Mental health may play big role in recovery after a heart attack
Psychological distress found to double the risk of subsequent cardiac events in younger adults
May 6, 2021
Science Daily/American College of Cardiology
Young and middle-aged adults who reported severe psychological distress -- such as depression or anxiety -- after suffering a heart attack were more than twice as likely to suffer a second cardiac event within five years compared with those experiencing only mild distress, according to a study presented at the American College of Cardiology's 70th Annual Scientific Session.
The study is the first to comprehensively assess how mental health influences the outlook for younger heart attack survivors, according to the researchers. The researchers also tracked inflammatory markers that appear to have a role in increasing cardiovascular risk among people experiencing distress. The findings align with previous studies focusing on older adults, bolstering the evidence for mental health as an integral part of a person's recovery after a heart attack.
"Our findings suggest that cardiologists should consider the value of regular psychological assessments, especially among younger patients," said Mariana Garcia, MD, a cardiology fellow at Emory University in Atlanta and the study's lead author. "Equally importantly, they should explore treatment modalities for ameliorating psychological distress in young patients after a heart attack, such as meditation, relaxation techniques and holistic approaches, in addition to traditional medical therapy and cardiac rehabilitation."
The researchers analyzed health outcomes in 283 heart attack survivors between the ages of 18 and 61, with an average age of 51 years. Study participants completed a series of validated questionnaires measuring depression, anxiety, anger, perceived stress and posttraumatic stress disorder within six months of their heart attack. Based on these questionnaires, the researchers established a composite score of psychological distress for each participant and grouped patients based on experiences of mild, moderate and high distress.
Within five years after their heart attack, 80 of the 283 patients suffered a subsequent heart attack or stroke, were hospitalized for heart failure or died from cardiovascular causes. These outcomes occurred in nearly half (47%) of patients experiencing high distress compared to 22% of those experiencing mild distress.
Previous studies suggest inflammation is one mechanism through which psychological distress may lead to heart problems. In the new study, patients who experienced high distress were also found to have higher levels of two inflammatory markers -- interleukin-6 and monocyte chemoattract protein-1 -- in their blood during rest and after mental stress. These markers, which increase during times of mental stress, are known to be associated with plaque buildup in the arteries and adverse cardiac events.
"It is thought that those who have had a heart attack may be particularly vulnerable to plaque rupture as a result of these inflammatory mechanisms at play," Garcia said. "The association we found was independent of known cardiovascular risk factors and suggests mechanisms involving systemic inflammation in response to stress may be implicated in the likelihood of a subsequent cardiac event."
The researchers also found that patients with high distress were more often Black, female and from a disadvantaged socioeconomic background and were more likely to smoke or have diabetes or high blood pressure.
"This finding highlights the importance of socioeconomic status in regard to higher distress and raises important questions about the role of race, sex and other factors," Garcia said.
The researchers plan to further investigate how socioeconomic and demographic factors may influence mental health among people who suffer a heart attack at a young age. Recent studies have suggested younger adults, especially women, account for an increasing proportion of the heart attacks occurring each year in the U.S., Garcia said, underscoring the importance of improving outcomes in this population.
"Outreach to the community has led to increased awareness of traditional heart disease risk factors and focus on things like diet and exercise, but many people, particularly younger people, may not be aware of the importance of mental health," Garcia said. "Our study offers a strong message to people recovering from a heart attack that ameliorating psychological distress is equally important."
Garcia cautioned that causation cannot be proven with an observational study and noted the possibility of recall bias among people with more severe disease, since psychological distress was self-reported in this study. While the study's sample size was relatively small, it did demonstrate a robust association using a prospective design.
https://www.sciencedaily.com/releases/2021/05/210506105433.htm
Too much, too little sleep linked to elevated heart risks in people free from disease
Sleep should be assessed along with other factors that increase heart disease
May 5, 2021
Science Daily/American College of Cardiology
People who clock six to seven hours of sleep a night had the lowest chance of dying from a heart attack or stroke when compared with those who got less or more sleep, according to a study being presented at the American College of Cardiology's 70th Annual Scientific Session. This trend remained true even after the research team accounted for other known conditions or risk factors for heart disease or stroke.
The study, according to researchers, is the first to explore the association between baseline cardiovascular risk and duration of sleep and adds to mounting evidence that sleep -- similar to diet, smoking and exercise -- may play a defining role in someone's cardiovascular risk.
"Sleep is often overlooked as something that may play a role in cardiovascular disease, and it may be among the most cost-effective ways to lower cardiovascular risk," said Kartik Gupta, MD, resident, Division of Internal Medicine, Henry Ford Hospital in Detroit and lead author of the study. "Based on our data, sleeping six to seven hours a night is associated with more favorable heart health."
For the study, Gupta and his team included data from 14,079 participants in the 2005-2010 National Health and Nutrition Examination Survey. Participants were followed for a median duration of 7.5 years to determine if they died due to heart attack, heart failure or stroke. Those surveyed were 46 years old on average, half were women and 53% were non-white. Less than 10% of participants had a history of heart disease, heart failure or stroke.
Researchers divided participants into three groups based on answers to a survey question about their average length of sleep -- less sleep (seven hours). Researchers then assessed participants' atherosclerotic cardiovascular disease (ASCVD) risk scores and levels of C-reactive protein (CRP), a key inflammatory marker known to be associated with heart disease.
The ASCVD risk score, which accounts for age, gender, race, blood pressure and cholesterol, is widely used to predict how likely someone is to have a heart attack or stroke or die from atherosclerosis, a hardening of the arteries, in the next 10 years. An ASCVD risk score less than 5% is considered low risk.
While the median ASCVD risk was 3.5% among all participants, there was a U-shape relationship based on sleep duration such that participants with six to seven hours had the lowest risk. The median 10-year ASCVD risk among people with less than six, six to seven and more than seven hours of sleep were 4.6%, 3.3% and 3.3%, respectively.
"Participants who slept less than six hours or more than seven hours had a higher chance of death due to cardiac causes. ASCVD risk score was, however, the same in those who sleep six to seven hours versus more than seven hours," Gupta said, adding that the ASCVD risk score may not adequately capture elevated cardiac risk in this subgroup and that results are perhaps stronger for participants sleeping less than six hours a night.
Levels of CRP, a protein made in the liver that rises when there is inflammation in the body, were also higher in participants with longer or shorter durations of sleep.
"Participants who sleep less or more than six to seven hours have higher ASCVD risk scores, which is likely driven by heightened inflammation as measured by CRP, which was found to be higher among those who had less or more sleep," Gupta said, adding that CRP levels were only collected at the start of the study. "The effect of sleep probably accrues over time; it takes time for the damage to happen."
According to the researchers, unlike some risk factors for heart disease that can't be changed, such as age or genetics, sleep habits can be adjusted and should be routinely asked about during medical visits.
"It's important to talk about not only the amount of sleep but the depth and quality of sleep too. Just because you are lying in bed for seven hours doesn't mean that you are getting good quality sleep," Gupta said, adding that this study is limited to sleep quantity, not quality or how well or deeply someone sleeps. For example, sleep apnea, which is a sleep disorder that results in frequent awakenings, is increasingly associated with cardiovascular disease.
The amount of sleep found to be favorable to heart health in this study differs slightly from national recommendations by the National Sleep Foundation and the American Academy of Sleep Medicine, which recommend most adults get seven to nine hours or seven or more hours of sleep a night, respectively. But, as Gupta explains, individuals were limited to choosing hour blocks (six, seven or eight hours, for example) when noting sleep time.
