Monday, March 30, 2020
heart failure

According to a new study analyzing the data of thousands of people, an excessive intake of a certain kind of amino acid — present in protein-rich foods — is associated with a higher cardiometabolic risk.

person slicing meat
A new study in humans adds to the evidence that protein-rich foods, such as meat, may have a negative effect on heart health.

Many people follow diets that are high in protein, which can help with weight loss and building muscle mass.

However, increasingly, researchers are starting to question whether protein-rich foods provide enough benefits to offset the potential risks.

For the most part, various recent studies have suggested that high protein foods may affect the health of the heart and the cardiovascular system.

For example, a study in animal models that Medical News Today covered last week found that diets that are high in protein may be directly responsible for cardiovascular problems, such as atherosclerosis.

Now, hot on its heels, a new study in humans points out a link between eating foods with a high sulfur amino acid content — typically high protein foods — and an increased cardiometabolic risk.

The research — the findings of which appear in EClinicalMedicine — comes from Pennsylvania (Penn) State University in State College.

Proteins comprise tiny compounds called amino acids, which vary in their components. Some contain atoms of the element sulfur, which gives them their name: sulfur amino acids.

Cardiometabolic risk and diet

Two sulfur amino acids occur in protein-rich food. These are methionine, an essential amino acid, and cysteine, a semi-essential amino acid.

The human body needs these amino acids to function well, and it must obtain them from a food source. The body cannot synthesize essential amino acids, and it cannot make enough of the semi-essential ones.

However, as with many other nutrients, if they are present in excessive quantities, amino acids can end up doing more harm than good.

This is what Penn State researchers noticed when they looked at the diets and health status of 11,576 individuals, whose data they accessed via the third National Health and Nutrition Examination Survey (NHANES III), which the Centers for Disease Control and Prevention (CDC) conducted.

The researchers came up with a composite cardiometabolic disease risk score assessing each participant’s risk of developing cardiometabolic problems, such as heart disease, stroke, and diabetes.

To do this, they measured the levels of tell-tale biomarkers — including cholesterol, triglycerides, glucose (sugar), and insulin — in the participants’ blood following a 10–16 hour fast.

“These biomarkers are indicative of an individual’s risk for disease, just as high cholesterol levels are a risk factor for cardiovascular disease,” explains study co-author Prof. John Richie.

“Many of these levels can be impacted by a person’s longer-term dietary habits leading up to the test,” Prof. Richie adds.

The researchers also analyzed information about the participants’ dietary habits, which included nutrient intake calculations. They excluded from the study any individuals who reported having an overly low intake of sulfur amino acids.

‘First epidemiologic evidence’

The team’s final analysis, which accounted for body weight measurements, revealed that the participants had an average intake of sulfur amino acids that was almost 2.5 times higher than the estimated average requirement of 15 milligrams per kilogram of body weight per day.

“Many people in the U.S. consume a diet rich in meat and dairy products, and the estimated average requirement is only expected to meet the needs of half of healthy individuals,” points out study co-author Xiang Gao.

“Therefore, it is not surprising that many are surpassing the average requirement when considering these foods contain higher amounts of sulfur amino acids,” says Gao.

Moreover, the investigators found that participants with higher sulfur amino acid intakes also tended to have higher composite cardiometabolic risk scores.

This association remained in place even after the researchers accounted for confounding factors, including age, biological sex, and a history of health conditions such as hypertension and diabetes.

As for the source of the sulfur amino acids, the team said that they were present in almost all foods, excluding grains, fruit, and vegetables.

“Meats and other high protein foods are generally higher in sulfur amino acid content,” notes lead author Zhen Dong, Ph.D.

“People who eat lots of plant-based products like fruits and vegetables will consume lower amounts of sulfur amino acids. These results support some of the beneficial health effects observed in those who eat vegan or other plant-based diets,” Dong adds.

The researchers caution that the current findings are, so far, only observational, pointing to an association rather than verifying causality.

“A longitudinal study would allow us to analyze whether people who eat a certain way do end up developing the diseases these biomarkers indicate a risk for,” notes Prof. Richie.

Nevertheless, he stresses that the recent study shows that researchers should pay more attention to the possible risks associated with dietary amino acids.

“For decades, it has been understood that diets restricting sulfur amino acids were beneficial for longevity in animals. This study provides the first epidemiologic evidence that excessive dietary intake of sulfur amino acids may be related to chronic disease outcomes in humans.”

– Prof. John Richie

New research uses high quality data to find that the type 2 diabetes drug rosiglitazone raises the risk of adverse cardiovascular events by 33%.

Rosiglitazone is a drug originally developed to treat type 2 diabetes. The United States Food and Drug Administration (FDA) approved it in 1999 under the name Avandia.

Although Europe suspended the drug due to concerns about its adverse effects on heart health, and the United States restricted its use, the research on its safety has so far yielded mixed results.

Now, a new study, appearing in the journal The BMJ has used more reliable data to investigate the effects of this drug on cardiovascular health.

