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Thursday, April 18, 2024
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Previous research has shown the community of bacteria and other microorganisms that lives in our gut, known as the gut microbiota, to affect our health and well-being in a multitude of ways, many of them positive.

Much of the information on the bacteria that make their home in our mouths, however, focuses on gum disease and its knock-on inflammatory effects around the body.

The role of oral bacteria in producing nitric oxide, which benefits cardiovascular and cognitive health, is much less well-known.

Many species of oral bacteria convert the inorganic nitrateTrusted Source in vegetables into nitrite. Nitrite is a precursor for nitric oxide, a signaling molecule that dilates blood vessels and transmits messages between neurons in the brain.

In older people, reduced availability of nitric oxide may contribute to hypertension (high blood pressure) and a decline in cognitive function.

A new study suggests that drinking beetroot juice, which is rich in inorganic nitrate, can alter the balance of bacteria in the mouth in favor of species that promote better cognitive and cardiovascular health.

The findings of this study help explain the proven benefits of beetroot juice for lowering blood pressure in people with hypertension.

Other vegetables that contain a lot of nitrates, including cabbage, lettuce, spinach, and celery, could offer similar benefits.

Scientists at the University of Exeter in the United Kingdom led the research, which features in the journal Redox Biology.

“We are really excited about these findings, which have important implications for healthy aging,” says lead author Prof. Anni Vanhatalo.

“Maintaining this healthy oral microbiome in the long term might slow down the negative vascular and cognitive changes associated with aging,” she adds.

Juice with or without nitrate

The study involved 26 individuals aged 70–80 years.

The researchers randomly assigned these participants to one of two groups. While they asked both groups to drink 140 milliliters of beetroot juice per day for 10 days, the experimental group drank a nitrate-rich juice, while the control group drank a nitrate-depleted juice.

The smell and taste of the two drinks were the same.

After a washout period of 3 days, the groups switched, and the participants consumed the other drink for 10 days.

The researchers asked the participants not to use mouthwash during the study.

Before, during, and after the experiment, they administered a battery of physiological and cognitive tests. They also identified bacterial species by sequencing genetic material in saliva samples from the participants.

Compared with the placebo condition, subjects who drank ordinary beetroot juice had larger numbers of oral bacteria associated with good vascular and cognitive health.

Their saliva also contained lower numbers of bacteria linked to inflammation.

On average, the participants’ systolic blood pressure fell by 5 millimeters of mercury after 10 days of drinking nitrate-rich beetroot juice. In addition, the tests indicated a greater availability of nitric oxide in their blood.

Those drinking the nitrate-rich juice also performed better on tests of sustained attention.

Clusters of bacterial species

The researchers used a statistical technique to identify two distinct clusters of bacterial species that flourished in the participants’ mouths when they drank regular beetroot juice.

These two clusters or “modules” (labeled MM5 and MM6) not only tended to co-occur in the same mouths but were also associated with improvements in cognitive function and blood pressure, respectively.

The authors propose that these nitrate-sensitive oral bacteria would make suitable probiotics to redress age-related declines in cardiovascular and cognitive health.

A third cluster of species, which previous research has associated with inflammation, failed to thrive in the mouths of participants drinking regular, high-nitrate beetroot juice.

This cluster included various disease-causing species, including Clostridium difficile.

Prof. Vanhatalo cautions that further research will be necessary to determine whether these findings apply to other groups of people.

“Our participants were healthy, active, older people with generally good blood pressure,” she explains.

“Dietary nitrate reduced their blood pressure on average, and we are keen to find out whether the same would happen in other age groups and among people in poorer health,” she adds.

The authors also note that the technique they used to identify bacteria, called 16S ribosomal sequencing, determines the relative abundance of the organisms rather than their absolute amounts or metabolic activity.

The latter quantities will influence the extent of nitrite production in the mouth and, therefore, the availability of nitric oxide.

In addition, the authors write that 16S sequencing (which effectively reads the sequence of a single gene) is not very good at identifying individual species of bacteria.

To develop probiotics, they say, researchers will need to use a technique called whole genome sequencing, which is more expensive but more accurate.

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April is Parkinson’s Awareness Month. With this in mind, this week’s edition of Medical Myths tackles the many misunderstandings that surround Parkinson’s disease. We discuss the symptoms and treatment, the outlook for people with the condition, and more.

Parkinson’s disease is a neurodegenerative movement disorder. Over time, dopamine-producing cells in a part of the brain called the substantia nigra deteriorate.

This deterioration, which leads to a reduction in dopamine, produces symptoms. The symptoms tend to develop slowly over time, often starting with a slight tremor in one hand or stiffness in movement.

Aside from tremor and stiffness, other symptoms include difficulties coordinating movements, changes in posture, a fixed facial expression, a reduced sense of smell, mood changes, and sleep problems.

As the disease progresses, some people with Parkinson’s develop dementia.

In 2016, an estimated 6.1 millionTrusted Source people worldwide had Parkinson’s disease. The number of cases has more than doubled in the last 25 years.

In this article, we dispel some of the most common myths associated with Parkinson’s disease.

1. Parkinson’s only affects movement

It is true that the medical community considers Parkinson’s disease a motor disorder. However, people with the condition often also experience nonmotor symptoms, which can begin before the motor symptoms.

Nonmotor symptoms can include cognitive impairment or dementia, depression and anxiety, sleep dysfunction, pain, apathy, sexual dysfunction, and bowel incontinence.

