Stress

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A study finds that 10 minutes of massage or relaxation can activate the body’s system for overcoming stress.

The damaging effects of stress are well-known, but fortunately, our bodies have a built-in system for managing and recovering from it. This system is called the parasympathetic nervous system (PSNS).

While there is plenty of anecdotal evidence that taking time to relax — especially when it involves massage — can activate the PSNS, the new study by psychologists at the University of Konstanz in Germany has scientifically measured and confirmed this effect.

In their paper, the researchers conclude that short periods of relaxation may be psychologically and physiologically regenerative and that the effect is even more pronounced with massage.

The senior author of the study is Prof. Jens Pruessner of the university’s Neuropsychology lab, who is a member of the Cluster of Excellence “Centre for the Advanced Study of Collective Behaviour.” He explains the importance of the new research:

“To get a better handle on the negative effects of stress, we need to understand its opposite — relaxation. Relaxation therapies show great promise as a holistic way to treat stress, but more systematic scientific appraisal of these methods is needed.”

The study appears in the September 2020 issue of Scientific Reports.

The study

For their study, the team divided the participants into three groups.

The first group received 10-minute head-and-neck massages with a moderate pressure intended to stimulate the PSNS’s vagus nerve. This nerve contains some 75% of the PSNS nerve fibers, branching out to the many organs in the body with which the system interacts.

The second group of individuals received much softer 10-minute neck-and-shoulder massages as a means of determining the PSNS-activating effect of simple tactile contact.

A third control group simply sat at a table relaxing for 10 minutes.

The researchers used both physiological and psychological measurements to evaluate the degree to which each intervention, or lack of, had activated the participants’ PSNS.

Neuropsychology doctoral student Maria Meier led the team, who assessed the tests’ physiological effect by measuring the participants’ heart rate, as well as their heart rate variability (HRV). HRV is a measurement of variations in the time intervals between heartbeats.

For example, when the body is in fight-or-flight mode, there is very little variation because the heart beats quickly at a steady rate. This will provide a low HRV value. When the body is relaxed, a greater degree of variation occurs, resulting in a higher HRV.

All of the participants had significantly higher HRV levels afterward. However, the most dramatic increases in HRV belonged to those who had received massages. The type of massage did not matter.

Simple tactile contact proved just as effective for helping an individual relax as a massage designed specifically to activate the PSNS.

Psychologically, all participants reported feeling less stressed and more relaxed after the tests.

Overall, the experiments confirmed that simply taking a few moments to relax can help a person manage stress. Adding a relaxing massage does even more to activate the PSNS and alleviate the physical and mental effects of stress.

Stress management

Meier concludes: “We are very encouraged by the findings that short periods of disengagement are enough to relax not just the mind but also the body. You don’t need a professional treatment in order to relax. Having somebody gently stroke your shoulders, or even just resting your head on the table for 10 minutes, is an effective way to boost your body’s physiological engine of relaxation.”

Equally important as the study’s finding is the development of a system for objectively evaluating relaxation therapies. With experts often citing stress as the driver of diseases such as depression, a reliable means of validating relaxation techniques clearly has value.

Says Meier, “Massage, being such a commonly used relaxation therapy, was our first study. Our next step is to test if other short interventions, like breathing exercises and meditation, show similar psychological and physiological relaxation results.”

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A new study has found a significant rise in people searching Google for anxiety symptoms during the pandemic.

New research found that in the United States, Google searches for ‘worry,’ ‘anxiety,’ and therapeutic techniques to manage worry and anxiety have increased during the pandemic.

The research, featuring as a commentary in the journal Psychological Trauma: Theory, Research, Practice, and Policy, highlights the burden the COVID-19 pandemic has placed not only on people’s physical health but also their mental health.

COVID-19 and mental health

COVID-19 has had a profound effect on people. The world is approaching one million recorded deaths from the disease. And, some of those who recovered from the initial virus effects continue to suffer long-term symptoms that are yet to be fully understood.

Once the knock-on effects of the disease factor in — for example, overwhelmed critical care units prolonging treatment times for people with other serious illnesses — then it is clear that the pandemic has had a devastating effect on people’s health around the world.

However, as well as people’s physical health, it is also becoming clear that the pandemic is significantly affecting their mental health.

Early in the pandemic, there were anecdotal reports that people’s mental health was worsening, including those with pre-existing mental health issues and those whose mental health was normally well. As time has gone on, more research has started to corroborate these reports.

Google Trends

In the present study, the researchers wanted to explore an alternative way of determining the pandemic’s effects on mental health: analyzing Google search requests.

Google Trends allows anyone to see the search terms that people use for various populations, globally and locally. As Dr. Michael Hoerger, Assistant Professor of Psychology and Psychiatry at Tulane University Cancer Center, New Orleans, and his co-authors note:

“Although by no means a ‘window into the soul,’ people’s search terms reflect relatively uncensored desires for information and thus lack many of the biases of traditional self-report surveys.”

Previous health science research has made use of Google Trends data in studies, and the present study’s investigators wanted to see how effective it could be in the context of mental health in the current pandemic.

To do this, they accessed weekly U.S. search terms from April 21, 2019 to April 21, 2020.

Worry and anxiety searches increased

By comparing the pre- and post-pandemic search terms, the researchers were able to identify four relevant themes.