Joshua D. Wallach, who is an assistant professor in the Department of Environmental Health Sciences at Yale School of Public Health in New Haven, CT, is the lead author of the new paper.

The need for more accurate data

The FDA approved rosiglitazone in 1999, a year ahead of Europe, note Wallach and colleagues in their paper.

Regulatory bodies warned about its potential effects on heart failure as early as 2006, and a meta-analysis of several trials pointed to a 43% higher risk of heart attack in 2007.

As a result, by 2010, the drug was pulled off European markets because it raised the risk of heart attack and stroke.

In the U.S., the drug is still available, although it features warnings on its packaging, and the FDA restricted its availability in 2010-2011.

The fact that the drug is still available is primarily due to the mixed results yielded by the investigation into the drug’s cardiovascular effects.

However, the new research suggests that these mixed results are due to the poor quality of the data that these previous studies used.

Namely, these previous papers did not have access to “individual patient data (IPD),” that is, raw data, such as the medical records of patients, instead of summary-level data, which are the final results of clinical trials, for example.

Studying rosiglitazone and heart health

To rectify this methodological problem, Wallach and colleagues set out to analyze over 130 clinical trials; the researchers had access to IPD for 33 of these trials. This totaled 48,000 adult patient data, of which researchers had IPD for 21,156.

The clinical trials were randomized, controlled, phase II-IV trials that had studied and compared the effects of rosiglitazone with any other control for at least 24 weeks.

“The control group was defined as patients who received any drug regimen other than rosiglitazone, including placebo,” explain the researchers.

The team examined the outcomes of “acute myocardial infarction, heart failure, cardiovascular-related death, and noncardiovascular-related death” in their analysis of trials for which they had IPD.

For the other trials, the researchers examined myocardial infarction and cardiovascular-related death only, using summary-level data.

A 33% higher risk of cardiovascular disease

The analysis revealed a 33% higher risk of heart attack, heart failure, cardiovascular deaths, and noncardiovascular-related deaths combined for people who were taking the drug compared with people who were taking another control substance, including placebo.

Wallach and colleagues conclude:

“The results suggest that rosiglitazone is associated with an increased cardiovascular risk, especially for heart failure events.”

The findings also serve to emphasize the importance of using raw data to accurately assess the safety of a drug, say the authors.

“Our study suggests that when evaluating drug safety and performing meta-analyses focused on safety, IPD might be necessary to accurately classify all adverse events,” they write.

“By including this data in research, patients, clinicians, and researchers would be able to make more informed decisions about the safety of interventions.”

“Our study highlights the need for independent evidence assessment to promote transparency and ensure confidence in approved therapeutics, and postmarket surveillance that tracks known and unknown risks and benefits.”

According to a recent study, more people in the United States are drinking more alcohol and experiencing the harmful effects. The number of hospitalizations is rising, as are death rates.

“Alcohol is not a benign substance, and there are many ways it can contribute to mortality,” says George F. Koob, Ph.D., director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

These range from more apparent contributors, such as liver disease and overdoses, to less obvious ones, such as falls.

A growing concern among experts is that rising consumption levels are leading to an increasing number of related deaths.

In the past 2 decades, alcohol consumption has risen sharply in the U.S., according to the findings of a new analysis, now summarized in the journal Alcoholism: Clinical and Experimental Research.

According to data from 2017, the researchers report, 70.1% of the U.S. population aged 18 and older drank alcohol that year. Each person who drank consumed approximately 3.6 gallons of pure alcohol, or about 2.1 standard drinks daily.

As consumption has risen, so has the level of harm. Various studies have noted an increase in alcohol-related hospitalizations and emergency department visits since 2000.

Between 2000 and 2015, the number of hospital visits related to alcohol shot up by 76.3% for people aged 12 and over.

The total number of emergency department visits linked with alcohol rose by over 47% between 2006 and 2014.

The researchers saw the biggest increases among the female population. They reported a 10.1% rise in the number of women who consumed alcohol between 2000 and 2016, and a 23.3% increase in binge drinking among women during the same period.

Similarly, the authors found that the increases in hospitalizations and emergency department visits were greater among women than men.

Studying death certificates 

After considering the increases in alcohol consumption and associated medical intervention, the researchers — all of whom work for the NIAAA — set out to investigate whether alcohol-related deaths were similarly on the rise.

Death certificates provide the most comprehensive way of determining the causes of death among large populations. However, tracking alcohol-related mortality is difficult because a certificate may be issued before the doctor can tell that alcohol was involved.

2014 study found that only 1 in 6 certificates recording death as a result of drunk driving listed alcohol as a contributor.

Fully aware of the unreliability of the reporting, the NIAAA team analyzed all death certificates filed in the U.S. between 1999 and 2017, in an effort to determine the number of alcohol-related deaths among people aged 16 and over.

They looked for any certificates that listed alcohol as a contributing cause of death. They also included certificates that recorded an alcohol-induced cause of death.

The investigators analyzed the results as a whole before separating them by age, sex, ethnicity, and race.

