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Friday, April 19, 2024
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The unmistakable taste and smell of coffee — not to mention its ability to perk people up in the morning — have made it one of the world’s most popular beverages.

Better still, observational studies indicate that coffee may protect against cardiovascular disease, diabetes, Parkinson’s disease, and certain cancers.

Prospective studies, which follow people over time, have provided evidence that drinking this beverage is safe for most people and is associated with lower mortality rates.

However, a new study suggests that some of the supposed health benefits of coffee for cardiovascular health may have been overblown. The research was limited to white British participants.

As a result of the caffeine that coffee contains, excessive consumption can cause unpleasant symptoms such as tachycardia (a fast resting heart rate) and palpitations.

Drinking coffee can also lead to a moderate, temporary increase in blood pressure.

So it may come as a surprise that regular coffee drinkers either have normal or reduced blood pressure compared with people who do not drink coffee.

One explanation may be that coffee drinkers develop a physiological tolerance for the effects of caffeine.

But a new study suggests that people with a high genetic risk of cardiovascular disease unconsciously reduce how much they drink to avoid unpleasant cardiovascular symptoms.

The research found that individuals with high blood pressure, angina, or arrhythmia drank less caffeinated coffee and were more likely to drink decaffeinated coffee.

Crucially, there was strong evidence that their genetic vulnerability to cardiovascular disease led to their reduced consumption of coffee.

This rules out the alternative explanation that consuming less coffee made them more vulnerable to cardiovascular disease.

Researchers at the University of South Australia in Adelaide conducted the study, which appears in The American Journal of Clinical NutritionTrusted Source.

Guided by genetics

“Whether we drink a lot of coffee, a little, or avoid caffeine altogether, this study shows that genetics are guiding our decisions to protect our cardio health,” Professor Elina Hyppönen, who led the research and directs the Australian Centre for Precision Health at the university.

“If your body is telling you not to drink that extra cup of coffee, there’s likely a reason why,” she adds. “Listen to your body — it’s more in tune with your health than you may think.”

In observational studies, this effect could give the false impression that coffee prevents high blood pressure and protects the heart.

In reality, people vulnerable to high blood pressure may simply avoid drinking coffee because, for them, the caffeine is more likely to cause unpleasant symptoms.

The scientists drew on information about 390,435 white British participants aged 39–73 years who are part of a medical and genetic database called UK Biobank.

On recruitment, participants reported their regular coffee consumption. Researchers also measured their blood pressure and heart rate and noted any cardiovascular symptoms.

Participants with high blood pressure, angina, or arrhythmia consumed less caffeinated coffee compared with those without these symptoms.

To determine whether regular coffee consumption caused the symptoms, or whether the symptoms triggered a reduction in coffee consumption, the researchers used a statistical technique called Mendelian randomization.

This technique exploits the random inheritance of genetic variants that increase a person’s risk of a particular outcome later in life — in this case, the association between blood pressure and heart rate with habitual coffee consumption.

Because factors, such as lifestyle or diet, cannot change a person’s genetic sequence, any associations that the researchers discovered must be due to the gene variants rather than any other factors.

When they analyzed the data, it showed that having a particular genetic variant determined how much coffee a person drank.

“What this means is that someone who drinks a lot of coffee is likely more genetically tolerant of caffeine, as compared to someone who drinks very little,” says Prof. Hyppönen.

“Conversely, a noncoffee drinker, or someone who drinks decaffeinated coffee, is more likely prone to the adverse effects of caffeine and more susceptible to high blood pressure,” she adds.

Psychological effects

Medical News Today asked Prof. Hyppönen whether the psychological effects that some people experience when they drink a lot of coffee, such as anxiety and agitation, could also play a role.

“This is not something that we looked at in our study, but any unpleasant sensation that an individual feels in response to coffee consumption is likely to reduce their wish to drink coffee,” said Prof. Hyppönen.

MNT asked Dr. Edo Paz, a doctor atdigital primary care platform K Health, about the effects of drinking too much coffee.

He responded:

“[D]rinking too much coffee can result in headache, anxiety, tremors, and difficulty sleeping. With regards to the heart, in particular, excess coffee intake can result in palpitations and may trigger events in the heart, such as abnormal heart rhythms, in susceptible individuals.”

The problem of reverse causation

The findings of the new research suggest that observational studies that found an association between coffee consumption and better health may have fallen prey to “reverse causation.”

In other words, heart health issues led people to drink less coffee, rather than the other way round.

Prof. Hyppönen said Mendelian randomization studies had cast doubt on other apparent protective effects.

For example, epidemiological studies have led people to infer that moderate alcohol consumption protects against cardiovascular disease, and that having excess weight reduces mortality compared with moderate weight.

“According to [Mendelian randomization] studies, there does not appear to be any benefit for having [excess weight] versus [slim or moderate] weight, with the possible exception for smokers,” she said.

Smoking reduces appetite and hence weight, but it also has links with a wide range of negative effects on health.

“Also for alcohol, [the] evidence suggests linear increases in blood pressure and stroke risk, with no benefit for light alcohol consumption,” she added.

While further studies are necessary using a more diverse population, this study suggests using a considered, personalized approach when promoting high coffee intakes.

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The miracle tree, Moringa, Moringa Oleifera, or the drumstick is a plant recognized for its medical properties. It is used to treat more than 300 conditions. All parts of the Moringa tree possess some medicinal or nutritional value” says Amrit Walia ( Amritpal Singh Walia ) Co-Founder of Pioneer Sustainable Agriculture PSA organic farm located in Nigeria.

One cup of fresh, chopped leaves contains protein, Vitamin B6, Vitamin C, Iron, Magnesium, Riboflavin, and Vitamin A.

