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Monday, April 29, 2024
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New research has found that short bursts of exercise may significantly improve levels of metabolites that are indicators of key physical health issues.

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

Health and physical activity

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

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

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

Metabolites

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

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

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

He continues:

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

Burst of exercise

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

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

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

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

Marker of fitness?

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

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

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

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

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

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

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

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

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

Repurposed drugs

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

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

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

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

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

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

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

Increased survival

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

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

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

Two mechanisms of action

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Breaking down lipids

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

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

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

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

Most of the participants had heterozygous familial hypercholesterolemia.

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

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

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

Commenting on the findings, Dr. Rosenson concludes:

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

Racial diversity

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

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

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

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

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

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

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

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

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

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

Three nights in a sleep lab

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

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

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

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

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

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

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

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

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

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

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

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

The importance of REM sleep

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Deep Vein Thrombosis and Pulmonary Embolism (DVT/PE) are often under-diagnosed and serious, but preventable medical conditions. Deep vein thrombosis (DVT) is a medical condition that occurs when a blood clot forms in a deep vein. These clots usually develop in the lower leg, thigh, or pelvis, but they can also occur in the arm.

It is important to know about DVT because it can happen to anybody and can cause serious illness, disability, and in some cases, death. The good news is that DVT is preventable and treatable if discovered

Risk Factors for DVT
Almost anyone can have a DVT. However, certain factors can increase the chance of having this condition. The chance increases even more for someone who has more than one of these factors at the same time.
Following is a list of factors that increase the risk of developing DVT:
*Injury to a vein often caused by: fractures, severe muscle injury, or major surgery (particularly involving the abdomen, pelvis, hip, or legs).

*Slow blood flow, often caused by: Confinement to bed (example, due to a medical condition or after surgery); Limited movement (example, a cast on a leg to help heal an injured bone); sitting for a long time, especially with crossed legs; or paralysis.
*Increased estrogen, often caused by: birth control pills, hormone replacement therapy, sometimes used after menopause, pregnancy, for up to three months after giving birth
*Certain chronic medical illnesses, such as: heart disease, lung disease, cancer and its treatment, inflammatory bowel disease (Crohn’s disease or ulcerative colitis)

Other factors that increase the risk of DVT include: Previous DVT or PE, family history of DVT or PE, age (risk increases as age increases), obesity, a catheter located in a central vein, inherited clotting disorders
Preventing DVT

The following tips can help prevent DVT:
*Move around as soon as possible after having been confined to bed, such as after surgery, illness, or injury.
If you’re at risk for DVT, talk to your doctor about:
*Graduated compression stockings (sometimes called “medical compression stockings”)
*Medication (anticoagulants) to prevent DVT.
When sitting for long periods of time, such as when traveling for more than four hours:
*Get up and walk around every two to three hours.
Exercise your legs while you’re sitting by:
*Raising and lowering your heels while keeping your toes on the floor
*Raising and lowering your toes while keeping your heels on the floor
*Tightening and releasing your leg muscles
Wear loose-fitting clothes.
You can reduce your risk by maintaining a healthy weight, avoiding a sedentary lifestyle, and following your doctor’s recommendations based on your individual risk factors.
Symptoms
About half of people with DVT have no symptoms at all. The following are the most common symptoms of DVT that occur in the affected part of the body: swelling, pain, tenderness, redness of the skin. If you have any of these symptoms, you should see your doctor as soon as possible.
PE: You can have a PE without any symptoms of a DVT.
Signs and symptoms of PE can include:
*Difficulty breathing
*Faster than normal or irregular heart beat
*Chest pain or discomfort, which usually worsens with a deep breath or coughing
*Coughing up blood
*Very low blood pressure, lightheadedness, or fainting

If you have any of these symptoms, you should seek medical help immediately.
Diagnosis of DVT /PE

The diagnosis of DVT or PE requires special tests that can only be performed by a doctor. That is why it is important for you to seek medical care if you experience any of the symptoms of DVT or PE.

Treatments for DVT /PE
Medication is used to prevent and treat DVT. Compression stockings (also called graduated compression stockings) are sometimes recommended to prevent DVT and relieve pain and swelling. These might need to be worn for two years or more after having DVT. In severe cases, the clot might need to be removed surgically.

PE: Immediate medical attention is necessary to treat PE. In cases of severe, life-threatening PE, there are medicines called thrombolytics that can dissolve the clot. Other medicines, called anticoagulants, may be prescribed to prevent more clots from forming. Some people may need to be on medication long-term to prevent future blood clots.

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

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

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

Vitamin B12 is essential to the body

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

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

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

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

Importance of iodine in the diet

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

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

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

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

A growing trend for vegan diets

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

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

The study appears in the journal Deutsches Ärzteblatt.