Firstly, following the announcement of the pandemic, search terms related to ‘worry’ increased significantly. These terms included ‘worry,’ ‘worry health,’ ‘panic,’ and ‘hysteria.’

Secondly, people shifted to searching for anxiety symptoms, which spiked after the initial flurry of worry-related search terms.

Thirdly, the researchers did not see a significant increase in other mental health search terms, such as depression, loneliness, suicidal ideation, or substance abuse.

Rather than interpreting this to suggest that these issues did not increase, the authors speculate that people’s searches relating to these issues may occur later, or that they may be better at utilizing self-care techniques concerning these.

Finally, the researchers noticed that not only did people understandably search for more online therapy rather than face-to-face therapy, they also searched for therapy techniques for dealing with anxiety symptoms.

Users did so with search terms such as ‘deep breathing’ and ‘body scan meditation.’

Tip of the iceberg

For Dr. Hoerger, “[o]ur analyses from shortly after the pandemic declaration are the tip of the iceberg.”

“Over time, we should begin to see a greater decline in societal mental health. This will likely include more depression, PTSD, community violence, suicide, and complex bereavement. For each person that dies of COVID, approximately nine close family members are affected, and people will carry that grief for a long time.” – Dr. Michael Hoerger

The researchers suggest that by continuing to track Google Trends data, public health bodies may be able to better identify people’s mental health needs promptly, reducing the pandemic’s psychological effects.

A study finds that getting enough sleep helps people maintain emotional equilibrium and enjoy the good things in life.

Research shows that a range of health conditions are associated with a lack of sleep. A new study from researchers at the University of British Columbia (UBC) in Vancouver, Canada, investigates the psychological — rather than physical — implications of missed sleep.

The scientists found that after an insufficient night of sleep, people have a reduced capacity for remaining positive when faced with emotionally challenging events. They are also less able to enjoy positive experiences.

The lead author of the study, health psychologist Nancy Sin of UBC, describes how this results in more stressful days for people who do not get enough sleep:

“When people experience something positive, such as getting a hug or spending time in nature, they typically feel happier that day. But we found that when a person sleeps less than their usual amount, they don’t have as much of a boost in positive emotions from their positive events.”

Stress is associated with a range of harmful effects, compounding the damage done by sleep deficits.

The study appears in the journal Health Psychology.

Daily diaries tell a story

“The recommended guideline for a good night’s sleep is at least seven hours, yet one in three adults don’t meet this standard,” says Sin.

To explore the effects of insufficient sleep, Sin and her colleagues analyzed an existing data set of 1,982 United States residents, 57% of whom were female. The participants gave their sociodemographic details and existing chronic conditions to the researchers at the start of the study.

The individuals kept daily diaries. For eight consecutive days, they were interviewed daily via phone calls, during which participants reported the number of hours they had slept the previous night.

Each person also described the events of their day. They recalled problems they had encountered: interpersonal tensions, arguments, feeling of discrimination, and stresses with their work associates and family. They also recalled the good things that happened. In addition, participants reported their emotional responses from that day, both positive and negative.

The pattern that emerged was a lessened ability to remain or feel positive when participants had less sleep. When experiencing stress, they found it harder to maintain emotional equilibrium. And when good things happened, feelings of joy or happiness were muted.

Such days may be more than unpleasant — earlier research, including Sin’s own, has found links between an inability to retain feelings of positivity and inflammation, as well as death.

“A large body of research shows that inadequate sleep increases the risk of mental disorders, chronic health conditions, and premature death. My study adds to this evidence by showing that even minor night-to-night fluctuations in sleep duration can have consequences in how people respond to events in their daily lives.” – Nancy Sin, UBC

The researchers found no evidence that not getting enough sleep increased participants’ negative emotions the following day.

Getting better rest

Previous research has found that individuals with chronic health conditions, including diabetes, cancer, and heart disease, tend to be more emotionally reactive when confronted with stressful events. Considering that getting more sleep could help to prevent this, Sin says she was interested to learn “whether adults with chronic health conditions might gain an even larger benefit from sleep than healthy adults.”

The study’s finding suggests this might be the case, she says.

“For those with chronic health conditions, we found that longer sleep — compared to one’s usual sleep duration — led to better responses to positive experiences on the following day.”

Sin hopes that studies such as hers will convince people to prioritize getting enough sleep as a way to stay healthy and have better days.

A study in mice suggests that the “glymphatic system,” which removes the brain’s toxic waste during sleep, may not operate efficiently in shift workers who sleep during the day. This may explain their increased risk of brain disorders, such as Alzheimer’s disease.

In 2012, researchers at the University of Rochester Medical Center (URMC), NY, discovered a previously unknown waste disposal system in the brain.

They dubbed it the glymphatic system because nerve cells called glial cells manage its operation, which fulfills a similar role for the brain that the lymphatic system does for the rest of the body.

The following year, the same team found that the glymphatic system is most active during sleep.

In their latest experiments, the researchers reveal that it is the body’s circadian rhythms, the “master clock” regulating the sleep-wake cycle of roughly 24 hours, that governs this system.

“These findings show that glymphatic system function is not solely based on sleep or wakefulness, but by the daily rhythms dictated by our biological clock,” says neuroscientist Dr. Maiken Nedergaard, co-director of the Center for Translational Neuromedicine at URMC and senior author of the study.