In this article, you will be able to understand the five prime uses of Moringa leaf that clearly distinguished it as an extraordinary species:

1. Moringa Leaf is Rich in Antioxidants
Moringa acts to reduce high levels of free radicals which may cause oxidative stress leading to diseases like type 2 diabetes or heart disease.

The basic antioxidants in Moringa are beta-carotene and Vitamin C. The exact figure of the number of antioxidants in the Moringa herb is staggering.

A few antioxidants present include propyl gallate, tocopherols (Vitamin E), ascorbic acid, chlorogenic acid, hydroxyanisole (BHT) citric acid, vanillin, potassium, reduced glutathione, and more. Quercetin is also present and crucial in the regulation of blood pressure.

2. Moringa Leaf Regulates Blood Sugar
Moringa herb produces effects similar to isothiocyanates plant compounds able to regulate blood sugar.
Sufficient research shows a significant reduction in blood sugar after short-term use of the herb with meals.

For instance, it was discovered that a group of diabetics who added 50 grams of moringa leaves to a meal reduced the rise in blood sugar by 21%.

3. Moringa Leaf Works to Reduce Inflammation
If you incur injury and develop wounds, Moringa can help you to stop inflammation.

Moringa is stocked with nutrients and antioxidants which are found in other anti-inflammatory foods like tomatoes, fatty fish, olive oil, and certain fruits.

By fighting harmful free radicals, the herb prevents sustained inflammation which can result in chronic problems like cancer or heart disease.

4. Moringa Leaf Promotes Prostate Health and Cure ED
The leaves and seeds of the Moringa plant are rich sulfur-containing compounds called glucosinolates, which fight cancer in the body, more specifically, benign prostate hyperplasias.

The condition which is prone to attack elderly man is characterized by enlargement of the prostate which makes urination difficult. Moringa can reverse the effects of prostate cancer by significantly reducing prostate weight.

The herb also reduces levels of prostate-specific antigen which is produced by the prostate gland.

Moringa can also cure erectile dysfunction. Its leaves contain useful plant compounds called polyphenols which enhance blood flow by increasing nitric oxide production while simultaneously lowering blood pressure.

Conclusion
The points discussed above show how versatile Moringa leaf is in the fields of health and medical care. The plant can be used for detoxification and in the treatment of digestive disorders.

The list of other ailments this wonder plant can treat include the following – scurvy, kidney stones, Athlete’s foot, dandruff, epilepsy, paralysis, convulsions, splenomegaly, epilepsy, antispasmodic, joint pain, edema, rheumatism, arthritis, cardiac hypertrophy, coronary artery disease, myocardial infarction, heart failure, and many more.

Do you have any experience with the Moringa Leaf extracts? Kindly share with us in the comments below.

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Stressful events — such as sitting an exam, giving a presentation, or attending a job interview — temporarily increase heart rate and blood pressure and dilate arteries.

This is a normal part of the body’s “fight-or-flight” response, but the lining of blood vessels, known as the endothelium, can take up to 90 minutes to recover after this kind of stress.

This may help to explain why a single episode of stress temporarily increases the risk of an acute cardiovascular event, such as a heart attack.

On the other hand, experts know that eating a diet rich in fruits and vegetables reduces a person’s risk of cardiovascular disease, heart attacks, and cardiovascular mortality.

Among the healthy nutrients found in fruits and vegetables are polyphenolic compounds known as flavanols. In the long term, these improve endothelial function and lower blood pressure.

The effects of flavanols during stress and in its immediate aftermath are unknown, however.

Scientists at the University of Birmingham in the United Kingdom have conducted the first study to investigate this question.

Their research suggests that drinking cocoa, which is rich in flavanols, in the hours before a stressful event can improve blood flow during the experience and help restore endothelial function in males aged under 45 years old afterward.

“Our findings are significant for everyday diet, given that the daily dosage administered could be achieved by consuming a variety of foods rich in flavanols — particularly apples, black grapes, blackberries, cherries, raspberries, pears, pulses, green tea, and unprocessed cocoa,” says senior author Dr. Catarina Rendeiro, Ph.D., of the university’s School of Sport, Exercise and Rehabilitation Sciences.

“This has important implications for measures to protect the blood vessels of those individuals who are more vulnerable to the effects of mental stress,” she adds.

The research, conducted by postgraduate student Rosalind Baynham, appears in the journal Nutrients.

Stress tests

The scientists recruited 30 healthy males between 18 and 45 years who underwent tests at the lab on two separate occasions at least 7 days apart.

The research involved them fasting for 12 hours before each session and abstaining from alcohol, vigorous exercise, and polyphenol-rich food and drink for 24 hours beforehand.

At the start of each visit, while the participants were relaxed, researchers assessed their “brachial flow-mediated dilatation,” which is a measure of endothelial function.

They also measured their blood pressure, heart rate, and blood flow.

On one of these visits, the participants drank regular cocoa, which is rich in flavanols, and on the other visit, they drank a special cocoa drink that was low in flavanols.

About 90 minutes later, they took a competitive test of mental arithmetic designed to elicit stress.

For example, during the test, the researchers filmed the participants, and they had to watch their performance on a screen. The researchers told the participants that “body language assessors” would assess them.

The arithmetic task got progressively faster, and the participants lost points whenever they got an answer wrong.

An experimenter in the room marked their responses and sounded an alarm when they made a mistake, or once every 10 answers if they did not.

At 30 and 90 minutes after the stress test, the researchers remeasured the participants’ endothelial function and blood pressure.

The results showed that 30 minutes after the stress test, all participants had impaired endothelial function. This measure remained significantly higher 90 minutes after the stress test.

However, participants who drank the high-flavanol cocoa saw smaller declines in endothelial function than those who consumed the low-flavanol cocoa.

In addition, high-flavanol cocoa increased blood flow during and after the test compared with low-flavanol cocoa.

Other cardiovascular and blood pressure measures were similar for both conditions.

