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Friday, April 19, 2024
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Scientists have offered a detailed view of the biochemical pathway surrounding Parkin — a protein that plays a key role in maintaining cellular energy.

The research, which appears in the journal Science Advances, may help scientists develop new treatments for Parkinson’s disease, type 2 diabetes, and cancer, which can all occur when Parkin is not functioning properly.

Mitophagy

Parkin’s central role is to remove damaged mitochondria, which are the power stations of the cell that are responsible for generating energy. Cellular stress can damage mitochondria.

Damaged or dysfunctional mitochondria tend to accumulate in the cell, and the body needs to clear them away using a process known as mitophagy. This process is essential for cell health and energy production.

Researchers have implicated mitochondrial dysfunction in neurodegenerative diseases such as Parkinson’s.

A key question for scientists has been how Parkin is able to respond to cellular stress so quickly. The signal for Parkin to do its work appeared to occur after it had already started.

Biochemical pathways

In the present study, the scientists gained a better perspective on the biochemical pathway that signals Parkin to clear away damaged mitochondria.

According to Prof. Reuben Shaw, director of the Salk Cancer Center in La Jolla, CA, and senior author of the study, “our findings represent the earliest step in Parkin’s alarm response that anyone has ever found by a long shot.”

“All the other known biochemical events happen at 1 hour; we have now found something that happens within 5 minutes.”

“Decoding this major step in the way cells dispose of defective mitochondria has implications for a number of diseases.”

Building on their prior research, the scientists searched for proteins that activate in response to the enzyme ULK1, which the enzyme AMPK triggers. They found that Parkin was a prime candidate.

The results were surprising as biochemical pathways are normally very complicated, involving up to 50 different proteins.

The scientists confirmed the findings using mass spectrometry. This process revealed how ULK1 was interacting with Parkin, offering a detailed view of how the various proteins work together.

It is this chain, from AMPK to ULK1 to Parkin, that accounts for the speed with which Parkin can react to cellular stress.

Future treatments?

By drawing a link between Parkin and AMPK, the research may aid in the development of new treatments for various diseases.

For Prof. Shaw, “the big takeaway […] is that metabolism and changes in the health of your mitochondria are critical in cancer, they are critical in diabetes, and they are critical in neurodegenerative diseases.”

“Our finding says that a diabetes drug that activates AMPK, which we previously showed can suppress cancer, may also help restore function in patients with neurodegenerative disease.”

“That is because the general mechanisms that underpin the health of the cells in our bodies are way more integrated than anyone could have ever imagined.”

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Stressful events — such as sitting an exam, giving a presentation, or attending a job interview — temporarily increase heart rate and blood pressure and dilate arteries.

This is a normal part of the body’s “fight-or-flight” response, but the lining of blood vessels, known as the endothelium, can take up to 90 minutes to recover after this kind of stress.

This may help to explain why a single episode of stress temporarily increases the risk of an acute cardiovascular event, such as a heart attack.

On the other hand, experts know that eating a diet rich in fruits and vegetables reduces a person’s risk of cardiovascular disease, heart attacks, and cardiovascular mortality.

Among the healthy nutrients found in fruits and vegetables are polyphenolic compounds known as flavanols. In the long term, these improve endothelial function and lower blood pressure.

The effects of flavanols during stress and in its immediate aftermath are unknown, however.

Scientists at the University of Birmingham in the United Kingdom have conducted the first study to investigate this question.

Their research suggests that drinking cocoa, which is rich in flavanols, in the hours before a stressful event can improve blood flow during the experience and help restore endothelial function in males aged under 45 years old afterward.

“Our findings are significant for everyday diet, given that the daily dosage administered could be achieved by consuming a variety of foods rich in flavanols — particularly apples, black grapes, blackberries, cherries, raspberries, pears, pulses, green tea, and unprocessed cocoa,” says senior author Dr. Catarina Rendeiro, Ph.D., of the university’s School of Sport, Exercise and Rehabilitation Sciences.

“This has important implications for measures to protect the blood vessels of those individuals who are more vulnerable to the effects of mental stress,” she adds.

The research, conducted by postgraduate student Rosalind Baynham, appears in the journal Nutrients.

Stress tests

The scientists recruited 30 healthy males between 18 and 45 years who underwent tests at the lab on two separate occasions at least 7 days apart.

The research involved them fasting for 12 hours before each session and abstaining from alcohol, vigorous exercise, and polyphenol-rich food and drink for 24 hours beforehand.

At the start of each visit, while the participants were relaxed, researchers assessed their “brachial flow-mediated dilatation,” which is a measure of endothelial function.

