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Friday, May 3, 2024
mental health

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In today’s turbulent political climate, hostility is becoming an increasingly familiar part of everyday life. This negative environment not only makes it uncomfortable to socialize, but prolonged, cynical hostility may pose a serious health issue.

According to a Baylor University-led study that appeared in the September 2020 issue of Psychophysiology, cynical hostility may cause an increased risk of developing cardiovascular disease.

The findings resulted from data collected from 196 participants in a stress test conducted by the Laboratory for the Study of Stress, Immunity, and Disease at Carnegie Mellon University in Pittsburgh, PA.

Participants took part in two lab sessions, 7 weeks apart. Sessions consisted of establishing a 20-minute baseline and a 15-minute psychological stress test.

Researchers recorded each person’s heart rate and blood pressure, and the participants completed a standard psychological scale to determine their personality and temperament.

The sessions involved placing participants in reasonably stressful situations, for example, asking them to take 5 minutes to prepare and then deliver a speech defending themselves from traffic violations or shoplifting accusations. All participants knew that the researchers would record and evaluate them.

As Alexandra T. Tyra, a doctoral candidate in psychology and neuroscience and the lead study author, explains, “These methods of social and self-evaluation are designed to increase the experience of stress and have been validated in prior research.”

Tyra’s team looked at three types of hostility: cognitive, which includes cynical hostility; emotional hostility, which links to chronic anger; and behavioral hostility, which involves verbal and physical aggression.

The researchers found that stress responses had no relationship to emotional or behavioral hostility.

“This does not imply that emotional and behavioral hostility are not bad for you,” says Tyra, “just that they may affect your health or well-being in other ways.”

The prolonged harm of cynical hostility

Cognitive hostility’s impact on the cardiovascular system ultimately comes down to how a person deals with repeated exposure to stress triggers.

Tyra explains how a typical reaction to repeated stress normally plays out, “When you’re exposed to the same thing multiple times, the novelty of that situation wears off, and you don’t have as big of a response as you did the first time.” This is a healthy reaction to stress.

With cynical hostility, a person continues to react to stressful circumstances with a similar intensity level, no matter how much exposure they have to similarly stressful situations.

Consistent arousal of this nature causes a strain on the cardiovascular system over time.

The Baylor University study represents the latest of its kind linking cynicism with adverse health problems. A 2014 study appearing in Neurology found that those with higher levels of cynical distrust in later life might be more likely to develop dementia.

The study author, Anna-Maija Tolppanen, Ph.D., of the University of Eastern Finland in Kuopio, believed her team’s findings showed a person’s “view on life and personality may have an impact on their health.”

Although it is more common to probe the harm caused by cynicism and negative thinking, some researchers try to find a positive outcome for less positive mindsets.

One such study looked at pessimism in particular. The research suggested “defensive pessimism” might be useful for developing actionable strategies in the face of the worst possible outcome.

Still, research has repeatedly linked suspicious thoughts and a hostile disposition with poor health.

Timely findings

Following the study, the Baylor University team believes the outcome of its research is very timely. It comes near the end of a year of extremes, dominated end-to-end by intense political debates and social commentary.

Some might find it natural to approach each adverse circumstance with excessive cynical hostility. However, these harsh stances might not be worth the added risk to a person’s cardiovascular health. With this in mind, the study authors offer a word of caution:

“Perhaps the next time someone thinks a negative thought about the motives, intentions or trustworthiness of their best friend, a co-worker or even a politician, they will think twice about actively engaging with that thought.”

Even as they weigh the immediate implications of their research, the study team hopes that future research will give more insight into how cynical hostility affects one’s health across an entire life span. What can we learn from following more cynically hostile test participants as they age?

For now, a crucial takeaway of this study, especially in such a tense political climate, is to keep an open mind and a cool head.

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A new survey identifies one LGB+ group that is more likely to start smoking cigarettes after coming out.

Previous research suggests that LGB+ individuals are more likely to smoke cigarettes. However, a new study from the School of Public Health at Boston University (BU), MA, looks more closely at sexual identity and smoking.

The research finds that the association applies only to bisexual people, primarily during the first 3 years after coming out.

People coming out as bisexual are twice as likely to start smoking after coming out when compared to heterosexual, lesbian, gay, or other non-heterosexual people.