People often overlook these symptoms, but they are important. As the authors of one paper on the topic explain:

“[N]onmotor symptoms dominate the clinical picture of advanced Parkinson’s disease and contribute to severe disability, impaired quality of life, and shortened life expectancy.”

2. Treatment only works for a few years

Although there is no cure for Parkinson’s disease, drugs can help people manage the condition. One of the most effective drugs is levodopa, which the body converts into dopamine once it enters the brain.

There is a long standing myth that levodopa can only relieve symptoms for about 5 years before it stops working. This is a myth. Levodopa can be effective for decades. However, over time, its effectiveness might reduce.

Medical News Today spoke with James Beck, Senior Vice President and Chief Scientific Officer of the Parkinson’s Foundation. He explained why levodopa becomes less potent:

“One of the cruel ironies about Parkinson’s disease is that the key enzyme that converts levodopa to dopamine (aromatic acid decarboxylase or AADC) is predominantly found in the dopamine neurons of the substantia nigra, which are lost during progression of the disease. So, the main way to make dopamine available to the Parkinson’s brain declines as the disease advances.”

In other words, it is not that levodopa stops being effective. Instead, the supply of the enzyme that it needs to be effective becomes more limited.

In the past, doctors and people with Parkinson’s have held off starting treatment because of fears that levodopa would slowly stop working. We now know, though, that this reduction in potency is due not to the length of time that a person takes levodopa but to the progression of the disease.

However, it is true that over time, each dose of levodopa might improve symptoms for a shorter period. This so-called wearing-off means that symptoms start to return before the next dose is due.

3. Levodopa makes symptoms worse

Another misconception about levodopa is that it can make Parkinson’s disease symptoms worse. This is not true.

It is important to note that levodopa can cause other motor symptoms, such as dyskinesia, which refers to involuntary jerky movements. However, the onset of dyskinesia is related to the progress of the underlying disease rather than how long an individual has been taking levodopa.

Therefore, doctors no longer recommend holding off on taking levodopa until later in the disease.

According to the American Parkinson’s Disease Association (APDA), dyskinesia does not generally appear until the individual has been taking levodopa for 4–10 years. The APDA also writes:

“Dyskinesia in its milder form may not be bothersome, and the mobility afforded by taking levodopa may be preferable to the immobility associated with not taking levodopa. People with Parkinson’s must weigh the benefits from using levodopa versus the impact of dyskinesia on their quality of life.”

4. Tremor always signifies Parkinson’s

Tremor is the most well-known symptom of Parkinson’s disease. However, it can also occur as part of other conditions, including drug-induced parkinsonism, vascular parkinsonism, dystonic or essential tremor, psychogenic disease, and dopa-responsive dystonia.

5. Doctors can always provide an accurate outlook

Although doctors understand the range of symptoms that are associated with Parkinson’s, it is very difficult to predict how an individual’s disease will progress. Parkinson’s varies substantially among individuals.

As the authors of one study explain, there are “radical differences in clinical manifestations and progression between patients.”

“The [reason for the] differences observed in how individuals experience Parkinson’s disease and its progression remains unknown.” Dr. Beck explained to MNT. “It could be based on how Parkinson’s began with each individual.”

Scientists are currently investigating ways of making better predictions. Hopefully, in the future, doctors will be able to provide a clearer idea of how an individual’s condition will progress.

6. Everyone with Parkinson’s has tremor

Tremor is perhaps one of the most recognizable symptoms of Parkinson’s disease. However, some people develop nonmotor symptoms before tremor appears.

Also, some individuals do not experience tremor at any point during the disease’s progression.

Speaking with MNT, Dr. Beck explained, “About 20% of people with Parkinson’s disease do not develop a tremor.” Although scientists do not know why this is the case, Dr. Beck believes that tremor severity, in general, might depend on which brain regions the disease affects.

He noted that some scientists think “that people who have a strong tremor have lost more dopamine neurons in an area adjacent to the substantia nigra called the retrorubral area. It is these dopamine neurons (or their loss) that contribute to Parkinson’s tremor.”

7. People might experience ‘flare-ups’

In some conditions, such as multiple sclerosis, people can experience exacerbations, or flare-ups, of their symptoms. Parkinson’s disease, however, does not tend to work in this way.

The symptoms, overall, progress very slowly, although they might fluctuate throughout the day.

If someone’s symptoms do worsen suddenly, it is likely due to other factors. For instance, one study investigated these types of exacerbations in 120 people with Parkinson’s over an 18-month period.

The most common cause was infection, accounting for more than 1 in 4 (25.6%) exacerbations. Other factors included anxiety, medication errors, poor adherence to medications, medication side effects, and a decline in health following surgery.

According to the authors, 81.4% of these episodes were “attributable to reversible or treatable causes.”

8. Beyond drugs, nothing can help

There is a persistent myth that drugs are the only way to ease symptoms or slow disease progression. This is a myth.

There is mounting evidence that staying physically active can reduce symptoms and potentially even slow disease progression.

The Parkinson’s Foundation explains that people with Parkinson’s “who start exercising earlier and [for] a minimum of 2.5 hours a week experience a slowed decline in quality of life compared [with] those who start later. Establishing early exercise habits is essential to overall disease management.”

Research suggests that exercise does not just reduce the motor symptoms of Parkinson’s. For instance, studies have found that exercise helps improve associated sleep problems and cognitive function in people with the condition.

