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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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A preclinical study has tested a new vaccine for Alzheimer’s disease. The researchers found that the vaccine, which targets the beta-amyloid protein, was safe and effective in mice.

Alzheimer’s disease is a progressive neurological condition and the most common cause of dementia.

According to the latest estimates from the Alzheimer’s Association, 1 in 10 people over the age of 65 years in the U.S. have Alzheimer’s disease, and experts expect the number of people with the condition to increase as the population ages. By 2050, projections show that 13.8 million people aged 65 years and over will have Alzheimer’s disease in the U.S.

While groups around the world are working to find an effective treatment for the condition, an alternative approach is to develop a vaccine. Although they are more commonly associated with infectious diseases, vaccines can also prime the body to defend itself against other, noninfectious molecules.

In Alzheimer’s disease, scientists believe that two processes drive the progression of the disease: the buildup of plaques comprising beta-amyloid proteins between neurons in the brain and tangled knots of the tau protein within neurons.

Since the general understanding is that beta-amyloid initiates the disease process, scientists have tried to develop a vaccine against it. The hope is that the immune system recognizes and destroys the beta-amyloid before it can aggravate the cell damage that the tau protein causes.

Although scientists have developed several vaccines, translating the findings from murine models into humans while ensuring safety is notoriously challenging, and the authorities have not yet approved any vaccines for use.

Researchers need to overcome the fact that as people age, their immune system becomes less responsive. As a result, without help, they will have a lower response to a vaccine.

Scientists usually overcome this problem by adding adjuvants that kickstart and enhance the immune response. However, a potential problem is that the adjuvants overstimulate the immune system, leading to inflammation.

A new study that the University of South Florida Health (USF Health) led describes a novel therapeutic vaccine for Alzheimer’s disease, which uses the body’s own immune cells to target beta-amyloid. The study found that this approach avoided the overstimulation of the immune system that can occur due to chemical adjuvants.

The study showed effective antibody production and memory improvements in vaccinated mice, and the findings appear in the Journal of Alzheimer’s Disease.

Harnessing dendritic cells

The new vaccine uses dendritic cells, which communicate with other immune cells, such as B cells and T cells, to guide the immune response.

“This therapeutic vaccine uses the body’s own immune cells to target the toxic [beta-amyloid] molecules that accumulate harmfully in the brain,” explains the senior author of the paper, Dr. Chuanhai Cao.

The dendritic cells are loaded with a modified version of beta-amyloid so that the body can detect and destroy the real thing.

“Because we use dendritic cells to generate antibodies, this vaccine can coordinate both innate and acquired immunity to potentially overcome age-related impairments of the immune system,” adds Dr. Cao.

In the new study, the researchers tested the vaccine in mouse models of Alzheimer’s disease. The mice were genetically modified to produce high levels of beta-amyloid and show cognitive difficulties similar to those that occur in humans with Alzheimer’s disease.

Memory improvements

The team gave some of the mice the vaccine, while others received the dendritic cells only (containing no beta-amyloid).

The mice that received the vaccine produced antibodies against beta-amyloid in their brains and blood. They also showed symptom improvements — for example, in memory tests, the vaccinated mice performed similarly to healthy mice.

The vaccinated mice also showed significantly improved working memory compared with mice that received only the dendritic cells. Working memory involves holding and manipulating information for a short time, and deficits in this form of memory are a common feature of Alzheimer’s disease.

Importantly, the vaccine did not cause an inflammatory response in the mice — a major concern when developing a vaccine and the main reason why researchers had to stop using a previous vaccine.

“Inflammation is a primary symptom of Alzheimer’s disease, so any possible treatment with neural inflammation as a side effect essentially pours gas on the fire,” explains Dr. Cao.

This study found no evidence of an inflammatory reaction. There were no significant differences in the amounts of inflammatory molecules called cytokines in the vaccinated mice compared with the nonvaccinated mice.

What next?

The strength of the new vaccine lies in its specificity, says Dr. Cao. The antigen on the vaccine stimulates a very specific response from T cells, which enables the destruction of beta-amyloid but prevents activity that could cause autoimmunity. “[…] it provides strong immunomodulatory effects without inducing an unwanted, vaccine-associated autoimmune reaction in the aging mice,” he says.

