as age, genetic changes, radiation therapy and family history, a large number of breast cancers arise in women harboring none of these, indicating the need to look beyond," Sharma says. "Our study suggests another risk factor, which is the microbiome. If your microbiome is perturbed, or if you harbor toxigenic microbes with oncogenic function, that could be considered an additional risk factor for breast cancer."
Sharma and colleagues performed several experiments to study the role of ETBF. First, they performed a meta-analysis of clinical data looking at published studies comparing microbial composition among benign and malignant breast tumors and nipple aspirate fluids of breast cancer survivors and healthy volunteers. B. fragilis was consistently detected in all breast tissue samples as well as the nipple fluids of cancer survivors.
In the lab, the team gave the ETBF bacteria by mouth to a group of mice. First, it colonized the gut. Then, within three weeks, the mouse mammary tissue had observable changes usually present in ductal hyperplasia, a precancerous condition. In additional tests, investigators found that hyperplasia-like symptoms also appeared within two to three weeks of injecting ETBF bacteria directly to the teats of mice, and that cells exposed to the toxin always exhibited more rapid tumor progression and developed more aggressive tumors than cells not exposed to the toxin. Breast cells exposed to the toxin for 72 hours retained a memory of the toxin and were able to start cancer development and form metastatic lesions in different mouse models. Investigators also found the Notch1 and beta-catenin cell signaling pathways to be involved in promoting EBFT's role in breast tissue.
In clinical studies, the investigators have started looking for microbiome changes among breast cancer patients to see how this impacts tumor progression and response to therapy. Meanwhile, Sharma says, "we definitely should try to maintain a healthy microbiome, including eating a healthy diet and exercising, and maintaining the correct body mass index."
Down the road, screening for microbiome changes could be as simple as stool sample tests, said lead author Sheetal Parida, a postdoctoral fellow at Johns Hopkins Medicine. "This is just one indicator, and we think there will be multiple," she said. "If we find additional bacteria responsible for cancer development, we can easily look at the stool and check for those. Women at high risk of developing breast cancer might have a high population of some of these."
https://www.sciencedaily.com/releases/2021/01/210106115710.htm
Sleep keeps teens on track for good mental health
February 10, 2021
Science Daily University of South Australia
As families settle back into a new school year, sleep experts at the University of South Australia are reminding parents about the importance of teenagers getting enough sleep, cautioning them that insufficient sleep can negatively affect their mental health.
In a new research paper, UniSA sleep experts Dr Alex Agostini and Dr Stephanie Centofanti confirm that sleep is intrinsically linked to mental health, but is commonly overlooked by health practitioners as a contributing factor.
Dr Agostini says it's imperative that parents and medical practitioners are aware of the bi-directional relationship between sleep and mental health, particularly across the teenage years.
"Getting enough sleep is important for all of us ¬¬- it helps our physical and mental health, boosts our immunity, and ensures we can function well on a daily basis," Dr Agostini¬ says.
"But for teenagers, sleep is especially critical because they're at an age where they're going through a whole range of physical, social, and developmental changes, all of which depend on enough sleep.
"Research shows that teenagers need at least eight hours of sleep each night. Without this, they're less able to deal with stressors, such as bullying or social pressures, and run the risk of developing behavioural problems, as well as anxiety and depression.
"If sleep drops to less than six hours a night, research shows that teens are twice as likely to engage in risky behaviours such as dangerous driving, marijuana, alcohol or tobacco use, risky sexual behaviour, and other aggressive or harmful activities."
In Australia, almost one in seven children and adolescents (aged 4-17 years) will experience a mental health disorder. The World Health Organization says that while half of all mental health conditions start by age 14, most cases go undetected and untreated.
Co-researcher, Dr Centofanti says while many factors contribute to later bedtimes for teenagers, technology is one of the greatest offenders.
"Teens spend a lot of time on devices, whether it's texting friends, playing games, or watching videos, using technology late into the night is one of the most common disruptors of good sleep. Overuse of technology can also contribute to mental health issues likely to increase anxiety," Dr Centofanti says.
"Not only can technology use make us feel anxious and awake, but the blue light emitted from technology inhibits the production of the sleep hormone melatonin to delay the natural onset of sleep. This is problematic because teens already have a biological tendency to want to stay up late and sleep in.