They also measured their blood pressure, heart rate, and blood flow.

On one of these visits, the participants drank regular cocoa, which is rich in flavanols, and on the other visit, they drank a special cocoa drink that was low in flavanols.

About 90 minutes later, they took a competitive test of mental arithmetic designed to elicit stress.

For example, during the test, the researchers filmed the participants, and they had to watch their performance on a screen. The researchers told the participants that “body language assessors” would assess them.

The arithmetic task got progressively faster, and the participants lost points whenever they got an answer wrong.

An experimenter in the room marked their responses and sounded an alarm when they made a mistake, or once every 10 answers if they did not.

At 30 and 90 minutes after the stress test, the researchers remeasured the participants’ endothelial function and blood pressure.

The results showed that 30 minutes after the stress test, all participants had impaired endothelial function. This measure remained significantly higher 90 minutes after the stress test.

However, participants who drank the high-flavanol cocoa saw smaller declines in endothelial function than those who consumed the low-flavanol cocoa.

In addition, high-flavanol cocoa increased blood flow during and after the test compared with low-flavanol cocoa.

Other cardiovascular and blood pressure measures were similar for both conditions.

Future investigations

The researchers note that the main limitation of their study was that it excluded females.

They report that, for the sake of consistency, they wanted to avoid the impact of hormonal fluctuations during the female menstrual cycle on the vascular changes under investigation.

This means that it is not possible to apply the outcomes of this study to females. Researchers remain unclear on the impact of flavanols on stress response in females.

However, existing evidence shows there are gender differences in how a body responds to stress. So, future studies should focus on females.

The researchers also write that a more in-depth investigation would include molecular measures of cardiovascular function. These should consist of nitric oxide, which is a signaling molecule that dilates blood vessels, and the stress hormone cortisol.

Finally, they write that future research should explore the effect of flavanol intake on stress responses in individuals at higher risk of cardiovascular diseases, such as high blood pressure, and people who experience mental stress, such as care workers.

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Researchers have found that a 2-week increase in fiber intake can significantly alter a person’s gut microbiome, including increasing species of bacteria that break down fiber.

However, the quantity of short-chain fatty acids (SCFAs) did not increase. SCFAs are the result of bacteria breaking down fiber, and they have diverse roles within the body.

For instance, SCFAs are used as a source of energy for the cells of the colon and are involved in cell signaling. Some SCFAs also have anti-inflammatory properties and might influence insulin sensitivity and body weight.

The research, which appears in the journal mSystems, lays the groundwork for future studies to explore in more detail the relationship between fiber intake, gut bacteria, and SCFAs.

Benefits of fiber

Fiber plays an important role in human health. For example, a recent review of various meta-analyses found that people who eat the most fiber significantly reduce their chances of dying due to a cardiovascular event.

However, only 1 in 20 people in the United States consume the recommended amount of fiber.

According to Dr. Katrine Whiteson, associate professor of molecular biology and biochemistry, co-director of the University of California, Irvine (UCI) Microbiome Initiative, and co-author of the present study:

“The lack of fiber intake in the industrialized world is starving our gut microbes, with important health consequences that may be associated with increases in colorectal cancer, autoimmune diseases, and even decreased vaccine efficacy and response to cancer immunotherapy.”

The small intestine cannot digest fiber. Instead, according to the authors of the present study, it passes into the colon, where microbes are able to break the fiber down.

This process results in the production of SCFAs. Experts believe they are important for a range of factors affecting a person’s health.

The authors of the present study wanted to study the relationship between a short-term increase in dietary fiber, the makeup of the gut microbiome, and the presence of SCFAs.

Two-week diet

To investigate, the researchers conducted a study involving 26 undergraduate students enrolled on a biology course at UCI, as well as their instructors.

In week 1, participants ate their normal diet and provided three stool samples for analysis.

In week 2, the participants started a high fiber diet. They tracked their nutritional intake using a fitness app, aiming for 40 grams (g) of fiber each day. To assist, the researchers provided them with 10 meals each week that were high in fiber from a range of different plants.

In the third week, the participants were encouraged to increase their fiber intake to 50 g per day. During this week, participants provided another three stool samples.

According to graduate student Andrew Oliver, a teaching assistant for the course, “students raised their fiber intake by an average of 25 g per day, but the variability of pre-intervention fiber intake was substantial.”

“A few students had to go from nearly zero to 50 g daily by the end of the study. We all became a little obsessed with how much fiber was in the food we were eating.”