9. Parkinson’s is fatal

This is a misconception. Parkinson’s is not fatal in the same way that a heart attack might be. People with Parkinson’s can live long and meaningful lives.

Compared with individuals who do not have Parkinson’s, those who do have the disease are likely to have a reduced life expectancy. This reduction is more significant for people who develop the disease at a younger age but less pronounced in those who do not develop dementia.

Although Parkinson’s is not fatal, it increases the risk of falls. Serious falls can be fatal, or they can require surgery, which increases the risk of complications or infections.

Another substantial risk is pneumonia. As people with Parkinson’s may have difficulty swallowing, they can inhale particles of food into the lungs. People with Parkinson’s also have weaker cough reflexes, so the food might stay in the lungs, where it can spark an infection.

The inability to cough out the infected material means that these infections can be fatal.

As the APDA explains, “Most patients die with Parkinson’s disease and not from it.”

Moving forward

Although there are still gaps in our knowledge about Parkinson’s disease, researchers continue to dive into the details. When MNT asked Dr. Beck about promising avenues of research, he said:

“I think genetic forms of Parkinson’s disease offer the best hope for treatments that may alter the course of the disease.” Scientists estimate that genetics are responsible for 10–15% of Parkinson’s cases.

“However, in order for any trial to succeed in targeting genetic Parkinson’s, we (patients and clinicians) need to know who carries disease-related mutations. Currently, no one really knows,” explained Dr. Beck.

“That is why the Parkinson’s Foundation launched PD GENEration, a national initiative that offers genetic testing and counseling at no cost for people with Parkinson’s disease. While this is not a cure for Parkinson’s now, our goals for PD GENEration are to accelerate clinical trials for the disease, improve Parkinson’s care and research, and empower people with Parkinson’s and their care teams.”

Slowly, researchers are unpicking the mechanisms at work in Parkinson’s, and, hopefully, they will one day identify more effective treatments and perhaps even a cure.

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Various common chemicals may harm the immune system, causing it to malfunction. This is known as immunotoxicity. These harmful effects may be temporary or permanent.

Possible immunotoxic effects include:

  • hypersensitivity
  • chronic inflammation
  • immunosuppression, or an impairment of the body’s ability to fight off infections
  • immunostimulation, which can cause tissue damage through immune responses
  • autoimmunity

In particular, if an immunotoxic substance causes the body to produce fewer antibodies, it can have an effect on the fight against active infections and the protection against future ones.

The FDA currently require immunotoxicity testing for food additives. However, most food additives received approval decades ago, and the FDA do not mandate updated testing on previously approved additives.

TBHQ and PFAS

TBHQ is a common preservative that manufacturers use to prolong their products’ shelf lives.

According to the Environmental Working Group (EWG), it is present in almost 1,250 processed foods, including Cheez-It crackers, Pop-Tarts, Reese’s Peanut Butter Cups, and Little Debbie Swiss Rolls.

However, this chemical has had immunotoxic effects in animal studies.

Chemicals may also leach from packaging or food processing equipment into food. Some bags, boxes, and food wrappers are coated with per- and polyfluoroalkyl substances (PFAS).

PFAS-based materials are also common in non-stick coatings on cookware, gaskets in food processing equipment, and repeat-use plastics.

The FDATrusted Source require immunotoxicity testing only for food contact substances with a high daily exposure. The immunotoxicity of many food additives and food contact substances is largely unknown.

The Environmental Protection Agency (EPA) use high throughput in-vitro testing in their ToxCast program. This type of testing exposes living cells, proteins, or biological molecules in a laboratory environment to chemicals to assess and identify any potential toxic effects. This potentially limits the need for animal testing.

The sparsity of current immunotoxicity data prompted the researchers from the EWG to conduct a study to evaluate the immunotoxic effects of common food additives and food contact substances. They also assessed the utility of ToxCast data in screening for immunotoxicity.

Lead study author Dr. Olga Naidenko, Ph.D., EWG’s vice president for science investigations, emphasizes the urgency of this research:

“The pandemic has focused public and scientific attention on environmental factors that can impact the immune system. Before the pandemic, chemicals that may harm the immune system’s defense against infection or cancer did not receive sufficient attention from public health agencies. To protect public health, this must change.”

The researchers analyzed a total of 63 direct food additives present on more than 10 product labels sold in the U.S. in 2018–2020. They also specifically assessed nine identified PFAS that migrate from food packaging to food.

The findings now appear in the International Journal of Environmental Research and Public Health.

The study evaluated these substances, concentrating on those with the highest number of active ToxCast assays. It focused further analyses on those substances with activity toward multiple immune-related targets and proteins involved in immune response, inflammation, and defense mechanisms.

The study compared the results of high throughput ToxCast data with available data from animal and epidemiological studies.

Altered immune responses

Strong data from both ToxCast testing and immunological laboratory animal studies indicate that TBHQ may cause immune functioning changes.

However, ToxCast screening yielded data that did not always agree with existing data: There were cases wherein ToxCast data conflicted with previous data or indicated risks that previous data had not found.

Three different situations happened with the food colorant FD&C Red 3 and PFAS such as perfluoroundecanoic acid (PFUnDA) and perfluorooctanoic acid (PFOA).

In the study, the ToxCast data indicated that FD&C Red 3 affected multiple immune parameters, but the researchers did not find reference to any animal or epidemiological study into the immunotoxicity of this food colorant.