According to Andrew Stokes, the study’s corresponding author, the new research “highlights the importance of moving beyond static measures of sexual identity towards more dynamic measures that capture critical periods of vulnerability.”

This shift in the researchers’ perspectives, says lead author and doctoral candidate Alyssa Harlow, “turned out to be really important because it revealed disparities that would have otherwise been missed if we measured identity at one time point, or grouped all LGB+ identities together.”

The research appears in the journal JAMA Pediatrics. Stokes and Harlow were joined in the study by BU’s Dielle Lundberg, Julia Raifman, Carl Streed, and Emelia Benjamin, as well as Andy S.L. Tan of the University of Pennsylvania in Philadelphia.

Three interviews, 3 years

The researchers followed 7,843 young people and young adults over 3 years by analyzing data from the nationwide Population Assessment of Tobacco and Health (PATH) study. The group, whose ages ranged between 14–29 years, was interviewed three times between 2013–2018.

“The PATH study is unique because it asks youth about their sexual orientation and gender identity. Most national surveys do not,” says Lundberg.

The researchers adjusted for a variety of factors, including individuals’ sex, age, education level for those over 18, their parents’ level of education, race, ethnicity, and where they lived.

One limitation of the study is that there were not enough transgender participants in the original survey to consider the group sufficiently represented, so the new research applies only to LGB+ individuals.

By the final round of interviews, 14% of the PATH participants reported having smoked cigarettes, while 6% were current smokers.

While initial analysis of the entire LGB+ group supports the doubled likelihood of being a smoker, breaking down the data by sexual identity revealed that it applied only to bisexual individuals. This association applied equally to those who had once smoked and to those who still did.

Individuals who had maintained the same LGB+ status throughout the 3 years were no more likely to smoke than people with a constant heterosexual identification.

The bisexual individuals who had just come out — moving from one identity to another during the 3-year survey period — were found to be the only group that was twice as likely to start smoking.

Being bisexual is unique in the LGBTQ+ community

“The findings point to a need for public health interventions specifically designed to address the unique needs, experiences, and stressors associated with coming out and identifying as bisexual,” according to Harlow, who notes that bisexual people “may experience stigma from heterosexual individuals as well as from within the LGB+ community.”

Harlow adds, “There’s also prior research showing that bisexual populations have worse mental health outcomes than LG+ populations.”

Providing much-needed support

To better address the needs of bisexual and LGBTQ+ individuals, people who are disproportionately affected by mental health and substance use issues, the authors say a more fine-grained approach to health surveys is necessary:

“We must advocate for better data. Whenever national surveys fail to ask about sexual orientation and gender identity, they are directly contributing to health inequities for LGBTQ+ populations.”

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New research has found that short bursts of exercise may significantly improve levels of metabolites that are indicators of key physical health issues.

The research, published in the journal Circulation, offers scientists a better understanding of the beneficial effects exercise can have on a person’s health.

Health and physical activity

Scientists have known for a long time that there is a link between physical activity and better health. As the Centers for Disease Control and Prevention (CDC) say, “Regular physical activity is one of the most important things you can do for your health.”

The CDC note that regular exercise can improve a person’s brain health; help them better manage their weight; reduce their chances of developing various diseases, including diabetes, some cancers, and cardiovascular disease; strengthen their muscles and bones; and improve mental health.

While scientists are well aware of these links, they do not fully understand the precise molecular mechanisms that help explain the link between being physically active and maintaining better health.

Metabolites

In this context, the researchers wanted to look at the association between metabolites that are indicators of health and exercise.

A person’s metabolism describes the chemical reactions that take place in their body. Metabolites either facilitate these reactions or are the end result of them. Scientists have identified relationships between exercise and certain changes in metabolites.

Dr. Gregory Lewis, section head of Heart Failure at Massachusetts General Hospital (MGH) and senior author of the study, says, “Much is known about the effects of exercise on cardiac, vascular, and inflammatory systems of the body, but our study provides a comprehensive look at the metabolic impact of exercise by linking specific metabolic pathways to exercise response variables and long-term health outcomes.”

He continues:

“What was striking to us was the effects a brief bout of exercise can have on the circulating levels of metabolites that govern such key bodily functions as insulin resistance, oxidative stress, vascular reactivity, inflammation, and longevity.”

Burst of exercise

The researchers made use of the Framingham Heart Study (FHS), a long-term study directed by the National Heart, Lung, and Blood Institute.