Going forward, the team hopes that the vaccine could serve to stop the progression of Alzheimer’s disease in humans, although further studies will be necessary to confirm that the vaccine can produce long lasting antibodies and is safe to use in people.

It is important to note that this study used a mouse model of Alzheimer’s disease. There is a sharp fall-off in translation from animal models to human treatments from many promising preclinical studies, ranging from 0% to 100% failure.

Also, there has been some debate about the effectiveness of targeting beta-amyloid rather than either focusing on the tau protein, launching a combined attack on both proteins, or dampening the inflammation that results in cellular damage.

Beyond Alzheimer’s disease, the researchers suggest that the vaccine type could help improve the immune system of people with other age-related disorders. The vaccine may “lay the foundation for future immunotherapies for aging-related disorders,” the authors conclude.

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A study suggests an intensive exercise program boosts cognitive performance and physical fitness in United States Air Force personnel. A nutritional supplement may also have some additional benefits.

While exercise is known to improve health and cognition, combining it with a nutritional supplement that mimics a Mediterranean diet may provide further advantages.

Scientists at the University of Illinois in Urbana-Champaign, Abbott Nutrition, and the U.S. Air Force Research Lab found that volunteers who consumed the supplement before and after training sessions had an edge in some measures of fitness and cognition 3 months later.

However, intensive exercise alone improved strength and endurance more than intensive training with the supplement.

On two cognitive performance measures, both the placebo group and the supplement group showed a slight reduction in performance, while other measures improved.

“The physical and mental health benefits of exercise are well known, but this study demonstrates how optimal nutrition can help boost brain function as well,” says study leader Chris Zwilling, a postdoctoral researcher at the University of Illinois.

“We are excited by the results because they provide critical insights into how simple dietary changes can make a big difference in helping people be as efficient and productive as possible in today’s world,” he adds.

The research appears in the journal Scientific Reports.

Strength and fitness training

The scientists recruited 148 active-duty male and female Air Force personnel from Wright Patterson Air Force Base in Dayton, OH, and randomly assigned them to two groups.

Both groups underwent a 12-week exercise program involving five daily sessions of 45 minutes, including rotating sessions of high-intensity interval training, aerobic fitness, and strength training each week.

One group drank the specially formulated nutritional supplement 30 minutes before and 1 hour after each session, while the second group consumed a placebo drink that looked and tasted the same. The supplement contained 267 calories of energy, while the placebo contained 100 calories.

Neither the researchers nor the participants knew who drank the special supplement and who drank the placebo.

The high-protein supplement contained a wide range of nutrients, including:

  • lutein, a carotenoid vitamin related to beta-carotene and vitamin A found in kale, spinach, avocados, and eggs
  • omega-3 fatty acids, found in oily fish such as mackerel and sardines
  • phospholipids, an essential component of cell membranes
  • beta-hydroxy beta-methylbutyrate, a supplement that helps increase muscle mass and aids recovery after exercise
  • folic acid
  • B vitamins
  • vitamin D

Participants took a series of cognitive and physical fitness tests before and after the exercise program. The cognitive tests assessed their memory, fluid intelligence — the ability to solve novel reasoning problems, executive function, and reaction time.

The exercise-only group had positive improvements in 5 out of 6 physical fitness measures and 4 out of 8 cognitive functioning measures. The research team recorded cognitive functioning increases in:

  • short-term memory
  • episodic memory
  • executive function reaction time
  • fluid intelligence and processing efficiency

The group who also took the supplement had improvements in all six fitness measures and 6 out of 8 cognitive measures. Compared with exercise alone, taking the supplement was associated with significant additional enhancements:

  • working memory increased
  • fluid intelligence reaction time decreased
  • lean muscle mass increased
  • resting heart rate, a measure of physical fitness, decreased

However, some of the figures in the study abstract were inaccurate. The authors have provided updated figures to Medical News Today and the journal.

Furthermore, the figures in the abstract were determined using raw data, which the paper did not provide. There were also some errors in rounding. Therefore, MNT is cautious about the study’s findings while the authors and the journal update the figures.