Highest rises among women, younger adults

The team found that the number of deaths linked to alcohol had more than doubled within the period of their investigation. Almost 1 million people had died from alcohol-related causes between 1999 and 2017.

In 1999, there were only 35,914 such deaths. In 2017, this figure had increased to 72,558.

That year, almost one-third of these deaths had resulted from liver disease, and nearly one-fifth had resulted from overdoses — either from alcohol alone or in combination with other drugs.

Although people aged 45–74 had the highest rate of alcohol-related death, the most significant increase occurred among people aged 25–34. In fact, every age group, except people aged 16–20 and 75 or over, saw an increase.

Although rates among Hispanic men and non-Hispanic black people decreased at first, they later increased, in line with all other groups.

As with rises in consumption and subsequent hospital visits, the increases in alcohol-related deaths were higher among women than men. The female population demonstrated an 85.3% rise, compared with a 38.7% rise among men.

A wake-up call 

The head of the NIAAA describes alcohol as “a growing women’s health issue.” He says: “The rapid increase in deaths involving alcohol among women is troubling and parallels the increases in alcohol consumption among women over the past few decades.”

Speaking about the report in its entirety, Koob states that it is “a wake-up call to the growing threat alcohol poses to public health.”

Koob also reminds us that the number of recorded alcohol-related deaths may be greatly underestimated, “We know that the contribution of alcohol often fails to make it onto death certificates.”

The middle-aged and elderly range is of particular concern. With that population set to almost double by 2060, the researchers point out, complications of their alcohol consumption could place a considerable burden on the healthcare system. The NIAAA director emphasizes:

“Better surveillance of alcohol involvement in mortality is essential in order to better understand and address the impact of alcohol on public health.”

A new form of viral pneumonia is spreading in China and has already been detected in neighbouring countries. In response to the outbreak of new strand of coronavirus, the World Health Organisation has urged countries to “strengthen their preparedness for health emergencies”.

Meanwhile, the Chinese government is keen to avoid a repeat of Severe Acute Respiratory Syndrome (SARS) or severe acute respiratory syndrome, another coronavirus that started in 2002 and killed nearly 800 people. But what is this new strand and what effect does it have on people?
Here is what you need to know.

What is the virus?
Coronaviruses (CoV) are a large family of viruses causing illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV).It is called a novel coronavirus (nCoV) when a new strain has been identified in humans.

Public Health England (PHE) is currently using the name Wuhan novel coronavirus (WN-CoV) for the new strand – named after where it was discovered – until there is an internationally accepted name for the virus and the disease or syndrome it causes. You may also see it referred to as the 2019 novel coronavirus (2019-nCoV) elsewhere.

Where did the virus come from?
On December 31, last year, the World Health Organisation (WHO) was informed of a cluster of cases of pneumonia of unknown cause in Wuhan City, Hubei Province, China.

On January 12 this year the novel coronavirus had been identified in samples obtained from cases. Initial analysis suggested that this was the cause of the outbreak. Many, but not all, of the cases identified in Wuhan had been to or worked in a seafood and live animal market in the city (Huanan South China Seafood Market).
This market was closed on January 1, 2020, and sanitised. As of January 14, no additional cases had been detected in Wuhan since January 3.

What are the symptoms?
A vendor gives out copies of newspaper with a headline of ‘Wuhan break out a new type of coronavirus, Hong Kong prevent SARS repeat’ at a street in Hong Kong.

Fever, fatigue and dry cough are the main symptoms in the early stage of illness and some patients may not progress to more severe illness, according to PHE.

Dyspnoea – a condition that causes difficulty with breathing – is said to be common in hospitalised patients, while vital signs were reported to be generally stable at the time of admission. Older patients with an underlying disease were more likely to progress to severe disease.

As of January 12, six of the 41 patients had recovered and been discharged, six have severe illness, and one patient died – though at least two more have died since. One individual who died was 61 and had pre-existing significant medical conditions and required intensive care.

How is the virus passed on?
Some coronaviruses are passed on easily from person to person, while others are not. Little is known about WN-CoV at this stage and investigations are ongoing but it is “reasonable to assume” the strand could be passed on between animals and humans, according to government advice.

That is because many cases were associated with a market containing a range of dead and live animals. According to Public Health England (PHE), authorities in China reported on January 14 that an infected man had worked in the Huanan seafood market, but his wife, who is also a confirmed case, denied having been to the same market. This means it is possible that there is limited human-to-human transmission within a family setting, but investigations are ongoing. Other coronaviruses are airborne and can be passed on between humans.

Should tourists avoid any countries?
The WHO is not currently recommending any trade or travel restrictions, based on information available.

Is there a vaccine?
When a disease is new, there is no vaccine until one is developed. It can take a number of years for a new vaccine to be developed, according to WHO.

Asthma is a chronic lung condition in which the airways narrow and become inflamed, which leads to wheezing, coughing, and chest tightness. Extrinsic asthma and intrinsic asthma are subtypes of asthma.