The researchers measured 588 metabolites in 411 middle-aged people before and immediately after 12 minutes of physical activity on an exercise bike. This allowed them to see the effect that exercise has on the metabolome.

In general, the researchers found that the short burst of exercise significantly altered 80% of a participant’s metabolites. In particular, they found that metabolites associated with adverse health outcomes when resting were reduced.

For example, high levels of glutamate have been linked to diabetes, heart disease, and hypertension, and the researchers found that these levels fell by 29% following exercise. The levels of dimethylguanidine valerate (DMGV), which are associated with liver disease and diabetes, fell by 18% following exercise.

Marker of fitness?

The researchers note that their findings may be valuable in helping doctors determine a person’s fitness levels.

Dr. Matthew Nayor, a cardiologist in the Heart Failure and Transplantation section of the MGH Cardiology Division, explains, “Intriguingly, our study found that different metabolites tracked with different physiologic responses to exercise, and might therefore provide unique signatures in the bloodstream that reveal if a person is physically fit, much the way current blood tests determine how well the kidney and liver are functioning.”

He adds, “Lower levels of DMGV, for example, could signify higher levels of fitness.”

By combining the information they gained from this analysis with blood samples taken during previous rounds of the FHS, the researchers were also able to determine the longer-term effects of exercise on a person’s metabolome.

Dr. Ravi Shah of the Heart Failure and Transplantation section of the MGH Cardiology Division notes, “We’re starting to better understand the molecular underpinnings of how exercise affects the body and use that knowledge to understand the metabolic architecture around exercise response patterns.”

He adds, “This approach has the potential to target people who have high blood pressure or many other metabolic risk factors in response to exercise, and set them on a healthier trajectory early in their lives.”

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Individuals infected with coronavirus are unlikely to catch the illness again for at least six months, researchers at the University of Oxford said Friday.

The finding comes as part of a large-scale study into Covid-19 reinfection after observations from healthcare professionals that the phenomenon was relatively rare.

Oxford University Professor David Eyre, one of the authors of the study, said the findings were “really good news”.

“We can be confident that, at least in the short term, most people who get Covid-19 won’t get it again,” he said.

The authors highlighted they had not yet gathered enough data to make a judgement on reinfection after six months.

However, the ongoing study has an end goal of verifying how long protection from reinfection lasts in total.

The director of infection prevention and control at study partners Oxford University Hospitals (OUH), Katie Jeffery, called the finding “exciting”.

It indicated “that infection with the virus provides at least short-term protection from re-infection”, she added.

US biotech firm Moderna announced this week its vaccine candidate was nearly 95 percent effective in a trial — a week after similar results were announced by pharma giant Pfizer and its German partner BioNTech.

The Oxford study into reinfection drew on data from regular coronavirus testing of 12,180 health care workers at OUH over a period of 30 weeks.

It found that none of the 1,246 staff with coronavirus antibodies developed a symptomatic infection.

Three members of staff with antibodies did test positive for the virus that causes Covid-19 but were all well and did not develop symptoms.

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Scientists discover that a drug used to treat arthritis shows promising initial results for treating COVID-19 in older adults.

An international team of scientists has found that the arthritis drug baricitinib shows promise for increasing the survival of older adults with COVID-19.

The new research, appearing in the journal Science Advances, lays the groundwork for larger, randomized controlled trials to confirm the initial findings.

Repurposed drugs

Alongside developing an effective and safe vaccine for SARS-CoV-2, scientists are also identifying potential treatments that may help increase the survival chances of people who develop COVID-19.

To do this quickly, scientists have turned to previously available drugs, looking to repurpose them as COVID-19 treatments. Since these medicines already have approval for use, many of the safety tests involved in the development of a novel drug are not required.

However, this is still no small task. There are thousands of potential drugs to search through when identifying those that may be worth testing.

To speed up the process, scientists used artificial intelligence (AI) systems that can rapidly analyze these medicines and determine if they could be effective COVID-19 treatments.

One such drug that artificial intelligence software identified in February 2020 was baricitinib, a medication for adult rheumatoid arthritis.

The software identified this drug because it had two potential mechanisms of action. The first might reduce inflammation, while the second might make it more difficult for the virus to access a person’s cells.

Since these initial findings, baricitinib has been used in clinical settings to treat COVID-19. The scientists behind the present study drew on this initial clinical data and conducted laboratory tests to determine how effective the drug may be as a treatment.