Working memory

Matt Kuchan, a research fellow and brain health scientist at Abbott and a co-author of the study, was impressed by the improvement in working memory among participants who took the supplement.

Working memory is a finite, temporary information store that predicts an individual’s ability to multitask and is often impaired in stressful situations. For example, it allows a person to remember a telephone number long enough to dial it or write it down.

“This is a really big deal,” says Kuchan. “First, because working memory is hard to improve. And secondly, because it is relevant to everybody.”

Strangely, two measures of cognitive function were slightly worse after the intervention for both the supplement and the placebo group: short-term memory and executive function accuracy.

It could be that these small performance decreases were due to test anxiety or chance.

The investigators say they did not design the study to determine which nutrients improved physical and cognitive performance. They also remain unsure if the enhanced cognition was due to the supplement, improvements in physical fitness, or a combination of both.

The study also took just 3 months, and therefore, it is not certain that real-life health programs could maintain these enhancements.

The research team discovered a link between the supplements and improvements that could not be explained by exercise in only 5 out of the 23 analyzed measures of cognitive health.

In addition, they made no adjustments in the statistical analysis to assess many variables in a single and relatively small study.

They also believe there may have been further benefits by using whole foods to deliver the nutrients, rather than supplements.

However, this would have presented several challenges in designing the study, for example, how to deliver exact quantities of several different nutrients.

The study provides evidence that intensive cardiovascular and resistance training offer rapid improvement in fitness, and in line with previous research, is associated with improvements in some measures of cognition.

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A high fat, low carb diet reversed heart failure in a mouse model of the condition. A 24-hour fast also led to improvements, mimicking the physiological effects of the diet.

In people with heart failure, the muscle on the right or left side of the heart — or on both sides — weakens. This impairment limits the organ’s ability to pump blood around the body, causing fatigue and shortness of breath, among other symptoms.

The leading causes are high blood pressure, diabetes, and ischemic heart disease, in which the heart muscle becomes starved of oxygen.

The National Heart, Lung, and Blood Institute estimate that about 5.7 million people in the United States have heart failure.

There is currently no cure, but medications and lifestyle changes can improve people’s quality of life and increase their lifespan.

Healthy heart muscle can draw upon a variety of chemical energy sources, depending on the circumstances. One of these is a molecule called pyruvate, which the body generates during the breakdown of the sugar glucose.

However, conditions such as heart failure and diabetes reduce this flexibility, starving the muscle of the fuel it needs to function effectively.

Fuel shuttle

Researchers have now traced this loss of flexibility to a transporter protein that shuttles pyruvate into mitochondria — the so-called power stations of cells.

Known as the mitochondrial pyruvate carrier (MPC) complex, it comprises two subunits: MPC1 and MPC2.

Researchers at the Saint Louis University School of Medicine in St. Louis, MO, led a team who discovered that the production of both subunits is reduced in failing human hearts.

The researchers compared heart tissue samples from people undergoing heart surgery with tissue samples from donor hearts that were healthy but unsuitable for transplant.

They then showed that mice that lack the gene for producing MPC2 steadily develop heart failure over time. Their hearts became outsized, or hypertrophied, and the organs’ ability to pump blood diminished.

Crucially, the scientists found that they could reverse the damage to the animals’ heart muscle by simply feeding them a special diet for 3 weeks.

“Interestingly, this heart failure can be prevented or even reversed by providing a high fat, low carbohydrate ‘ketogenic’ diet,” explains Kyle S. McCommis, Ph.D., assistant professor of biochemistry and molecular biology at the university, who led the research.

“A 24-hour fast in mice, which is also ‘ketogenic,’ also provided significant improvement in heart remodeling,” he adds.

Ketogenic diet

The ketogenic diet has been growing in popularity in recent years, with research suggesting that it has a range of possible health benefits. These include supporting weight loss, improving heart health, and preventing seizures in some types of epilepsy.

By severely restricting the intake of carbohydrates, such as glucose and other sugars and starches, the diet forces the body to break down fat, producing molecules called ketones that it can use as fuel. Intermittent fasting may achieve similar effects, though adhering to the regimen can be challenging.