Future investigations

The researchers note that the main limitation of their study was that it excluded females.

They report that, for the sake of consistency, they wanted to avoid the impact of hormonal fluctuations during the female menstrual cycle on the vascular changes under investigation.

This means that it is not possible to apply the outcomes of this study to females. Researchers remain unclear on the impact of flavanols on stress response in females.

However, existing evidence shows there are gender differences in how a body responds to stress. So, future studies should focus on females.

The researchers also write that a more in-depth investigation would include molecular measures of cardiovascular function. These should consist of nitric oxide, which is a signaling molecule that dilates blood vessels, and the stress hormone cortisol.

Finally, they write that future research should explore the effect of flavanol intake on stress responses in individuals at higher risk of cardiovascular diseases, such as high blood pressure, and people who experience mental stress, such as care workers.

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People with dementia have difficulties with their memory, attention, thinking, and reasoning that interfere with everyday activities. These cognitive difficulties are not part of the typical aging process.

According to the Centers for Disease Control and Prevention (CDC)Trusted Source, in 2014, around 5 million adults in the United States had dementia. However, the CDC estimate this number may be close to 14 million by 2060.

The World Health Organization (WHO) report that there are around 50 millionTrusted Source dementia cases globally, with around 10 million new cases being diagnosed every year.

Alzheimer’s disease is the most common cause of dementia, accounting for 60–70% of cases.

About 5–10% of cases are associated with impaired blood flow to the brain — for example, as a result of a stroke — and are known as vascular dementia.

Genetic and environmental factors, including diet and lifestyle, are known to affect the development and progression of dementia.

Previous researchTrusted Source links people’s overall meat consumption to their risk of developing the condition.

However, a new study from scientists at the University of Leeds in the United Kingdom suggests there is a link between eating processed meat in particular and an increased risk of developing dementia.

Processed meats include products such as sausages, bacon, salami, and corned beef.

That said, the research also indicates that red meat may have a protective effect against dementia.

The study appears in The American Journal of Clinical NutritionTrusted Source.

Diet, genetics, and lifestyle

The scientists analyzed data from the UK Biobank, a database of genetic and health information from around half a million volunteers in the U.K. aged 40–69 years.

On recruitment to the project, every participant filled out a dietary questionnaire and completed 24-hour dietary assessments.

This allowed the researchers to estimate the total amount of meat each participant regularly consumed and how much of each type they ate.

The database also allowed them to identify which participants had thegene variant APOE ε4 allele, which is known to increase a person’s risk of dementia.

They then used hospital and mortality records to identify subsequent cases of dementia from all causes, Alzheimer’s disease, and vascular dementia during the follow-up period of around 8 years.

Of the 493,888 participants, 2,896 had all-cause dementia. These included 1,006 cases of Alzheimer’s disease and 490 cases of vascular dementia.

To estimate the role of meat consumption, the researchers had to account for a wide range of other factors that are known to affect a person’s likelihood of having dementia.

These included age, gender, ethnicity, education, and socioeconomic status. In addition, the researchers accounted for lifestyle factors, such as smoking, physical activity, and consumption of fruits and vegetables, fish, tea, coffee, and alcohol.

After these adjustments, they found that each additional 25-g portion of processed meat eaten per day was associated with a 44% increase in the risk of dementia from all causes.

This intake was also associated with a 52% increased risk of Alzheimer’s disease.

By contrast, each additional 50-g portion of unprocessed meat eaten per day was linked to a 19% reduction in the risk of all-cause dementia and a 30% reduced risk of Alzheimer’s disease.

The results for unprocessed poultry and total meat consumption were not statistically significant.

Eating large amounts of processed meat was also associated with a higher risk of vascular dementia, but the link with steadily increasing daily consumption was not significant.

As expected, the researchers noted that having the APOE ε4 allele increased the risk of dementia 3–6-fold. However, it did not significantly affect the observed associations between diet and dementia.

Processed meat and disease risk

A large body of evidence has linked consumption of processed meat to cancer. In 2015, the WHO even went so far as to define it as a carcinogen.

“Worldwide, the prevalence of dementia is increasing, and diet as a modifiable factor could play a role,” says Huifeng Zhang, a Ph.D. student at the School of Food Science and Nutrition at the University of Leeds, who was the lead researcher of the new study.

“Our research adds to the growing body of evidence linking processed meat consumption to increased risk of a range of nontransmissible diseases,” she adds.

It is important to note that the researchers have reported their results as percentage increases in the risk of developing dementia, or “relative risk.”

This is in contrast to the change in “absolute risk,” or how many extra cases there will be per 1,000 individuals, for example.

Ms. Zhang told Medical News Today that data from the UK Biobank are unsuitable for calculating absolute risk, because it is not a representative sample of the entire population.

For example, she said, it does not contain a sufficiently high proportion of individuals aged over 70 years.

The risk of dementia rises with age, so this imbalance would skew any calculation of absolute risk.

It is also worth noting that this was an observational study, so it could not prove that consuming processed meat causes dementia. It does, however, demonstrate a statistical association between the two.

“It’s always important to remember when looking at studies like this that they can’t attribute causation and [that] important confounding factors might account for apparent associations,” says Prof. Robert Howard, professor of old age psychiatry at University College London in the U.K., who was not involved in the study.

“As a doctor who works clinically with people with dementia and conducts research into potential dementia treatments, the data wouldn’t persuade me to give up my breakfast bacon,” he adds.

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For many decades, nutritionists have recommended a balanced diet to provide the body with the proper nutrients to stay healthy. The core components of this diet include vegetables, fruits, grains, proteins, and dairy.

A recent study by researchers at the Harvard T. H. Chan School of Public Health in Boston, MA, provides further evidence for current dietary guidelines and expands on them, finding that consuming at least 2 fruit and 3 vegetable servings on a daily basis may lower the risk of both disease-related death and death from all causes.