Increased survival

The scientists looked at 83 patients from the University of Pisa, Italy, and the Albacete Hospital, Spain. The participants had an average age of 81 years, with moderate to severe COVID-19, and were given baricitinib as treatment. The research team compared this group to a control group of patients from Italy and Spain, who did not take the drug.

The scientists found that the group who received baricitinib was less likely to need mechanical ventilation, while the patients were less likely to die compared with the control group.

Specifically, 34.9% of the control group either died or needed mechanical ventilation, compared with 16.9% of the patients treated with baricitinib.

Two mechanisms of action

To better understand how baricitinib may causing this beneficial effect, the scientists studied its impact on miniature human organs grown in a laboratory.

This confirmed the initial findings of the AI software: that baricitinib reduces inflammation and makes it more difficult for the virus to access a person’s cells.

A leading cause of death for people with COVID-19 has been acute respiratory distress syndrome. This occurs when a person’s inflammatory response to SARS-CoV-2 goes out of control, damaging respiratory system cells and potentially affecting many other organs in their body.

The scientists found that this inflammatory response can also make it easier for the virus to enter a person’s cells as it replicates itself within their body.

Baricitinib seems to work by reducing both of these reactions, significantly increasing the chances of survival.

According to the study’s co-lead author Prof. Volker Lauschke, associate professor in Personalized Medicine and Drug Development at the Karolinska Institutet in Stockholm, Sweden, “[t]his study confirms what AI predicted, and what we were hearing from patient case reports.”

“For instance, one case involved an 87-year-old severely unwell patient from Foggia, Italy, who showed rapid improvement after being given the drug, whereas her husband and son, who did not receive baricitinib, died.”

“This study has also shone a light on exactly how this drug may protect us at the cellular level. This helps us understand why other types of drugs are proving beneficial, or not beneficial, as we help identify other treatments which may tackle COVID-19.” – Prof. Volker Lauschke

The next step is to confirm the initial findings in larger, randomized controlled trials, which are already proceeding.

For Prof. Justin Stebbing, of the Department of Surgery and Cancer at Imperial College London, United Kingdom, and study co-lead author, “[w]e have seen the top-line results of a randomized study called the Adaptive Covid Treatment Trial-2 announced recently, showing benefits of baricitinib plus remdesivir, compared to remdesivir alone in over 1,000 patients.”

“Other very large trials occurring now include COV-BARRIER, and this will help create a fuller picture of the benefits and side effects of the oral medication (a small number of the patients in our study needed to stop the treatment due to problems with liver function).

“Further trials comparing baricitinib to other drugs in COVID-19 patients would also be helpful in improving outcomes.”

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A clinical trial has found that a monoclonal antibody reduces low-density lipoprotein (LDL) cholesterol levels by 50% in people with an inherited condition called familial hypercholesterolemia.

Individuals with high levels of low-density lipoprotein (LDL) or “bad” cholesterol in their blood are at increased risk of developing atherosclerosis (narrowed arteries) and cardiovascular disease.

Doctors define severe hypercholesterolemia as untreated LDL cholesterol levels of at least 190 milligrams per deciliter (mg/dl) of blood.

Cardiologists in the U.S. recommend that individuals who are at very high risk of cardiovascular disease due atherosclerosis aim for an LDL cholesterol level of around 70 mg/dl of blood.

Lifestyle changes can help reduce LDL, but people usually need to take cholesterol-lowering drugs to reach this goal. In addition, certain genetic differences can make achieving this objective more difficult for some people.

Worldwide, approximately 1 in 250 adults have an inherited condition called heterozygous familial hypercholesterolemia. This usually results from mutations in a gene for a receptor that removes LDL from the bloodstream.

Doctors usually prescribe a standard “triple therapy” of three types of cholesterol-lowering drugs for hypercholesterolemia:

  • A high dose of a statin, which reduces the amount of cholesterol the body produces.
  • A PCSK9 inhibitor, which boosts the number of LDL receptors in the liver.
  • Ezetimibe, which limits the absorption of cholesterol from the intestine.

For individuals whose LDL cholesterol level remains too high despite taking the maximum tolerable dose of this drug combination, a new drug called evinacumab that acts on a different target may soon be available.

A clinical trial published in The New England Journal of Medicine suggests that evinacumab could further reduce LDL levels in these individuals by around 50%.