The new research indicates that a ketogenic diet promotes the breakdown of fatty acids in heart muscle cells. This process produces an alternative fuel called acetyl-CoA, which the mitochondria can use as an energy source instead of pyruvate.

“Thus, these studies suggest that consumption of higher fat and lower carbohydrate diets may be a nutritional therapeutic intervention to treat heart failure,” says McCommis.

The scientists showed that the diet reversed heart failure by promoting the breakdown of fatty acids in mitochondria rather than ketones. Supplying the mitochondria with extra ketones only slightly improved heart failure.

Converging evidence

The findings from this study appear in the journal Nature Metabolism.

Two studies by other research groups, which feature in the same issue, independently show that the MPC transporter protein plays a central role in heart failure.

P. Christian Schulze and Jasmine M. F. Wu, who are both cardiologists from the University Hospital Jena in Germany, have written a comment article for the journal about the three papers.

While several questions remain unanswered about the regulation of MPC levels in healthy and failing hearts, they conclude:

“The current findings suggest a role for specific ketogenic diets as a supportive, nonpharmacologic treatment in people with heart failure.”

The cardiologists speculate that the findings could also inspire the development of new drugs for heart failure that work by boosting the breakdown of fatty acids in heart muscle cells.

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Over the years, scientists have demonstrated an association between red and processed meats and cancer. However, they are still unpicking the mechanisms that drive this relationship.

The authors of a recent study, which appears in BMC Medicine, argue that at least part of the answer might lie in an immune interaction.

Nutrition and dietary habits play pivotal roles in a wide range of health conditions, including type 2 diabetes, obesity, cancer, hypertension, and cardiovascular disease.

Red meats and processed meats have each received a fair amount of attention in this regard. Both have been implicated in cancer risk, but how they exert their influence is up for debate. As the authors of the latest study explain:

“Although various mechanistic explanations have been proposed, [such as a] high energy/fat diet, N-nitroso, nitrates, nitrites, heme iron, [and] compounds produced by gut microbiome or during cooking, none seems to be specific to red meat or dairy.”

A role for antibodies?

The authors point to tentative evidence that N-glycolylneuraminic acid (Neu5Gc) might be a risk factor for colorectal cancer.

Neu5Gc is a carbohydrate, or sugar, present in foods derived from mammals, and it is abundant in red meat and dairy. It occurs at low levels in some fish but is absent from poultry.

Humans cannot synthesize Neu5Gc, but when we consume it, small amounts accumulate on cell surfaces. When immune cells encounter this nonhuman material, it triggers the production of anti-Neu5Gc antibodies. Studies have shown that humans have a wide range of these antibodies.

Scientists have also found evidence that long-term exposure to these antibodies promotes inflammation and cancer in animal models. However, they have yet to identify any clear effect of eating mammalian products on levels of these antibodies.

As these anti-Neu5Gc antibodies travel around the body, they bump into Neu5Gc on cell surfaces, sparking inflammation. Experts believe that this, in turn, exacerbates cancer, because cancer cells tend to have higher levels of Neu5Gc on their surfaces.

In one study, researchers demonstrated an association between levels of circulating Neu5Gc antibodies and colorectal cancer risk. However, the level of antibodies was not associated with red meat intake.

Now, the latest study has set out to unpick the relationship between a person’s diet and their levels of Neu5Gc once and for all.

Diet and Neu5Gc

In the study, a group of scientists — most from Tel Aviv University, in Israel, or the Sorbonne Paris Cité Epidemiology and Statistics Research Center, in Bobigny, France — took data from the NutriNet-Santé survey. This extensive survey conducted in France aims to investigate the complex relationships between nutrition and health.

The authors of the present study took data from 16,149 adults, all of whom had registered a minimum of six dietary records.

Meanwhile, the researchers calculated the amount of Neu5Gc in a wide range of common foods. Using this data, they constructed what they refer to as the “Gcemic index,” which ranks food according to levels of Neu5Gc —specifically, the Neu5Gc content in each food relative to the amount measured in beef.

Next, the researchers analyzed blood samples from 120 participants with at least eighteen 24-hour dietary records; they noted the levels of anti-Neu5Gc antibodies in the serum.