"To make a real difference to teenage mental health, both parents and medical practitioners must understand how sleep can affect mental health in teenagers."
https://www.sciencedaily.com/releases/2021/02/210210091215.htm
Health ranks as top concern for veterans immediately after military service
Findings based on survey of nearly 10,000 veterans
January 2, 2020
Veterans Affairs Research Communications
In a survey of nearly 10,000 veterans newly separated from military service, most were satisfied with their work and social well-being, but more than half reported chronic physical health problems, and a third reported chronic mental health conditions.
In the months after separating from military service, most veterans are less satisfied with their health than with their work or social relationships, found a study by Veterans Affairs researchers. While the veterans surveyed were mostly satisfied with their work and social well-being, a majority were dealing with chronic physical health conditions and a third reported chronic mental health conditions.
According to Dr. Dawne Vogt of the VA Boston Healthcare System and Boston University, lead author on the study, the results highlight the importance of addressing veterans' health concerns early.
"What remains to be seen is whether those veterans with health conditions -- which were more commonly experienced by deployed veterans -- continue to maintain high levels of well-being in other life domains over time," she says. "Given that it is well-established that health problems can erode functioning in other life domains, it may be that these individuals experience declines in their broader well-being over time."
The results appear Jan. 2, 2019, in the American Journal of Preventive Medicine.
More than 200,000 U.S. service members transition out of military service each year. Researchers have pointed to the early transition period as a critical time to address challenges veterans may face in readjusting to civilian life.
To investigate which of these challenges are most pressing to newly separated veterans, researchers from the VA National Center for PTSD and colleagues surveyed almost 10,000 veterans from a population-based roster of all separating service members.
All participants left the military in the fall of 2016. Veterans were surveyed about three months after their separation, and then six months after that.
The researchers found that the biggest concern was health. At both three and nine months after leaving the military, 53% of participants said they had chronic physical health conditions. About 33% reported chronic mental health conditions at both time points.
The most commonly reported health conditions were chronic pain, sleep problems, anxiety, and depression. Slightly more than half of participants said they had reduced satisfaction with their health between when they first left the military and a few months later. Health satisfaction did not change much between three and nine months after separation.
While physical and mental health was a concern for many veterans, most reported high vocational and social well-being. The majority of participants said they were satisfied with their work and social relationships and that they were functioning well in these areas. According to Vogt, the fact that most participants had high work and social satisfaction "highlights the resilience of the veteran population, and should provide some reassurance to those concerned about the well-being of newly separated veterans."
More than three-quarters of participants said they were in an intimate relationship in the months after they left the military. Almost two-thirds reported that they had regular contact with their friends and extended family and that they were involved in their broader communities.
Over half of participants had found work three months after military separation. While most participants reported high work satisfaction, the study group showed an overall decline in work functioning over the first year after military separation. Functioning declined even though overall employment rates increased. The researchers hypothesized that this decline in work functioning could be due to health concerns, which are known to erode broader well-being over time.
The study also found differences in well-being based on other factors. Enlisted veterans showed consistently poorer health, vocational, and social well-being than officers. Veterans who had deployed to a war zone had more health concerns than veterans who did not deploy.
There were also several differences between men and women. Male veterans were more likely to be employed than female veterans both three and nine months after leaving the military. Men were also more likely to report hearing conditions, high blood pressure, and high cholesterol. Women were more likely to endorse mental health conditions at nine months post-separation. They also reported more depression and anxiety at both timepoints.
The researchers have shared their findings with the VA Transition Assistance Program (TAP), which helps Veterans transition back to civilian life. The program is jointly managed by VA and the departments of Defense and Labor, in coordination with the departments of Education and Homeland Security, as well as the U.S. Office of Personnel Management and the U.S. Small Business Administration. According to Vogt, the results could help TAP and other programs that help veterans with readjustment decide how to allocate their resources. Vogt writes that the findings "suggest that maybe we don't need as much focus on promoting employment right now, and need more emphasis on treatment of mental/physical health conditions."
The researchers say their findings have implications not only for VA but for the wide spectrum of organizations nationwide -- more than 40,000 in all -- that provide programs, services, and support for veterans making their transition back to civilian life. Historically, much of the support for veterans leaving the military has primarily focused on providing employment and educational assistance and informing veterans of their benefits. But the findings suggest that veterans' health concerns should be prioritized, says Vogt. Interventions should also target at-risk subgroups of veterans. The researchers concluded that addressing newly separated veterans' health concerns could promote their broader well-being and longer-term readjustment.