The symptoms of these subtypes are the same, but they have different triggers:

  • Extrinsic asthma symptoms occur in response to allergens, such as dust mites, pollen, and mold. It is also called allergic asthma and is the most common form of asthma.
  • Intrinsic asthma has a range of triggers, including weather conditions, exercise, infections, and stress. People may call it nonallergic asthma.

In this article, we discuss the causes, symptoms, and treatment of intrinsic and extrinsic asthma.

Intrinsic vs. extrinsic asthma

Intrinsic and extrinsic asthma are two subtypes of asthma, which people more commonly refer to as allergic and nonallergic asthma.

Both types cause the same symptoms. The difference between the two subtypes is what causes and triggers asthma symptoms. The treatments are similar for each type, although the prevention strategies differ.

Triggers

Woman taking inhaler for asthma whilst playing football. Intrinsic and extrinsic asthma have the same symptoms but different triggers
Intrinsic and extrinsic asthma have the same symptoms but different triggers.

In people with extrinsic asthma, allergens trigger the respiratory symptoms. Common triggers for extrinsic asthma include:

  • pollen
  • mold
  • dust mites
  • pet dander
  • cockroaches
  • rodents

In some cases, a person is allergic to more than one substance, and several allergens trigger asthma symptoms.

In people with intrinsic asthma, allergies are not responsible for the symptoms. Instead, the following triggers cause symptoms:

  • cold
  • humidity
  • stress
  • exercise
  • pollution
  • irritants in the air, such as smoke
  • respiratory infections, such as colds, the flu, and sinus infections

In some cases, intrinsic asthma can occur with no known cause.

Prevalence

Extrinsic or allergic asthma is the most common form of the disease. According to the Asthma and Allergy Foundation of America, about 60% of people with asthma have allergic asthma.

Less commonly, intrinsic or nonallergic asthma occurs. Research in The Journal of Allergy and Clinical Immunologyindicates that intrinsic asthma occurs in anywhere from 10% to 33% of people with asthma.

It occurs more often in females than males and typically develops later in life than extrinsic asthma.

Causes

In all types of asthma, a person has overly sensitive airways and airway inflammation, which produces asthma symptoms.

Inflammation causes swelling in the airways that narrows the tubes and makes breathing difficult. The body also produces excess mucus, which further impairs breathing. These factors decrease the amount of air that can get into the lungs.

The inflammatory processes are similar in extrinsic and intrinsic asthma. In both, the immune system releases cells called T-helper cells and mast cells.

Research has found that there may be more similarities between the two types of asthma than researchers previously thought. Both types of asthma involve the production of IgE locally at the airways in response to the relevant triggers:

  • Extrinsic asthma occurs when the immune system overreacts to a harmless substance, such as pollen or dust. The body releases an antibody called immunoglobin E (IgE). The release of this antibody leads to inflammation and asthma symptoms.
  • Intrinsic asthma occurs when something other than allergens triggers an immune system response. People are not always able to identify the trigger.

Symptoms

The symptoms of extrinsic and intrinsic asthma are the same and may include:

  • wheezing
  • chest tightness
  • shortness of breath
  • coughing
  • increased mucus production
  • trouble breathing

Symptoms can vary in severity and may develop suddenly. Ignoring the signs and symptoms of an asthma attack can lead to a life-threatening situation. Recognizing symptoms as soon as possible and following an asthma action plan can help decrease the severity of an attack and reduce complications.

Treatments

The treatment options for intrinsic and extrinsic asthma are similar and include medications, lifestyle changes, and the avoidance of triggers. Since the triggers are different, the prevention strategies may differ.

Reducing triggers

It may be easier to identify the triggers for extrinsic asthma because allergies are the culprit. With both types of asthma, the identification of triggers allows an individual to take steps to reduce exposure and decrease symptoms.

The following steps can help reduce asthma symptoms in people with extrinsic asthma:

  • fixing leaky pipes to prevent mold buildup
  • keeping doors and windows closed when the pollen count is high
  • vacuuming often to reduce dust
  • keeping pets out of the bedroom

Triggers of intrinsic asthma do not involve a specific allergen. Due to the variability of triggers, it can take a little longer to determine the cause of flare-ups. People may find that avoiding humid, dry, or cold weather can prevent symptoms.

Medications

People can use the following medications to treat flare-ups of both intrinsic and extrinsic asthma:

Short-acting bronchodilators

Short-acting bronchodilators, also called quick relief medications, reduce symptoms fast. They work by relaxing the muscles of the airways.

Long-acting medications

People take long-acting bronchodilators daily, and they also open up the airways. Long-acting bronchodilators do not treat sudden symptoms as they take longer to work than short-acting bronchodilators.

Corticosteroids

Corticosteroids decrease inflammation in the airways. People take steroids daily to prevent symptoms.

Omalizumab

Omalizumab is an anti-IgE antibody therapy that prevents the release of IgE. Reducing IgE decreases the allergic response and prevents asthma symptoms.

People usually use omalizumab to treat extrinsic asthma, but it may also help with intrinsic asthma.