The study appears in Circulation, a scientific journal of the American Heart Association (AHA).

Current dietary guidelines

“While groups like the American Heart Association recommend 4–5 servings each of fruits and vegetables daily, consumers likely get inconsistent messages about […] the recommended amount and which foods to include and avoid,” says Dr. Dong D. Wang, M.D., Sc.D., an epidemiologist and nutritionist at Harvard Medical School and lead author of the study.

The Department of Health and Human Services and the Department of Agriculture published their recommendations in the form of the 2020–2025 Dietary Guidelines for Americans.

According to this set of guidelines, half of the plate for every meal should contain fruits and vegetables.

However, the guidelines also note that more than 80% of people in the United States do not meet this recommendation and should aim to increase their consumption of nutrient-dense foods.

Participant dietary information

The researchers collected self-reported dietary information from two large cohort studies: the Nurses’ Health Study (NHS) and the Health Professionals’ Follow-up Study (HPFS).

The NHS cohort included registered female nurses between the ages of 30 and 55 years, while the HPFS cohort included males aged 40–75 years with occupations in the health profession. These studies included follow-ups with the participants every 2–4 years to accumulate dietary information over a span of approximately 30 years.

The researchers excluded participants with baseline heart disease, cancer, or diabetes, leaving them with data from 66,719 females and 42,016 males.

They also incorporated data from an additional 26 studies involving a total of 1.9 million participants, which examined the relationship between fruit and vegetable intake and death rates.

The high participant numbers and continuous longitudinal assessments provided the team with an extensive collection of data for analysis.

However, it is important to note that the criteria of the two cohorts — occupation and corresponding education — suggest a similar socioeconomic status across the participants, who may have been more likely than other members of the population to have access to a healthy diet. The study does not address the realities and effects of food insecurity.

Nutritional values of fruits and vegetables lower risk of death

The study outcomes showed that an increased intake of fruits and vegetables is associated with a lower risk of death, including death due to cancer, heart disease, or respiratory disease.

Additionally, the researchers saw the lowest risk of death at a threshold of a combined 5 servings, beyond which there was no apparent benefit on risk.

These results point to the nutritional value of these foods. For example, higher consumption of fruits and vegetables increases the intake of potassium and antioxidant activity, which link to lower blood pressure and improved lung function, respectively.

As the data are fully self-reported, there may be discrepancies between the actual and reported intakes. Participants with higher intake, in particular, may have tended to overestimate how many servings they consumed.

This margin of error may blur the defined threshold of 5 servings, so the study authors acknowledge that slightly higher servings (up to 10) could also lead to lowered risk.

This study also expands beyond current guidelines by differentiating among specific groups of fruits and vegetables.

The researchers observed trends with a lowered risk of death for leafy greens and foods rich in vitamin C and beta carotene. Fruits and vegetables that fall into these categories include spinach, kale, carrots, and citrus fruits.

Conversely, they did not identify any trends for fruit juices or starchy vegetables, such as potatoes and peas. One possible reason for the latter is the prominence of canned foods. The canning process may deprive starchy vegetables of their antioxidant properties.

Compared with whole fruits, the fluid form of juices may cause a more rapid elevation of blood glucose and insulin levels, which can increase the risk of disease.

In contrast to the existing guidelines, which include canned foods and juices among the recommended foods and drinks, this study calls for further research on the effects of these items on health.

Continued support for ‘5-a-day’ serving recommendation

Rather than being an interventional study, in which researchers directly implement variables and analyze the effects, this study was observational. As a result, it is not possible to conclude that the trends present in this study indicate a causal relationship.

Regardless, there is plentiful evidence that highlights the benefits of a balanced diet containing plenty of fruits and vegetables. The present conclusions also correspond to findings from similar observational studies on the associations between fruit and vegetable intake and disease.

The findings of this study conform to the overall current dietary guidelines to eat at least 5 servings of fruits and vegetables a day. Additionally, it provides further insight into the specificities and benefits of fruit and vegetable intake.

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Around 1 million people in the United States and 10 million people worldwide have Parkinson’s. It is the second most common neurodegenerative disorder after Alzheimer’s disease.

Parkinson’s disease is a progressive brain disorder that affects dopamine-producing neurons. It causes tremors, muscular stiffness or rigidity, and slowness of movement, among other symptoms.

Loss and degeneration of dopamine-producing neurons in a specific region of the brain called the substantia nigra causes the movement-related, or “motor,” symptoms that can characterize Parkinson’s.

There is no cure for Parkinson’s disease, though several drug treatments can help alleviate the symptoms. The most commonly prescribed medication for this purpose is levodopa (Sinemet), which replenishes dopamine levels.

“Currently, there is no preventive medicine for Parkinson’s disease,” notes Dr. Akiko Kojima-Yuasa, an associate professor at the Graduate School of Human Life Science at Osaka City University, in Japan, “we only have coping treatments.”

One cause of cell loss in the substantia nigra is oxidative stress. This led Dr. Kojima-Yuasa and colleagues to investigate whether sesaminol, a powerful antioxidant, could prevent nerve cell death in a model of Parkinson’s.

Sesaminol is found in abundance in sesame seed husks, which are a waste product from the industrial extraction of sesame oil.

Oxidative damage

The researchers used a toxic chemical called 6-hydroxydopamine to model the oxidative damage that occurs in Parkinson’s.

When they applied the chemical to human nerve cells growing in lab cultures, the concentration of damaging reactive oxygen species increased, and the cells began to die off.

Adding sesaminol to the cultures significantly reduced the concentration of reactive oxygen species and prevented cell death. Sesaminol appeared to shield the cells from oxidative damage by increasing their production of two protective proteins: Nrf2 and NQO1.

Next, the researchers turned to a standard animal model of Parkinson’s disease, which involves dosing mice with the neurotoxin rotenone.