Vogt points out the importance of addressing veterans' readjustment challenges before they worsen and have a chance to erode broader well-being. She says this may require re-evaluating support methods. "Given that most transition support is targeted to veterans with the most acute or chronic concerns," she says, "this recommendation may require rethinking how veteran programs prioritize their efforts. While it makes sense to target resources to those with greatest need, it is better to support individuals before their concerns become chronic when we can."
Work is underway to expand on this study using the same study group. The research team is analyzing how veterans' health and well-being changes in the second and third year after leaving service, as well as how veterans' initial health status impacts their subsequent well-being in other areas.
https://www.sciencedaily.com/releases/2020/01/200102143403.htm
Vitamin D supplementation: Possible gain in life years combined with cost savings
February 10, 2021
Science Daily/German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ)
In recent years, three meta-analyses of clinical studies have come to the conclusion that vitamin D supplementation was associated with a reduction in the mortality rate from cancer of around 13 percent. Scientists at the German Cancer Research Center (DKFZ) have now transferred these results to the situation in Germany and calculated: If all Germans over the age of 50 were to take vitamin D supplements, up to 30,000 cancer deaths per year could possibly be avoided and more than 300,000 years of life could be gained -- in addition, health care costs could be saved.
For several years now, scientists have been investigating the influence of an adequate supply of vitamin D on the prognosis of numerous diseases. The focus is particularly on inflammatory diseases, diabetes, respiratory diseases and cancer.
Three meta-analyses of large clinical studies have been published in recent years on the question of how vitamin D supply affects cancer mortality rates. The studies* came to the same conclusion: cancer mortality is reduced by around 13 percent with vitamin D supplementation -- across all cancers. Only methodologically high-quality randomized trials from all parts of the world were included in the meta-analyses. Exactly what biological mechanisms might underlie this is not yet clear.
"In many countries around the world, the age-adjusted rate of cancer mortality has fortunately declined over the past decade," says Hermann Brenner, an epidemiologist at the German Cancer Research Center (DKFZ). "However, given the often considerable costs of many new cancer drugs, this success has often come at a high price. Vitamin D, on the other hand, is comparatively inexpensive in the usual daily doses."
Vitamin D deficiency is common in the elderly population and especially among cancer patients. Brenner and colleagues now calculated what costs would be incurred by vitamin D supplementation of the entire population of Germany from the age of 50. They contrasted this sum with the potential savings for cancer therapies, which are often associated with costs in the range of several 10,000 euros, particularly in the case of advanced cancers during the last months of patients' lives.
The scientists based this calculation on a daily administration of 1,000 international units of vitamin D at a cost of 25 euros per person per year. In 2016, approximately 36 million people over the age of 50 lived in Germany, resulting in annual supplementation costs of 900 million euros.
The researchers took the cost of cancer treatment from the scientific literature, assuming mean additional treatment costs of €40,000 for the last year of life. A 13 percent reduction in cancer mortality in Germany corresponded to approximately 30,000 fewer cancer-related deaths per year, the treatment costs of which amounted to €1.154 billion in the model calculation. Compared with the costs of vitamin supplementation, this model calculates an annual saving of €254 million.
The researchers determined the number of years of life lost at the time of cancer death using data from the German Federal Statistical Office. Brenner considers the costs and effort of a routine determination of the individual vitamin D level to be dispensable, since an overdose is not to be feared with a supplementation of 1000 international units. Such a prior testing had not been made in the clinical trials either.
"In view of the potentially significant positive effects on cancer mortality -- additionally combined with a possible cost saving -- we should look for new ways to reduce the widespread vitamin D deficiency in the elderly population in Germany. In some countries, foods have even been enriched with vitamin D for many years -- for example, in Finland, where cancer mortality rates are about 20 percent lower than in Germany. Not to mention that there is mounting evidence of other positive health effects of adequate vitamin D supply, such as in lung disease mortality rates," says Brenner, adding, "Finally, we consider vitamin D supplementation so safe that we even recommend it for newborn babies to develop healthy bones."
To improve one's vitamin D levels at absolutely no cost, DKFZ's Cancer Information Service recommends spending time outdoors in the sunshine, two to three times a week for about twelve minutes. Face, hands and parts of arms and legs should be uncovered and without sunscreen for this period of time.
https://www.sciencedaily.com/releases/2021/02/210210133333.htm
Coffee lovers, rejoice! Drinking more coffee associated with decreased heart failure risk
Circulation: Heart Failure Journal Report
February 9, 2021
Science Daily/American Heart Association
Dietary information from three large, well-known heart disease studies suggests drinking one or more cups of caffeinated coffee may reduce heart failure risk, according to research published today in Circulation: Heart Failure, an American Heart Association journal.