More research is needed to further validate these results.
https://www.sciencedaily.com/releases/2021/05/210505090300.htm
Circadian rhythm research could turn early birds into night owls
May 4, 2021
Science Daily/American Institute of Physics
How body clocks work could lead to science that can turn an early bird into a night owl or vice versa as well as other advances, like helping crops grow all year long.
In Applied Physics Reviews, by AIP Publishing, scientists at Penn State report on their work advancing knowledge about circadian rhythms, the natural process that governs sleep and waking patterns in humans, animals, and plants.
Researchers have identified a set of genes, called clock genes, that control these rhythms. But a more complicated network of genes than previously known appears related to circadian rhythms. More fully understanding this network is key to understanding how the rhythms work and could potentially be changed.
The authors detail a statistical model they are using to help identify all the genes involved in this network. With the help of scientists from other disciplines, they hope to fully understand how these genes work together to make one person more productive in the early morning while another thrives in the middle of the night.
Doing so could lead to the creation of medicines that would help someone who is naturally a day person but required to work nights, or one who struggles to be productive first thing in the morning.
"If we understand the gene for a night owl, we can develop a drug to activate that gene for an early bird who has to live a lifestyle like a night owl," said author Rongling Wu, director of the Center for Statistical Genetics at Penn State.
There are also possible health benefits. Disrupted circadian rhythms have been linked to health issues including depression, anxiety, weight gain, and cardiovascular disease.
And while most people probably think of circadian rhythms in humans, plants and animals have them, too. A breakthrough in understanding the clock-gene network could help increase crop production.
For example, wheat, which tends to "rest" during the middle of the day, could be modified to grow all day long and be harvested more quickly. Or a crop that does not grow well in northern areas with less daylight and colder temperatures could have genes altered to make it ignore those conditions.
"We can increase our production," Wu said. "If we can activate the correct gene, we can use all of that time. But we need to bring together different researchers from other fields to better understand such a complex problem."
https://www.sciencedaily.com/releases/2021/05/210504112602.htm
Short-term exposure to air pollution may impede cognition; Aspirin could help
May 3, 2021
Science Daily/Columbia University's Mailman School of Public Health
Exposure to air pollution, even over the course of just a few weeks, can impede mental performance, according to a new study led by researchers at Columbia University Mailman School of Public Health. However, these adverse effects were lessened in people taking nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin. The study is among the first to explore short-term air pollution exposures and the use of NSAIDs to mitigate their effects. The results are published in the journal Nature Aging.
Examples of events that would increase someone's exposure to air pollution over the short term could include forest fires, smog, second-hand cigarette smoke, charcoal grills, and gridlock traffic.
The researchers examined the relationship between exposures to fine particulate matter (PM2.5) and black carbon, a component of PM, and cognitive performance in 954 older white males from the Greater Boston Area enrolled in the Normative Aging Study. They also explored whether taking NSAIDs could modify their relationships. Cognitive performance was assessed using the Global Cognitive Function (GCF) and Mini-Mental State Examination (MMSE) scales. Air pollution levels were obtained from a site in Boston.
Elevated average PM2.5 exposure over 28 days was associated with declines in GCF and MMSE scores. Men who took NSAIDs experienced fewer adverse short-term impacts of air pollution exposures on cognitive health than non-users, though there were no direct associations between recent NSAID use and cognitive performance. The researchers postulate that NSAIDs, especially aspirin, may moderate neuroinflammation or changes in blood flow to the brain triggered by inhaling pollution.
"Despite regulations on emissions, short-term spikes in air pollution remain frequent and have the potential to impair health, including at levels below that usually considered hazardous," says senior author Andrea Baccarelli, MD, PhD, chair of the Department of Environmental Health Sciences. "Taking aspirin or other anti-inflammatory drugs appears to mitigate these effects, although policy changes to further restrict air pollution are still warranted."
The link between long-term PM exposure and impaired cognitive performance in the aging population is well-established. Reported effects include reduced brain volume, cognitive decrements, and dementia development. Air pollution has also been associated with poor cognition of children and adults. Until now, however, little was known about the effects of short-term exposure to air pollution.
The researchers say future studies should investigate the specific effects of chemical components of air pollution on cognitive performance, exposure sources in the environment, and whether cognitive impairments due to short-term air pollution exposures are transient or persistent. Randomized clinical trials of NSAID use are needed to validate their protective effects.
https://www.sciencedaily.com/releases/2021/05/210503135611.htm
Stress slows the immune response in sick mice
April 28, 2021
Science Daily/Cell Press
The neurotransmitter noradrenaline, which plays a key role in the fight-or-flight stress response, impairs immune responses by inhibiting the movements of various white blood cells in different tissues, researchers report April 28th in the journal Immunity. The fast and transient effect occurred in mice with infections and cancer, but for now, it's unclear whether the findings generalize to humans with various health conditions.
"We found that stress can cause immune cells to stop moving and prevents immune cells from protecting against disease," says senior study author University of Melbourne's Scott Mueller (@SMuellerLab) of the Peter Doherty Institute for Infection and Immunity (Doherty Institute). "This is novel because it was not known that stress signals can stop immune cells from moving about in the body and performing their job."
One main function of the sympathetic nervous system (SNS) is to coordinate the fight-or-flight stress response -- a group of changes that prepare the body to fight or take flight in stressful or dangerous situations to protect itself from possible harm. Most tissues, including the lymph nodes and spleen, are innervated by SNS fibers. Stress-induced activation of the SNS can suppress immune responses, but the underlying mechanisms have been poorly characterized. "We hypothesized that SNS signals might modify the movement of T cells in tissues and lead to compromised immunity," Mueller says.
White blood cells, also known as leukocytes, travel constantly throughout the body and are highly motile within tissues, where they locate and eradicate pathogens and tumors. Although the movement of leukocytes is critical for immunity, it has not been clear how these cells integrate various signals to navigate within tissues. "We also speculated that neurotransmitter signals might be a rapid way to modulate leukocyte behavior in tissues, in particular during acute stress that involves increased activation of the SNS," Mueller says.
To test this idea, the researchers used advanced imaging to track the movements of T cells in mouse lymph nodes. Within minutes of being exposed to noradrenaline, T cells that had been rapidly moving stopped in their tracks and retracted their arm-like protrusions. This effect was transient, lasting between 45 and 60 minutes. Localized administration of noradrenaline in the lymph nodes of live mice also rapidly halted the cells. Similar effects were observed in mice that received noradrenaline infusions, which are used to treat patients with septic shock -- a life-threatening condition that occurs when infection leads to dangerously low blood pressure. This finding suggests that therapeutic treatment with noradrenaline might impair leukocyte functions.
"We were very surprised that stress signals had such a rapid and dramatic effect on how immune cells move," Mueller says. "Since movement is central to how immune cells can get to the right parts of the body and fight infections or tumors, this rapid movement off-switch was unexpected."
Other experiments revealed that SNS signals inhibit the migration of distinct immune cells, including B cells and dendritic cells, exerting these effects in different tissues such as skin and liver. Additional results suggest that the effects of SNS activation on cell motility may be mediated by the constriction of blood vessels, reduced blood flow, and oxygen deprivation in tissues, resulting in an increase in calcium signaling in leukocytes.