The toxin reduces dopamine production in the animals’ brains. This impairs their motor abilities and reduces their gut motility, which are both classic symptoms of Parkinson’s in humans. In fact, people with the disease might experience constipation decades before difficulties with movement become apparent.

Mice that ate a diet containing sesaminol for 36 days had higher dopamine levels and performed better on a standard test of motor abilities than control-group mice that ate a normal diet. The gut motility of the mice in the test group was also normal.

In addition, the mice that ate sesaminol had lower levels of alpha-synuclein in their substantia nigras. Alpha-synuclein is a protein that clumps together to form larger structures called Lewy bodies, which are a characteristic feature of neurodegeneration in Parkinson’s.

The research has been published in the journal Heliyon.

Preventive treatment?

In their paper, the scientists conclude:

“Notably, the protective effect was observed with the feeding of a small amount of sesaminol. These results show that sesaminol is very suitable for use as a preventive treatment of [Parkinson’s disease]. Further detailed elucidation of the mechanism of action will be necessary for practical application.” Dr. Kojima-Yuasa and her team are keen to start clinical trials of the extract.

The authors suggest that sesaminol may be able to cross the blood-brain barrier in humans. This barrier prevents pathogens and large molecules from entering the brain. Further investigation, however, is needed to support the findings.

Overall, it is worth keeping in mind that results of studies in cell cultures and animal models do not always reflect what happens in the human body.

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A recent article in JAMA discusses why older adults appear to be coping better with loneliness and social isolation than younger adults during the COVID-19 pandemic.

Pandemics are stressful, and the loneliness that comes with isolation takes a toll on mental health.

Surveys from the Centers for Disease Control and Prevention (CDC) conducted between June 24 and June 30, 2020, found that 40.9% of respondents experienced at least one mental or behavioral health condition. These ranged from symptoms of anxiety, depression, and trauma to starting or increasing substance use.

While all humans need social contact, some cope better with less contact than others.

Young and old

Social deprivation, the reduction or prevention of levels of social interaction considered normal depending on culture, is particularly harmful for adolescents.

A 2020 review of studies investigating social isolation and loneliness, published between January 1, 1946, and March 29, 2020, found that these factors strongly predicted later depression in children, adolescents, and young adults.

Additionally, loneliness correlated with an increased risk of mental health problems up to 9 years later in life.

An April 2020 article from the European Paediatric Association investigated adolescent mental health during the COVID-19 pandemic. The researchers reviewed data from preliminary studies in China and found that those aged 3–18 were more clingy, distracted, irritable, and fearful of asking coronavirus-related questions. They also had trouble sleeping, poor appetites, and separation problems.

Young adults are also vulnerable to the psychological effects of social isolation. An October 2020 studyfound that in a group of 564 adults aged 22–29 years, 60.7% of whom were female, loneliness increased between January and April–May. This effect was more prevalent in females, as were increased symptoms of depression.

Social isolation can also cause physical symptoms, such as a weakened immune system, an increased risk of diabetes, and an increased risk of death.

A 2016 study found a strong link between a poor social life and an elevated risk of inflammation during adolescence.

In older adults, a lack of social interaction is linked to a greater risk of hypertension, compared with diabetes.

The CDC cite 2020 estimates that one-third of adults aged 45 or older feel lonely, and almost 1 in 4 adults 65 or older are socially isolated. This is associated, they report, with health risks, including higher rates of depression, anxiety, and suicide.

However, while older adults may be experiencing significant social isolation from loved ones, this may not necessarily translate into worsening mental health, according to a recent Viewpoint article in JAMA.

Older adults less severely affected

A group of researchers at institutions in Massachusetts, California, and Pennsylvania looked at early data from several global studies on older adults and mental health during the pandemic.

While older adults are considered a vulnerable population for severe COVID-19 and related mortality, the researchers found that these adults were less negatively affected by mental health strain than younger adults.

One report from the CDC, for example, concluded that older adults were less likely to start or increase substance use and less likely to think about suicide.

Of course, these findings do not apply to every older adult. In the same report, the CDC acknowledge that adults from marginalized groups or low-income households, and those who provided unpaid caregiving services were more likely to experience adverse health effects.

This is consistent with other evidence of higher levels of anxiety, depression, stress, and post-traumatic stress disorder in people of color, compared with white people, during the COVID-19 pandemic.

Factors affecting resiliency in older adults

Based on the evidence, the authors suggest that older adults better withstand the mental health strains of the pandemic thanks to increased resilience and a drive to stay connected with others.

They explain that some global studies have shown that resilience is linked to maintaining meaningful relationships with others and access to mental health care.

“However, despite this early resilience, older adults expressed concerns about their longer-term physical and financial well-being,” the authors caution.

Resilience might also be linked with wisdom. The analysis found that having wisdom is associated with higher levels of compassion and less loneliness.

Improving resiliency

The researchers observe that increased access to technology could improve resiliency in some older adults who do not have smartphones, for example.

“Many older adults do not have the resources required to deal with the stress of COVID-19. This may include material (e.g., lack of access to smart technology), social (e.g., few family members or friends), or cognitive or biological (e.g., inability to engage in physical exercise or participate in activities or routines) resources.”

Increasing access to technology and related education may help older adults maintain social relationships and boost their engagement with mental health services.

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In our ‘Hope behind the headlines’ series, we continue to round up the most encouraging results in COVID-19 research. But, as the pandemic continues to unfold with many countries embracing a second lockdown, a critical approach to these hopeful results is more necessary than ever.

In a live social media chat, Dr. Anthony Fauci announced a few days ago that the first doses of a safe coronavirus vaccine are set to become available in late December this year or early January 2021. This is, of course, if everything continues to go smoothly.