Lifestyle changes

Lifestyle changes might also help decrease symptoms of both types of asthma.

People with asthma may wish to consider adopting the following lifestyle practices:

  • maintaining a healthy weight
  • quitting smoking
  • avoiding secondhand smoke
  • reducing stress
  • getting a flu vaccine each year
  • washing the hands frequently to decrease the risk of infection

Outlook

Although there is currently no cure for either extrinsic or intrinsic asthma, people can manage the symptoms with medications, prevention methods, and lifestyle changes.

Intrinsic asthma is often harder to control than extrinsic asthma, as identifying its triggers is sometimes difficult. People can work closely with a doctor to determine the causes of asthma symptoms and find an effective treatment.

Walnuts may not just be a tasty snack, they may also promote good-for-your-gut bacteria. New research suggests that these “good” bacteria could be contributing to the heart-health benefits of walnuts. In a randomized, controlled trial, researchers found that eating walnuts daily as part of a healthy diet was associated with increases in certain bacteria that can help promote health. Additionally, those changes in gut bacteria were associated with improvements in some risk factors for heart disease.

Kristina Petersen, assistant research professor at Penn State, said the study — recently published in the Journal of Nutrition — suggests walnuts may be a heart- and gut-healthy snack.

“Replacing your usual snack — especially if it’s an unhealthy snack — with walnuts is a small change you can make to improve your diet,” Petersen said. “Substantial evidence shows that small improvements in diet greatly benefit health. Eating two to three ounces of walnuts a day as part of a healthy diet could be a good way to improve gut health and reduce the risk of heart disease.”Previous research has shown that walnuts, when combined with a diet low in saturated fats, may have heart-healthy benefits. For example, previous work demonstrated that eating whole walnuts daily lowers cholesterol levels and blood pressure.

According to the researchers, other research has found that changes to the bacteria in the gastrointestinal tract — also known as the gut microbiome — may help explain the cardiovascular benefits of walnuts.“There’s a lot of work being done on gut health and how it affects overall health,” said Penny Kris-Etherton, distinguished professor of nutrition at Penn State. “So, in addition to looking at factors like lipids and lipoproteins, we wanted to look at gut health. We also wanted to see if changes in gut health with walnut consumption were related to improvements in risk factors for heart disease.”

For the study, the researchers recruited 42 participants with overweight or obesity who were between the ages of 30 and 65. Before the study began, participants were placed on an average American diet for two weeks. After this “run-in” diet, the participants were randomly assigned to one of three study diets, all of which included less saturated fat than the run-in diet. The diets included one that incorporated whole walnuts, one that included the same amount of alpha-linolenic acid (ALA) and polyunsaturated fatty acids without walnuts, and one that partially substituted oleic acid (another fatty acid) for the same amount of ALA found in walnuts, without any walnuts.

In all three diets, walnuts or vegetable oils replaced saturated fat, and all participants followed each diet for six weeks with a break between diet periods. To analyze the bacteria in the gastrointestinal tract, the researchers collected fecal samples 72 hours before the participants finished the run-in diet and each of the three study diet periods. “The walnut diet enriched a number of gut bacteria that have been associated with health benefits in the past,” Petersen said. “One of those is Roseburia, which has been associated with protection of the gut lining. We also saw enrichment in Eubacteria eligens and Butyricicoccus.”

The researchers also found that after the walnut diet, there were significant associations between changes in gut bacteria and risk factors for heart disease. Eubacterium eligens was inversely associated with changes in several different measures of blood pressure, suggesting that greater numbers of Eubacterium eligens was associated with greater reductions in those risk factors.

Additionally, greater numbers of Lachnospiraceae were associated with greater reductions in blood pressure, total cholesterol, and non-High Density Lipo-protein (HDL) cholesterol. There were no significant correlations between enriched bacteria and heart-disease risk factors after the other two diets.

Regina Lamendella, associate professor of biology at Juniata College, said the findings are an example of how people can feed the gut microbiome in a positive way. “Foods like whole walnuts provide a diverse array of substrates — like fatty acids, fiber and bioactive compounds — for our gut microbiomes to feed on,” Lamendella said. “In turn, this can help generate beneficial metabolites and other products for our bodies.” Kris-Etherton added that future research can continue to investigate how walnuts affect the microbiome and other elements of health.

“The findings add to what we know about the health benefits of walnuts, this time moving toward their effects on gut health,” Kris-Etherton said. “The study gives us clues that nuts may change gut health, and now we’re interested in expanding that and looking into how it may affect blood sugar levels.”

A team at George Mason University, Fairfax, VA, has uncovered another electronic cigarette health concern. This time, it relates to stroke risk.

In recent years, the popularity of e-cigarettes has soared.

A 2016 study found that 10.8 million adults in the United States were current e-cigarette users. It is common for people to switch from traditional cigarettes to the e-variety because they think they are a healthier option.

But newly issued health warnings have pointed to the potential risks of smoking e-cigarettes. In June 2019, the U.S. saw an outbreak of lung injuries associated with e-cigarettes.