"Our results reveal that an unanticipated consequence of modulation of blood flow in response to SNS activity is the rapid sensing of changes in oxygen by leukocytes and the inhibition of motility," Mueller says. "Such rapid paralysis of leukocyte behavior identifies a physiological consequence of SNS activity that explains, at least in part, the widely observed relationship between stress and impaired immunity."
Moreover, SNS signals impaired protective immunity against pathogens and tumors in various mouse models, decreasing the proliferation and expansion of T cells in the lymph nodes and spleen. For example, treatment with SNS-stimulating molecules rapidly stopped the movements of T cells and dendritic cells in mice infected with herpes simplex virus 1 and reduced virus-specific T cell recruitment to the site of the skin infection. Similar effects were observed in mice with melanoma and in mice infected with a malarial parasite.
"Our data suggest that SNS activity in tissues could impact immune outcomes in diverse diseases," Mueller says. "Further insight into the impact of adrenergic receptor signals on cellular functions in tissues may inform the development of improved treatments for infections and cancer."
The degree to which SNS activation affects leukocyte behavior or disease outcomes in humans remains to be determined. Notably, increased SNS activity is prominent in patients with obesity and heart failure, while psychological stress can cause blood vessel constriction in patients with heart disease. An unappreciated impact of increased SNS activity, particularly in individuals with underlying health conditions, might be impaired leukocyte behavior and functions. The findings may also have important health implications for patients who use SNS-activating drugs to treat diseases such as heart failure, sepsis, asthma, and allergic reactions.
Moving forward, the researchers will further examine the mechanisms by which immune cells are affected by SNS stress signals and explore relevant strategies to boost anti-cancer responses in patients. "This knowledge will allow us to test the impact of drugs that block the sympathetic stress pathway, such as beta blockers, on the outcomes of vaccination and cancer treatments," Mueller says. "These types of drugs might be safe treatment options for patients where stress could contribute to poor immune function."
https://www.sciencedaily.com/releases/2021/04/210428113807.htm
Research shows consuming prebiotic supplements once a day has a positive impact on anxiety levels
April 27, 2021
Science Daily/University of Surrey
In a paper published in the journal Scientific Reports, researchers from Surrey investigated whether the daily consumption of a prebiotic food supplement could improve overall wellbeing in a group of 18 to 25 year-olds. The study found that those who received a daily dose of prebiotics improved mental wellbeing by reducing anxiety levels and had better gut health than the control group.
Researchers studied a group of 64 healthy female participants with no current or previous clinical diagnoses of anxiety. Participants received either a daily dose of the prebiotic galacto-oligosaccharides (GOS) or a placebo for 28 days.
All those involved in the trial completed surveys about their health experiences, including mood, anxiety and sleep quality and provided a stool sample for gut microbiome sequencing analysis.
Dr Kathrin Cohen Kadosh, Reader in Developmental Cognitive Neuroscience at the University of Surrey and Head of the Social Brain and Development Lab, said:
"This new research marks a significant step forward in that we were able to show that we can use a simple and safe food supplement such as prebiotics to improve both the abundance of beneficial gut bacteria in the gut and to improve mental health and wellbeing in young women."
Dr Nicola Johnstone, Research Fellow from the University of Surrey, said:
"This is an exciting study that brings together different dimensions in mental health research; finding prebiotic effects in a sub-clinical group shows promise for translational clinical research on multiple markers of mental health."
https://www.sciencedaily.com/releases/2021/04/210427122408.htm
Men's loneliness linked to an increased risk of cancer
April 27, 2021
Science Daily/University of Eastern Finland
A recent study by the University of Eastern Finland shows that loneliness among middle-aged men is associated with an increased risk of cancer. According to the researchers, taking account of loneliness and social relationships should thus be an important part of comprehensive health care and disease prevention. The findings were published in Psychiatry Research.
"It has been estimated, on the basis of studies carried out in recent years, that loneliness could be as significant a health risk as smoking or overweight. Our findings support the idea that attention should be paid to this issue," Project Researcher Siiri-Liisi Kraav from the University of Eastern Finland says.
The study was launched in the 1980s with 2,570 middle-aged men from eastern Finland participating. Their health and mortality have been monitored on the basis of register data up until present days. During the follow-up, 649 men, i.e. 25% of the participants, developed cancer, and 283 men (11%) died of cancer. Loneliness increased the risk of cancer by about ten per cent. This association with the risk of cancer was observed regardless of age, socio-economic status, lifestyle, sleep quality, depression symptoms, body mass index, heart disease and their risk factors. In addition, cancer mortality was higher in cancer patients who were unmarried, widowed or divorced at baseline.
"Awareness of the health effects of loneliness is constantly increasing. Therefore, it is important to examine, in more detail, the mechanisms by which loneliness causes adverse health effects. This information would enable us to better alleviate loneliness and the harm caused by it, as well as to find optimal ways to target preventive measures."
https://www.sciencedaily.com/releases/2021/04/210427094811.htm
Should You Start A Keto Diet?
Guest Post by John Mullen
*Note: AV Stim is not endorsing any products or services through guest posts, thanks.
With everyone wanting a new and healthy lifestyle, people are wondering if the Keto diet is worth investing in. While the doctors who created Keto have said that they only recommend it for extreme situations concerning health, new studies are being done to determine if it's safe. So far, they have concluded more investigation is needed. However, with a doctor and coach to guide you, many people have been able to succeed.
What Keto Is About
The Keto diet is meant to help your body in a new way. When wondering if you should start a Keto Diet, you will need to understand what it will do to you. A Keto diet is low carb, moderate protein, and tons of fat. The thought process behind this is that it is believed that you will be able to burn fat more effectively and offer your body additional benefits to utilize. Many doctors have said that this isn't a long-term solution, though others have said that it could be.
The hope is that by adopting a higher fat content diet, your body will be using it as an alternative way to have fuel. When you eat fewer carbs or fewer calories, your liver is believed to produce what is known as ketones. Those ketones are then supposed to be a fuel source for your body to function more healthily.
Who Should Never Attempt Keto
Because of how Keto burns fat and how it affects glucose, if you have diabetes or take medication for this disease, you should never attempt this diet because it can put you into a state of life-threatening ketoacidosis. High blood pressure is another condition that makes this diet a no-go. The same is true if you take medication for it, are pregnant, or breastfeeding, you should never attempt this diet either as it can cause harm to you and your child.
A Coach Can Help
Trusting a coach to help you through this journey will help you in the short and long term. A coach will guide you and allow you to make the best decisions for your body and mind while helping ensure that you stay in good health as long as possible. They will also ensure that you stop if your body can't take this diet. Exercise and watching your food will be another area that they can help. If you find this diet works for you, you may end up with a slimmer form.
Finding A Physical Therapist That Can Help You Heal
Guest Post: John Mullen, Training Cor, Santa Clara CA
Pain doesn't have to be a part of life, but it doesn't have to be. You can end the pain from long-term injuries and tension. If a physical therapist is what you need, you shouldn't wait for the pain to worsen. There are many injuries related to sports, activity from exercising, or injuries from accidents. Whatever the case may be, a physical therapist will be able to help you heal your injuries.
Price
One thing to consider is how it will affect your wallet. Finding a physical therapist that can help you heal shouldn't cause you to go broke. What they should do is clarify your liability while establishing the cost at the outset and establishing how you will be able to pay. Taking any form of payment will be standard and offer plans to ensure that you have an option you can utilize. Most therapy services are usually covered by your insurance as well.
