Stroke

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

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

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

COVID-19 and mental health

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

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

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

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

Google Trends

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

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

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

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

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

Worry and anxiety searches increased

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

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

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

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

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

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

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

Tip of the iceberg

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

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

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

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A new study has explored the link between the Zika and chikungunya arboviruses and neurological or cerebrovascular diseases.

New research has helped clarify the link between the Zika and chikungunya arboviruses — viruses carried by arthropods such as mosquitoes — and neurological complications.

The study also found that a person who has both Zika and chikungunya is more likely to have severe symptoms and more likely to experience a stroke.

The research, appearing in the journal The Lancet Neurology, will help clinicians better treat patients who contract these viruses, which are endemic in various parts of the world.

Arthropods and arboviruses

Arboviruses are carried by mosquitoes, midges, ticks, and sandflies — all of which belong to the phylum Arthropoda and are known as arthropods. When an infected arthropod bites a human, the human may contract the arbovirus.

The Centers for Disease Control and Prevention (CDC) note that more than 130 types of arbovirus can cause disease in humans. Two arboviruses that have recently spread throughout South America are Zika and chikungunya.

In the Americas, both viruses are commonly spread by the same mosquito species, and according to the CDC, both can cause broadly similar symptoms, including joint or muscle pain, a fever, headaches, swelling, and a rash.

While most people recover without needing treatment in a hospital, both types of illness can occasionally cause severe symptoms. Moreover, if contracted during pregnancy, Zika leads to an increased risk of developmental abnormalities and complications, including microcephaly, which affects the development of the head.

In addition to these risks, there is a growing awareness that neurological diseases are linked to Zika and chikungunya.

According to Dr. Maria Lúcia Brito Ferreira, a neurologist and department head at the Hospital da Restauração, in Recife, Brazil, and the lead author of the present study:

“Zika infection most often causes a syndrome of rash and fever without many long-term consequences, but these neurological complications — although rare — can require intensive care support in hospital, often result in disability, and may cause death.”

Arboviruses and neurological disease?

In the present study, the researchers wanted to explore the different ways that arboviruses such as Zika and chikungunya result in neurological diseases. They also wanted to assess whether people who contract two arboviruses tend to develop different diseases or experience a change in disease severity.

To do so, they conducted a 2-year study starting on December 4th, 2014, in Recife during an epidemic of Zika and chikungunya. In addition, the dengue arbovirus, which causes dengue fever and has been linked to neurological complications, is also endemic in the area.

The researchers recruited 201 people who had been admitted to the Hospital da Restauração with neurological issues and who had symptoms suggesting an arbovirus infection. Fifty-four percent of the participants were female, and the average median age was 48.

Laboratory analyses revealed that among these 201 participants, 148, or 74%, had arboviral infections.

Just under half of the 201 participants had a single viral infection — 41 had Zika, 55 had chikungunya, and two had dengue.

A quarter of the participants, or 50, had some signs of two viral infections, and 46 of them had Zika and chikungunya.

Dual viruses made symptoms more severe

The researchers found that a significant number of the participants with a confirmed arboviral infection had symptoms affecting either their central nervous system or peripheral nervous system.

There was a clear split between Zika and chikungunya: of the 55 participants with chikungunya, 26, or 47%, had a disease related to their central nervous system, compared with only six, or 15%, of the 41 participants with Zika.

In contrast, 63% of the participants with Zika had a peripheral nervous system disease, mainly Guillain-Barré syndrome, compared with 16% of the participants with chikungunya.

The researchers also found that the participants who had both Zika and chikungunya infections as well as Guillain-Barré syndrome had more severe symptoms, requiring a longer hospital stay and a greater degree of intensive care.

Finally, the researchers discovered a link between stroke and having two viral infections.

Of the 46 participants with both Zika and chikungunya, eight, or 17%, had a stroke or a transient ischemic attack — sometimes known as a “mini-stroke.” This compares with five, or 6%, of the 96 participants who had only a single viral infection.

Broader implications

As well as contributing new knowledge about Zika and chikungunya, the research has implications for other viral diseases. As Dr. Suzannah Lant, a clinical research fellow at the University of Liverpool and a contributor to the study, explains, “Our study highlights the potential effects of viral infection on the brain, with complications like stroke.”

“This is relevant to Zika and chikungunya, but also to our understanding of other viruses, such as [SARS-CoV-2, the virus behind COVID-19], which is increasingly being linked to neurological complications.”