Experts believe that vitamin E acetate — an ingredient found in some e-cigarettes containing THC — may be the link.

In December 2019, the Centers for Disease Control and Prevention (CDC) reported that more than 2,500 individuals from the U.S., Puerto Rico, and the U.S. Virgin Islands were hospitalized or died as a result of using vapes, e-cigarettes, or associated products.

Recent studies, albeit small-scale, have found both benefits and risks to e-cigarettes.

One study that appears in PNAS found that nicotine from e-cigarette smoke caused lung cancer in mice as well as precancerous growth in the bladder.

However, a second study, appearing in the Journal of the American College of Cardiology, noted a significant improvement in vascular health within a month of a traditional smoker switching to e-cigarettes.

A trend among the young

Despite their nicotine content, the variety of e-cigarette flavors available has led to the products becoming a trend among young adults. There is also a concern this habit could lead to conventional cigarette smoking.

Equally worrying findings have come from a new study that appears in the American Journal of Preventive Medicine. The study found that young adults smoking both traditional and e-cigarettes face a significantly higher risk of stroke.

Using data from the 2016-17 Behavior Risk Factor Surveillance System (BRFSS), the study examined smoking-related responses from a total of 161,529 people aged between 18 and 44.

Just over half of the respondents were female, with 50.6% identifying as white and just under a quarter identifying as Hispanic.

The team calculated the adjusted odds ratios for strokes among those who currently smoked, former smokers who now used e-cigarettes, and people who used both.

“It’s long been known that smoking cigarettes is among the most significant risk factors for stroke,” says lead investigator Tarang Parekh from George Mason University.

“Our study shows that young smokers who also use e-cigarettes put themselves at an even greater risk.”

Tarang Parekh

An important message and a ‘wake-up call’

The study identified that young adults who smoked both traditional and e-cigarettes were almost twice as likely to have a stroke compared with conventional cigarette smokers.

This risk rose to almost three times as likely when compared with non-smokers. Results also showed there was no clear advantage to switching from traditional cigarettes to e-cigarettes.

However, people using e-cigarettes who had never smoked before did not display an increased stroke risk. This may be down to factors including young age and normal heart health.

This study relied on self-reported data, which is a limitation. However, the findings prove the need for large-scale, long-term studies to confirm which detrimental health effects e-cigarettes are causing and which ingredients are responsible.

“This is an important message for young smokers who perceive e-cigarettes as less harmful and consider them a safer alternative,” Parekh states.

According to Parekh, the results are “a wake-up call” for policymakers to urgently regulate e-cigarette products “to avoid economic and population health consequences.”

“We have begun understanding the health impact of e-cigarettes and concomitant cigarette smoking, and it’s not good.”

Tarang Parekh

Researchers have found that living in polluted cities may cause the bones to be weaker and easier to break.

The researchers also found that city-dwellers exposed to toxic air have weaker hips and spines and are more prone to fractures

The Spanish researchers believe that bones are weakened because tiny pollutants seep into the blood when inhaled and speed up the ageing process.

A study carried out India of nearly 4,000 people found that those exposed to toxic particles had less bone density in their lower back and those who inhaled more toxic airborne particles had less bone mass in their spines and hips.

Meanwhile, previous studies have linked pollution to low levels of parathyroid hormone, which regulates calcium production, leading to more fragile bones.

Researchers found that smog-filled towns and cities have been linked to an increased risk of stroke, heart disease, lung cancer, acute respiratory diseases such as asthma and even dementia.

Although, there have only been a few studies into the effect of toxic airborne particles on bone health, the results have so far been inconclusive.

Researchers from the Barcelona Institute for Global Health in their latest paper, looked at 3,700 people who were all residents from 28 villages outside the city of Hyderabad in southern India between 2009 and 2012.

The researchers took measurements of PM2.5 and black carbon in the atmosphere in each village.

PM2.5 is the finest type of particulate matter, while black carbon is a larger toxin. Both come mainly from petrol and diesel vehicle exhausts.

Their analysis revealed average PM2.5 exposure was 33 micrograms per metre cubed (ug/m3) – far above the maximum 10ug/m3 levels recommended by the World Health Organisation.

By comparison, the average level is 13ug/m3 in London, 12ug/m3 in New York and 10ug/m3 in Sydney.

The researchers also cross-referenced pollution levels with X-rays measuring bone mass in participants’ lower back, known as the lumbar spine, and hip.

The results showed that exposure to air pollution was associated with lower levels of bone mass.

For every 3ug/m3 increase in fine particulate matter, there was a decrease of -0.57g of bone mass in the spine and -0.13g in the hip, while an increase of 1ug/m3 of carbon saw bone density shrink by -1.13g in the spine and -0.35g in the hip.

The study lead author, Otavio Ranzani said: “This study contributes to the limited and inconclusive literature on air pollution and bone health.

“Inhalation of polluting particles could lead to bone mass loss through the oxidative stress and inflammation caused by air pollution.’ The findings were published in the journal Jama Network Open.