Coronary artery disease, heart failure and stroke are among the top causes of death from heart disease in the U.S. "While smoking, age and high blood pressure are among the most well-known heart disease risk factors, unidentified risk factors for heart disease remain," according to David P. Kao, M.D., senior author of the study, assistant professor of cardiology and medical director at the Colorado Center for Personalized Medicine at the University of Colorado School of Medicine in Aurora, Colorado.
"The risks and benefits of drinking coffee have been topics of ongoing scientific interest due to the popularity and frequency of consumption worldwide," said Linda Van Horn, Ph.D., R.D., professor and Chief of the Department of Preventive Medicine's Nutrition Division at the Northwestern University Feinberg School of Medicine in Chicago, and member of the American Heart Association's Nutrition Committee. "Studies reporting associations with outcomes remain relatively limited due to inconsistencies in diet assessment and analytical methodologies, as well as inherent problems with self-reported dietary intake."
Kao and colleagues used machine learning through the American Heart Association's Precision Medicine Platform to examine data from the original cohort of the Framingham Heart Study and referenced it against data from both the Atherosclerosis Risk in Communities Study and the Cardiovascular Health Study to help confirm their findings. Each study included at least 10 years of follow-up, and, collectively, the studies provided information on more than 21,000 U.S. adult participants.
To analyze the outcomes of drinking caffeinated coffee, researchers categorized consumption as 0 cups per day, 1 cup per day, 2 cups per day and ?3 cups per day. Across the three studies, coffee consumption was self-reported, and no standard unit of measure were available.
The analysis revealed:
In all three studies, people who reported drinking one or more cups of caffeinated coffee had an associated decreased long-term heart failure risk.
In the Framingham Heart and the Cardiovascular Health studies, the risk of heart failure over the course of decades decreased by 5-to-12% per cup per day of coffee, compared with no coffee consumption.
In the Atherosclerosis Risk in Communities Study, the risk of heart failure did not change between 0 to 1 cup per day of coffee; however, it was about 30% lower in people who drank at least 2 cups a day.
Drinking decaffeinated coffee appeared to have an opposite effect on heart failure risk -- significantly increasing the risk of heart failure in the Framingham Heart Study. In the Cardiovascular Health Study however; there was no increase or decrease in risk of heart failure associated with drinking decaffeinated coffee. When the researchers examined this further, they found caffeine consumption from any source appeared to be associated with decreased heart failure risk, and caffeine was at least part of the reason for the apparent benefit from drinking more coffee.
"The association between caffeine and heart failure risk reduction was surprising. Coffee and caffeine are often considered by the general population to be 'bad' for the heart because people associate them with palpitations, high blood pressure, etc. The consistent relationship between increasing caffeine consumption and decreasing heart failure risk turns that assumption on its head," Kao said. "However, there is not yet enough clear evidence to recommend increasing coffee consumption to decrease risk of heart disease with the same strength and certainty as stopping smoking, losing weight or exercising."
According to the federal dietary guidelines, three to five 8-ounce cups of coffee per day can be part of a healthy diet, but that only refers to plain black coffee. The American Heart Association warns that popular coffee-based drinks such as lattes and macchiatos are often high in calories, added sugar and fat. In addition, despite its benefits, research has shown that caffeine also can be dangerous if consumed in excess. Additionally, children should avoid caffeine. The American Academy of Pediatrics recommends that, in general, kids avoid beverages with caffeine.
"While unable to prove causality, it is intriguing that these three studies suggest that drinking coffee is associated with a decreased risk of heart failure and that coffee can be part of a healthy dietary pattern if consumed plain, without added sugar and high fat dairy products such as cream," said Penny M. Kris-Etherton, Ph.D., R.D.N., immediate past chairperson of the American Heart Association's Lifestyle and Cardiometabolic Health Council Leadership Committee, Evan Pugh University Professor of Nutritional Sciences and distinguished professor of nutrition at The Pennsylvania State University, College of Health and Human Development in University Park. "The bottom line: enjoy coffee in moderation as part of an overall heart-healthy dietary pattern that meets recommendations for fruits and vegetables, whole grains, low-fat/non-fat dairy products, and that also is low in sodium, saturated fat and added sugars. Also, it is important to be mindful that caffeine is a stimulant and consuming too much may be problematic -- causing jitteriness and sleep problems."