According to senior study author Prof. Tom Solomon, director of the Health Protection Research Unit in Emerging and Zoonotic Infections at the University of Liverpool, “Although the world’s attention is currently focused on COVID-19, other viruses that recently emerged, such as Zika and chikungunya, are continuing to circulate and cause problems.”

“We need to understand more about why some viruses trigger stroke, so that we can try and prevent this happening in the future.” – Prof. Tom Solomon

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

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

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

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

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

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

The study appears in the journal Health Psychology.

Daily diaries tell a story

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

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

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

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

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

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

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

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

Getting better rest

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Gamma-delta T cells

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

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

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

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

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

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

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

The gut-brain axis

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

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

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

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

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

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

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

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

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

In their paper, they conclude:

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

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

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

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

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

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

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

Common cold vs. flu

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

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

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

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

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

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

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

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

Seasonal patterns

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

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

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

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

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

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

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

Cold air affects our first line of defense

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

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

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

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

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

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

Vitamin D and other myths

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

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

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

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

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

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

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

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

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

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

How to prevent viruses and treat symptoms

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

The best way for people to protect themselves is by:

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

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

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

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

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

A person should contact a doctor if they experience:

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

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

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

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

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

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

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

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

11 years of data

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

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

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

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

20% bodyweight reduction

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

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

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

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

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

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

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

An alternative to surgery?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The findings appear in the journal Diabetologia.

The cohort

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

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

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

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

Loneliness predicts diabetes onset

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

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

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

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

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

Stress-related mechanism?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Persistent inequality

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

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

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

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

The authors write:

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

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

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

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

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

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

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

A mixture of snail slime and evaporated milk is an instant cure for stroke, claims a Facebook post shared in Nigeria.

“This works hundred percent,” it reads. “Do this mixture regularly for instant results for patients suffering from stroke.” The post has been shared more than 5,000 times.

A stroke occurs when brain cells are suddenly deprived of oxygen and die. This can happen when blockage or rupture of an artery stops blood flow to the brain.

The risk factors for stroke include hypertension, elevated lipids, diabetes and other lifestyle factors such as smoking, low levels of physical activity, an unhealthy diet and abdominal obesity. Stroke can lead to death and survivors may experience loss of vision, speech, paralysis and dementia.

But can a simple mixture of snail slime and evaporated milk cure the symptoms of stroke?

Claim ‘distracts from real therapy’
The claimed cure has been posted on several websites. But Africa Check has found no evidence in scientific literature that it is effective.

Yakub Nyandaiti, a professor of neurology at the college of medical sciences at Nigeria’s University of Maiduguri, told us there was no basis for the claim.

“There is no scientific evidence to the claim,” he said.

“I have not read about the mixture. I am not even aware that such a mixture exists as a treatment for stroke. I would not advise any stroke patient to try the mixture. My simple advice to stroke patients is to visit a neurologist.”

Njideka Okubadejo, a professor of neurology at the faculty of clinical sciences at the University of Lagos, said the claim may actually harm victims of stroke.

“When a person suffers a stroke we have a clear strategy we put in place as treatment,” she said.

“It includes three things: physical therapy, medication and lifestyle modification. This strategy is the same all over the world. Advising stroke patients to combine snail water and milk distracts them from focusing on the things that can be beneficial to their health.”

If you or someone you know suffers a stroke, consult a doctor. The condition is serious and life-threatening, and will not be cured by a mixture of snail slime and evaporated milk.

If your cholesterol level has crept up over the years, you may wonder whether changing your diet can help. Ideally, your total cholesterol value should be 200 milligrammes per deciliter (mg/dL) or lower. But it is the harmful Low-Density Lipo-protein (LDL) ‘bad’ cholesterol value that experts worry about the most. Excess LDL builds up on artery walls and triggers a release of inflammatory substances that boost heart attack risk.

“To prevent heart disease, your LDL should be 100 mg/dL or lower,” says Dr. Jorge Plutzky, director of preventive cardiology at Harvard-affiliated Brigham and Women’s Hospital. But many Americans have LDL values that are less than optimal (100 to 129 mg/dL) or borderline high (130 to 159 mg/dL).

If you fall into either of those categories, you may be able to nudge down your LDL to a healthier level by changing what you eat, particularly if your current diet could use some improvement. However, most people with higher LDL values likely will also need to take a cholesterol-lowering drug, such as a statin, says Dr. Plutzky.