The findings appear in the journal Nature Communications.

Toxic waste products

One of the processes that occur during sleep is the clearance of toxic products of metabolism that accumulate in the brain during wakefulness. One such waste product is the protein beta-amyloid, which — if not removed — forms the plaques associated with Alzheimer’s disease.

An ongoing failure to remove waste products such as beta-amyloid may partly explain why chronic sleep disruption is an early sign of neurodegenerative disorders such as Alzheimer’s.

In their early work, Dr. Nedergaard and her colleagues showed that the glymphatic system is a network of channels adjoining blood vessels in the brain.

The channels comprise projections, or “endfeet,” from a type of glial cell known as astrocytes. The endfeet effectively enclose the blood vessels in a hollow sheath.

During sleep, the glymphatic system pumps cerebrospinal fluid around the brain in time with the pulsing of arteries. This liquid washes away soluble waste products before draining into the lymphatic system.

But the new research reveals the activity of the glymphatic system is governed by the body’s biological clock, rather than sleep.

In humans, circadian rhythm regulates our physiology cycle between wakefulness during the day and sleep at night.

“Because this timing also influences the glymphatic system, these findings suggest that people who rely on cat naps during the day to catch up on sleep, or work the night shift, may be at risk for developing neurological disorders,” says Lauren Hablitz, Ph.D., a research assistant professor in Nedergaard’s lab and the first author of the paper.

“In fact, clinical research shows that individuals who rely on sleeping during daytime hours are at much greater risk for Alzheimer’s and dementia, along with other health problems,” she adds.

Fluorescent tracer

The researchers made their discovery in mice, which are nocturnal — their sleep-wake cycle is the reverse of that characteristic in humans.

To monitor cerebrospinal fluid movement through the animals’ brains, they injected a fluorescent tracer that they could see through the animals’ skulls.

This revealed that the flow of fluid into the brain was around 53% higher during the day while the animals were asleep, compared with the night when they were active.

Crucially, this cycle of activity in their glymphatic system persisted even when the researchers anesthetized the mice throughout the day and night.

It also continued when they kept the rodents in constant light for 10 days.

This strongly suggests that circadian rhythms govern this system and therefore may not operate efficiently during daytime sleep in humans.

Finally, the researchers show that the circadian regulation of cerebrospinal fluid through the brain depends on a water channel called aquaporin-4 in the membrane of the endfeet.

In mice genetically engineered to lack this channel, the usual tidal flow of fluid across the day and night was completely absent.

Disrupted daily rhythms

The authors note that while much research is needed, their work suggests disrupting circadian rhythms may prevent the efficient removal of the brain’s toxic byproducts.

This may lead to the chronic inflammation that characterizes neurodegenerative disorders such as Alzheimer’s.

They conclude:

“Although glymphatic function has yet to be studied in models of circadian disruption, such as in shiftwork, it has been established that shift workers are at increased risk for neurodegenerative disorders […] Understanding how these rhythms, all with different timing and biological functions, interact to affect glymphatic function and lymphatic drainage may help prevent morbidity associated with circadian misalignment.”

A new study in mice adds to the evidence suggesting that the immune system not only attacks invading pathogens but can also influence mood.

Over the past few years, scientists have discovered some intriguing links between immunity and the mind.

One of the immune signaling molecules, or cytokines, that mediates these links is called interleukin-17a (IL-17a).

IL-17a plays a role in psoriasis, which is an autoimmune skin condition, but it may also contribute to the depression that many people experience. Indeed, a study involving a mouse model of psoriasis found that IL-17a caused depression-like symptoms.

In humans, researchers have also linked the molecule to treatment resistant depression.

Research in mice has even implicated IL-17a in the development of autism.

“The brain and the body are not as separate as people think,” says Prof. Jonathan Kipnis, a neuroscientist at the Washington University School of Medicine in St Louis, MO.

While working at the University of Virginia School of Medicine in Charlottesville, Prof. Kipnis and colleagues found that IL-17a causes anxiety-like behavior in mice.

“We are now looking into whether too much or too little of IL-17a could be linked to anxiety in people,” says Prof. Kipnis.

The scientists have published the results of their mouse study in the journal Nature Immunology. Kalil Alves de Lima, a postdoctoral researcher who is also now at the University of Washington, led the research.

Gamma-delta T cells

Immune cells called gamma-delta T cells produce IL-17a. The cells are present in the meninges, which are the membranes surrounding the brain and spinal cord.

To determine what effect IL-17a might have on behavior, the scientists studied mice whose gamma-delta T cells did not produce any IL-17a and mice who lacked the cells completely.

They put the mice through standard tests of memory, social behavior, foraging, and anxiety. The mice performed just as well as normal mice on all tests apart from two that measure anxiety levels.

In those tests, the mice who lacked gamma-delta T cells or did not produce any IL-17a were more likely to explore open areas. In the wild, this kind of behavior would put them at greater risk of being eaten by predators.

The researchers interpreted this as a sign of reduced anxiety in animals without IL-17a signaling in their central nervous system.

Next, the scientists investigated how the signal affects neurons in their brains. They found receptors for IL-17a on a type of stimulatory nerve cell called a glutamatergic neuron.

When they genetically manipulated the neurons to prevent them from making these receptors, the mice exhibited less anxiety-like behavior.