The researchers then analyzed the samples using DNA sequencing to identify the makeup of the bacteria. They used gas chromatography to measure SCFAs.

Microbiome composition

The researchers found that the composition of the participants’ gut microbiomes changed by around 8% following the dietary intervention.

This was largely due to increases in bacteria known for breaking down fiber, including Bifidobacterium, Bacteroides, and Prevotella.

However, the researchers saw no statistically significant increase in SCFAs. They speculate that this may be because stool samples do not accurately represent levels of SCFAs in the gut, which are primarily found in the cell walls of the intestines.

The researchers also suggest that the 2-week intervention may not have been long enough to see any difference in SCFAs.

According to Dr. Whiteson, “we hope to carry out longer dietary fiber interventions and study how fiber can support the gut microbiome and promote health.”

“At this time during a pandemic, when we need our immune health and healthy vaccine responses, we encourage everyone to think about the plant diversity of their diets and add some beans, berries, and avocados where they can.”

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

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

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

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

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

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

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

1. Parkinson’s only affects movement

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

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

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

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

2. Treatment only works for a few years

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

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

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

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

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

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

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

3. Levodopa makes symptoms worse

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

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

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

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

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

4. Tremor always signifies Parkinson’s

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

5. Doctors can always provide an accurate outlook

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

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

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

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

6. Everyone with Parkinson’s has tremor

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

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

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

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

7. People might experience ‘flare-ups’

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

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

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

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

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

8. Beyond drugs, nothing can help

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

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

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

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

9. Parkinson’s is fatal

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

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

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

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

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

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

Moving forward

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

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

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

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

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

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

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

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

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

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

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

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

  • inflammation
  • hormonal disturbances
  • genetic factors

Brain circuitry

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

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

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

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

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

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

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

The research appears in the journal Molecular PsychiatryTrusted Source.

Appetite and emotions

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

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

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

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

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

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

Drug combination

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Natural remedies for anxiety and stress

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

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

1. Exercise

woman-jogging-through-park-listening-to-headphones
Exercise may help to treat anxiety.

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

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

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

2. Meditation

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

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

3. Relaxation exercises

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

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

4. Writing

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

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

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

5. Time management strategies

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

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

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

6. Aromatherapy

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

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

7. Cannabidiol oil

cbd-oil
CBD oil comes from the marijuana plant.

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

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

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

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

8. Herbal teas

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

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

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

9. Herbal supplements

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

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

10. Time with animals

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

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

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

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

Other treatment options

person-having-counseling-or-therapy
Therapy may help to treat chronic anxiety.

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

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

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

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

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

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

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

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

Natural anxiety remedies can replace or complement traditional treatments.

Outlook

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

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

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Globally, heart disease is the number one cause of death. It is responsible for 17.9 million deaths each year.

According to the Centers for Disease Control and Prevention (CDC), in the United States, one person dies every 36 seconds from cardiovascular disease. Heart disease accounts for 1 in 4 deaths in the U.S.

As February is American Heart Month, today, we will tackle some persistent myths about heart disease.

1. Young people do not need to worry about heart disease

It is true that heart disease is more likely to affect people over the age of 65, but 4–10% of heart attacks occur in people under the age of 45 years, mainly in men. In addition, it is how we live our lives as children, adolescents, and adults that lays the groundwork for heart health as we age.

For instance, eating a diet that is high in trans and saturated fats or smoking tobacco slowly increases the risk of heart disease as we age. Changes to lifestyle today build the foundation for a healthier heart in later life.

In the U.S. as a whole, heart disease mortality has slowly dropped since the 1970s, although the trend seems to be slowing. However, in some regions, rates have increased.

One study that investigated heart disease mortality in different age groups in the U.S. found that “over 50% of counties [experienced] increases in heart disease mortality from 2010 through 2015 among adults aged 35–64 years.”

2. People should avoid exercise if they have heart disease

This is a myth. Exercise helps strengthen the heart muscle and improve blood flow around the body.

In August 2020, the European Society of Cardiology published guidelines on exercise in patients with cardiovascular disease. Prof. Sanjay Sharma, who was involved in creating the guidelines, explains:

“The chance of exercise triggering a cardiac arrest or heart attack is extremely low.” However, he also adds a note of caution: “People who are completely inactive and those with advanced heart disease should consult their doctor before taking up sports.”

3. I take cholesterol-lowering drugs, so I can eat whatever I like

Some drugs, such as statins, reduce the level of cholesterol in the blood. However, this does not mean that a person who is taking statins can consume foods containing saturated fats with abandon.