Dr. Fauci, the director of the National Institute of Allergy and Infectious Diseases (NIAID), was referring to two candidate vaccines currently underway: one in development by Moderna Therapeutics in collaboration with NIAID, and the other in development by Pfizer in partnership with BioNTech.

Since then, Pfizer announced a 90% effectiveness rate for its candidate vaccine. In this article, we track the progress of these therapeutics and offer a critical — yet hopeful — perspective.

Why mRNA vaccines are speedier

MNT recently covered what Tal Zaks, Chief Medical Officer of Moderna Therapeutics, and Prof. Uğur Şahin, co-founder and CEO of BioNTech, had to say about their candidate vaccine at the recent Wired Health:Tech event.

Both the Moderna-NIAID and Pfizer-BioNTech vaccines use mRNA — that is, they use genetic information rather than a viral base to “train” the immune system to respond to SARS-CoV-2, the new coronavirus that causes COVID-19.

The speakers explained how an mRNA-based vaccine could be made available faster and is generally superior to other types of vaccines that use a viral base.

They cited “the infrastructure required” as being “relatively small and quick.” They also mentioned that, because the starting point is genetic information rather than the virus itself, “there is a component of speed that allows you to get into the clinic and then […] scale-up manufacturing.”

However, it is worth noting that while both of these candidate mRNA vaccines for COVID-19 show promise in early-stage clinical trials, there is no data available yet to confirm that they can prevent people from developing the disease.

It is also important to note that there are no human-licensed mRNA vaccines for other diseases. If the Food and Drug Administration (FDA) approve these vaccines, it will be groundbreaking, not just in the fight against COVID-19, but for mRNA vaccines in general.

By December we should know if we have a safe, effective vaccine

Both candidate vaccines are currently in stage 3 of clinical trials, to test their efficacy in large-scale studies comprising tens of thousands of people.

Moderna expects to release its trial stage results later in November. By December, we should know “whether or not we have a safe and effective vaccine,” Dr. Fauci said in the live session.

Pfizer announced the results of its late-stage clinical trials this week. In a move that boosted stock markets across the globe, the company said their candidate vaccine is 90% effective. Dr. Albert Bourla, Pfizer’s CEO, hailed the results as a “great day for humanity.”

“Today is a great day for science and humanity. The first set of results from our phase 3 COVID-19 vaccine trial provides the initial evidence of our vaccine’s ability to prevent COVID-19.” – Dr. Albert Bourla

However, it is worth noting that, at the time of publication, Pfizer have not yet released their data. It is likely their 90% effectiveness rate derives from a small number of participants. Therefore, questions remain about whether the candidate vaccine is safe and effective in older adults and vulnerable populations, who are likely to receive it first.

As soon as the data are released, MNT will cover the ins and outs of the trial and offer a critical perspective.

However, as Dr. Fauci said in his live session, if everything goes well, the first vaccine doses will become available to high-risk people and groups considered most vulnerable and most in need “by the end of December or the beginning of January.”

However, it is unlikely that life will return to normal “until the end of 2021 at least,” he continued. This is because it will take a while before a vaccine is mass-distributed, and even after it is, vaccine-induced immunity takes some time to build up on a national and then global level.

While the end of 2021 feels like a long while ahead, there are other reasons to keep our hopes up in the meantime. Here are other immunity-related scientific findings that we can add to our arsenal in the fight against the new coronavirus.

More proof of long-lasting immunity

Scientists have shown that those who have had the virus may have at least some level of lasting immunity. This is helpful not just for those who have had the infection, but also for using their plasma and possibly T cells to treat others.

For instance, researchers at the University of Arizona College of Medicine in Tucson have found that people who have had COVID-19 develop long-lasting immunity. Their study appears in the journal Immunity.

The Tucson scientists tested for SARS-CoV-2 antibodies in almost 6,000 people right after the infection and again several months later. Co-lead researcher Prof. Deepta Bhattacharya says, “We clearly see high-quality antibodies still being produced 5–7 months after SARS-CoV-2 infection.”

“Many concerns have been expressed about immunity against COVID-19 not lasting. We used this study to investigate that question and found immunity is stable for at least 5 months.” – Prof. Deepta Bhattacharya

The researcher is likely referring to a few studies that point to declining antibodies over time, such as the study conducted at Imperial College London in the United Kingdom. However, the results obtained by Prof. Bhattacharya’s team counter these findings.

Even more hopeful is the parallel that Prof. Bhattacharya draws with SARS-CoV-2’s cousin, SARS-CoV, where evidence suggests immunity could last 12–17 years.

“If SARS-CoV-2 is anything like the first one, we expect antibodies to last at least 2 years, and it would be unlikely for anything much shorter,” he says.

Over 90% of COVID-19 patients had antibodies for 5 months

Another study that appears in the journal Science also adds credence to this notion of long-lasting antibody immunity.

This large-scale analysis summed up over 30,000 people and found that most of those who had the virus and experienced mild-to-moderate disease “experience robust […] antibody responses” lasting up to 5 months.

Florian Krammer, Ph.D., from the Department of Microbiology at the Icahn School of Medicine at Mount Sinai, New York, NY, is the study’s senior author. He says:

“While some reports have come out saying antibodies to this virus go away quickly, we have found just the opposite — that more than 90% of people who were mildly or moderately ill produce an antibody response strong enough to neutralize the virus, and the response is maintained for many months.”

However, the scientists note that their study is not proof that these antibodies protect against reinfection. But, they say, it is also unlikely that they wouldn’t offer protection. More studies are needed to prove this with certainty.

“Although this cannot provide conclusive evidence that these antibody responses protect from reinfection, we believe it is very likely that they will decrease the odds ratio of reinfection, and may attenuate disease in the case of breakthrough infection.” – Florian Krammer et al.

“We believe it is imperative to swiftly perform studies to investigate and establish a correlation of protection from infection with SARS-CoV-2,” conclude Krammer and colleagues.