The gut-brain axis

Previous animal research has revealed a multitude of possible links between bacteria living in the gut and behavior, including anxiety-like behaviors.

This connection is known as the gut-brain axis, and scientists have proposed the immune system as one possible way that messages pass between them.

To investigate the role of IL-17a in the gut-brain axis, Alves de Lima and colleagues injected the mice with lipopolysaccharide. This is a toxin that bacteria produce. It provokes a strong immune reaction.

In response to the injection, gamma-delta T cells in the meninges surrounding the animals’ brains produced more IL-17a.

In another experiment, when the researchers treated the mice with antibiotics to kill the bacteria in their guts, the animals produced less IL-17a.

Together, the results of these experiments suggest that the immune system has evolved not only to fight infection but also to adjust behavior to keep animals safe while they are in a weakened state.

“Selecting special molecules to protect us immunologically and behaviorally at the same time is a smart way to protect against infection. This is a good example of how cytokines, which basically evolved to fight against pathogens, also are acting on the brain and modulating behavior.” – Kalil Alves de Lima

The team is now investigating how gamma-delta T cells in the meninges surrounding the brain can detect the presence of bacteria elsewhere in the body.

The researchers are also looking into exactly how IL-17a signaling in the brain changes behavior.

In their paper, they conclude:

“Our findings provide new insights into the neuroimmune interactions at the meningeal–brain interface and support further research into new therapies for neuropsychiatric conditions.”

Although the physiology of mice and humans is very similar, scientists need to carry out much more research to explore the possible links between the human immune system and mood.

Welcome to the latest edition of our Medical Myths series. Today, to mark World Alzheimer’s Day, we will be tackling myths relating to both Alzheimer’s disease and dementia at large.

Today, an estimated 5.8 million people aged 65 years or older in the United States have dementia.

Due to the fact that the average lifespan of people in the U.S. has increased over recent decades, some experts project that by 2050, the number of older adults with dementia could reach 13.8 million.

Figures of this stature spark justifiable fear, and, as we have found in previous Medical Myths articles, fear tends to breed misconceptions.

In this article, we aim to dispel 11 of these myths.

1. Dementia is inevitable with age

This statement is not true. Dementia is not a normal part of aging.

According to a report that the Alzheimer’s Association published, Alzheimer’s disease, which is the most common form of dementia, affects 3% of people aged 65–74 years in the U.S.

As a result of the risk increasing as we age, 17% of people aged 75–84 years and 32% of people aged 85 years and older have a dementia diagnosis.

2. Dementia and Alzheimer’s disease are the same thing

This is not quite correct. Alzheimer’s is a type of dementia, accounting for 60–80% of all dementia cases. Other types of dementia include frontotemporal dementia (FTD), vascular dementia, mixed dementia, and Lewy body dementia.

The National Institute on Aging define dementia as “the loss of cognitive functioning — thinking, remembering, and reasoning — and behavioral abilities to such an extent that it interferes with a person’s daily life and activities.”

Although dementias share certain characteristics, each type has a distinct underlying pathology.

Alzheimer’s disease is associated with a buildup of so-called plaques and tangles in the brain. These structures interfere with brain cells, eventually killing them. In contrast, brain cell death in vascular dementia occurs due to a lack of oxygen, which can result from a stroke, for instance.

FTD, as another example, occurs when abnormal protein structures form in the frontal and temporal lobes of the brain, causing the brain cells in these regions to die.

3. A family member has dementia, so I will get it

A common myth is that dementia is purely genetic. In other words, if a person’s family member has a dementia diagnosis, they are guaranteed to develop dementia later in life. This is not true.

Although there is a genetic component to some forms of dementia, the majority of cases do not have a strong genetic link.

As we learned above, rather than genetic factors, the most significant risk factor for dementia is age. However, if a parent or grandparent developed Alzheimer’s when they were younger than 65 years, the chance of it passing on genetically is higher.

Early-onset Alzheimer’s is relatively uncommon, though. It occurs in about 5.5% of all Alzheimer’s cases.

As the majority of dementia cases are Alzheimer’s disease, this means that most dementia cases are not hereditary. FTD, which is much less common, has a stronger genetic link, but if a parent or grandparent develops the condition, it does not mean that children or grandchildren are guaranteed to develop it.

Today, FTD affects an estimated 15–22 in every 100,000 people. Of these individuals, 10–15% have a strong family history of the condition.

4. Dementia only affects older adults

Age is a risk factor for dementia, but dementia can affect younger adults in rare cases. Some scientists estimate that, in people aged 30–64 years, 38–260 people in 100,000 — equivalent to 0.038–0.26% — develop early-onset dementia.

In the 55–64 age bracket, this increases to close to 420 people in 100,000, or 0.4%.

5. Using aluminum pans causes Alzheimer’s

In the 1960s, scientists injected rabbits with high levels of aluminum. They found that the animals developed neurological lesions similar to those that form in the brains of people with Alzheimer’s.

Additionally, some studies have identified aluminum within the plaques associated with Alzheimer’s. However, aluminum also appears in the healthy brain, and researchers have not established a causal link between this element and the disease.

Following on from these studies, myths still circulate that drinking from aluminum cans or cooking with aluminum pots increases the risk of Alzheimer’s.

However, since those early experiments, scientists have not found a clear association between Alzheimer’s and using aluminum pots and pans.