ToxCast, laboratory animal, and human study data demonstrated that PFUnDA affected multiple immune parameters and increased immune suppression risk.

However, the ToxCast data did not show strong activity for immune targets with PFOA, whereas animal and human studies demonstrated immunosuppressive effects.

The study attributed the lack of consistency in the findings to a lack of understanding of the exact mechanism of PFAS toxicity. The limitations of currently available high throughput testing to capture the full extent of the potential mechanism for immunotoxicity may also have had an impact.

The researchers conclude that both ToxCast and study data suggest that chemicals indirectly or directly added to foods, such as THBQ and PFAS, may adversely affect immune system functioning.

The EWG stress that the FDA should prioritize and integrate updated immunotoxicity testing to identify harmful chemicals into standard safety assessments to protect public health and well-being.

Scott Faber, senior vice president for government affairs at the EWG, adds, “Food manufacturers have no incentive to change their formulas. Too often, the FDA [allow] the food and chemical industry to determine which ingredients are safe for consumption.”

“Our research shows how important it is that the FDA take a second look at these ingredients and test all food chemicals for safety.”

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By 2030, experts predict that nearly half of all adults in the United States will have obesity.

There are well-known links between obesity and a wide range of physical illnesses, including type 2 diabetesTrusted Source, hypertensionTrusted Source, rheumatoid arthritisTrusted Source, and some forms of cancerTrusted Source.

However, there is also a complex two-way relationship between obesity and mental illness.

According to a report from the Centers for Disease Control and Prevention (CDC), 43%Trusted Source of the U.S. adults aged 20 years and over who are living with depression also have obesity. There is also an association between mental illness in general and obesity.

Weight gain is a recognized side effect of many antidepressant medications. Conversely, research suggests that obesity can have a psychological effect on people that predisposes them to depression.

But researchers believe that there may also be a more direct, physiological link between the two conditions.

Among the possible causes that obesity and mental illness may have in common are:

  • inflammation
  • hormonal disturbances
  • genetic factors

Brain circuitry

There is also a possibility that certain neural circuits in the brain predispose people to both obesity and mental health conditions. However, exactly where these circuits are and how they work have been unclear.

Researchers from Baylor College of Medicine in Houston, TX, recently led a team of researchers that may have discovered such a circuit in mice.

The team found that feeding mice a high fat diet disrupted the circuit, which led not only to weight gain but also to signs of anxiety and depression on standard behavioral tests.

When the researchers used genetic techniques to restore the normal functioning of nerve receptors in the circuit, this resulted in weight loss and eliminated the animals’ signs of anxiety and depression.

Remarkably, despite still having a healthy appetite, the mice reduced their food intake and were no longer interested in high fat food.

“We were surprised to see that the animals lost weight not because they lost their appetite but because genetically aided readjustment of the mental states changed their feeding preference from high fat to low fat food,” says Dr. Guobin Xia, a postdoctoral associate at Baylor who is co-first author of the study.

Two drugs that target the same nerve receptors in this brain circuit had similar beneficial effects on the mice and their feeding preferences.

The research appears in the journal Molecular PsychiatryTrusted Source.

Appetite and emotions

The newly identified brain circuit comprises connections between neurons in the hypothalamus and those in another brain region called the bed nucleus of the stria terminalis (BNST)Trusted Source.

Whereas the hypothalamus plays a central role in the hormonal regulation of appetite and physiology, among other functions, the BNST is involved in stress and fear responses.

The researchers showed that in mice, eating a high fat diet disrupted the circuit, dulling its ability to regulate appetite and emotions.

“This newly discovered circuit was malfunctioning in mice that were both obese and depressed,” says Dr. Xia.

The scientists found that they could restore the circuit by tweaking the activity of two nerve receptors in the BNST, either genetically or with drugs that target the receptors.

This reversed the negative effects of the high fat diet, eliminating signs of anxiety and depression and reducing body weight.

Drug combination

The Food and Drug Administration (FDA) has already approved the two drugs, zonisamide and granisetron, as treatments for epilepsy and for preventing nausea, respectively.

Dr. Qi Wu, who is the corresponding author of the new study, explains:

“We discovered that the combination of two clinically approved drugs, zonisamide and granisetron, profoundly reduced anxiety and depression in mice and promoted weight loss by synergistically acting upon two different molecular targets within our newly identified brain circuit.”

The researchers believe that their findings could lead to future clinical trials of this drug combination for treating the link between obesity and mental health conditions.

Until other researchers have confirmed the findings and conducted clinical trials, however, these early results from a study in animals remain tentative and may not translate to humans.

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Mindfulness is a mental practice in which a person directs their attention to the present moment, having a nonjudgmental awareness of their immediate surroundings, thoughts, and feelings.

A study by researchers at Wake Forest School of Medicine in Winston-Salem, NC, investigates the therapeutic value of online mindfulness sessions for people who have found that the COVID-19 pandemic has affected their emotional health.

After an experimental online mindfulness session, 89% of participants reported that the experience had been helpful.

The principal investigator for the research is Dr. Rebecca Erwin Wells, M.P.H., of Wake Forest School of Medicine, who says:

“We are all born with the capacity for mindfulness. It can help reduce stress and anxiety, and mindfulness meditation practice can help enhance this ability.”