Cholesterol is either consumed in the food that you eat or produced in the liver. Statins block an enzyme in the liver that is necessary for producing cholesterol, reducing overall blood cholesterol levels. However, this means that ingested cholesterol can still make it into the blood.

In short, statins may just be able to override the adverse effects of a poor diet, but a poor diet will increase risk of other independent risk factors for heart disease, such as obesity, hypertension, and diabetes.

4. Heart disease runs in my family, so there is nothing I can do to stop it

If close family members have experienced heart disease, it could mean that you have an increased risk. However, it is not set in stone, and there are a number of ways to reduce the risk, even for people with a genetic susceptibility.

These include eating a healthful diet, stopping smoking, managing blood pressure, and exercising regularly.

It is also worth noting that if heart disease runs in the family, it may not be a sign of genetic susceptibility. Families tend to share lifestyle factors, such as diet and exercise habits, both of which can impact the risk of heart disease.

5. Vitamins can prevent heart disease

Although most vitamins, taken at the recommended doses, are unlikely to be bad for heart health, there is no evidence that taking any vitamin supplements can reduce the risk of heart disease. And they certainly cannot replace a healthful diet and regular exercise.

For instance, a systematic review and meta-analysis looked for associations between multivitamin and mineral supplements and a number of cardiovascular outcomes, including coronary heart disease and stroke.

The analysis, published in 2018, took data from 18 existing studies, including 2,019,862 participants.

The authors concluded that multivitamin and mineral “supplementation does not improve cardiovascular outcomes in the general population.”

According to Victoria Taylor, the nutrition lead at the British Heart Foundation: “There are no shortcuts when it comes to nutrition — supplements are not a replacement for healthy food. You might be prescribed a vitamin or mineral supplement by a health professional for other reasons, but we do not recommend people take multivitamins to help prevent heart and circulatory diseases.”

6. I have smoked for years, there is no point stopping now

This is a myth. Smoking tobacco is a major cause of heart disease. As soon as a person stops smoking, the health benefits begin. The National Institute on Aging write:

“It doesn’t matter how old you are or how long you’ve been smoking, quitting smoking at any time improves your health. When you quit, you are likely to add years to your life, breathe more easily, have more energy, and save money.”

They also explain that you will lower the risk of heart attack and stroke and have better circulation.

7. Heart disease only really affects men

This is a myth, as heart disease is the leading cause of death in both men and women. In 2017 in the U.S., 24.2% of men and 21.8% of women died from heart disease.

However, when strokes, which have similar risk factors, are added in, the figures are even more similar between men and women: 28.7% of men and 28% of women died from heart disease or stroke.

It is a common misconception that only men are affected by heart disease. It is true that men tend to develop cardiovascular disease at an earlier age than women and have a greater risk of coronary heart disease. However, women have a higher risk of stroke.

One paper explains, “Although the incidence of [cardiovascular disease] in women is usually lower than in men, women have a higher mortality and worse prognosis after acute cardiovascular events.”

8. Cardiac arrest and heart attack are the same

Heart attacks and cardiac arrests are not the same thing. A heart attack is a circulation problem. It occurs when the coronary artery, which carries oxygenated blood to the muscles of the heart, becomes blocked.

A cardiac arrest is an “electrical problem,” where the heart stops pumping blood around the body effectively. Cardiac arrests are often caused by a heart attack.

During a heart attack, an individual is likely to be conscious. During a cardiac arrest, they are almost always unconscious. Both are a medical emergency.

9. Coughing during a heart attack can save your life

According to some sources, coughing vigorously during a heart attack — so-called cough CPR — can save your life.

This is an internet distortion of a paper published over 40 years ago, which showed that patients who had a cardiac arrest during arteriography in hospital and who coughed every 1–3 seconds stayed conscious for an additional 39 seconds.

There is no evidence that this technique works in the community for heart attacks that are not induced by medical procedures.

According to Christopher Allen, a senior cardiac nurse:

“The absolute priority when you think you or someone else is having a heart attack is to call [the emergency services]. This way, paramedics can assess and aid you, and you’ll get to hospital as fast as possible. There is no medical evidence to support ‘cough CPR.’”

10. People with heart disease should avoid eating all fat

A person with cardiovascular disease certainly should reduce their intake of saturated fats — which are found in foods such as butter, biscuits, bacon, and sausages — and partially hydrogenated and trans fats, which are found in foods such as baked goods, frozen pizzas, and microwave popcorn.

However, unsaturated fats can provide benefits. For instance, there is some evidence that omega-3, which is a polyunsaturated fat, might protect heart health.