Activities You Can Utilize
Physical therapy centers will each have unique and individualized programs, but they will also have activities in place for you to utilize to help yourself heal and gain strength. These can include things like the following.
Rock climbing
Soccer
Swimming
Bicycling
Weight loss
Committed to helping you in every way, the activities can strengthen joints and troubled areas. For example, swimming is easier on the knees than other activities and is often recommended to help support them.
Areas That Can Be Treated
There are many different areas on your body that can be injured. Another issue to consider is what happens post-partum. Luckily, a proper center will be able to take care of you during that time as well. Some of the different areas that the treatment center can help you with are these.
Hips
Knees
Feet
Ankles
Neck
It might surprise you, but incontinence is an issue that centers work with as well. In many cases, muscle exercises can help strengthen you and help with this particular issue, but they will help you heal in this way.
Choosing The Right Option
When you are looking for someone to help you heal, finding someone you can trust to give you the best treatment is vital. Make the best decision for yourself, and know that you know yourself better than anyone else. The proper therapist will put your needs first while helping you get stronger.
Overgrowth of gut yeast in newborns may increase asthma risk
April 20, 2021
Science Daily/eLife
An overgrowth of yeast in the gut within the first few months of life may cause changes to the immune system that increase the risk of asthma later on, shows a study published today in eLife.
Asthma is a common and sometimes difficult-to-manage, life-long lung condition that affects one in 10 children in developed countries. The findings explain a possible cause of asthma and may help scientists develop new strategies to prevent or treat the condition.
The period just after birth is a critical window for the development of a healthy immune system and gut microbiome. Disruptions to gut bacteria that produce anti-inflammatory compounds called short-chain fatty acids (SCFAs) early in life have previously been linked to asthma.
"We recently showed that overgrowth of a type of gut yeast called Pichia kudriavzevii in newborns in Ecuador is associated with an increased risk of asthma," says first author Rozlyn Boutin, an MD/PhD student in the Department of Microbiology and Immunology at the University of British Columbia, Vancouver, Canada. "In this study, we wanted to see if we could replicate these findings in children from an industrialised setting and identify how fungi of the gut microbiota affect the development of the immune system."
Boutin and colleagues began with a study of 123 newborns in Canada, who are part of the CHILD Cohort Study. They again found that an overgrowth of Pichia kudriavzevii in the stools of the newborns during the first three months of life was associated with a higher risk of asthma.
To understand how this yeast overgrowth might contribute to asthma later in life, the team applied Pichia kudriavzevii to newborn mice with immature gut microbiota communities. In this mouse model of asthma, the team found that the newborns exposed to the yeast experienced more lung inflammation than those who were unexposed. Applying Pichia kudriavzevii to an adolescent mouse model, however, did not cause this excess inflammation.
"Our findings show that there is a critical window in early life where disruptions in the gut microbiota caused by Pichia kudriavzevii affect the development of the immune system and increase the risk and severity of asthma later in life," Boutin says.
Previous studies have shown that bacterial
Research shows pain relieving effects of CBD
April 25, 2021
Science Daily/Syracuse University
It's been hailed as a wonder drug and it's certainly creating wonder profits. By some estimates, the Cannabidiol (or CBD) market could be worth $20 billion dollars by 2024.
While users tout its effectiveness in pain relief, up until now there's been limited experimental human research on the actual effectiveness of the drug. However, a new study led by University researchers sheds light on the ability of CBD to reduce pain along with the impact that the so-called placebo effect may have on pain outcomes.
"For science and the public at large the question remained, is the pain relief that CBD users claim to experience due to pharmacological effects or placebo effects," says Martin De Vita, a researcher in the psychology department in the College of Arts and Sciences. "That's a fair question because we know that simply telling someone that a substance has the ability to relieve their pain can actually cause robust changes in their pain sensitivity. These are called expectancy effects."
De Vita, along with Stephen Maisto, research professor and professor emeritus of psychology, were uniquely prepared to answer that exact question. The pair, along with fellow lab member and doctoral candidate Dezarie Moskal, previously conducted the first systematic review and meta-analysis of experimental research examining the effects cannabinoid drugs on pain.
As the first experimental pain trial to examine CBD, their study yielded consistent and noteworthy results. Among other findings, the data showed that CBD and expectancies for receiving CBD do not appear to reduce experimental pain intensity, but do make the pain feel less unpleasant.
De Vita and Maisto used sophisticated equipment that safely induces experimental heat pain, allowing them to measure how the recipient's nervous system reacts and responds to it. "Then we administer a drug, like pure CBD, or a placebo and then re-assess their pain responses and see how they change based on which substance was administered," says De Vita.
Researchers then took it a step farther by manipulating the information given to participants about which substances they received. In some cases, participants were told that they got CBD when they actually received a placebo, or told they would be getting a placebo when they actually got CBD.
"That way we could parse out whether it was the drug that relieved the pain, or whether it was the expectation that they had received the drug that reduced their pain," according to De Vita. "We hypothesized that we would primarily detect expectancy-induced placebo analgesia (pain relief). What we found though after measuring several different pain outcomes is that it's actually a little bit of both. That is, we found improvements in pain measures caused by the pharmacological effects of CBD and the psychological effects of just expecting that they had gotten CBD. It was pretty remarkable and surprising."
"The data is exciting but pretty complex in that different pain measures responded differently to the drug effect, to the expectancy, or both the drug and expectancy combined -- so we're still trying to figure out what is behind the differential data with different kinds of pain measures," said Maisto. "The next step is studying the mechanisms underlying these findings and figuring out why giving instructions or CBD itself causes certain reactions to a pain stimulus."
Most people think of pain as an on and off switch, you either have it or you don't. But pain, as De Vita describes it, is a complex phenomenon with several dimensions influenced by psychological and biological factors.
For example, whereas pain intensity reflects a "sensory" dimension of pain, unpleasantness represents an "affective," or emotional, aspect of pain. "If you think of pain as the noxious noise coming from a radio the volume can represent the intensity of the pain, while the station can represent the quality," says De Vita.
Results from his previous study showed that while cannabinoid drugs weren't reducing the volume of pain, they were "changing the channel making it a little less unpleasant." According to De Vita, "It's not sunshine and rainbows pleasant, but something slightly less bothersome. We replicated that in this study and found that CBD and expectancies didn't significantly reduce the volume of the pain, but they did make it less unpleasant -- it didn't bother them as much."
As part of the study De Vita and Maisto developed advanced experimental pain measurement protocols "to pop the hood and start looking at some of these other mechanistic pain processes," says De Vita. "It's not just pain, yes or no, but there are these other dimensions of pain, and it would be interesting to see which ones are being targeted. We found that sometimes pharmacological effects of CBD brought down some of those, but the expectancies did not. Sometimes they both did it. Sometimes it was just the expectancy. And so, we were going into this thinking we were going to primarily detect the expectancy-induced pain relief but what we found out was way more complex than that and that's exciting."
One important note to also consider is the source of the CBD. "What we used in our study was pure CBD isolate oil," says De Vita. "Commercially available CBD products differ in their content and purity, so results might be different for different CBD products, depending on what other compounds they may or may not contain."
https://www.sciencedaily.com/releases/2021/04/210423130221.htm
Shift-work causes negative impacts on health, affects men and women differently
April 21, 2021
Science Daily/University of Waterloo
Shift-work and irregular work schedules can cause several health-related issues and affect our defence against infection, according to new research from the University of Waterloo.