Although researchers will, eventually, establish the precise relationship between aluminum and Alzheimer’s, consuming aluminum through the diet is unlikely to play a major role.

As the Alzheimer’s Society explain: “Aluminum in food and drink is in a form that is not easily absorbed into the body. Hence, the amount taken up is less than 1% of the amount present in food and drink. Most of the aluminum taken into the body is cleaned out by the kidneys.”

However, they also write that some research has found “a potential role for high dose aluminum in drinking water in progressing Alzheimer’s disease for people who already have the disease.”

6. Dementia signals the end of a meaningful life

Thankfully, this is not the case. Many people with a dementia diagnosis lead active, meaningful lives. Some people fear that if a doctor diagnoses them with dementia, they will no longer be able to go for a walk alone and will have to stop driving their vehicle immediately.

It is true that these adjustments may come in time as the condition progresses, but in mild cases of dementia, no changes may be necessary. As dementia worsens, changes to the way an individual leads their life are likely, but that does not mean that the person cannot lead a fulfilling life.

“Too many people are in the dark about dementia — many feel that a dementia diagnosis means someone is immediately incapable of living a normal life, while myths and misunderstandings continue to contribute to the stigma and isolation that many people will feel,” explains Jeremy Hughes, former Chief Executive of the Alzheimer’s Society.

“[W]e want to reassure people that life doesn’t end when dementia begins.” – Jeremy Hughes

7. Memory loss always signifies dementia

Although memory loss can be an early symptom of dementia, it does not necessarily signify the start of this condition. Human memory can be unpredictable, and we all forget things occasionally. However, if memory loss is interfering with everyday life, it is best to speak with a doctor.

Although memory issues tend to be an early sign of Alzheimer’s disease, that is not the case for other forms of dementia. For instance, early signs and symptoms of FTD can include changes in mood and personality, language difficulties, and obsessive behavior.MEDICAL NEWS TODAY NEWSLETTERStay in the know. Get our free daily newsletter

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8. Dementia is always preventable

This, unfortunately, is untrue. Importantly, though, certain factors can either reduce the risk of certain types of dementia developing or delay their onset.

For instance, the Lancet Commission’s 2020 report on dementia prevention, intervention, and care lists 12 factors that increase the risk of dementia:

  • less education
  • hypertension
  • hearing impairment
  • smoking
  • obesity
  • depression
  • physical inactivity
  • diabetes
  • low levels of social contact
  • alcohol consumption
  • traumatic brain injury
  • air pollution

Some of these factors are more difficult to modify than others, but working on changing any of them might help reduce the risk of developing dementia. The authors of the report explain:

“Together, the 12 modifiable risk factors account for around 40% of worldwide dementias, which consequently could theoretically be prevented or delayed.”

However, as Dr. Nancy Sicotte, a neurologist at Cedars-Sinai hospital in Los Angeles, CA, explains, “Reducing your risk requires starting these lifestyle changes from the get-go, not waiting until you’re 70.”

9. Vitamins and supplements can prevent dementia

Linked to the section above, this is also false. To date, there is no strong evidence that any vitamin or mineral supplements can reduce the risk of dementia. In 2018, the Cochrane Library conducted a review with the aim of answering this question.

Their analysis included data from more than 83,000 participants across the 28 included studies. Although the authors report “some general limitations of the evidence,” they conclude:

“We did not find evidence that any vitamin or mineral supplementation strategy for cognitively healthy adults in mid or late life has a meaningful effect on cognitive decline or dementia, although the evidence does not permit definitive conclusions.”

10. All people with dementia become aggressive

In some cases, people with dementia might find it increasingly hard to make sense of the world around them. This confusion can be frustrating, and some individuals might respond to the emotions in an angry manner. However, this is not the case for everyone.

In a study involving 215 people with dementia, 41% of the participants developed aggression during the 2-year study. When they looked at factors that increased the risk of developing aggression, the researchers identified two of the primary factors as physical pain and a low quality relationship between the person and their caregiver.

11. Dementia is never fatal

Unfortunately, dementia can be fatal. According to a recent study, which appears in JAMA Neurology, dementia may be a more common cause of death than experts have traditionally thought it to be. The authors “found that approximately 13.6% of deaths were attributable to dementia over the period 2000–2009.”

Dementia worries people, especially as they age, and this is justifiable in many ways. However, it is important to counter misinformation that might enhance concerns and stigma.

For now, researchers are working tirelessly to develop better ways to treat and prevent dementia. In the future, hopefully, science will reduce the impact of dementia and, therefore, the fear associated with the condition.

The cold and flu season is starting to rear its ugly head, and we cannot seem to get away from the coughing and sneezing. But why are we more prone to these infections during the colder months?

Viral infections that cause the common cold or flu can range from a nuisance to a serious health threat.

According to the Centers for Disease Control and Prevention (CDC), “common colds are the main reason that children miss school and adults miss work.”

Although most cases of the common cold and flu tend to go away by themselves, every year, flu kills an estimated 290,000 to 650,000 people worldwide.

What do scientists know about how plummeting temperatures allow these viruses to spread, and what is the best way of preventing colds and flu? We investigate.

Common cold vs. flu

First, we need to distinguish between the common cold and flu, because the viruses that cause these do not necessarily behave in the same way.