However, a 2017 study by Columbia University of more than nine million people was the first to find a link between traffic fumes and fractures caused by osteoporosis.

Osteoporosis is a health condition that weakens bones, making them fragile and more likely to break.

The study linked pollution exposure to low levels of parathyroid hormone, which regulates calcium production, leading to weaker bones and more hospitalisations for fractures.

The study found hospital admissions for bone fractures were higher in communities with elevated levels of PM2.5, as more than 80 per cent of the world’s urban population is breathing unsafe levels of air pollution.

Described as an invisible killer, it causes an estimated seven million premature deaths yearly worldwide, according to the World Health Organisation (WHO).

However, health experts fear that pollution is also fuelling increases in degenerative diseases such as Alzheimer’s and other forms of dementia.

Previous studies found that air pollution has a negative impact on students’ cognitive abilities.

Many pollutants are thought to directly affect brain chemistry in a variety of ways.

For instance, particulate matter from traffic and industry can carry toxins through small passageways and directly enter the brain.

Culled from www.dailymail.co.uk

Lung cancer is the second most common type of cancer in adults in the United States. It is also the leading cause of death from cancer.

Lung cancer treatment is much more effective when the disease is in its earlier stages. However, most people with lung cancer do not experience symptoms until the disease has spread.

Some people experience subtle symptoms of early stage lung cancer, but these symptoms more often stem from other health issues or factors such as smoking.

Below, we describe early symptoms of lung cancer, as well as risk factors and when to see a doctor.

Possible signs and symptoms of early stage lung cancer

According to the American Cancer Society (ACS), most types of lung cancer do not cause symptoms until they have spread to other areas.

However, some people experience subtle symptoms during the earlier stages of the disease.

The early lung cancer symptoms that we describe below usually result from some other cause. However, people who experience these symptoms should consider visiting their doctors as a precautionary measure.

Sudden weight loss

The American Society of Clinical Oncology report that weight loss is often the first noticeable sign of cancer.

They estimate that 40% of people who receive a cancer diagnosis experience unexplained weight loss during that time.

Cancer can cause weight loss for many reasons, including:

  • changes to immune function
  • changes to metabolism
  • changes to hormones
  • a sudden loss of appetite
  • difficulty swallowing

Shortness of breath

Shortness of breath and wheezing can also be early symptoms of lung cancer.

Some people may experience a slight cough in addition to shortness of breath. Others may have difficulty catching their breath but have no cough.

Cough

A slight cough that does not go away can indicate early stage lung cancer. Some people assume that this cough is only a result of smoking.

A person who regularly coughs because of another lung condition may notice changes in their cough, and these can likewise indicate lung cancer.

Also, a cough that produces blood may result from lung cancer or another issue with the lungs. Anyone who experiences this symptom should see a doctor.

General fatigue

Lung cancer can cause the number of red blood cells in the body to drop. The medical term for this issue is anemia.

Because red blood cells carry oxygen, a person with anemia may not take in enough oxygen to support their body’s needs. This can result in tiredness and fatigue. Severe fatigue can make it difficult to function on a day-to-day level.

Shoulder, chest, or back pain

Most people with lung cancer do not feel pain or other symptoms during the early stages. This is because there are very few nerve endings in the lungs.

However, pain can occur when lung cancer invades the chest wall, ribs, vertebrae, or certain nerves. For example, Pancoast tumors, which form at the very top of the lungs, often invade nearby tissues, causing shoulder pain.

As a tumor develops, a person may begin to feel pain in their:

  • arms
  • chest
  • back

Hoarse voice

A person with lung cancer or another respiratory disease may develop a hoarse, raspy voice.

This can happen if a tumor presses on the laryngeal nerve, which is located within the chest. When the nerve is compressed, it can paralyze a vocal cord, causing the voice to change.

Risks

According to the Centers for Disease Control and Prevention (CDC)cigarette smoking is still the biggest risk factor for lung cancer, accounting for 80–90% of lung cancer-related deaths.

Other risk factors for lung cancer include:

  • using other tobacco products, such as cigars or pipe tobacco
  • inhaling secondhand smoke
  • being exposed to radon gas, possibly from materials within the home
  • working with dangerous chemicals, such as asbestos, arsenic, or diesel
  • living in a highly polluted area
  • having other lung conditions, such as chronic obstructive pulmonary disease
  • having a family history of lung cancer

When describing risk, organizations and experts sometimes use the term “pack-year.” A pack-year refers to the number of cigarettes smoked per day each year. So a person with a 30 pack-year smoking history may have:

  • smoked one pack per day for 30 years
  • smoked two packs per day for 15 years

The ACS recommend yearly lung cancer screenings for people aged 55–74 who:

  • currently smoke or have quit smoking in the past 15 years
  • have at least a 30 pack-year smoking history
  • currently smoke and are receiving counseling to help them quit
  • are aware of the potential benefits and harms of screening
  • have access to a facility that has experience with lung cancer screening and treatment

Screening cannot detect every instance of lung cancer, but it does lower a person’s chance of dying from the disease.