Study design

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

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

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

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

Key research findings

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

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

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

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

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

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

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

Study limitations to consider

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

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

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

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

Final thoughts

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

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

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

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A recent study reveals that losing fat without reducing muscle mass results in a significantly lower risk of heart failure in people with type 2 diabetes.

In the United States, around 1 in 10 people have diabetes, and 90–95% of them have type 2 diabetes. Type 2 diabetes usually develops after age 45. Estimates suggest that by 2045, 700 million adults worldwide will have this condition.

Type 2 diabetes usually begins as insulin resistance. This is a condition wherein the body’s cells no longer react to the insulin the pancreas produces to control blood sugar.

Genetics, ethnicity, and advancing age all play a role in the development of insulin resistance and diabetes. However, excess weight, a lack of exercise, an unhealthful diet, and smoking may be driving factors in its occurrence.

Once doctors diagnose this condition, the primary treatments they advise generally include taking medications and making certain lifestyle changes, such as losing weight and improving the diet.

As diabetes nearly doubles the risk of death due to heart disease or stroke and increases the risk of having heart failure by a factor of two in males and five in females, many researchers are focusing on preventing these and similar health complications for those with diabetes.

Heart failure, or congestive heart failure, occurs when the heart muscle does not pump the blood adequately. This leads to a buildup of fluid in the lungs or legs, or sometimes both.

Heart failure has a number of potential causes. For example, after a heart attack (when the heart muscle sustains damage due to a lack of oxygen), the muscle is weak and cannot pump well.

Heart failure can also occur due to type 2 diabetes. This is as a result of direct harm to the heart muscle from raised blood sugar and systemic inflammation associated with the condition.

One prevention strategy includes weight loss for people with overweight or obesity. However, not much is known regarding what type of weight loss has the most impact on reducing the risk of diabetes-related heart issues.

The study

To investigate this further, researchers at the University of Texas Southwestern Medical Center (UTSW) in Dallas analyzed data from the Look AHEAD study.

This is a randomized trial investigating weight loss due to intensive lifestyle intervention, consisting of healthful eating and increased physical activity versus support and education alone in people with type 2 diabetes.

The UTSW research, which appears in the journal Circulation, received funding from the National Heart, Lung, and Blood Institute, the Texas Health Resources Clinical Scholars Program, and the National Institutes of Health (NIH).

The researchers selected 5,103 people from the Look AHEAD study who did not have heart failure at the beginning of the study. The participants also had sufficient baseline measurements needed for prediction equations to estimate how much fat mass and lean (muscle) mass they had.

Data on the participants’ weight and waist circumference were available at the beginning of the study and over a 4-year period. The team also noted hospitalizations for heart failure over a 12-year time frame.

During the trial’s 12-year follow-up, 257 study participants were hospitalized for heart failure treatment.

In the Look AHEAD study, scientists used a scanning technique called dual-energy X-ray absorptiometry (DXA) to determine body composition in a subset of about 1 in 5 of the participants. These participants also had information recorded on factors such as height, weight, waist circumference, and ethnicity.

This meant that the researchers could validate existing equations that predict the proportion of fat mass and lean mass from these factors, which are simple to collect compared with the much more complicated process of conducting a DXA scan.

The researchers’ analysis of the subset of participants with DXA scans provided a new equation specific to this study group. They applied this new equation to the remaining participants without a DXA scan to accurately predict their fat mass and lean mass.

This revealed that adults in the study who had lost weight were less likely to develop heart failure if they lowered their fat mass and waist circumference. However, losing lean mass did not change their risk.

The investigators note that although the risk of heart failure decreased in those who lost body fat and reduced their waist circumference, the study data showed no significant reductions in heart attack risk.

The team also considered the participants’ ejection fraction (EF) ratio. This is a measurement of the amount of blood leaving the heart with each contraction.

The data showed that reducing body fat mass by 10% resulted in a 22% lower risk of heart failure with preserved EF ratio and a 24% lower risk of heart failure with reduced EF ratio.

“Our study suggests that simply losing weight is not enough. We may need to prioritize fat loss to truly reduce the risk of heart failure.” – Study co-author Dr. Kershaw Patel, a cardiologist at Houston Methodist Hospital in Texas

Supporting evidence

A study from May this year, which appears in the journal Circulation Research, compared obesity phenotypes, diabetes, and cardiovascular diseases.

The comparison suggests that some people who have a healthy weight or overweight but an excess amount of fat deposits around the internal organs and under the skin have a higher risk of diabetes and heart disease.