“We found a significant correlation between high consumption of Neu5Gc from red meat and cheeses and increased development of those antibodies that heighten the risk of cancer,” explains corresponding author Dr. Veder Padler-Karavani, of Tel Aviv University.

“For years, there have been efforts to find such a connection, but no one did. Here, for the first time, we were able to find a molecular link thanks to the accuracy of the methods used to measure the antibodies in the blood and the detailed data from the French diet questionnaires.”

Now, combining earlier knowledge and the data provided by the new study, the theory becomes more solid: Consuming mammal products, such as red meat and dairy increases the amount of Neu5Gc on cell surfaces. In turn, this increases the level of circulating anti-Neu5Gc antibodies.

With an increase in these antibodies comes an increase in inflammation, which might raise the risk of exacerbating certain medical conditions, such as cancer.

It is worth noting that the immune response described above is unlikely to be the only link between red meat and cancer.

The authors also mention other factors, including the high fat content in meat and mutagens — chemical compounds that cause irreversible changes in cellular genetic material — such as heterocyclic amine, which is produced when meat is cooked at high temperatures.

In the future, the researchers hope that their Gcemic index will become a tool to assess the amount of Neu5Gc in a person’s diet. This might help design personalized recommendations for at-risk individuals.

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A study finds sleep deprivation makes unwelcome thoughts occur more frequently and makes them harder to manage.

It’s not uncommon for unwelcome thoughts to cross a person’s mind now and again.

According to psychologist Marcus Harrington of the Department of Psychology at the University of York in the United Kingdom, “For most people, thought intrusions pass quickly, but for those [who are experiencing] psychiatric conditions, such as post-traumatic stress disorder (PTSD), they can be repetitive, uncontrollable, and distressing.”

Harrington is the lead author of a new study investigating the effect of sleep deprivation on unwanted thoughts.

The study finds that sleep deprivation increases the frequency of unwanted thoughts and lessens an individual’s ability to control them.

Funded by the Medical Research Council, the research appears in Clinical Psychological Science.

Unwanted thoughts

“In everyday life,” says Harrington, “mundane encounters can remind us of unpleasant experiences. For example, a car driving too fast on the motorway might cause us to retrieve unwanted memories from a car accident many years ago.”

However, for people with some psychiatric disorders, unwelcome thoughts can be a frequent, persistent, and often emotionally destructive intrusion.

“It is clear,” says Harrington, “that the ability to suppress unwanted thoughts varies dramatically between individuals, but, until now, the factors that drive this variability have been mysterious. Our study suggests sleep loss has a considerable impact on our ability to keep unwanted thoughts out of our minds.”

A lack of sleep and the resulting inability to manage unwelcome thoughts may also be self-perpetuating.

“The study also suggests that the onset of intrusive thoughts and emotional disturbances following bouts of poor sleep could create a vicious cycle, whereby upsetting intrusions and emotional distress exacerbate sleep problems, inhibiting the sleep needed to support recovery.” – Senior author Dr. Scott Cairney

The study

The researchers recruited 60 healthy individuals with an average age of 20 to participate in the study. The researchers randomly assigned them to a sleep group or a sleep-deprivation group. There were 30 participants in the sleep deprivation group and 29 in the sleep group because the researchers disqualified one participant.

The participants had to forego naps, caffeine, and alcohol on test days.

The researchers trained each person to associate face photos with either negative or neutral images from the International Affective Picture System. The participants also learned suppression techniques to help them overcome unpleasant memories. After their training, they went to sleep for the night.

The following day, participants were shown faces and asked to try and suppress the associations the faces provoked.

People who had sufficient sleep could successfully suppress unwelcome thoughts and reported that doing so became easier over time.

The participants also reported a reduction in their emotional response to negative images. Researchers supported this with observations of a reduction in their sweat response as they viewed the images.

Individuals from the sleep-deprivation group reported having a difficult time suppressing their thoughts. They also reported that experiencing and then managing intrusive thoughts remained a challenge throughout the study.

Participants who were sleep-deprived reported a 50% increase in unwanted thoughts compared with those who were well-rested.

The authors write:

“Even after sleep-deprived participants initially gained control over unwanted memories and prevented them from intruding, they were consistently more susceptible to relapses when reminders were confronted again later compared with rested individuals.”