Smokers vs. nonsmokers

According to the CDC, people who smoke are 15–30 times more likely to die from lung cancer than people who do not.

Meanwhile, according to statistics from 2013–2014, about 1 in 4 people who do not smoke, including children, are exposed to secondhand smoke. This increases their risk of developing the disease.

Quitting smoking at any age can lower the risk of lung cancer.

When to see a doctor

The symptoms above usually result from issues other than lung cancer. However, anyone who experiences any of the following issues should visit a doctor:

  • a cough that lasts longer than 2–3 weeks
  • a persistent cough that worsens
  • a cough that produces blood
  • aches or pains when breathing or coughing
  • persistent shortness of breath
  • persistent tiredness or fatigue
  • recurrent chest infections
  • unexplained weight loss

Summary

Lung cancer is the second most common form of cancer. It can affect anyone but is particularly prevalent among people who smoke.

Usually, lung cancer does not cause symptoms until it has spread. As a result, it is not always possible to detect lung cancer in its earliest stages.

Nonetheless, some people experience subtle symptoms during the initial stages. It is important to recognize these because treatment is typically more effective when a person receives it early.

Anyone who experiences early symptoms of lung cancer should see a doctor. In many cases, something other than cancer is the cause. Still, it is best to seek medical advice as a precaution.

Insomnia can have a serious impact on a person’s health and well-being. Now, a study of females aged 50 and over has found that some parts of the diet most likely contribute to this sleep disorder.

Insomnia affects many people all over the world. According to the National Sleep Foundation, up to 40% of people in the United States experience some insomnia symptoms each year.

Researchers have taken due note of this, as numerous studies have suggested that insomnia is not just a mild annoyance: It may actually be linked with many other negative health outcomes.

According to the Centers for Disease Control and Prevention (CDC), short sleep duration and sleep disruptions are associated withTrusted Source cardiovascular problems, diabetes, and depression, to name a few.

For this reason, specialists have been looking for ways of preventing or treating insomnia and other sleep disorders — starting by looking for all the possible causes.

Existing research has already called attention to the fact that diet may influence a person’s sleep qualityTrusted Source. Now, a study from Columbia University Vagelos College of Physicians and Surgeons in New York City, NY, suggests that a diet high in refined carbohydrates — particularly added sugars — is linked to a higher risk of insomnia. This, at least, appears to be the case among females aged 50 and over.

The research team reports these findings in a study paper that now appears in The American Journal of Clinical NutritionTrusted Source.

“Insomnia is often treated with cognitive behavioural therapy or medications, but these can be expensive or carry side effects,” explains senior study author James Gangwisch, PhD.

But, he adds, “[b]y identifying other factors that lead to insomnia, we may find straightforward and low cost interventions with fewer potential side effects.”

The possible underlying mechanism

The researchers worked with the data of 53,069 female participants aged 50–79, all of whom had enrolled in the Women’s Health Initiative Observational Study between September 1994 and December 1998.

To understand whether or not there really is a link between dietary choices and the risk of insomnia, the investigators looked for any associations between different diets and sleep disruptions.

Gangwisch and colleagues found a link between a higher risk of insomnia and a diet rich in refined carbohydrates. This includes foods with added sugars, soda, white rice, and white bread.

The researchers caution that it was unclear from their analysis whether the consumption of refined carbohydrates led to insomnia, or that people who experienced insomnia were more likely to consume refined carbs, especially sugary foods.

However, they do note that there is a possible underlying mechanism that might explain added sugars causing sleep disruptions.

“When blood sugar is raised quickly, your body reacts by releasing insulin, and the resulting drop in blood sugar can lead to the release of hormones such as adrenaline and cortisol, which can interfere with sleep,” Gangwisch explains.

Why fruit will not impact sleep

The study authors also explain why not all foods that contain sugar will lead to the same effect. Fruits and vegetables — which naturally contain sugar — are unlikely to raise blood sugar levels nearly as quickly as foods containing added sugars.

This is because these natural foods are also high in fiber, which means that the body absorbs the sugar more slowly, preventing a spike in blood sugar levels.

Indeed, the female participants who had diets rich in vegetables and whole fruits — but not fruit juices — did not have an increased risk of insomnia.

“Whole fruits contain sugar, but the fiber in them slow the rate of absorption to help prevent spikes in blood sugar,” says Gangwisch.

“This suggests that the dietary culprit triggering the women’s insomnia was the highly processed foods that contain larger amounts of refined sugars that aren’t found naturally in food.”

James Gangwisch, Ph.D.

The researchers only worked with females aged 50 and over, but they believe that the findings could also apply to males and people of other ages. Going forward, they argue that this idea is worth exploring in more detailed studies.

“Based on our findings, we would need randomized clinical trials to determine if a dietary intervention, focused on increasing the consumption of whole foods and complex carbohydrates, could be used to prevent and treat insomnia,” concludes Gangwisch.