This would be good news for people with mutations in the gene for the LDL receptor who don’t respond particularly well to PCSK9 inhibitors.

“There’s an unmet need for agents that address refractory hypercholesterolemia through a pathway that’s independent of the LDL receptor,” explains principal investigator Robert Rosenson, MD, Director of Cardiometabolic Disorders at the Icahn School of Medicine at Mount Sinai in New York, N.Y.

“If approved by the U.S. Food and Drug Administration, evinacumab may potentially fill that clinical gap for patients by reducing severely elevated LDL cholesterol,” he adds.

Breaking down lipids

Evinacumab is a monoclonal antibody that targets a protein called angiopoietin-like 3 (ANGPTL3). Normally, ANGPTL3 inhibits enzymes that break down lipids, including LDL, high-density lipoprotein (HDL), and triglycerides.

People with a faulty version of the gene that makes ANGPTL3 have abnormally low levels of these lipids in their blood. As a result, their chance of developing coronary artery disease is 41% lower than the general population.

By disabling ANGPTL3 with an antibody, drug developers hoped to recreate these beneficial effects in people with very high cholesterol levels.

In this phase II clinical trial, the researchers randomly assigned 272 people to receive either evinacumab — through intravenous or subcutaneous administration at various doses — or placebo treatments.

Most of the participants had heterozygous familial hypercholesterolemia.

After 16 weeks, LDL cholesterol had fallen by an average of 56% compared with placebo in those who received a subcutaneous dose of 450 mg of evinacumab weekly.

Among those who received a monthly intravenous injection of 15 mg evinacumab per kilogram of body weight, LDL cholesterol fell by 50.5% compared with the placebo group.

The authors note that some people prefer subcutaneous administration because they can do it themselves at home, avoiding the need to take time off work to visit a clinic.

Commenting on the findings, Dr. Rosenson concludes:

“Our study demonstrates that a regimen of either subcutaneous or intravenous evinacumab can have a significant impact on LDL cholesterol […] If approved for use in this setting, evinacumab could potentially arm cardiologists with a major new add-on therapy to bring patients with [heterozygous familial hypercholesterolemia] to or closer to their cholesterol-lowering goal.”

Racial diversity

The authors concede that their study had some limitations. For example, the numbers in each arm of the study were relatively small, and treatment lasted only 16 weeks.

In addition, the racial diversity of participants was not as broad as the researchers had hoped, so the results may not apply to all people in the wider population.

One of the people treated with subcutaneous evinacumab had difficulty breathing, and another had a mild anaphylactic reaction.

The pharmaceutical company Regeneron, which makes evinacumab, sponsored the study.

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A study reveals how getting less sleep than normal may impair the brain’s capacity to regulate fear. The finding helps explain why frequent sleep disturbances make people more prone to anxiety and post-traumatic stress disorder (PTSD).

Sleep plays a crucial role in maintaining mental health. For example, people with insomnia are approximately three times as likely to develop an anxiety disorder compared with those who sleep normally, according to a systematic review of research published in 2019.

Other studies find that people who experience frequent sleep disturbances — a common issue for health workers and military personnel — have a higher risk of PTSD.

Not getting enough rapid eye movement (REM) sleep, which is the sleep stage when most dreaming occurs, seems to be a particularly important factor in this increased risk.

Sleep in general, and REM sleep in particular, are known to play a vital role in “fear extinction.” This is the process of learning where the stimuli previously associated with unpleasant sensations or experiences now become harmless.

A new brain-imaging study that appears in the journal Biological Psychiatry: Cognitive Neuroscience and Neuroimaging shows how sleep loss disrupts the brain’s ability to forget fear-provoking memories the following day.

Three nights in a sleep lab

Sleep researchers led by Anne Germain, Ph.D., at the University of Pittsburgh, PA, and Edward Pace-Schott, Ph.D., at Harvard Medical School and Massachusetts General Hospital in Charlestown, MA, invited 154 volunteers to spend 3 nights in a sleep lab.

On the first night, the researchers allowed them to follow their usual sleep times. But on the second night, the scientists randomly assigned them to one of three groups: normal sleep, sleep restriction, and sleep deprivation.

The normal sleep group was allowed to go to bed and wake up at their usual times, while the research team woke the sleep restriction group after they had slept half their usual amount. The sleep deprivation group were not allowed any sleep at all.