The study mentions a caveat. Since scientists know that sleep helps solidify pre-bedtime memorization, perhaps those deprived of sleep could not utilize the memory suppression techniques they learned the night before as the sleep group could.

Says Cairney:

“This study offers an important insight into the impact of sleep on mental health. Besides post-traumatic stress disorder and depression, our findings might have implications for our understanding of other disorders linked to sleep disturbances, such as obsessive-compulsive disorder and schizophrenia.”

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Red-gloved hands gently dip cotton swabs down nostrils and mouths of people taking turns to stand in front of a tall booth, masks lowered and head tilted backwards. Inside the booth to which the gloves are attached is a COVID-19 sample collector.

Set up by Nigerian health investment firm Flying Doctors in eight of the country’s worst-affected states, the mobile booths, which separate the sample collector from the people being tested, have boosted COVID-19 testing. Between 80 and 100 samples are collected per booth every day, although the number varies among states. Nigeria is conducting an average of 2500-3000 tests daily.

Flying Doctors founder, Dr Ola Brown, explains that at the start of the pandemic, Nigeria had few people trained to take COVID-19 test samples, and collectors would also visit people at homes to take samples, heightening infections risks through exposure.

“It [the sample collection booth] reduces to zero the number of infections on the people conducting the tests. Secondly, it also saves a lot of time compared [with] the people testing having to go to people’s houses to do the tests and thirdly, it saves money because people [are] not having to change their PPE [personal protective equipment]” frequently, says Dr Brown.

For Dr Walter Kazadi, World Health Organization (WHO) representative in Nigeria, “expanding access to services such as sample collection and diagnostic testing are critical for an effective response.” WHO continues to support Nigeria’s Centre for Disease Control and the national response system by providing resources for training and supplies for sample collection and testing.

The COVID-19 response across African has propelled a raft of innovations. Across the continent, innovators have worked to create tools to help public health experts manage challenges ranging from contact tracing and clinical care to local production of equipment and supplies as well as laboratory and testing materials.

Many of the innovations were already existing but have had to be redirected or adapted to COVID-19 response. For example, Zipline, a California-based firm, repurposed its high-speed drones that were in use in both Ghana and Rwanda to deliver medical packages to clinics and hospitals to now identify COVID-19 hotspots and collect samples. In anticipation of new treatments and vaccines that may become available, the company is poised to help with distribution.

In Kenya, to support contact tracing in public transport, a mobile phone-based application, mSafari, was launched in March by its developers in collaboration with the ministries of Health and Transport.

Most of the innovations are homegrown. The mobile booths in Nigeria are made locally. In all there are 14 booths in Abuja, Kano, Kaduna, Lagos, Ogun, Oyo, Rivers and Zamfara states. Flying Doctors also has transformed one vehicle into a mobile laboratory. In total, the organization has three laboratories. It has trained more than 100 molecular laboratory scientists to carry out COVID-19 testing.

Working with various foundations, the organization has made its testing free to encourage people to turn up. COVID-19 testing in Africa still lags other regions of the world. The World Health Organization Regional Office for Africa recommends 10 tests per 10 000 people per week in the region. Just 12 countries recently surpassed the threshold.

While Africa has recorded relatively fewer COVID-19 infections compared with other regions, the decline in cases seen between July and September has plateaued, with spikes in cases reported in some countries. Dr Brown stressed the criticality of testing and maintenance of vigilance on COVID-19.

“I think [that] one of the things that has really impacted the focus on testing is the fact that not many people have died in Africa compared [with] Europe or America. When people aren’t dying and when people aren’t getting horrifically sick and we’re not seeing those numbers of course it [testing] gets deprioritized especially in a country that has limited resources,” she says.

“It’s important for everybody to remain vigilant … and continue to really keep our guard up.”

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Maiduguri, 30 October, 2020 – The 9th Joint Operations Review of WHO health emergency operations in the north-east Nigeria has resolved to maintain the grading of the humanitarian health emergency declared in 2016. WHO graded the emergency at grade 3 owing to its severity and impact on public health which significantly reduces access to basic health services and renders the population vulnerable to disease outbreaks, malnutrition, injuries and mental health.