The researchers say that it is not possible to determine the risk of cardiovascular disease and type 2 diabetes based on body mass index (BMI) alone — mostly because body composition is so diverse.

They suggest that since excessive amounts of fat tissue largely define cardiovascular risks, reducing body fat is critical for prevention.

Implications and limitations

The results of the UTSW study suggest that for people with diabetes who also have overweight, losing weight, in general, may not be adequate to reduce heart health risks.

If further studies replicate these findings, it could confirm that losing weight by shedding visceral fat from around the organs — rather than losing muscle mass — is a key factor when it comes to reducing the risk of heart failure in type 2 diabetes.

The study authors also say that further investigation is necessary to determine if building or maintaining muscle in addition to losing fat mass would be even more effective in reducing the risk of diabetes-related heart failure.

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In a small clinical trial, patients with major depressive disorder (MDD) who were given two doses of psilocybin along with psychotherapy showed a reduction in depressive symptoms. The psychedelic’s therapeutic effects persisted for up to 4 weeks with minimal side effects.

Psychedelics are known for their hallucinogenic properties, but their mind-altering effects may also benefit people with depression.

According to the National Institute of Mental Health, about 17.3 million adults in the United States have experienced at least one depressive episode.

Currently, the gold standard for treating MDD is psychotherapy or antidepressant medication. A 2014 study in World Psychiatry found that psychotherapy combined with antidepressants was more effective than the former alone.

Replacing antidepressants with hallucinogenic mushrooms

New antidepressants are ketamine-like drugs that show a high therapeutic response. A 2014 meta-analysis in Psychopharmacology reports that roughly 0.5 milligrams per kilogram of ketamine effectively reduced depressive symptoms. These effects also lasted 2–3 days after treatment. However, there are some drawbacks.

While currently approved by the Food and Drug Administration (FDA), there are some short-term side effects to consider when using ketamine, such as feeling strange or bizarre, numbness, and difficulties speaking.

Ketamine has a high liability for addiction and may have a large potential for abuse. A 2018 study in Neurobiology of Stress found that repeated low-dose ketamine treatments for treatment-resistant depression resulted in cognitive impairments and potential for abuse.

To avoid people abusing their medication, alternative treatments to support psychotherapy are needed — enter psilocybin.

There is growing evidence of psilocybin’s antidepressant properties. A study in the Journal of Psychopharmacology demonstrateda single psilocybin dose that produced an antidepressant and anxiolytic response in cancer patients, which lasted for 5 years.

Compared with ketamine, psilocybin has lower addictive properties, which would be beneficial as a potential add-on for current treatments. However, clinical research evaluating this substance in combination therapies is limited.

Recently, researchers at Johns Hopkins University published an article contributing to the research investigating the effectiveness of psilocybin-assisted therapy for depression.

“These data expand the findings of previous studies involving patients with cancer and depression, as well as patients with treatment-resistant depression, by suggesting that psilocybin may be effective in the much larger population of MDD,” write the study authors.

Their clinical trial results appear in JAMA Psychiatry.

Johns Hopkins clinical trial

From August 2017 to April 2019, the researchers of the current study recruited adults with MDD who were not taking antidepressant medications and had no history of psychotic disorder, suicide attempts, or hospitalizations. The scientists randomly assigned a total of 24 participants to an immediate or a delayed treatment group.

The psychedelic-assisted therapy lasted for 8 weeks, with 18 in-person visits and 2 days for psilocybin treatment.

Participants in the immediate treatment group began the psilocybin treatment during an 11-hour supportive psychotherapy session. The researchers allowed for a 1.6-week break between the first and second doses. In contrast, the delayed treatment group waited 8 weeks before receiving psilocybin-assisted therapy.

Reduction in severity of depression

At the time of enrollment, participants had a score of 23 in the GRID-Hamilton Depression Rating Scale (GRID-HAMD), which indicates moderate depression. After a 1-week and 1-month follow-up, participants in the immediate treatment group dropped to a score of 8, indicating mild depression.

In the entire cohort, 67% reduced the severity of their depressive symptoms 1 week after psilocybin treatment. This percentage grew to 71% when researchers followed up after 4 weeks.

After 1 week, the researchers found that 58% of the cohort were no longer classified as clinically depressed. By week 4, they found that 54% of the participants were no longer classified as depressed.

Limitations from the clinical trial design

Several limitations exist that could challenge the usefulness of the study results. The research had insufficient minority representation, as recruitment leaned towards non-Hispanic whites.

This is important because while white people typically report more cases, the American Psychiatric Association note that Black and Hispanic Americans are more likely to experience depression for more extended periods. In response, the researchers acknowledge the need for future studies to validate this proof of concept in more representative populations.