These health-related issues occur because the body's natural clock, called the circadian clock, can be disrupted by inconsistent changes in the sleep-wake schedule and feeding patterns often caused by shift work. To study this, researchers at Waterloo developed a mathematical model to look at how a disruption in the circadian clock affects the immune system in fighting off illness.
"Because our immune system is affected by the circadian clock, our ability to mount an immune response changes during the day," said Anita Layton, professor of Applied Mathematics, Computer Science, Pharmacy and Biology at Waterloo. "How likely are you to fight off an infection that occurs in the morning than midday? The answer depends on whether you are a man or a woman, and whether you are among quarter of the modern-day labour force that has an irregular work schedule."
The researchers created new computational models, separately for men and women, which simulate the interplay between the circadian clock and the immune system. The model is composed of the core clock genes, their related proteins, and the regulatory mechanism of pro- and anti-inflammatory mediators. By adjusting the clock, the models can simulate male and female shift-workers.
The results of these computer simulations conclude that the immune response varies with the time of infection. Model simulation suggests that the time before we go to bed is the "worst" time to get an infection. That is the period of the day when our body is least prepared to produce the pro- and anti-inflammatory mediators needed during an infection. Just as importantly, an individual's sex impacts the severity of the infection.
"Shift work likely affects men and women differently," said Stéphanie Abo, a PhD candidate in Waterloo's Department of Applied Mathematics. "Compared to females, the immune system in males is more prone to overactivation, which can increase their chances of sepsis following an ill-timed infection."
The study, Modeling the circadian regulation of the immune system: sexually dimorphic effects of shift work, authored by Waterloo's Faculty of Mathematics' Layton and Abo, was recently published in the journal PLoS Computational Biology.
https://www.sciencedaily.com/releases/2021/04/210421082937.htm
Heart health of shift workers linked to body clock
April 16, 2021
Science Daily/European Society of Cardiology
Working hours that deviate from an individual's natural body clock are associated with greater cardiovascular risk, according to research presented at ESC Preventive Cardiology 2021, an online scientific congress of the European Society of Cardiology (ESC).
"Our study found that for each hour the work schedule was out of sync with an employee's body clock, the risk of heart disease got worse," said study author Dr. Sara Gamboa Madeira of the University of Lisbon, Portugal.
At least 20% of European employees work atypical hours or shifts,2 and growing scientific evidence associates these with deleterious cardiovascular outcomes.3 A number of explanations have been proposed, including sleep disruption and unhealthy behaviours. This study focused on the role of circadian misalignment, which is the difference between the "social clock" (e.g. work schedules) and the individual "biological clock."
Dr. Gamboa Madeira explained: "We all have an internal biological clock which ranges from morning types (larks), who feel alert and productive in the early morning and sleepy in the evening, to late types (owls), for whom the opposite is true -- with most of the population falling in between. Circadian misalignment occurs when there is a mismatch between what your body wants (e.g. to fall asleep at 10pm) and what your social obligations impose on you (e.g. work until midnight)."
The study included 301 blue collar workers, all performing manual picking activity in the distribution warehouses of a retail company in Portugal. Staff always worked either early morning (6am-3pm), late evening (3pm-midnight), or night (9pm-6am) shifts. Participants completed a questionnaire on sociodemographic factors (age, sex, education), occupational factors (work schedule, seniority), and lifestyle factors and had their blood pressure and cholesterol measured.
The Munich ChronoType Questionnaire was used to assess sleep duration, and to estimate each individual's internal biological clock (also called chronotype). It was also used to quantify the amount of circadian misalignment (i.e. the mismatch between an individual's biological clock and working hours) -- referred to as social jetlag. Participants were divided into three groups according to hours of social jetlag: 2 hours or less, 2-4 hours, 4 hours or more.
The researchers used the European relative risk SCORE chart which incorporates smoking, blood pressure and cholesterol to calculate relative cardiovascular risk. Relative risk ranges from 1 (non-smoker with healthy blood pressure and cholesterol) to 12 (smoker with very high blood pressure and cholesterol). In this study, a relative risk of 3 or more was considered "high cardiovascular risk." The researchers then investigated the association between social jetlag and high cardiovascular risk.
The average age of participants was 33 years and 56% were men. Just over half (51%) were smokers, 49% had high cholesterol, and 10% had hypertension. One in five (20%) were classified as high cardiovascular risk. Some 40% had a short sleep duration on workdays (6 hours or less). The average social jetlag was nearly 2 hours. In most workers (59%), social jetlag was 2 hours or less, while for 33% of staff it was 2-4 hours, and in 8% it was 4 hours or more.
A higher level of social jetlag was significantly associated with greater odds of being in the high cardiovascular risk group. The odds of being classified high cardiovascular risk increased by 31% for each additional hour of social jetlag, even after adjusting for sociodemographic, occupational, lifestyle, and sleep characteristics and body mass index.
Dr. Gamboa Madeira said: "These results add to the growing evidence that circadian misalignment may explain, at least in part, the association found between shift work and detrimental health outcomes. The findings suggest that staff with atypical work schedules may need closer monitoring for heart health. Longitudinal studies are needed to investigate whether late chronotypes cope better with late/night shifts and earlier chronotypes to early morning schedules, both psychologically and physiologically."
https://www.sciencedaily.com/releases/2021/04/210416091053.htm
Mindfulness can make you selfish
A pioneering new study examines the social effects of mindfulness
April 14, 2021
Science Daily/University at Buffalo
Mindfulness is big business. Downloads of mindfulness apps generate billions of dollars annually in the U.S., and their popularity continues to rise. In addition to what individual practitioners might have on their phones, schools and prisons along with 1 in 5 employers currently offer some form of mindfulness training.
Mindfulness and meditation are associated with reducing stress and anxiety, while increasing emotional well-being. Plenty of scholarship supports these benefits. But how does mindfulness affect the range of human behaviors -- so-called prosocial behaviors -- that can potentially help or benefit other people? What happens when the research looks outwardly at social effects of mindfulness rather than inwardly at its personal effects?
It's within the area of prosocial behaviors that a new paper by University at Buffalo researchers demonstrates the surprising downsides of mindfulness, while offering easy ways to minimize those consequences -- both of which have practical implications for mindfulness training.
"Mindfulness can make you selfish," says Michael Poulin, PhD, an associate professor of psychology in the UB College of Arts and Sciences and the paper's lead author. "It's a qualified fact, but it's also accurate.
"Mindfulness increased prosocial actions for people who tend to view themselves as more interdependent. However, for people who tend to view themselves as more independent, mindfulness actually decreased prosocial behavior."
The results sound contradictory given the pop culture toehold of mindfulness as an unequivocal positive mental state. But the message here isn't one that dismantles the effectiveness of mindfulness.
"That would be an oversimplification," says Poulin, an expert in stress, coping and prosocial engagement. "Research suggests that mindfulness works, but this study shows that it's a tool, not a prescription, which requires more than a plug-and-play approach if practitioners are to avoid its potential pitfalls."
The findings will appear in a forthcoming issue of the journal Psychological Science.
Poulin says independent versus interdependent mindsets represent an overarching theme in social psychology. Some people think of themselves in singular or independent terms: "I do this." While others think of themselves in plural or interdependent terms: "We do this."