Most of the time, the common cold manifests with a trilogy of symptoms: a sore throat, a blocked nose, and coughing and sneezing. There are more than 200 viruses that can cause the common cold, but coronaviruses and rhinoviruses are by far the most common culprits.

There are four human coronaviruses that account for between 10% and 30% of colds in adults. These are in the same family of viruses as SARS-CoV-2, which causes COVID-19. However, it mostly causes only mild illness.

Interestingly, around a quarter of people who have an infection with a common cold virus do not experience any symptoms at all.

The flu develops due to the influenza virus, of which there are three different types: influenza A, influenza B, and influenza C.

Common colds and flu share many symptoms, but an infection with influenza also tends to manifest with a high temperature, body aches, and cold sweats or shivers. This may be a good way to tell the two apart.

As with the common cold, a significant number of people who have an influenza infection do not show any symptoms.

So, now that we know the difference between the common cold and flu, we will look at when we tend to be most vulnerable to an infection with these viruses.

Seasonal patterns

The CDC monitor flu activity closely. Influenza can occur at any time of year, but most cases follow a relatively predictable seasonal pattern.

The first signs of influenza activity usually start around October, according to the CDC, and peak at the height of winter. However, in some years, flu outbreaks can stick around and last until May.

The peak month for flu activity in the seasons spanning 1982–1983 through 2017–2018 was February, followed by December, January, and March.

Other temperate locations across the globe see similar patterns, with cold temperatures and low humidity being the prime factors, according to one 2013 analysis. The same cannot be said for tropical areas, however.

In those regions, there may be outbreaks during rainy, humid months or relatively consistent levels of flu cases all year round.

This may seem counterintuitive. Indeed, although influenza data do support such a link, scientists do not fully understand how viruses are able to exert their maximum damage at both low and high temperature and humidity extremes.

There are several theories, however, ranging from the cold affecting how viruses behave and how well our immune system copes with infections to spending more time in crowded places and getting less exposure to sunlight.

Cold air affects our first line of defense

Common cold and flu viruses try to gain entry into our bodies through our noses. However, our nasal lining has sophisticated defense mechanisms against these microbial intruders.

Our noses constantly secret mucus. Viruses become trapped in the sticky snot, which is perpetually moved by tiny hairs called cilia that line our nasal passages. We swallow the whole lot, and our stomach acids neutralize the microbes.

However, cold air cools the nasal passage and slows down mucus clearance.

Once a virus has penetrated this defense mechanism, the immune system takes control of fighting off the intruder. Phagocytes, which are specialized immune cells, engulf and digest viruses. However, researchers have also linked cold air to a decrease in this activity.

Rhinoviruses actually prefer colder temperatures, making it difficult not to succumb to the common cold once the thermometer plummets.

In one laboratory study, these viruses were more likely to commit cell suicide, or apoptosis, or to encounter enzymes that made short work of them when grown at body temperature.

Vitamin D and other myths

During winter, levels of UV radiation are much lower than in summer. This has a direct effect on how much vitamin D our bodies can make.

There is evidence to suggest that vitamin D is involved in making an antimicrobial molecule that limits how well the influenza virus can replicate in laboratory studies.

Consequently, some people believe that taking vitamin D supplements during the winter months can help keep flu at bay. Indeed, a 2010 clinical trial showed that school children who took vitamin D3 daily had a lower risk of contracting influenza A.

systematic review concluded that vitamin D provided protection against acute respiratory infection.

However, there have been no large-scale clinical trials to date, and discrepancies between individual studies make it difficult for scientists to draw firm conclusions.

Another factor that may contribute to cold and flu infections in the fall and winter months is that we spend more time indoors as the weather becomes less hospitable.

This might lead to two effects: crowded spaces helping spread viruses-laden droplets from person to person, and central heating causing a drop in air humidity, which — as we have already seen — is linked to influenza outbreaks.

However, many of us live our lives in crowded spaces all year round, and in isolation, this theory cannot explain flu rates.

Scientists continue to study seasonal patterns of respiratory infections to tease out how different factors may influence their spread.

In the meantime, what is the best way to protect ourselves from these viruses?

How to prevent viruses and treat symptoms

A person’s chance of catching a cold this winter is very high. In fact, the CDC estimate that adults have two to three colds each year.

The best way for people to protect themselves is by:

  • frequently washing the hands with soap and water
  • not touching the eyes, nose, or mouth
  • staying away from people who are already sick

If a person does have a cold, the CDC recommend staying at home and avoiding contact with others.

These rules also apply to influenza. However, receiving a yearly flu shot is the best way of preventing flu.

“Getting a flu vaccine during 2020–2021 will be more important than ever,” the CDC advise.

However, should a person contract a winter virus, here are eight home remedies to consider to help ease the symptoms.

A person should contact a doctor if they experience:

  • difficulty breathing
  • persistent chest or abdominal pain
  • severe muscle pain or weakness
  • seizures
  • difficulty urinating
  • a fever or cough that keeps returning
  • persistent dizziness or confusion
  • a worsening of an existing chronic medical condition

We also have a guide on how to tell the difference between flu, the common cold, and COVID-19.

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Data spanning more than 11 years suggest that testosterone injections could be a novel treatment for obesity in men. The results show that long-term testosterone therapy may be comparable to weight loss surgery, with a lower risk of complications.