The following morning, the volunteers underwent a standard experimental procedure for fear conditioning and extinction, while the researchers scanned their brains using functional MRI.

The procedure for conditioning fear involved showing subjects three different colors, one at a time, on a screen while they lay in the scanner.

A mild electric shock accompanied the presentation of two of the colors. This taught the participants to associate these colors with being shocked.

To extinguish this fear learning, one of these colors was then presented in the absence of any shock, allowing participants to learn that it was now “safe.“

In the evening, the volunteers were again presented with the colors inside the MRI scanner to discover whether they had successfully erased the fear conditioning.

The scans revealed that during the extinction procedure, the brains of those who had slept normally engaged a network of regions called the salience network, which is involved in conditioned fear. They also employed regulatory areas of the prefrontal cortex that inhibit emotions such as fear.

In contrast, in the brains of subjects whose sleep was restricted, the salience network and pain aversion regions were strongly activated at all stages. Their regulatory regions stayed relatively quiet.

“We found that among the three groups, those who had only gotten half a night’s sleep showed the most activity in brain regions associated with fear and the least activity in areas associated with control of emotion,” says Dr. Pace-Schott.

On their third night in the lab, all the volunteers were allowed to sleep as normal.

The importance of REM sleep

The researchers speculate that sleeping only the first half of the night deprives a person of most of their REM sleep, which occurs predominantly toward the end of a normal sleep period.

Studies have found that REM sleep helps people unlearn fearful memories from the previous day. The new research suggests it is also important for unlearning fear conditioning on the following day.

The researchers were surprised to discover that fear-related regions in the brains of participants who they completely deprived of sleep did not activate during the experiment’s fear conditioning and extinction phases.

In the evening, when the researchers tested participants’ memories of the fear extinction, the pattern of activity in their brains was similar to that in the brains of subjects who slept normally.

The scientists speculate that a compensatory mechanism may kick in when people are totally sleep-deprived, protecting their brains from fear conditioning.

They write that a similar mechanism may explain why some people with depression experience a temporary easing of their symptoms through sleep deprivation therapy.

However, the current study suggests that partial sleep deprivation fails to activate this protective mechanism.

“Medical workers and soldiers often have curtailed or interrupted sleep rather than missing an entire night’s sleep […] Our findings suggest that such partially sleep-deprived individuals might be especially vulnerable to fear-related conditions such as PTSD.” – Dr. Pace-Schott

The findings may also have implications for exposure therapy for PTSD and phobias, which involves exposing patients to fear-provoking stimuli in a controlled therapeutic setting. They suggest the treatment may not work well after a poor night’s sleep.

The authors note one important limitation of their study was that it tested the effect of a single night of reduced sleep. Chronic sleep deprivation may have different effects on the brain and its ability to unlearn fearful memories.

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More than four billion people could be overweight by 2050, with 1.5 billion of them obese, if the current global dietary trend towards processed foods continues, a first-of-its-kind study predicted Wednesday.

Warning of a health and environmental crisis of “mind-blowing magnitude”, experts from the Potsdam Institute for Climate Impact Research (PIK) said that global food demand would leap 50 percent by mid-century, pushing past Earth’s capacity to sustain nature.

Food production already hoovers up three-quarters of the world’s freshwater and one-third of its land — and accounts for up to a third of greenhouse gas emissions.

Providing a long-term overview of changing global eating habits between 1965 and 2100, the researchers used an open-source model to forecast how food demand would respond to a variety of factors such as population growth, ageing, growing body masses, declining physical activity and increased food waste.

They found that “business as usual” — a continuation of current trends — will likely see more than four billion people, or 45 percent of the world’s population, overweight by 2050.

The model predicted that 16 percent would be obese, compared with nine percent currently among the 29 percent of the population who are overweight.

“The increasing waste of food and the rising consumption of animal protein mean that the environmental impact of our agricultural system will spiral out of control,” said Benjamin Bodirsky, lead author of the study published in Nature Scientific Reports.

“Whether greenhouse gasses, nitrogen pollution or deforestation: we are pushing the limits of our planet — and exceeding them.”

While trends vary between regions, the authors said that global eating habits were moving away from plant- and starch-based diets to more “affluent diets high in sugar, fat, and animal-source foods, featuring highly-processed food products”.

At the same time, the study found that as a result of increasing inequality along with food waste and loss — food that is produced but not consumed due to lack of storage or overbuying — around half a billion people will still be undernourished by mid-century.