There are also cultural differences layered on top of these perspectives. People in Western nations most often think of themselves as independent, whereas people in East Asian countries more often think of themselves as interdependent. Mindfulness practices originated in East Asian countries, and Poulin speculates that mindfulness may be more clearly prosocial in those contexts. Practicing mindfulness in Western countries removes that context.
"Despite these individual and cultural differences, there is also variability within each person, and any individual at different points in time can think of themselves either way, in singular or plural terms," says Poulin.
The researchers, which included Shira Gabriel, PhD, a UB associate professor of psychology, C. Dale Morrison and Esha Naidu, both UB graduate students, and Lauren M. Ministero, PhD, a UB graduate student at the time of the research who is now a senior behavioral scientist at the MITRE Corporation, used a two-experiment series for their study.
First, they measured 366 participants' characteristic levels of independence versus interdependence, before providing mindfulness instruction or a mind wandering exercise to the control group. Before leaving, participants were told about volunteer opportunities stuffing envelopes for a charitable organization.
In this experiment, mindfulness led to decreased prosocial behavior among those who tended to be independent.
In the next experiment, instead of having a trait simply measured, 325 participants were encouraged to lean one way or the other by engaging in a brief but effective exercise that tends to make people think of themselves in independent or interdependent terms.
The mindfulness training and control procedures were the same as the first experiment, but in this case, participants afterwards were asked if they would sign up to chat online with potential donors to help raise money for a charitable organization.
Mindfulness made those primed for independence 33% less likely to volunteer, but it led to a 40% increase in the likelihood of volunteering to the same organization among those primed for interdependence. The results suggest that pairing mindfulness with instructions explaining how to make people think of themselves in terms of their relationships and communities as they're engaging in mindfulness exercises may allow them to see both positive personal and social outcomes.
"We have to think about how to get the most out of mindfulness," Poulin says. "We have to know how to use the tool."
https://www.sciencedaily.com/releases/2021/04/210414100147.htm
How to gain a sense of well-being, free and online
April 14, 2021
Science Daily/Yale University
In 2018, when Professor Laurie Santos introduced her course "Psychology and the Good Life," a class on the science of happiness, it became the most popular in the history of Yale, attracting more than 1,200 undergraduate enrollees that first semester. An online course based on those teachings became a global phenomenon. By latest count, 3.38 million people have enrolled to take the free Coursera.orgcourse, called "The Science of Well Being."
But the popularity of the course posed an interesting question. Does taking the course and participating in homework assignments -- which include nurturing social connections, compiling a gratitude list, and meditation -- really help improve a sense of well-being?
The answer is yes, according to two new studies that measured the psychological impact on individuals who took Santos's or a similar course. The findings suggest that free online courses that teach principles of positive psychology can enrich the lives of millions of people.
In the latest study, published April 14 in the journal PLOS ONE, researchers at Johns Hopkins University and Yale found that people who took the online "Science of Well Being" course reported a greater sense of well-being than those enrolled in another Yale Coursera course, "Introduction to Psychology." Although learners in both classes said they experienced significant improvement in their well-being after taking the courses, those who took the "Science of Well-Being" course reported greater mental health benefits than those learning about the basics of psychology.
Unlike the psychology course, "The Science of Well Being" requires participants to do exercises known to improve psychological health, such as improving sleep patterns, developing exercise routines, and practicing meditation, the authors say. Before and after taking the course, participants answered questions designed to measure factors related to psychological health such as positive emotions, engagement, and strength of relationships.
"Knowledge is great but it isn't enough. You also have to do the work," said lead author David Yaden, research fellow in the Department of Psychiatry and Behavioral Sciences at Johns Hopkins.
A similar study in Health Psychology Open, conducted by researchers at Yale and the University of Bristol, surveyed people who took either a live or an online credit-bearing course based on Santos's original class and found similar psychological benefits for enrollees.
Yaden stressed, however, that the classes are not a substitute for professional treatment for those who suffer from diagnosed mental illness. "These courses are not a panacea or replacement for psychotherapy or medication," he said.
However, both Yaden and Santos, who co-authored the study, say the findings show that massive open online courses can provide at least modest value to millions of people at no cost.
"We wanted to know if we could scale these benefits and we can," Santos said. "Even bringing a small mental health benefit to millions of people can have a huge value."
https://www.sciencedaily.com/releases/2021/04/210414155014.htm
Want to be robust at 40-plus? Meeting minimum exercise guidelines won't cut it
5 hours of moderate activity a week may be required to avoid midlife hypertension
April 15, 2021
Science Daily/University of California - San Francisco
Young adults must step up their exercise routines to reduce their chances of developing high blood pressure or hypertension -- a condition that may lead to heart attack and stroke, as well as dementia in later life.
Current guidelines indicate that adults should have a minimum of two-and-a-half hours of moderate intensity exercise each week, but a new study led by UCSF Benioff Children's Hospitals reveals that boosting exercise to as much as five hours a week may protect against hypertension in midlife -- particularly if it is sustained in one's thirties, forties and fifties.
In the study publishing in American Journal of Preventive Medicineon April 15, researchers followed approximately 5,000 adults ages 18 to 30 for 30 years. The participants were asked about their exercise habits, medical history, smoking status and alcohol use. Blood pressure and weight were monitored, together with cholesterol and triglycerides.
Hypertension was noted if blood pressure was 130 over 80 mmHg, the threshold established in 2017 by the American College of Cardiology/American Heart Association.
The 5,115 participants had been enrolled by the Coronary Artery Risk Development in Young Adults (CARDIA) study and came from urban sites in Birmingham, Ala., Chicago, Minneapolis and Oakland, Calif. Approximately half the participants were Black (51.6 percent) and the remainder were White. Just under half (45.5 percent) were men.
Fitness Levels Fall Fast for Black Men Leading to More Hypertension
Among the four groups, who were categorized by race and gender, Black men were found to be the most active in early adulthood, exercising slightly more than White men and significantly more than Black women and White women. But by the time Black men reached age 60, exercise intake had slumped from a peak of approximately 560 exercise units to around 300 units, the equivalent to the minimum of two-and-a-half hours a week of moderate intensity exercise recommended by the U.S. Department of Health and Human Services. This was substantially less exercise than White men (approximately 430 units) and slightly more than White women (approximately 320 units). Of the four groups, Black women had the least exercise throughout the study period and saw declines over time to approximately 200 units.
"Although Black male youth may have high engagement in sports, socio-economic factors, neighborhood environments, and work or family responsibilities may prevent continued engagement in physical activity through adulthood," said first author Jason Nagata, MD, of the UCSF Division of Adolescent and Young Adult Medicine. Additionally, Black men reported the highest rates of smoking, which may preclude physical activity over time, he noted.
Physical activity for White men declined in their twenties and thirties and stabilized at around age 40. For White women, physical activity hovered around 380 exercise units, dipping in their thirties and remaining constant to age 60.
Rates of hypertension mirrored this declining physical activity. Approximately 80-to-90 percent of Black men and women had hypertension by age 60, compared with just below 70 percent for White men and 50 percent for White women.
"Results from randomized controlled trials and observational studies have shown that exercise lowers blood pressure, suggesting that it may be important to focus on exercise as a way to lower blood pressure in all adults as they approach middle age," said senior author Kirsten Bibbins-Domingo, MD, PhD, of the UCSF Department of Epidemiology and Biostatistics.