Over 42% of adults in the United States have obesity, according to the Centers for Disease Control and Prevention (CDC). Obesity has links to several chronic health conditions, including heart disease and type 2 diabetes.

Recent findings that obesity may also worsen outcomes in COVID-19 have encouraged some governments to create entirely new public health strategies to encourage people to lose weight.

However, obesity is a complex issue with both medical and social causes, and achieving lasting weight loss can be challenging for many people. This means researchers are looking for new strategies to help treat obesity — beyond merely cutting calories.

Data recently presented at the virtual European and International Congress on Obesity support the use of testosterone therapy to treat men with obesity.

Long-term testosterone treatment reduced body weight by 20% on average.

11 years of data

The pharmaceutical company Bayer and Gulf Medical University in the United Arab Emirates led the research, using 11 years’ worth of data.

The researchers collected data since 2004 of 471 men with functional hypogonadism, or low testosterone production, and obesity from a German urological practice.

Around 58% of the men received an injection of testosterone every 3 months for the duration of the study, while the remainder chose not to have the treatment and therefore acted as controls. The average age of the participants was 61.57.

Medical staff administered and documented all injections at a doctor’s office, which assures that all participants received the treatment in a consistent manner. No participants dropped out of the study.

20% bodyweight reduction

The men who received testosterone lost on average 23 kilograms (kg) (equivalent to 20% body weight) during the study period, while those who did not receive treatment gained an average of 6 kg.

Body mass index (BMI) correspondingly decreased by an average of 7.6 points in those who received testosterone therapy, compared with an increase of 2 points in the control group.

Waist circumference, which is a risk factor for cardiometabolic disease, decreased by an average of 13 centimeters (cm) in the treatment group, compared with a 7 cm increase in the control group.

The testosterone-treated men also had less internal (visceral) fat by the end of the study period. They may have had a lower risk of cardiovascular disease than those who did not receive treatment.

Overall, 28% of men in the control group had a heart attack, and 27.2% had a stroke during the study period. There were no major cardiovascular events in the men who received testosterone therapy.

Likewise, while more than 20% of the control group developed type 2 diabetes during the study period, nobody in the treatment group developed the condition.

Commenting on the results, Farid Saad of Bayer said: “Long-term testosterone therapy in hypogonadal men resulted in profound and sustained […] weight loss, which may have contributed to reductions in mortality and cardiovascular events.”

An alternative to surgery?

The researchers also presented data specific to men who were eligible for bariatric surgery. This is a surgical treatment for obesity, which encompasses gastric band, gastric bypass, and gastric sleeve surgery.

Rates of bariatric surgery are on the rise in the U.S., with more than 250,000 people undergoing weight loss surgery in 2018 alone.

Although bariatric surgery is a proven means of achieving weight loss, there are serious risks associated with the surgery, which does not always have positive outcomes.

This part of the study included 76 men with class 3 obesity (a BMI of 40 or above), making them eligible for bariatric surgery. Of these, 59 received testosterone treatment and lost 30 kg on average.

The BMI of the men also reduced by an average of 10 points, which could be enough to take them out of the highest obesity class, provided their BMI was less than 50 to begin with.

According to Saad, these results suggest testosterone therapy could be as effective as surgery for weight loss — but without the risk of serious complications.

“We believe testosterone therapy should be discussed with patients as an alternative to surgery and should be considered for male patients who cannot undergo surgery.” – Farid Saad, Consultant in Medical Affairs Andrology, Bayer AG

This study is based on data exclusively from men, and all participants had clinically low testosterone levels. Scientists need to conduct further studies to validate the use of this approach in other populations.

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A study of older adults in the United Kingdom finds that people who are lonely are more likely to develop type 2 diabetes, independent of other risk factors such as smoking, alcohol consumption, and weight.

Loneliness, in which a person’s social needs are not met, may be on the rise. A recent report found that almost half of people in the United States sometimes or always feel alone.

Loneliness is even more common among younger generations, with almost 80% of Gen Z and more than 70% of millennials experiencing this feeling.

Some believe that technology may play a part in feelings of loneliness among younger generations, with social media and other forms of online communication increasingly replacing genuine human connection.

Beyond the negative emotional impact of feeling isolated, loneliness is also a major risk to physical health. Research has associated loneliness with coronary heart disease and found that loneliness may be a greater threat to health than obesity.

One study even suggested that people who are lonely have a higher mortality risk than individuals who do not feel alone.

A new study from Kings College London in the U.K. adds to the list of health concerns associated with loneliness, finding that people who are lonely may be more likely to develop type 2 diabetes.

The researchers found that loneliness was a significant predictor of diabetes. This finding held when they took account of potential confounding factors, such as age, sex, ethnicity, wealth, smoking, physical activity, body weight, alcohol consumption, hypertension, and cardiovascular disease.

The findings appear in the journal Diabetologia.

The cohort

The study, which is the first to find an association between loneliness and type 2 diabetes, is based on data from more than 4,000 people aged 50 years and above, with an average age of 65 years. The collection of the data took place during the English Longitudinal Study of Ageing.

At the start of the current study, none of the participants had diabetes, and they all had blood glucose levels within a healthy range.

During a follow-up period of 12 years, 264 people in the study (roughly 6% of the sample) developed type 2 diabetes.

The researchers found that the level of loneliness that people experienced at the start of the study was a significant predictor of who would go on to develop diabetes.