“There is enough food in the world — the problem is that the poorest people on our planet have simply not the income to purchase it,” said co-author Prajal Pradhan.

“And in rich countries, people don’t feel the economic and environmental consequences of wasting food.”

The UN’s Intergovernmental Panel on Climate Change warned in a special report last year that humanity will face increasingly painful trade-offs between food security and rising temperatures within decades unless emissions are curbed and unsustainable farming and deforestation are halted.

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No fewer than 63,958 Nigerians died of diabetes and its complications in 2019, out of 2.7 million living with the non- communicable disease (NCD) in the country.

It has also been predicted that there would be a 143 per cent increase in prevalence of the chronic disease between 2019 and 2045, that is, there would be 3.861 million more Nigerians (6.5 million) to live with the condition if nothing is done to stop the trend.

These figures were disclosed by a panel of experts during “Novo Nordisk World Diabetes Day Webinar (Nigeria)” held to mark the World Diabetes Day (WDD) 2020 at the weekend.

To check the situation, the experts, among other recommendations, urged the Federal Government to conduct a national prevalence study on diabetes and other non-communicable diseases and to strengthen the primary health care centres to be able to screen, diagnose and treat the disease.

The theme for the WDD 2020, “The Nurse and Diabetes”, is meant to raise awareness around the crucial role that nurses play in supporting people living with diabetes.

The panel of experts include: Consultant Physician/ Endocrinologist, Lagos State University Teaching Hospital (LASUTH), Prof. Anthonia Ogbera; Consultant Physician/ Endocrinologist, Enugu State University Teaching Hospital (ESUTH) and Vice President, Diabetes Association of Nigeria (DAN), Dr. Ejiofor Ugwu; Senior Nursing Officer/Diabetes Educator, EKO HOSPITAL Lagos, Mrs. Adekunbi Ayanrinde and Senior Diabetes Nurse, Educator, ISN products Nigeria Limited, Mrs. Cynthia Ozoalor.

Ogbera, in a paper on the strategies to reduce the rising burden of diabetes in Nigeria, said the disease killed more people than COVID-19, Human Immuno-deficiency Virus (HIV) and other diseases. She raised the alarm that the burden of the disease is rising in the country, but expressed regret that the focus in disease control in Nigeria and other Sub Saharan African countries is on communicable and infectious diseases, leaving NCDs patients to suffer. “So there should be a shift in focus,” Ogbera said.

According to the endocrinologist, Nigeria ranks next to South Africa on the continent as worst affected countries with 2.7 million people living with the disease. “Diabetes is a lifelong condition so there must be a life long follow up,” she said.

On how to stem the tide, Ogbera recommended: “Scale up screening and diagnosis.

Once people are told they have diabetes they run to tertiary and secondary facilities. It should not be so. The PHC centres should be scaled up. We should keep on educating the public. Patients should be treated with a target.

“We need to conduct national prevalence study. We do not have any factual data. The only one done in 1990 showed the prevalence was 2.2 per cent when we were just 90 million people in Nigeria. There should be access to medical education. The message is to strengthen PHC to be able to detect and manage diabetes.”

Ugwu recommended adoption of holistic approach and multi-disciplinary measures involving different experts in the healthcare industry, including doctors, nurses, pharmacists, dieticians, physiotherapists and others.

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A new study comparing a vegan diet with a mixed diet has found no difference in vitamin B12 levels. However, one-third of the vegan participants were iodine-deficient.

There are many benefits to a vegan diet, including a lower risk of heart disease, cancer, and type 2 diabetes.

However, a growing concern is the lack of dietary nutrients that are mainly present in animal foods. Two important nutrients are vitamin B12 and iodine.

Vitamin B12 is essential to the body

Vitamin B12, also known as cobalamin, helps the body form nerves, red blood cells, and DNA. Maintaining adequate vitamin B12 levels is also crucial for cell metabolism and supporting the nervous system.

According to the National Institutes of Health (NIH), the average adult needs about 2.4 micrograms (mcg) of vitamin B12. The only natural sources of vitamin B12 are animal-based. They include various types of meats and fish, as well as dairy products, clams, and eggs.

As vitamin B12 does not occur naturally in plant-based foods, those eating only these foods are at risk for vitamin B12 deficiency. A 2017 study in the journal Nutrients found that 69.9% of males and 83.4% of females who were under the age of 55 years and identified as vegan lacked sufficient vitamin B12.