The inspiration for the study comes from a program of free daily mindfulness sessions called “Mindfulness for Milan,” which Italian physician Dr. Licia Grazzi presented during the lockdown period. Dr. Grazzi is one of the recent study’s co-authors.

The results appear in the journal Global Advances in Health and Medicine.

Trying online mindfulness

From March 23 to August 4, 2020, the researchers recruited healthcare professionals, individuals with migraine, and the general public to participate in their study.

Of the 233 participants, 203 came from 116 different zip codes in the United States. In addition, there were 20 participants from other countries and 10 people who participated from unknown locations.

The researchers asked each of the participants to complete a pre-session survey, take part in a 15-minute online video mindfulness session, and then respond to a post-session survey.

Of those taking part, 63% had never practiced mindfulness before.

The session began with a white coat-wearing female instructor providing an overview of mindfulness. A guided practice followed that instructed individuals to bring their attention to the present moment, their breathing, and simply “being.”

The practice encouraged the gentle release of thoughts, feelings, and sensations throughout the session. A bell sound signaled the start and end of the session.

The effect of the class

Of the 144 individuals who completed the post-session survey, 76% said that the experience reduced their anxiety, while 80% reported feeling less stressed.

Slightly more than half of the participants — 55% — said that the class allayed their concerns about COVID-19.

Overall, 89% of people felt that the session helped them, with the same percentage considering the online format to be effective. In total, 74% said that they would recommend online mindfulness sessions to their friends and family. Individuals were also interested in more sessions, either weekly (48%), daily (36%), or monthly (17%).

Just under two-thirds of the participants — 65% — were interested in learning more about mindfulness. An additional 24% said that they might be interested.

The researchers note that 21% of participants were retirees, suggesting that age does not limit the value of mindfulness practice.

Limitations of the study

The study’s authors note several limitations of the research.

Firstly, the completion of the post-session survey may have been affected by some participants continuing to meditate after the session, which would give too much weight to the opinions of non-meditators. Participants may also have become distracted after the session or experienced technical issues.

Secondly, most of the sessions occurred in the early months of the pandemic, possibly artificially heightening people’s emotions and the effect of the session.

Finally, the participants in the study were overwhelmingly white (84%). The authors note:

“Further investigation is needed to understand the reasons behind lack of participant diversity: recruitment methods vs. lack of interest or access. While online programs improve accessibility, lack of internet or low technological proficiency may create disparities for some populations.”

Online mindfulness resources

The researchers also conducted an analysis of interest in mindfulness online. They collected the results of Google searches for the Boolean phrase “mindfulness + COVID” on both May 19, 2020 — toward the start of the pandemic — and August 23, 2020.

On the first date, searches yielded 63.5 million results, whereas there were 96.4 million results on the second date. This 52% increase in the number of sites on which the search phrase appeared suggests a growing interest in mindfulness as the pandemic continued.

The study also contains a list of recommended online mindfulness resources.

A Google search for “mindfulness-based stress reduction” classes led the authors to extensive online mindfulness resources, guided recordings, and external links that members of the Academic Consortium for Integrative Medicine and Health had provided.

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

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

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

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

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

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

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

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

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

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

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

Diet, genetics, and lifestyle

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Processed meat and disease risk

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

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

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

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

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

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

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

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

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

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

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

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Researchers recommend patients should receive jab before surgery, urge governments to prioritise surgical patients for coronavirus immunisation

British and Nigerian researchers have recommended that patients waiting for elective surgery should get COVID-19 vaccines ahead of the general population – potentially helping to avoid thousands of post-operative deaths linked to the virus.

The researchers, according to a new study funded by the National Institute for Health Research (NIHR), the United Kingdom (UK), found that between 0.6 per cent and 1.6 per cent of patients develop COVID-19 infection after elective surgery. They found patients who develop COVID-19 infection are at between four- and eight-fold increased risks of death in the 30 days following surgery. For example, whereas patients aged 70 years and over undergoing cancer surgery would usually have a 2.8 per cent mortality rate, this increases to 18.6 per cent if they develop COVID-19 infection.

Based on the high risks that surgical patients face, the scientists calculate that vaccination of surgical patients is more likely to prevent COVID-19-related deaths than vaccines given to the population at large – particularly among the over-70s and those undergoing surgery for cancer. For example, whereas 1,840 people aged 70 years and over in the general population need to be vaccinated to save one life over one year, this figure is only 351 in patients aged 70 years and over having cancer surgery.

Overall, the scientists estimate that global prioritisation of pre-operative vaccination for elective patients could prevent an additional 58,687 COVID-19-related deaths in one year.

They said this could be particularly important for Low- and Middle-income Countries (LMICs) where mitigation measures such as nasal swab screening and COVID-free surgical pathways, which can reduce the risk of complications related to the virus, are unlikely to be universally implemented.

The COVIDSurg Collaborative international team of researchers, led by experts at the University of Birmingham, UK has scheduled to publish its findings today in BJS (incorporating the British Journal of Surgery and the European Journal of Surgery), after studying data for 141,582 patients from across 1,667 hospitals in 116 countries -including Australia, Brazil, China, India, Nigeria, UAE, UK and USA – creating the world’s largest ever international study on surgery.

Co-lead author, Mr. Aneel Bhangu, from the University of Birmingham, commented: “Preoperative vaccination could support a safe re-start of elective surgery by significantly reducing the risk of COVID-19 complications in patients and preventing tens of thousands of COVID-19-related post-operative deaths.