Loneliness predicts diabetes onset

The assessment of loneliness occurred at the start of the study using a scale that a psychologist at the University of California, Los Angeles, developed. The scale requires people to rate questionnaire items such as “How often do you feel that you lack companionship?” and “How often do you feel part of a group of friends?”

The researchers found a significant association between loneliness and the onset of type 2 diabetes, even when they controlled for confounding factors, including smoking, alcohol consumption, weight, blood pressure, and cardiovascular disease.

The association was also independent of mental health factors, such as depression and whether a person lived alone.

“The study also demonstrates a clear distinction between loneliness and social isolation, in that isolation or living alone does not predict type 2 diabetes, whereas loneliness, which is defined by a person’s quality of relationships, does,” explains lead author Dr. Ruth Hackett.

This finding highlights the importance of the quality of human interactions that a person has, rather than the quantity.

Stress-related mechanism?

Although the reason for this association is not yet clear, the researchers suggest that it could be related to how the body manages stress.

Previous research has shown, for example, that loneliness is associated with changes to levels of the stress hormone cortisol, which plays a role in diabetes.

“If the feeling of loneliness becomes chronic, then every day you’re stimulating the stress system, and over time, that leads to wear and tear on your body, and those negative changes in stress-related biology may be linked to type 2 diabetes development,” explains Dr. Hackett.

However, it is important to note that this is currently only a hypothesis. Although this study provides a correlation between loneliness and type 2 diabetes, it does not show a causative link between the two factors.

Other limitations of the study include the fact that there was only one measurement of loneliness during the study. Also, the data on type 2 diabetes were based on self-reporting, rather than objective medical records.

The authors also note that the overall strength of the association between the two factors was small. Nevertheless, the study highlights loneliness as a potential risk factor for type 2 diabetes and provides a basis for future studies to investigate this connection in more detail.

A study in the United States demonstrates that mortality rates from heart failure are higher in counties where people face more poverty and social deprivation.

Heart failure, sometimes called congestive heart failure, is a chronic condition in which the heart is unable to pump enough blood around the body to meet its needs.

The condition is irreversible, although there are treatments that can help people live longer, more active lives.

About 5.7 million people in the U.S. have heart failure, according to the National Heart, Lung, and Blood Institute.

A new study suggests that the risk of dying from the condition is not spread evenly across the country, but that mortality rates are higher in poorer, more socially deprived areas.

Researchers at University Hospitals Cleveland Medical Center, OH, analyzed 1,254,991 deaths from heart failure across 3,048 counties between 1999 and 2018.

They used two standard indices of social deprivation: the Area Deprivation Index (ADI), which takes into account multiple local measures, including employment, poverty, and education, and the Social Deprivation Index (SDI), which is based on income and housing.

After adjusting for age, they found that the average death rate from heart failure per county was 25.5 deaths per 100,000 head of population.

However, counties with higher rates of socioeconomic deprivation had higher death rates from heart failure, and the association held up regardless of race or ethnicity, sex, and degree of urbanization.

The levels of deprivation that the ADI measures accounted for roughly 13% of the variability in heart failure mortality among counties. This scale of risk is similar to that of other recognized risk factors for heart failure, such as obesity and diabetes, say the scientists. Correlation with housing and income — the social factors that the SDI measures — accounted for 5% of this variability.

The study features in the latest issue of the Journal of Cardiac Failure.

Persistent inequality

The research revealed that the imbalance in survival rates between wealthy and deprived areas changed little between 1999 and 2018.

“Analysis of trends in heart failure mortality shows that these disparities have persisted throughout the last two decades,” says first author Dr. Graham Bevan, a resident physician at University Hospitals.

Bevan and his colleagues say that a range of factors may be responsible for the increased risk of dying from heart failure in poorer counties. These include reduced access to healthcare, substandard care, and poor health literacy.

They also note that the successful treatment of heart failure is dependent on patients adhering to a complex and often expensive drug regimen.

The authors write:

“Regardless of the contributing factors, the association between communities with high socioeconomic deprivation and [heart failure] mortality is strong and suggests that targeting social deprivation may be impactful in reducing [heart failure] mortality. Additionally, the yield of intensive [heart failure] preventive strategies may be higher in areas with high social deprivation.”

The American Heart Association (AHA) believe that aggressively tackling the major clinical risk factors for heart failure could significantly reduce the death toll. These clinical factors include hypertension, heart attacks, obesity, diabetes, and disorders of the heart valves.

“Living in a particular county should not mean you’re more likely to die from heart failure,” says co-author Dr. Sadeer G. Al-Kindi, a cardiologist at University Hospitals’ Harrington Heart and Vascular Institute.

“University Hospitals has a history of addressing healthcare disparities in underserved communities and, armed with the information from this study, we can thoughtfully create solutions to better serve these populations.”

One of the limitations of their study, the authors write, was that it relied on the information given on death certificates, which may not be accurate in every instance.

Also, the study was not designed to tease apart the effects of other recognized risk factors for heart failure mortality, some of which — such as lack of physical activity, obesity, diabetes, and high blood pressure — may also be associated with poverty. However, a recent study showed that these factors together failed to account for 57% of the geographical variation in deaths from heart failure among counties in the U.S.

This new study suggests that socioeconomic deprivation may help explain part of that variation.