Since vitamin B12 is vital in making red blood cells, insufficient levels can increase the risk of anemia. Also, without vitamin B12, the brain cannot function correctly, which can lead to cognitive impairments. There is also evidence of a link between this vitamin deficiency and depression, Alzheimer’s, Parkinson’s disease, and dementia.

Importance of iodine in the diet

Iodine is another essential nutrient for the body. Iodine is crucial to making thyroid hormones, and the recommended intake for an adult is 150 mcg. However, about 38% of the world’s population lack adequate iodine levels.

Iodine is in fish, eggs, and dairy products. Unlike vitamin B12, iodine is naturally available to vegans in seaweed.

Despite some natural sources, getting sufficient iodine can still be challenging for vegans. A 2011 study in The Journal of Clinical Endocrinology & Metabolism found vegans to be at high risk for iodine deficiency.

Low iodine levels can force the thyroid to absorb iodine from the blood, which may lead to hypothyroidism. Iodine deficiency during pregnancy or in young children may also impair cognitive development and increase the risk of intellectual disabilities.

A growing trend for vegan diets

Despite the nutritional concerns, eating plant-based foods remains increasingly popular. For instance, a 2017 study in the Journal of Nutrition Education and Behavior found that in 2012, 1.9% of people in the U.S. followed a vegan or vegetarian diet for health reasons. This was an 18.8% increase from 2002.

In response to the rising interest in veganism, researchers at the German Federal Institute for Risk Assessment sought to find any updates regarding the average vegan’s nutritional health.

The study appears in the journal Deutsches Ärzteblatt.

Study design

The researchers selected a total of 72 participants aged 30–57 years from Berlin, of whom 36 were vegan, and 36 were eating an omnivorous diet consisting of both plant and animal foods.

The team used questionnaires to collect demographic information from these individuals, including their age, education level, and lifestyle factors.

Using the German Nutrient Database, the researchers used a 3-day dietary protocol to measure nutrient intake in both groups. They excluded dietary supplement use from the calculations.

The researchers also took 60-milliliter blood samples and 24-hour urine samples to observe vitamin and mineral levels. They identified some of these, such as vitamin B12, through biomarkers. For example, high concentrations of holotranscobalamin indicate a vitamin B12 deficiency.

Key research findings

During the 3-day recording, those on a vegan diet showed lower concentrations of cholesterol than the omnivores.

The vegan group also consumed more fiber, vitamin E, vitamin K, and folate. However, these participants did not eat as many foods high in vitamin B12, vitamin D, and iodine as the omnivores.

In the blood, the vegan participants had lower levels of vitamin B2, vitamin B3, vitamin E, vitamin A, selenoprotein P, and zinc than the omnivores. However, they had high levels of folate and vitamin K1.

In the urine samples, iodine and calcium levels were low in those following a vegan diet.

A surprising finding was the lack of vitamin B12 deficiency in vegans. The researchers attribute this to a growing knowledge of the lack of vitamin B12 in plant-based diets.

“Most vegans are aware that a vegan diet is associated with the risk of vitamin B12 deficiency, and vitamin B12 is by far their most frequently taken supplement,” write the authors.

Another interesting finding was that both groups had low iodine levels, although this was more apparent in vegans. Only 8% of vegans achieved adequate iodine levels compared with 25% of omnivores.

Study limitations to consider

Understanding the study’s recruitment process is important when interpreting the data. The authors note that participants were most likely a convenience sample. This means that they chose people who were easy to reach, as they enrolled people who responded to their announcement.

A convenience sample may have created bias in the results, as the people who took the time to respond may already have been health conscious. However, the subjectiveness in recruitment remains debatable.

“Since the same recruitment strategy was used for vegans and omnivores, and a BMI ≥ 30 kg/m2 was chosen as an exclusion criterion, it can be assumed that the level of health consciousness was similar in both groups,” note the authors.

The study also used a small sample size of 72 participants, which is unlikely to be representative of the general population in Germany.

Final thoughts

“Consequently, the results of our study provide first insights into the current vitamin and mineral status in vegans versus omnivores in the German population,” write the authors.

This updated nutritional information could help guide vegans toward prioritizing iodine in addition to vitamin B12 supplementation.

Doing so may help circumvent the health risks associated with following a plant-based diet.

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