“Many countries, particularly low- and middle-income countries, will not have widespread access to COVID vaccines for several years. While vaccine supplies are limited, governments are prioritising vaccination for groups at highest risk of COVID-19 mortality. Our work can help to inform these decisions.”

Co-lead author, Dr. Dmitri Nepogodiev, from the University of Birmingham, commented: “Restarting elective surgery is a global priority. Over 15,000 surgeons and anaesthetists from across 116 countries came together to contribute to this study, making it the largest ever-scientific collaboration. It’s crucial that policy makers use the data we have collected to support a safe restart to elective surgery; COVID vaccination should be prioritised for elective surgery patients ahead of the general population.”

Co-lead author and national lead for Nigeria, Prof. Adesoji Ademuyiwa, from the Department of Surgery, College of Medicine, University of Lagos (CMUL), commented: “Indeed vaccine supplies in LMICs are limited, but it is imperative to consider patients about to undergo elective surgery as a high risk group for COVID-19 vaccination.”

During the first wave of the pandemic, up to 70 per cent of elective surgeries were postponed, resulting in an estimated 28 million procedures being delayed or cancelled. While surgery volumes have started to recover in many countries, on-going disruption is likely to continue throughout 2021, particularly in the event of countries experiencing further waves of COVID-19. Vaccination is also likely to decrease post-operative pulmonary

The University of Birmingham is ranked among the world’s top 100 institutions, its work brings people from across the world to Birmingham, including researchers and teachers and more than 6,500 international students from over 150 countries.

“SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study” – COVIDSurg Collaborative is published by the British Journal of Surgery.

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Many people have chronic stress and anxiety. They face symptoms such as nervousness, agitation, tension, a racing heart, and chest pain.

In fact, anxiety is among the most common mental health issues. In the United States, more than 18 percent of adults are affected by anxiety disorders each year.

In some cases, another health condition, such as an overactive thyroid, can lead to an anxiety disorder. Getting an accurate diagnosis can ensure that a person receives the best treatment.

In this article, learn about a wide range of natural and home remedies that can help with stress and anxiety.

Natural remedies for anxiety and stress

Natural remedies are generally safe to use alongside more conventional medical therapies.

However, alterations to the diet and some natural supplements can change the way antianxiety medications work, so it is essential to consult a doctor before trying these solutions. The doctor may also be able to recommend other natural remedies.

1. Exercise

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Exercise may help to treat anxiety.

Exercise is a great way to burn off anxious energy, and research tends to support this use.

For example, a 2015 review of 12 randomized controlled trials found that exercise may be a treatment for anxiety. However, the review cautioned that only research of higher quality could determine how effective it is.

Exercise may also help with anxiety caused by stressful circumstances. Results of a 2016 studyTrusted Source, for example, suggest that exercise can benefit people with anxiety related to quitting smoking.

2. Meditation

Meditation can help to slow racing thoughts, making it easier to manage stress and anxiety. A wide range of meditation styles, including mindfulness and meditation during yoga, may help.

Mindfulness-based meditation is increasingly popular in therapy. A 2010 meta-analytic review suggests that it can be highly effective for people with disorders relating to mood and anxiety.

3. Relaxation exercises

Some people unconsciously tense the muscles and clench the jaw in response to anxiety. Progressive relaxation exercises can help.

Try lying in a comfortable position and slowly constricting and relaxing each muscle group, beginning with the toes and working up to the shoulders and jaw.

4. Writing

Finding a way to express anxiety can make it feel more manageable.

Some research suggests that journaling and other forms of writing can help people to cope better with anxiety.

A 2016 study, for example, found that creative writing may help children and teens to manage anxiety.

5. Time management strategies

Some people feel anxious if they have too many commitments at once. These may involve family, work, and health-related activities. Having a plan in place for the next necessary action can help to keep this anxiety at bay.

Effective time management strategies can help people to focus on one task at a time. Book-based planners and online calendars can help, as can resisting the urge to multitask.

Some people find that breaking major projects down into manageable steps can help them to accomplish those tasks with less stress.

6. Aromatherapy

Smelling soothing plant oils can help to ease stress and anxiety. Certain scents work better for some people than others, so consider experimenting with various options.

Lavender may be especially helpful. A 2012 study tested the effects of aromatherapy with lavender on insomnia in 67 women aged 45–55. Results suggest that the aromatherapy may reduce the heart rate in the short term and help to ease sleep issues in the long term.

7. Cannabidiol oil

cbd-oil
CBD oil comes from the marijuana plant.

Cannabidiol (CBD) oil is a derivative of the cannabis, or marijuana, plant.

Unlike other forms of marijuana, CBD oil does not contain tetrahydrocannabinol, or THC, which is the substance that creates a “high.”

CBD oil is readily available without a prescription in many alternative healthcare shops. Preliminary research suggests that it has significant potential to reduce anxiety and panic.

In areas where medical marijuana is legal, doctors may also be able to prescribe the oil.

8. Herbal teas

Many herbal teas promise to help with anxiety and ease sleep.

Some people find the process of making and drinking tea soothing, but some teas may have a more direct effect on the brain that results in reduced anxiety.

Results of a small 2018 trial suggest that chamomile can alter levels of cortisol, a stress hormone.

9. Herbal supplements

Like herbal teas, many herbal supplements claim to reduce anxiety. However, little scientific evidence supports these claims.