The resolution to maintain the grading came out of a three-day Joint Operations Review of WHO’s health emergency response programmes in the north-east Nigeria conducted from the 26th – 28th October, 2020 in Maidguri, Borno State. The review concluded that risks for negative impact on health remained very high and have been further compounded by the country-wide ongoing COVID-19 outbreak. The capacity of the State Governments and supporting partners to mitigate the risks or respond to the health emergencies has been affected by recent reduction in national and foreign assistance funding.

At the 3-day review, WHO Nigeria Representative, Nigeria, Dr Walter Kazadi Mulombo reaffirmed WHO’s commitment to continue providing the urgently needed leadership and coordination of the health sector partners to provide healthcare services to the populations in need of healthcare services across Borno, Adamawa and Yobe states.

“The operational environment in the BAY states is characterized by rising insecurity, driving waves of new displacements, deepening food insecurity and malnutrition, a situation that is compounded by the COVID-19 pandemic and therefore obligates WHO to maintain the current grade 3 health emergency in order to sustain its current level of operations in the region,” says Dr Mulombo.

Health emergency expert at WHO headquarters, Dr Jorge Castilla explained that the protracted nature of the crisis in the north-east Nigeria and continued attacks on healthcare facilities and workers continue to decrease access to healthcare service. “The eleven-year old insurgency in north-east Nigeria has resulted in deterioration of healthcare services, malnutrition and reduced coping mechanism for even populations in relatively more secure locations.”

Speaking at a meeting with the WHO Country Representative, His Excellency, the Executive Governor of Borno State, Professor Umara Zulum, reaffirmed the State’s confidence in the work of WHO in the State. “I am confident that WHO would help the State to mobilize all health sector partners to support the provision of healthcare services in line with the State’s plans that include resettlement of internally displaced persons back to their original homes or alternative safe locations.”

The Joint Operational Review is an internal bi-annual exercise of WHO to review the organization’s health emergency programme in the north-east Nigeria with a view to improving current standards and developing the roadmap for future interventions. The 9th review was attended by WHO emergency experts from the headquarters, WHO African regional office, WHO Nigeria and health emergency experts in north-east Nigeria, officials of Borno, Adamawa and Yobe states, the Federal Ministry of Health, Nigeria Centre for Disease Control, humanitarian donors including EU, GIZ, Department for Commonwealth Office formerly DFID, JICA and Dangote Foundation and other implementing partners (FHI 360 and Terres des Hommes).

Techincal Contacts:

Dr Rex Mpazanje; Email:mpazanjer [at] who.int; Tel: +234 803 960 0874

Dr Chima Onuekwe; Email: onuekwec [at] who.int; Tel: +234 803 777 1775

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A new study using a global online survey demonstrates that COVID-19 stay-at-home orders resulted in a dramatic increase in unhealthful lifestyle changes.

According to the study — which appeared in the journal Obesity — there were significant increases in sedentary leisure behaviors, declines in physical activity, and increases in anxiety and weight gain, especially in people with obesity.

On the upside, lockdown resulted in substantial improvements in healthful eating.

Since the first reported case of COVID-19 in Wuhan, China, SARS-CoV-2 has spread rapidly worldwide, posing a grave health threat.

On March 11, 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic, with the United States announcing a national emergency on March 13.

The impact of stay-at-home orders

The U.S. implemented different strategies to limit person-to-person contact in order to mitigate the spread of the virus. Although stay-at-home, quarantine, and social distancing measures diminish transmission of SARS-CoV-2, other health ramifications of these actions are not entirely understood.

The abrupt closures of fitness clubs, restaurants, and places of employment alter eating and physical activity habits. The fear of developing COVID-19, in addition to stay-at-home orders, may provoke added feelings of loneliness and isolation, further exacerbating stress and anxiety.

Stress during a pandemic may result in:

  • anxiety and fear about health, loss of support services, finances, or unemployment
  • sleep disruption or altered sleeping patterns
  • changed eating habits
  • trouble concentrating
  • worsening of chronic health problems, including mental health conditions
  • increased use of alcohol, tobacco, and other substances

Stress associated with altered sleeping patterns, more frequent snacking, and consuming sweet foods may also lead to weight gain.