Antibodies from older males may be most helpful

These antibodies have the potential to protect people from severe cases of COVID-19, while some people’s antibodies may be stronger and more helpful than others.

A new study — led by Prof. Sabra Klein, of the Johns Hopkins Bloomberg School’s Department of Molecular Microbiology and Immunology in Baltimore, MD — tested the ability of antibody-rich blood plasma to inactivate the new coronavirus in cells containing the virus.

The researchers used widely available tests to determine the level of antibodies in 126 adults who had recovered from mild or moderate, lab-confirmed COVID-19. They wanted to see which donors provided the strongest antibodies.

The team found that a strong antibody response correlated with being hospitalized for the disease, being male, and being older.

“We propose that sex, age, and severity of disease should be used to guide the selection of donors for convalescent plasma transfer studies because we found that these were significant patient characteristics that not only predicted the amount of antibody but the quality of that antibody.” – Prof. Sabra Klein

T cells may succeed if antibodies fail

It is worth noting that some studies question the “lifespan” of antibodies, such as the recently published Imperial College London study. But even if antibodies may decline shortly after infection — a hypothesis that is still contentious — there are other aspects of immunity that may help protect against COVID-19, for example, T cells.

A new study that used cell cultures suggests that adoptive immunotherapy — a technique where specialists take the cells that target the virus from the blood of someone who has had the virus and inject them in people with compromised immunity — could protect those with weakened immunity from severe COVID-19.

Dr. Michael Keller, a pediatric immunology specialist who led the study, comments on his team’s findings, saying, “We found that many people who recover from COVID-19 have T cells that recognize and target viral proteins of SARS-CoV-2, giving them immunity from the virus because those T cells are primed to fight it.”

“This suggests that adoptive immunotherapy using convalescent T cells to target these regions of the virus may be an effective way to protect vulnerable people, especially those with compromised immune systems due to cancer therapy or transplantation.”

However, it is important to note that this study was preclinical, used cell cultures, and even in those cells, it did not directly test T cells’ ability to destroy the new coronavirus.

Instead, the researchers found that the T cells stimulated an immune response to a small segment of the new coronavirus — a part of its membrane. Namely, they released interferon, which is crucial in the response to SARS-CoV-2 infection. Most other vaccines target the virus’ spike protein, but targeting the membrane could provide a new avenue for vaccine development.

Furthermore, the number of participants used for the study was relatively small, while many of the donors only had mild COVID-19 symptoms. Finally, not every participant had a positive COVID-19 or antibody test.

In our next installment of Hope behind the headlines, we will take a closer look at the role of T cells in offering immunity, as well as tracking the progress of the Pfizer-BioNTech vaccine.

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A small observational study has found no evidence that osteoporosis drugs increase the risk of getting COVID-19. The research hints that some of the drugs may even reduce the risk.

In people with osteoporosis, progressive reductions in bone density increase the risk of fractures. The condition tends to affect older people, and its incidence among females increases following menopause.

Researchers have yet to directly test the possible effect of drug treatments for osteoporosis on a person’s risk of developing COVID-19. Influential health organizations, such as the American College of Rheumatology, recommend that people continue taking their medications as usual.

Now, researchers led by a team from the Hospital del Mar Medical Research Institute, in Barcelona, Spain, have analyzed data from 2,102 patients who received treatments for osteoporosis, osteoarthritis, and fibromyalgia at the hospital.

The mean age of the patients was 66.4 years, and 80.5% were female. Around 64% had osteoarthritis, 44% had osteoporosis, and 27% had fibromyalgia.

The researchers compared the incidence of COVID-19 in these patients between March 1 and May 3, 2020, with the incidence in Barcelona as a whole over the same period, during the first wave of infections in Spain.

The age-adjusted incidence rate for COVID-19 was 3.7% in the general population of Barcelona, compared with 4.7% for this group of patients. However, when the researchers focused on the subset of 914 patients with osteoporosis, they found a lower rate of infection: around 3%.

The data appeared to show that some drugs increased COVID-19 risk, some decreased it, and others had no effect. However, this was an observational study, rather than a clinical trial, and the group sizes were too small to draw any definitive conclusions.

The researchers report their findings in the journal Aging.

Statistical models

The physicians and scientists used a statistical modeling technique called Poisson regression to estimate the relative risk of COVID-19 associated with particular treatments.

After adjusting for factors already known to affect the risk, including age, sex, and health conditions such as diabetes and cardiovascular disease, their models suggested that most of the treatments had no influence on the incidence of infection.

These included drugs that directly target osteoporosis, such as oral bisphosphonates or vitamin D, as well as nonsteroidal anti-inflammatory drugs that target chronic pain caused either by fractures from weakened bones or coexisting musculoskeletal conditions.

Antihypertensive drugs, used to treat the common comorbidity of high blood pressure, also showed no influence on COVID-19 infection rates.

According to the models, three osteoporosis treatments were potentially associated with a reduced risk of COVID-19.

Denosumab, a monoclonal antibody treatment, was associated with a 42% reduced risk. There was a considerable degree of uncertainty about this value — it could range from a 72% reduced risk to a 22% increased risk.

Intravenous zoledronate was associated with a 38% reduced risk, with a range of 73% reduction to 41% increase. Meanwhile, calcium showed a 36% reduced risk, with a range of 63% reduction to 12% increase.

“The study suggests that some of these treatments may protect patients against infection by [SARS-CoV-2, the virus that causes] COVID-19, although further studies still need to be conducted on more patients to prove it,” says the study’s first author, Dr. Josep Blanch-Rubió.

Both denosumab and zoledronate are known to modify the immune system, and they do so in different ways.

Denosumab decreases the activity of immune signalling molecules called cytokines, which are involved in the excessive immune reaction that characterizes severe COVID-19.