Dietary directives
Avoiding foods that are high in cholesterol isn’t the best way to lower your LDL. Your overall diet — especially the types of fats and carbohydrates you eat — has the most impact on your blood cholesterol values. “As the American Heart Association has noted, you’ll get the biggest bang for your buck by lowering saturated fat and replacing it with unsaturated fat,” says registered dietitian Kathy McManus, director of the Department of Nutrition at Brigham and Women’s Hospital.

That means avoiding meat, cheese, and other high-fat dairy products such as butter, half-and-half, and ice cream. Equally important is replacing those calories with healthy, unsaturated fats (such as those found in vegetable oils, avocados, and fatty fish) rather than refined carbohydrates such as white bread, pasta, and white rice. Unlike healthy fats, these starchy foods aren’t very filling, and they can trigger overeating and weight gain.

The other big problem with refined carbs: They are woefully low in fibre, which helps flush cholesterol out of the body.

The fibre factor
Your body can’t break down fiber, so it passes through your body undigested. It comes in two varieties: insoluble and soluble. Fiber-containing foods usually feature a mix of the two.

Insoluble fibre does not dissolve in water. While it doesn’t directly lower LDL, this form of fiber fills you up, crowding other cholesterol-raising foods out of your diet and helping to promote weight loss.

Soluble fibre dissolves in water, creating a gel. This gel traps some of the cholesterol in your body, so it’s eliminated as waste instead of entering your arteries.

Soluble fibre also binds to bile acids, which carry fats from your small intestine into the large intestine for excretion. This triggers your liver to create more bile acids — a process that requires cholesterol. If the liver doesn’t have enough cholesterol, it draws more from the bloodstream, which in turn lowers your circulating LDL.

Finally, certain soluble fibres (called oligosaccharides) are fermented into short-chain fatty acids in the gut. These fatty acids may also inhibit cholesterol production.

The “best” foods
The following 11 foods are good sources of fibre or unsaturated fat (or both). But they’re not in any particular order and are simply suggestions. Most whole grains, vegetables, and fruits are good sources of fiber. And most nuts and seeds (and the oils made from them) provide monounsaturated or polyunsaturated fats.

1. Oatmeal. This whole grain is one of the best sources of soluble fiber, along with barley (see “Grain of the month,” at right). Start your day with a bowl of steel-cut or old-fashioned rolled oats, topped with fresh or dried fruit for a little extra fiber.

2. White beans. Also called navy beans, this variety ranks highest in fiber content. Try different types of beans as well, such as black beans, garbanzos, or kidney beans, which you can add to salads, soups, or chili. But avoid prepared baked beans, which are canned in sauce that’s loaded with added sugar.

3. Avocado. The creamy, green flesh of an avocado is not only rich in monounsaturated fat; it also contains both soluble and insoluble fiber. Enjoy this fruit sliced in salad, pureed into dip, or mashed and spread on a slice of whole-grain toast.

4. Eggplant. Although not everyone’s favorite, these deep purple vegetables are one of the richest sources of soluble fiber. One idea: oven-roast or grill whole eggplants until soft and use the flesh in a Middle Eastern dip called baba ghanoush.

5. Carrots. Raw baby carrots are a tasty and convenient snack — and they also give you a decent dose of insoluble fiber.

6. Almonds. Among nuts, almonds are highest in fiber, although other popular varieties such as pistachios and pecans are close behind. Walnuts have the added advantage of being a good source of polyunsaturated, plant-based omega-3 fatty acids.

7. Kiwi fruit. Contrary to popular belief, you don’t need to peel these fuzzy, brown fruits. But to avoid the skin, slice one in half and scoop out the inside with a spoon for an easy, fiber-rich, sweet snack.

8. Berries. Because these fruits are packed with tiny seeds, their fiber content is higher than most other fruits. Raspberries and blackberries provide the most, but strawberries and blueberries are also good sources.

9. Cauliflower. This cruciferous veggie not only provides fiber, but it can also serve as a substitute for white rice. Just shred or whirl in a food processor until it resembles rice, then sauté with a little olive oil until tender.

10. Soy. Eating soybeans and foods made from them, such as soymilk, tofu, and tempeh, was once touted as a powerful way to lower cholesterol. More recent analyses showed the effect is modest, at best. Still, protein-rich, soy-based foods are a far healthier choice than a hamburger or other red meat.

11. Salmon. Likewise, eating cold-water fish such as salmon twice a week can lower LDL by replacing meat and delivering healthy omega-3 fats. Other good fish options include chunk light canned tuna and tinned sardines.