Researchers at Louisiana State University’s (LSU’s) Pennington Biomedical Research Center designed an innovative online global survey study to quantify changes in physical activity, sedentary behaviors, sleep, mental health, and dietary habits in adults aged 18 and older before and during the initial phase of the COVID-19 lockdown.

The anonymous online survey, accessed through Facebook, the research center’s web page, and an email listserv, ran from April 3, 2020, to May 3, 2020. More than 12,000 individuals looked at the survey, with a total of 7,753 surveys included for analysis.

About 95% of the participants resided in the U.S., United Kingdom, Australia, and Canada. The participants were predominantly white, female, and living in a two-person household, with an average age of 51.

Approximately 32% of the participants had overweight, 34% had obesity, and 32% had a healthy weight. The results of the online survey demonstrated substantial lifestyle changes during the pandemic.

Significant lifestyle behavior changes

Eating out four or more times per week declined by 10%, whereas cooking at home six or more times per week increased by 26% during the pandemic. The validated questionnaire also indicated significant increases in overall healthful eating.

About 44% of the participants reported an increase in unhealthful snacking, while approximately 26% reported increased healthful snacking. The study reported that 36% of the individuals perceived declines in healthful eating, and 21% perceived increases.

A perceived increase in unhealthful eating accompanied trouble falling asleep, decreased physical activity, increased sedentary habits, and nearly twice the reported anxiety levels than in those eating more heathfully.

Sedentary leisure activities increased by 21 minutes on weekdays and 17 minutes on weekends. Physical activity significantly decreased by 18 minutes per week and declined by 112 minutes per week in terms of metabolic equivalents after adjusting for exercise intensity.

The results also showed that sleep onset and wake time increased substantially by 42 minutes and 59 minutes, respectively. Additionally, about 44% of the participants reported worse sleep quality, while 10% experienced improved sleep quality.

As many as 75% of the participants reported being concerned or moderately concerned for their health or their family members’ health (87.5%) due to COVID-19. Reported symptomatic anxiety also significantly increased — by 14% — compared with before the pandemic.

The study results demonstrated incredibly disproportionate changes in health behaviors in individuals with obesity that stemmed from COVID-19 stay-at-home orders.

“Overall, people with obesity improved their diets the most. But they also experienced the sharpest declines in mental health and the highest incidence of weight gain,” says Dr. Leanne Redman, associate executive director for Scientific Education at Pennington Biomedical Research Center.

A total of 24% of the participants with obesity reported symptomatic anxiety compared with 17% for both the individuals with a healthy weight and those with overweight. However, symptomatic anxiety was similar among all three groups before the pandemic.

During lockdown, weight gain occurred in 33% of the individuals with obesity compared with 25% of the participants with a healthy weight and 21% of those with overweight.

Even though the participants with obesity had a lower baseline physical activity than the participants with a healthy weight and the participants with overweight, the change in physical activity was the same across the three groups. The individuals with obesity also had greater sleep onset increases than the people in other two groups, but wake time remained the same.

The self-reported survey study design was a significant limitation due to the possible introduction of recall bias. Another drawback of the study was the lack of diversity of the study population, which primarily comprised older white adult women from similar geographic locations.

Understanding the impact

According to Dr. John Kirwan, executive director of LSU’s Pennington Biomedical Research Center:

“This study is the first to survey thousands of people across the globe on lifestyle behavior changes in response to stay-at-home orders. […] The study demonstrates that chronic diseases like obesity affect our health beyond the physical.”

“Dr. Redman’s study is just one of many initiatives the center launched to help understand COVID-19’s impact and to slow its spread,” he adds.

The lead author of the study, Dr. Emily Flanagan, also notes that the research team would like physicians and scientists to change how they manage patients with obesity by:

  • making mental health screenings more frequent during and following the pandemic
  • staying in contact with patients and study participants, respectively, with the help of remote visits and telehealth to prevent irreversible changes to health that the pandemic may cause

She also suggests that so-called virtual visits could alleviate the concerns patients may have about the safety of traditional, face-to-face visits.

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