The authors speculate that zoledronate, meanwhile, may protect the lungs from the infection by stimulating T cells and natural killer cells.

Musculoskeletal conditions such as osteoarthritis and fibromyalgia can cause chronic pain, and fractures resulting from osteoporosis can also be painful. Some pain medications commonly prescribed to people with these health issues appeared to increase the risk of COVID-19.

This was particularly true for pregabalin, which was associated with a 55% increased risk of COVID-19, with a range of estimates of 14% reduced pain to 280% increased pain.

People with these conditions also frequently experience mood disorders, such as depression. Most of the antidepressants in the analysis were associated with an increased risk, apart from duloxetine, which was associated with a 32% reduced risk, with a range of 66% decrease to 34% increase.

Dr. Alba Gurt, a study author and primary care physician at the Pere Virgili Hospital Center, in Barcelona, concludes:

“The data from the study would indicate that the [osteoporosis] treatments and duloxetine administered to our primary care patients are safe against infection by [the virus that causes] COVID-19 and could even reduce its incidence. However, studies with a higher number of patients are required to verify this.”

Important limitations

The analysis had some important limitations that are common to all observational studies. The associations identified may result from hidden “confounders” — other influences on the risk of developing COVID-19 that the researchers did not take into account.

The statistical power of the study was limited due to the relatively small numbers of patients with osteoporosis taking each medication and the possibility of complex drug interactions.

Also, the estimates of relative risk have wide confidence intervals — a term that describes the level of certainty about the risk. As a result, it is possible that denosumab, zoledronate, and calcium could all increase the risk of COVID-19, though the estimates veered more toward the drugs having a protective effect.

Overall, the actual risks or benefits of these osteoporosis treatments with regard to COVID-19 may be very different from what the team has found.

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An infusion of immune cells from people who have recovered from COVID-19 could shield those with compromised immune systems from the infection responsible for the disease, a lab-based study of cellular cultures suggests.

People who have recently received a bone marrow or organ transplant or are undergoing cancer treatment have reduced immunity. This makes them especially vulnerable to infections with viruses such as SARS-CoV-2, which causes COVID-19.

The Cellular Therapy Program at Children’s National, a hospital in Washington, D.C., uses a technique called “adoptive immunotherapy” to protect those with weakened immune systems from viruses including cytomegalovirus and the Epstein-Barr virus.

The technique involves isolating T cells that target the virus from the blood of someone recovering from the infection. After the cells have been cultured in a lab, healthcare providers inject them into people with weakened immunity, protecting them from the infection.

A team from Children’s National has now investigated the potential of adoptive immunotherapy to protect against COVID-19.

This preclinical research involved testing the immune capabilities of T cells from individuals recovering from the illness.

“We found that many people who recover from COVID-19 have T cells that recognize and target viral proteins of SARS-CoV-2, giving them immunity from the virus because those T cells are primed to fight it,” says Dr. Michael Keller, a pediatric immunology specialist who led the study.

“This suggests that adoptive immunotherapy using convalescent T cells to target these regions of the virus may be an effective way to protect vulnerable people, especially those with compromised immune systems due to cancer therapy or transplantation.”

These individuals’ vulnerability to infection can prevent or delay the treatments they need.

“This approach could serve as a viable option to protect or treat them, especially since their underlying conditions may make vaccines for SARS-CoV-2 unsafe or ineffective,” says Dr. Catherine Bollard, director of the hospital’s Center for Cancer and Immunology Research.

Dr. Bollard is also the senior author of the new study, which has been published in the journal Blood.

Immune targets

For the research, 46 individuals recovering from COVID-19 donated blood. Most had experienced only mild symptoms, and the researchers analyzed the samples around 36 days after the onset of the symptoms.

They identified T cells that recognized parts of proteins in the virus’s membrane, spike, and nucleocapsid, the shell surrounding its genetic material.

The researchers expanded these immune cells in the lab and found that they responded to the viral proteins by producing interferon gamma, a signaling molecule that orchestrates the immune system’s assault on viruses.

Many of the cells targeted a part of the membrane that is highly conserved, meaning that it changes little, if at all, as the virus evolves. This suggests that the virus may not be able to evolve ways to evade this part of the human immune system.

Vaccines currently in development target key parts of the spike proteins that give coronaviruses their characteristic crown-like appearance.

The authors propose that the highly conserved part of the membrane that they have identified might be another worthwhile target. A vaccine that trained T cells to recognize this part of the virus could provide long-lasting protection against the infection.

The study adds to evidence that even if the number of circulating antibodies declines steeply in the months after SARS-CoV-2 infection, as a recently published preprint of one study suggests, T cells may continue to protect against reinfection.

The authors also note that T cell immunity to two closely related coronaviruses — which cause severe acute respiratory syndrome, or SARS, and Middle East respiratory syndrome, or MERS — appears to persist for years.

Unanswered questions

One important drawback of this study is that it did not directly test the ability of donors’ T cells to inactivate the virus, either in the lab or in humans.

As the researchers acknowledge, future studies will have to evaluate whether adoptive T cell immunotherapy is safe and effective for people at high risk of severe COVID-19.

In addition, they highlight that their sample size was relatively small and that many of the donors had only experienced mild symptoms of the illness. Moreover, not every participant had laboratory-confirmed COVID-19 or a positive antibody test.

Finally, the authors address the possibility that T cell therapy could provoke excessive inflammation that results from a massive release of immune signaling molecules known as cytokines. They note, however, that this “cytokine release syndrome” is associated with cytokines other than interferon gamma in people with COVID-19.

They conclude:

“As other inflammatory complications, such as cytokine release syndrome, are very rare after virus-specific T cell therapy, the risk of inflammatory complications after adoptive T cell therapy for COVID-19, particularly when utilized early and derived from donors who themselves did not have inflammatory disease, are likely low.”

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