It is vital to work with a doctor who is knowledgeable about herbal supplements and their potential interactions with other drugs.

10. Time with animals

Pets offer companionship, love, and support. Research published in 2018 confirmed that pets can be beneficial to people with a variety of mental health issues, including anxiety.

While many people prefer cats, dogs, and other small mammals, people with allergies will be pleased to learn that the pet does have to be furry to provide support.

A 2015 studyTrusted Source found that caring for crickets could improve psychological health in older people.

Spending time with animals can also reduce anxiety and stress associated with trauma. Results of a 2015 systematic reviewTrusted Source suggest that grooming and spending time with horses can alleviate some of these effects.

Other treatment options

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Therapy may help to treat chronic anxiety.

Anxiety that is chronic or interferes with a person’s ability to function warrants treatment.

When there is no underlying medical condition, such as a thyroid problem, therapy is the most popular form of treatment.

Therapy can help a person to understand what triggers their anxiety. It can also help with making positive lifestyle changes and working through trauma.

One of the most effective therapies for anxiety is called cognitive behavioral therapy (CBT). The goal is to help a person understand how their thoughts affect their emotions and behavior and to replace those reactions with positive or constructive alternatives.

CBT can help with generalized anxiety and anxiety relating to a specific issue, such as work or an instance of trauma.

Medication can also help a person to manage chronic anxiety. A doctor may prescribe medications in any of the following groups:

  • antianxiety drugs called benzodiazepines, including Xanax and Valium
  • antidepressants called selective serotonin reuptake inhibitors, including Prozac
  • sleeping medications, if anxiety interferes with sleep

People should follow the doctor’s instructions when using these drugs, as they can have severe and possibly life threatening adverse effects.

Natural anxiety remedies can replace or complement traditional treatments.

Outlook

Untreated anxiety can get worse and cause more stress in a person’s life. However, anxiety is highly treatable with therapy, natural remedies, lifestyle changes, and medications.

A person may need to try several combinations of therapies and remedies before finding one that works. A doctor can help a person to determine which options are best.

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The researchers behind the study note that over the past 50 years, death rates from CVD have fallen in both males and females in the United States.

However, the rate of decline has been slower among females than males, and the rate of heart attacks in females aged 35–54 years is actually increasing.

In addition, research suggests that even though females have a lower incidence of CVD than males, they have a higher mortality rate and worse prognosis after an acute cardiovascular event.

As CVD seems to affect the sexes differently, there is an urgent need to determine whether doctors should offer different advice about prevention to their male and female patients.

A new study by researchers at the University of California, Los Angeles, suggests that the focus for females should be on maintaining or increasing muscle mass rather than losing fat.

The findings appear in the Journal of the American Heart Association.

Body composition

The researchers analyzed body composition data from the National Health and Nutrition Examination Survey (NHANES) 1999–2004 and CVD mortality data from NHANES 1999–2014.

The data came from a total of 5,627 females and 5,836 males, all aged over 20 years.

Based on the data, the researchers split the study participants into four groups:

  • low muscle mass and low body fat
  • low muscle mass and high body fat
  • high muscle mass and low body fat
  • high muscle mass and high body fat

In both sexes, the raw data showed that higher levels of fat were associated with higher CVD mortality, regardless of muscle mass.

However, after accounting for other factors that are known to affect CVD mortality, the relationship between body fat and the risk of dying from CVD changed completely in females.

After making these adjustments, the researchers found that females with high body fat and high muscle mass had a 42% lower risk of dying from CVD compared with females who had a low muscle mass and low body fat.

By contrast, males with high muscle mass and high body fat had a 26% reduced risk of dying from CVD compared with males with low measurements, while those with high muscle mass and low body fat had a 60% decreased risk.

Less emphasis on weight loss?

The researchers believe that their study supports the need for a shift in the focus of the advice that healthcare professionals give to females. This shift is toward increasing muscle mass through physical exercise and away from weight loss.

They write:

“[I]t demonstrates the potential importance of advice to maximize muscle mass in women. This diverges from the current emphasis on weight loss in CVD prevention, and thus methods to practically achieve such body composition alteration need to be further evaluated.”

It is worth emphasizing that the apparent protective effect of fat in females only emerged after adjusting for other CVD risk factors.

Among these CVD risk factors were:

  • cholesterol levels
  • high blood pressure (hypertension)
  • diabetes and prediabetes
  • hormone replacement therapy (HRT)

There is a highly complex interplay between body fat and these other risk factors. For example, excess body weight increases the risk of diabetes and hypertension, which, in turn, raise the risk of CVD.

Nonetheless, the authors note several plausible ways in which fat might provide some protection to females.

For instance, they highlight research suggesting that fat in the thighs and buttocks has a protective effect on metabolism that offsets the harm from abdominal fat.

They also note that in premenopausal females, the body stores about 50% of its fat just beneath the skin in the thighs and buttocks, whereas in males, the body stores 98% of the total fat more deeply in the upper body.

During and after menopause in females, however, fat tissue begins to accumulate in the abdomen, where it is associated with increased CVD risk.

The authors also note that in individuals of the same age and weight, the female body tends to accumulate fat by multiplying the number of fat cells, whereas the male body typically grows larger fat cells.

Large (“hypertrophied”) fat cells are associated with negative metabolic consequences, they write.

Limitations of the study

The researchers acknowledge some limitations of their study.