The study also fails to address the long-term effects of psilocybin treatment. Unlike the investigation on cancer patients, which had a 5-year follow up, the current research followed up after only 1 month.

There were also variables in the study design that could question psilocybin’s effectiveness as an antidepressant drug. One comes from a lack of a placebo group. Placebos are essential in determining whether a person truly benefitted from the drug and not from outside factors. For this reason, the safety of using psilocybin remains unknown.

Final thoughts

Overall, the authors find their clinical trial supports the use of psilocybin-assisted therapy for MDD.

“Although the rapid antidepressant effects of psilocybin are similar to those reported with ketamine, the therapeutic effects are different. Ketamine effects typically last for a few days to 2 weeks, whereas the current study showed that clinically significant antidepressant response to psilocybin therapy persisted for at least 4 weeks, with 71% of the participants continuing to show a clinically significant response (≥50% reduction in GRID-HAMD score) at week 4 of follow-up.”

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A study finds that social anxiety and depression lead to a greater use of dating apps and affect what people hope to gain from them.

Pew Research Center data released in February this year indicate that, in the United States, as many as 30% of adults have used a dating site or app.

According to a Statista survey, in the first quarter of 2020, Tinder, the most popular of these apps, had more than 6 million subscribers.

There are numerous reasons for using a dating app. Now, a new study from Ryerson University in Toronto, Canada, looks specifically at the link between social anxiety, depression, and dating apps.

According to this research, there is a link between social anxiety and depression and a more extensive use of dating apps.

“With increased symptoms of social anxiety and depression, women may be even more likely to turn to technology for social connection, especially if alternative forms of social contact are reduced due to social avoidance.” – Senior author Martin Antony, from Ryerson University in Toronto, Canada

The study appears in Cyberpsychology, Behavior, and Social Networking.

Why do people use dating apps?

Previous research suggests there are six things people who use Tinder hope to attain. These “Tinder motives” are:

  • love
  • casual sex
  • ease of communication
  • self-worth validation
  • thrill of excitement
  • trendiness

The prevailing theory tested in the new research is the positive link between social anxiety and depression with a greater use of dating apps. In addition, the researchers predicted positive associations between social anxiety and depression and a desire for:

  • ease of communication for men, due to the anxiety associated with asking potential partners for a date, traditionally perceived as a male responsibility
  • love, equally for both genders
  • self-worth validation, equally for both genders
  • the thrill of excitement, especially for men
  • casual sex, especially for men

The study authors also predicted a negative association between social anxiety, depression, and contacting dating app matches equally for both genders.

The study’s findings

A total of 374 individuals who use dating apps were recruited for the study and responded to questions posed through Amazon’s Mechanical Turk platform.

There were no inclusion or exclusion criteria, and each person received $1 for taking part in the study.

The researchers asked participants to fill out the 17-question Social Phobia Inventory (SPIN), in which a person describes the anxiety they have experienced in social situations over the past week. Researchers recognize the SPIN survey for its usefulness as a psychometric measure.

In addition, individuals completed the equally well-regarded 21-question Depression Anxiety Stress Scales survey for measuring anxiety, depression symptoms, and stress.

Participants also completed the Tinder Motives Scale survey that tracked the importance of five of the six Tinder motives to the individual. The research team did not include trendiness because they considered the survey ineffective for measuring its significance.

The scientists measured individuals’ use of dating apps through the Online Dating Inventory questionnaire to assess their use and behavior.

The researchers found that social anxiety and depression are not interchangeable, and were variously linked, or not, with different motives for using dating apps.

The researchers’ general hypothesis was deemed correct: social anxiety and depression do appear to be associated with greater dating app use. Beyond that, the authors of the study drew a variety of conclusions.

They found that:

  • Social anxiety and depression are associated with the use of dating apps for ease of communication by both genders, though the effect is more pronounced for women.
  • Women with social anxiety are more likely to be interested in obtaining love through dating apps. Depression did not affect whether people were looking for this, for either men or women.
  • Dating apps are used for self-worth validation by people of both genders with social anxiety. This was also true of people with depression, with a stronger effect in women than men.
  • Contrary to the researchers’ expectations, there was a positive link between social anxiety and the thrill of excitement for women, though not for women living with depression, and not for men.
  • There was an association between social anxiety in men and women with an effort to obtain casual sex. This was also true in people living with depression, with a stronger effect in women.

The researchers also discovered a negative correlation between social anxiety and depression in men and the likelihood that they would actually contact a person who turned out to be a match. The likelihood a woman would initiate contact was not affected at all by their level of depression.

The study authors point out that they cannot know whether social anxiety and depression lead to greater dating app use or the other way around, suggesting this open question would benefit from further research.

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