Study limitations that may have impacted the results of the analysis included differences in the way coffee drinking was recorded and the type of coffee consumed. For example, drip, percolated, French press or espresso coffee types; origin of the coffee beans; and filtered or unfiltered coffee were details not specified. There also may have been variability regarding the unit measurement for 1 cup of coffee (i.e., how many ounces per cup). These factors could result in different caffeine levels. In addition, researchers caution that the original studies detailed only caffeinated or decaffeinated coffee, therefore these findings may not apply to energy drinks, caffeinated teas, soda and other food items with caffeine including chocolate.
https://www.sciencedaily.com/releases/2021/02/210209083513.htm
Fungi in the gut prime immunity against infection
February 5, 2021
Science Daily/Weill Cornell Medicine
Common fungi, often present in the gut, teach the immune system how to respond to their more dangerous relatives, according to new research from scientists at Weill Cornell Medicine. Breakdowns in this process can leave people susceptible to deadly fungal infections.
The study, published Feb. 5 in Cell, reveals a new twist in the complex relationship between humans and their associated microbes, and points the way toward novel therapies that could help combat a rising tide of drug-resistant pathogens.
The new discovery stemmed from work on inflammatory bowel disease, which often causes patients to carry larger than normal populations of fungi in their guts. These patients often develop strong antibody responses against mannan, a molecule common to a wide range of fungal species. However, Dr. Iliyan Iliev, associate professor of immunology in medicine in the Division of Gastroenterology and Hepatology at Weill Cornell Medicine, noticed that healthy controls in these studies also had some level of anti-fungal antibodies. "There was no actual evidence for fungal infections in the healthy individuals that we examined, so we started thinking about the possible function of those antibodies," said Dr. Iliev, who is senior author on the study and a member of the Jill Roberts Institute for Research in Inflammatory Bowel Disease.
The team developed a platform that allowed them to determine which gut fungi are targeted by antibodies in the blood of individual patients. They detected a strong response against the yeast Candida albicans. Turning to experiments in mice, Dr. Iliev and Itai Doron, a Weill Cornell Medicine Graduate School of Medical Sciences doctoral candidate in the lab and lead author on the study, found that colonizing the animals' guts with Candida albicans caused them to develop antibodies against the fungus in their bloodstreams, even though they didn't develop blood-borne fungal infections. Instead, the animals' immune cells appeared to transport fungal antigens to the spleen, stimulating the production of circulating antibodies in the bloodstream. "Those fungi just educate that immune response," Dr. Iliev said.
Iliev and his colleagues mimicked this process by treating mice with immunosuppressive drugs. When a Candida species colonizes the gut of these mice, the fungus moves into the bloodstream, causing a fatal infection. Treating the mice with purified anti-fungal antibodies from donor animals protected the immunosuppressed mice from these infections. The same strategy worked against infection with either Candida albicans or the emerging pathogenic yeast Candida auris, which has become a major cause of fungal disease in immunosuppressed patients and the elderly in recent years.
Collaborating with researchers at INSERM in Paris, France, the Weill Cornell Medicine team also looked at serum from patients with mutations in a gene called CARD9. This mutation affects a critical adapter protein in the immune system, leaving the affected individuals susceptible to severe fungal infections. Dr. Iliev's team found that the serum of these patients lacked the anti-fungal antibodies normally seen in serum of patients without this mutation. Experiments in mice confirmed an essential and specific role for CARD9 in priming the production of anti-fungal antibodies.
Graphic depicting relationship between fungi in gut, antibody levels and CARD gene Relationship between gut fungi, anti-fungal antibodies, CARD9 gene, and fungal immunity. Image courtesy of the Iliev lab.
The results suggest that normal intestinal fungi such as Candida albicans may function as a kind of intestinal vaccine against fungal infection in healthy people, by inducing the production of bloodborne antibodies that can target multiple species of potentially pathogenic fungi. When those fungi do enter the bloodstream, the antibodies bind them and target them for destruction by cells of the immune system. In patients with suppressed immunity, the anti-fungal antibodies may decline, leaving them vulnerable to fungal infection. New therapies that involve either stimulating the production of anti-fungal antibodies, or injecting such purified antibodies directly into patients' bloodstreams, could potentially help combat these increasingly common infections.