"Teenagers and those in their early twenties may be physically active but these patterns change with age. Our study suggests that maintaining physical activity during young adulthood -- at higher levels than previously recommended -- may be particularly important."
More Exercise from Youth to Midlife Offers Best Protection Against Hypertension
When researchers looked at the 17.9 percent of participants who had moderate exercise for at least five hours a week during early adulthood -- double the recommended minimum -- they found that the likelihood of developing hypertension was 18 percent lower than for those who exercised less than five hours a week. The likelihood was even lower for the 11.7 percent of participants who maintained their exercise habits until age 60.
Patients should be asked about physical activity in the same way as they are routinely checked for blood pressure, glucose and lipid profiles, obesity and smoking, Nagata said, and intervention programs should be held at schools, colleges, churches, workplaces and community organizations. Black women have high rates of obesity and smoking, and low rates of physical activity, he said, and should be an important group for targeted intervention.
"Nearly half of our participants in young adulthood had suboptimal levels of physical activity, which was significantly associated with the onset of hypertension, indicating that we need to raise the minimum standard for physical activity," Nagata said. "This might be especially the case after high school when opportunities for physical activity diminish as young adults transition to college, the workforce and parenthood, and leisure time is eroded."
https://www.sciencedaily.com/releases/2021/04/210415090724.htm
Your neighborhood may affect your brain health
Study finds evidence of more brain aging in people living in disadvantaged areas
April 19, 2021
Science Daily/American Academy of Neurology
Middle-age and older people living in more disadvantaged neighborhoods -- areas with higher poverty levels and fewer educational and employment opportunities -- had more brain shrinkage on brain scans and showed faster decline on cognitive tests than people living in neighborhoods with fewer disadvantages, according to a study published in the April 14, 2021, online issue of Neurology®, the medical journal of the American Academy of Neurology. Researchers say such brain aging may be a sign of the earliest stages of dementia.
"Worldwide, dementia is a major cause of illness and a devastating diagnosis," said study author Amy J. H. Kind M.D., Ph.D., of the University of Wisconsin School of Medicine and Public Health in Madison. "There are currently no treatments to cure the disease, so identifying possible modifiable risk factors is important. Compelling evidence exists that the social, economic, cultural and physical conditions in which humans live may affect health. We wanted to determine if these neighborhood conditions increase the risk for the neurodegeneration and cognitive decline associated with the earliest stages of Alzheimer's disease and dementia."
For the study, researchers identified 601 people from two larger studies of Wisconsin residents. Participants had an average age of 59 and no thinking or memory problems at the start of the study, although 69% had a family history of dementia. They were followed for 10 years.
Participants had an initial MRI brain scan and then additional scans every three to five years. With each scan, researchers measured brain volume in areas of the brain linked to the development of Alzheimer's dementia. Participants also took thinking and memory tests every two years, including tests that measured processing speed, mental flexibility and executive function.
Researchers used the residential address of each participant and a measure called the Area Deprivation Index to determine if each participant lived in an advantaged or disadvantaged neighborhood. Neighborhoods in the index are determined by census areas of 1,500 residents. The index incorporates information on the socioeconomic conditions of each neighborhood and its residents, ranking neighborhoods based on 17 indicators including income, employment, education and housing quality.
Of all participants, 19 people lived in the 20% most disadvantaged neighborhoods in their state and 582 people lived in the 80% of all other neighborhoods in their state. People in the first group were then matched one to four to people in the second group for race, sex, age and education and compared.
At the start of the study, there was no difference in brain volume between people living in the most disadvantaged neighborhoods and those in other neighborhoods. But at the end, researchers found brain shrinkage in areas of the brain associated with dementia in people in the most disadvantaged neighborhoods, while there was no shrinkage in the other group. Researchers also found a higher rate of decline on tests that measure risk of Alzheimer's disease.
"Our findings suggest that increased vigilance by healthcare providers for early signs of dementia may be particularly important in this vulnerable population," said Kind. "Some possible causes of these brain changes may include air pollution, lack of access to healthy food and healthcare and stressful life events. Further research into possible social and biological pathways may help physicians, researchers and policymakers identify effective avenues for prevention and intervention in Alzheimer's disease and related dementia."
Limitations of the study included a small number of participants from highly disadvantaged neighborhoods and a limited geographic setting. Future studies should involve larger and more diverse groups of people over longer periods of time.
https://www.sciencedaily.com/releases/2021/04/210419110148.htm
Study indicates longer reproductive life span experienced by U.S. women
Researcher analyzes factors driving the increase in age at natural menopause
April 22, 2021
Science Daily/Texas Tech University Health Sciences Center
As females age, their bodies typically undergo two significant changes that generally occur during adolescence and middle age. The first, known as menarche, is the time during puberty when a girl begins having monthly menstruation cycles, which often tends to range from 8-13 years of age. She enters the second change, known as menopause, 12 months following her last menstruation cycle when her ovarian function ceases, usually sometime in her 40s or 50s.
The time after menarche and prior to menopause is known as a woman's reproduction life span and marks the years when she is most able to bear children. For many women, these events occur naturally. However, women can enter menopause earlier than expected due to other issues. Women that undergo radiation therapy for cancer typically stop menstruating, as do women who undergo surgical menopause procedures such as having their ovaries removed.
Because each woman experiences these life stages at different times, one woman's reproductive life span is generally shorter or longer than that of another, sometimes significantly so. Duke Appiah, Ph.D., from the Texas Tech University Health Sciences Center (TTUHSC) Graduate School of Biomedical Sciences, said those differences can affect much more than a woman's reproductive health.
For instance, Appiah said, researchers have known a link exists between the duration of a woman's reproductive life span and her overall metabolic health, but they haven't known why. Part of that link, he opined, could be caused by a woman being naturally exposed to estrogen and various estrogen compounds. Estrogens can be beneficial because they can help protect or delay the onset of certain health issues. However, they also have been associated with some diseases, and women that normally have less estrogen and remain that way through menopause are more likely to develop heart disease or osteoporosis.
"If the reproductive life span is longer, then that means they still have exposure to the natural estrogens, which will also help delay some diseases like cardiovascular disease and osteoporosis, and to some extent, even cancer," Appiah said.
But why do some women who have longer reproductive life spans, and therefore longer exposure to estrogens, still develop metabolic issues?
It's a question Appiah and a group of collaborators set out to address in a research letter to the Journal of the American Medical Association (JAMA). The letter, "Trends in Age at Natural Menopause and Reproductive Life Span Among U.S. Women, 1959-2018," was published in JAMA's April 8 issue. Appiah's collaborators included Chike C. Nwabuo, M.D., MPH, from Johns Hopkins University; Imo A. Ebong, M.D., M.S., from the University of California, Davis; Melissa F. Wellons, M.D., MHS, from Vanderbilt University Medical Center; and Stephen J. Winters, M.D., from the University of Louisville.
Appiah, an assistant professor of public health at the TTUHSC and director of the university's master's program in public health, said women who enter menopause at age 40-45 years have a higher risk of developing cardiovascular disease, whereas those who become menopausal after the age of 50 experience a higher risk of breast cancer.