Firstly, the study design did not allow them to prove cause-and-effect relationships between muscle mass or fat mass and CVD mortality, only associations.

In addition, they say that the technique that they used to measure the body composition of volunteers — called “dual energy X‐ray absorptiometry” or DXA — can overestimate muscle mass in older people and individuals who lead sedentary lives.

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As we pass the 1-year mark of the COVID-19 pandemic, scientists are still discovering the specific characteristics of this new disease.

Perhaps the most obvious physical impact of COVID-19 is on the lungs, but doctors and researchers have also found links between COVID-19 and various other organs and systems, including the heart, brain, and kidneys.

SARS-CoV-2 infection also appears to affect the largest organ of the body — the skin.

In a recent study, which appears in the British Journal of Dermatology, a group of researchers teamed up with the British Association of Dermatologists to develop a better understanding of the skin manifestations associated with COVID-19.

COVID-19 and the skin

The first mention of a link between COVID-19 and skin changes came from China in the early phase of the outbreak.

Initially, it seemed that skin changes were relatively uncommon. In one analysis from February 2020, for instance, researchers reported rashes in fewer than 0.2% of 1,099 people with laboratory-confirmed COVID-19 across 552 hospitals.

Shortly after, in March, a study identified “cutaneous manifestations” in 18 out of 88 patients, or 20.4%, who were receiving treatment for COVID-19 at one hospital in Italy.

Since then, a number of other studies have identified skin changes associated with COVID-19. However, some of these reports only included limited numbers of participants. To date, scientists have not identified the full extent and variety of skin changes related to SARS-CoV-2 infection.

The most recent study investigates the issue in a large sample of participants.

A fresh look

The authors of the recent study took data from the COVID Symptom Study app. This collects a wealth of data, including information about participants’ age, sex, ethnicity, weight, height, general health, and use of medications, as well as whether the person is a healthcare worker.

Since May 2020, the app has prompted users to report any SARS-CoV-2 testing and results. A person can also report any symptoms.

In all, the researchers had access to data from 336,847 app users, 17,407 of whom had undergone a SARS-CoV-2 test, either positive or negative. The scientists also included data from 54,652 people who had registered at least one symptom of COVID-19 but had not taken a test. The authors refer to this group as “symptomatic untested users.”

Additionally, the researchers sent out a survey, which was advertised on social media. This was not targeted at users of the app. It asked for information about when a rash appeared, how long it lasted, and what other symptoms were present.

From this survey, the researchers extracted usable data from 11,544 people. Of this group, 2,328 had provided a photo of their rash and gave permission to share it. The team selected a subset of these photos, which they whittled down to 260 images.

The images were “blindly assessed and independently categorized by four experienced dermatologists.” Among the 260 photographs, 52 were discarded by at least one dermatologist, and 208 images were analyzed.

Rashes linked with SARS-CoV-2 infection

Of the 2,021 app users who tested positive for SARS-CoV-2, 8.8% reported skin-related changes, 6.8% reported body rashes, and 3.1% reported rashes on the hands or feet, which are called acral rashes.

The authors note that only 1.1% of this group experienced both body and acral rashes, suggesting that the two occur for different reasons, the researchers believe.

The body rashes, they theorize, might be caused by “immunological reactions to the virus,” whereas acral rashes could result from blood clots or damaged blood vessel walls.

In the group of untested symptomatic users who reported at least one of the main symptoms of COVID-19, the results were similar, with 8.2% reporting skin changes.

From the independent survey of 11,544 participants, the researchers analyzed the timing of skin changes.

According to the analysis of survey respondents who had tested positive for SARS-CoV-2 and experienced skin changes, 47% of these changes appeared at the same time as other COVID-19 symptoms. For 35% of the respondents, skin changes developed after other symptoms had started.

For 17% of the participants in this group, a rash appeared before other symptoms. And, interestingly, in 21% of participants, a rash was the only symptom.

Rash types

Using the photos of the participants’ rashes, the scientists identified the most common types, which were:

  • papular rashes (41.2%) — small, raised bumps
  • urticaria (30%) — red, itchy welts
  • acral rashes (23.1%) — lesions on the hands or feet

Acral lesions and papular rashes lasted for an average of 13 or 14 days, respectively, and urticaria for just 5 days.

The scientists have added the images to an online database.

Limitations

It is crucial to note that the participants in this study were predominantly white Europeans. As the researchers acknowledge, “We could not assess whether ethnicity affected the prevalence of cutaneous symptoms, as the number of non‐European users with skin symptoms was too low.”

Also, the authors explain that their study sample contained “larger proportions of female and younger individuals, compared with those observed in hospital settings.”

Another limitation is that the study relied on self-reported data. Countering this concern, the authors point out that “The presence of a rash, especially if symptomatic, is less subjective and more specific than other symptoms, such as fatigue or headaches.”

The team also recognizes that some skin reactions could have been caused by medications taken to treat COVID-19 or other conditions. However, the authors believe that “Drugs are unlikely to have been a major alternate cause of rashes.”

“Cutaneous manifestations of COVID-19 are sometimes the first or even the only sign of SARS-CoV-2 infection,” explains senior author Dr. Mario Falchi, of King’s College London, in the United Kingdom. He continues:

“Recognition of such early signs and symptoms of COVID-19 may enable identification of cases missed when relying only on the core symptoms, allowing preventive measures to be put in place to minimize further spreading of the infection.”

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