If that approach works, it would be a welcome development. "Many fungal infections in immunosuppressed patients and elderly patients are happening by translocation of pathogenic Candida species from the gastrointestinal tract, and the survival rates upon systemic spreading are alarmingly low," said Dr. Iliev.
https://www.sciencedaily.com/releases/2021/02/210205155813.htm
How air pollution may increase the risk of cardiovascular disease
Fine particulate air pollution stimulates production of inflammatory cells, leading to inflammation of the arteries
February 4, 2021
Science Daily/Massachusetts General Hospital
Tiny particles of air pollution -- called fine particulate matter -- can have a range of effects on health, and exposure to high levels is a known risk factor for cardiovascular disease. New research led by investigators at Massachusetts General Hospital (MGH) reveals that fine particulate matter has a detrimental impact on cardiovascular health by activating the production of inflammatory cells in the bone marrow, ultimately leading to inflammation of the arteries. The findings are published in the European Heart Journal.
The retrospective study included 503 patients without cardiovascular disease or cancer who had undergone imaging tests at MGH for various medical reasons. The scientists estimated participants' annual average fine particulate matter levels using data obtained from the U.S. Environment Protection Agency's air quality monitors located closest to each participant's residential address.
Over a median follow-up of 4.1 years, 40 individuals experienced major cardiovascular events, such as heart attacks and strokes, with the highest risk seen in participants with higher levels of fine particulate matter at their home address. Their risk was elevated even after accounting for cardiovascular risk factors, socioeconomic factors, and other key confounders. Imaging tests assessing the state of internal organs and tissues showed that these participants also had higher bone marrow activity, indicating a heightened production of inflammatory cells (a process called leukopoiesis), and elevated inflammation of the arteries. Additional analyses revealed that leukopoiesis in response to air pollution exposure is a trigger that causes arterial inflammation.
"The pathway linking air pollution exposure to cardiovascular events through higher bone marrow activity and arterial inflammation accounted for 29% of the relationship between air pollution and cardiovascular disease events," says co-first author Shady Abohashem, MD, a cardiovascular imaging fellow at MGH. "These findings implicate air pollution exposure as an underrecognized risk factor for cardiovascular disease and suggest therapeutic targets beyond pollution mitigation to lessen the cardiovascular impact of air pollution exposure."
Co-first author Michael Osborne, MD, a cardiologist at MGH, explains that therapies targeting increased inflammation following exposure to fine particulate matter may benefit patients who cannot avoid air pollution. "Importantly, most of the population studied had air pollution exposures well below the unhealthy thresholds established by the World Health Organization, suggesting that no level of air pollution can truly be considered safe," he says.
https://www.sciencedaily.com/releases/2021/02/210204135742.htm
Alcohol consumption linked to portion of cancer incidence and mortality
Findings call for implementation of policies and cancer control efforts to reduce alcohol consumption
January 19, 2021
Science Daily/American Cancer Society
A new study finds that alcohol consumption accounts for a considerable portion of cancer incidence and mortality in all 50 states and the District of Columbia. The article, which appears in Cancer Epidemiology, states that the proportion of cancer cases attributable to alcohol consumption ranged from a high of 6.7% in Delaware to a low of 2.9% in Utah. Similarly, Delaware had the highest proportion of alcohol-related cancer deaths (4.5%) and Utah had the lowest (1.9%).
This study conducted by Farhad Islami, MD, PhD, and colleagues at the American Cancer Society is the first to estimate contemporary proportions and counts of alcohol-attributable cancer cases and deaths for all states. Data shows the proportions were generally higher in New England and Western states and lower in Midwestern and Southern states.
"This information is important for prioritizing state-level cancer prevention and control efforts to reduce alcohol consumption and the burden of alcohol-related cancers," said Dr. Islami.
The proportion of alcohol-related cancers was far greater for some individual cancer types. For oral cavity/pharyngeal cancer cases, for example, it ranged from 36% in Utah to 62.5% in Delaware and was 45% or more in 45 states and the District of Columbia. By sex, alcohol-related cancer cases and deaths for most evaluated cancer types were higher among men, in part reflecting higher levels of alcohol consumption among men.
In the U.S. on average, alcohol consumption accounted for 4.8% of cancer cases and 3.2% of cancer deaths, or about 75,200 cancer cases and 18,950 cancer deaths annually, during 2013 to 2016.
In addition, the authors say, "healthcare providers and public health practitioners can educate the community to expand the currently limited awareness of the cancer-related risks of alcohol consumption." The American Cancer Society's guideline for Diet and Physical Activity for Cancer Prevention states that it is best not to consume alcohol; for those who do drink, consumption should be limited to no more than 1 drink per day for women and 2 drinks per day for men.
https://www.sciencedaily.com/releases/2021/01/210119114255.htm