"These characteristics have clinical significance, but we wanted to see in the United States over the past 60 years, if there have been any changes in age at menopause, reproductive life span and to age at menarche," Appiah explained. "If it was changing, we wanted to find out what factors are possibly associated with these changes. Not many studies have been done in the U.S. to look at trends in age at menopause. If we can see some of the factors which are associated with or are driving having natural menopause at an earlier age, perhaps we can intervene."
Appiah said many of the previous studies are outdated and used data from shorter time periods such as 1910-1950. None of these studies investigate the link between age at menopause and the development of metabolic health issues. They also failed to address factors that may cause a woman to enter menopause earlier in her life.
To collect data for his study, Appiah used successive surveys spanning the 1959-1962 National Health Examination Survey I (NHES I) through the National Health and Nutrition Examination Survey (NHANES) for 2017-2018. The NHANES is a biennial survey conducted by the Centers of Disease Control and Prevention to generally evaluate the health of children and adults in the U.S. In addition to providing a significantly larger sample size, the NHANES provides a cross-sectional sample of the non-institutionalized U.S. adult population. It includes a detailed demographic and behavioral questionnaire, a physical examination, laboratory testing and a list of all prescription medications used by the respondent.
Using this data, Appiah was able to analyze 7,773 women aged 40 to 74 years at the time of the survey and who had reached natural menopause. From the 1959-1962 NHES I to the 2015-2018 NHANES, the mean age at which women reached natural menopause increased from 48.4 years to 49.9 years and the mean age at menarche fell from 13.5 years to 12.7 years. This resulted in an increase of the mean reproductive life span from 35.0 years to 37.1 years.
In multivariable adjusted models Appiah saw that race and ethnicity (Black and Hispanic), poverty, current and former smoking status and hormone therapy use were associated with earlier age at natural menopause and a shorter reproductive life span. Factors such as more years of education and use of oral contraceptives were associated with women who reached natural menopause at a later age and had longer reproductive life span.
Appiah said other factors not assessed in their study such as lifestyle and behavior factors, improved access to health care, nutrition, obesity and environmental factors may be related to the increasing trends in age at natural menopause and reproductive life span.
In past research, Appiah has shown that menopause is associated with metabolic conditions, which also influence the development of certain diseases. More importantly, he said, his work has shown that researchers tend to be more concerned about the age at which women reach menopause when they actually need to identify factors that are causing women to reach menopause at an earlier age because those factors tend to be more important.
"This study was to give some empirical evidence to some of my past studies, but then for future studies, I'm still looking at how age and menopause is associated with cardiac structure and function, for instance, how the heart beats, how the heart becomes bigger with age," Appiah said. "This paper has given perspective to some of my past work, and it's also given some direction to my future work, whereby I'll look at whether age at natural menopause and length of reproductive life span is a marker for overall health in women."
https://www.sciencedaily.com/releases/2021/04/210415090803.htm
Poor iodine levels in women pose risks to fetal intellectual development in pregnancy
April 22, 2021
Science Daily/University of South Australia
An increasing number of young women are at increased risk of having children born with impaired neurological conditions, due to poor iodine intake.
Dietary changes, including a growing trend towards the avoidance of bread and iodised salt, as well as a reduced intake of animal products containing iodine can contribute to low iodine levels.
A small pilot study undertaken by the University of South Australia (UniSA) comparing iodine levels between 31 vegan/plant-based participants and 26 omnivores has flagged the potential health risk.
Urine samples showed iodine readings of 44 ug/L in the plant-based group, compared to the meat eaters' 64 ug/L level. Neither group came close to the World Health Organization's recommended 100 grams per litre.
Participants from both groups who chose pink or Himalayan salt instead of iodised salt had severely deficient iodine levels, averaging 23 ug/L.
The findings have been published in the International Journal of Environmental Research and Public Health.
While the study was undertaken in South Australia, it builds evidence on a 2017 US study that found nearly two billion people worldwide were iodine deficient, resulting in 50 million experiencing clinical side effects.
UniSA research dietitian Jane Whitbread says adequate iodine is essential for fetal intellectual development.
"Mild to moderate iodine deficiency has been shown to affect language development, memory and mental processing speeds," Ms Whitbread says.
"During pregnancy, the need for iodine is increased and a 150mcg supplement is recommended prior to conception and throughout pregnancy. Unfortunately, most women do not take iodine supplements before conceiving. It is important to consume adequate iodine, especially during the reproductive years."
Dietary sources of iodine include fortified bread, iodized salt, seafoods including seaweeds, eggs, and dairy foods.
Concerns about the link between poor iodine status and impaired neurological conditions in newborns prompted the mandatory fortification of non-organic bread with iodised salt in 2009 in Australia.
It has since been reported that women who consume 100g of iodine-fortified bread every day (approximately three pieces) have five times greater chance of meeting their iodine intake compared to women who don't consume that much. The average amount of bread consumed by women in this study was one piece of bread.
The growing preference of Himalayan salt over iodized table salt may also be problematic, Ms Whitbread says. A quarter of women in the study reported using the pink salt which contains an insignificant level of iodine.
Another issue is that plant-based milks have low levels of iodine and are not currently fortified with this nutrient.
Neither group met the estimated average requirement (EAR) for calcium.
The vegan/plant-based group also did not reach the recommended levels for selenium and B12 without supplementation, but their dietary intake of iron, magnesium, vitamin C, folate and fibre was higher than the meat eaters. This reflects the inclusion of iron-rich soy products, wholemeal foods, legumes, and green leafy vegetables in their diet.
The researchers recommended that both new salts and plant milks be fortified with iodine as well as a campaign to raise awareness about the importance of iodine in the diet, especially for women in their reproductive years.
They also called for a larger study sample to determine iodine status of Australian women.
https://www.sciencedaily.com/releases/2021/04/210422093858.htm
Objective analysis of stress in the classroom
April 15, 2021
Science Daily/Ruhr-University Bochum
Is it the difficulty of a task that determines whether or not students are stressed when working on it? Biologists working in biology didactics set out to find out the answers; to this end, the team used questionnaires and measured the heart rate in 209 test participants.
"This enables us to contrast the subjective perception of stress with an objective measurement method and compare the two," explains Nina Minkley. Contrary to expectations, it turned out that the effort invested in the task does not increase with its difficulty, nor does the stress level. The study was featured in the journal Frontiers in Education.
Simple questionnaire surveys criticised
To date, the stress experience of students has mostly been surveyed with questionnaires. But this approach has been criticised, because many factors have an effect on one's own perception that have nothing to do with the task. "For example, women often report higher stress levels than men," points out Nina Minkley. The researchers can only speculate why this is the case. In the current study, they used an objective method of measuring stress levels.
They equipped 209 secondary school students who were working on biology tasks with chest straps that monitor the heart rate. They also had the participants fill out several questionnaires on their self-concept, their interest in biology and their perception of the tasks. "When we are relaxed, the individual heartbeats differ slightly, whereas when we are stressed, they are less variable," explains Nina Minkley. Thus, the change in heart rate variability is an objective measurement of the stress level.
Mental effort causes stress
Comparing the questionnaire answers with the measured heart rates revealed that it was mainly mental engagement, i.e. the effort the students invested in solving the tasks, that correlated with the objective stress level. Contrary to expectations, however, more difficult tasks did not increase stress. "Perhaps some tasks can be so difficult that students don't even try to work on them," concludes Nina Minkley. "Such objective measures could be used in future studies primarily to survey subjective cognitive stress dimension."
https://www.sciencedaily.com/releases/2021/04/210415114105.htm