The American Heart Association recommend “that all adults eat fish (particularly fatty fish) at least 2 times a week. Fish is a good source of protein and is low in saturated fat. Fish, especially oily species like mackerel, lake trout, herring, sardines, albacore tuna, and salmon, provide significant amounts of the two kinds of omega-3 fatty acids shown to be cardioprotective, [eicosapentaenoic acid] and [docosahexaenoic acid].”

They also recommend eating plant-derived omega-3 fatty acids. These can be found in tofu and other forms of soybeans; walnuts, flaxseeds, and their oils; and canola oil.

The take-home

Heart disease is common, but it is not inevitable. There are lifestyle changes that we can all implement to reduce the risk of developing cardiovascular problems, whatever our age.

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For many decades, nutritionists have recommended a balanced diet to provide the body with the proper nutrients to stay healthy. The core components of this diet include vegetables, fruits, grains, proteins, and dairy.

A recent study by researchers at the Harvard T. H. Chan School of Public Health in Boston, MA, provides further evidence for current dietary guidelines and expands on them, finding that consuming at least 2 fruit and 3 vegetable servings on a daily basis may lower the risk of both disease-related death and death from all causes.

The study appears in Circulation, a scientific journal of the American Heart Association (AHA).

Current dietary guidelines

“While groups like the American Heart Association recommend 4–5 servings each of fruits and vegetables daily, consumers likely get inconsistent messages about […] the recommended amount and which foods to include and avoid,” says Dr. Dong D. Wang, M.D., Sc.D., an epidemiologist and nutritionist at Harvard Medical School and lead author of the study.

The Department of Health and Human Services and the Department of Agriculture published their recommendations in the form of the 2020–2025 Dietary Guidelines for Americans.

According to this set of guidelines, half of the plate for every meal should contain fruits and vegetables.

However, the guidelines also note that more than 80% of people in the United States do not meet this recommendation and should aim to increase their consumption of nutrient-dense foods.

Participant dietary information

The researchers collected self-reported dietary information from two large cohort studies: the Nurses’ Health Study (NHS) and the Health Professionals’ Follow-up Study (HPFS).

The NHS cohort included registered female nurses between the ages of 30 and 55 years, while the HPFS cohort included males aged 40–75 years with occupations in the health profession. These studies included follow-ups with the participants every 2–4 years to accumulate dietary information over a span of approximately 30 years.

The researchers excluded participants with baseline heart disease, cancer, or diabetes, leaving them with data from 66,719 females and 42,016 males.

They also incorporated data from an additional 26 studies involving a total of 1.9 million participants, which examined the relationship between fruit and vegetable intake and death rates.

The high participant numbers and continuous longitudinal assessments provided the team with an extensive collection of data for analysis.

However, it is important to note that the criteria of the two cohorts — occupation and corresponding education — suggest a similar socioeconomic status across the participants, who may have been more likely than other members of the population to have access to a healthy diet. The study does not address the realities and effects of food insecurity.

Nutritional values of fruits and vegetables lower risk of death

The study outcomes showed that an increased intake of fruits and vegetables is associated with a lower risk of death, including death due to cancer, heart disease, or respiratory disease.

Additionally, the researchers saw the lowest risk of death at a threshold of a combined 5 servings, beyond which there was no apparent benefit on risk.

These results point to the nutritional value of these foods. For example, higher consumption of fruits and vegetables increases the intake of potassium and antioxidant activity, which link to lower blood pressure and improved lung function, respectively.

As the data are fully self-reported, there may be discrepancies between the actual and reported intakes. Participants with higher intake, in particular, may have tended to overestimate how many servings they consumed.

This margin of error may blur the defined threshold of 5 servings, so the study authors acknowledge that slightly higher servings (up to 10) could also lead to lowered risk.

This study also expands beyond current guidelines by differentiating among specific groups of fruits and vegetables.

The researchers observed trends with a lowered risk of death for leafy greens and foods rich in vitamin C and beta carotene. Fruits and vegetables that fall into these categories include spinach, kale, carrots, and citrus fruits.

Conversely, they did not identify any trends for fruit juices or starchy vegetables, such as potatoes and peas. One possible reason for the latter is the prominence of canned foods. The canning process may deprive starchy vegetables of their antioxidant properties.

Compared with whole fruits, the fluid form of juices may cause a more rapid elevation of blood glucose and insulin levels, which can increase the risk of disease.

In contrast to the existing guidelines, which include canned foods and juices among the recommended foods and drinks, this study calls for further research on the effects of these items on health.

Continued support for ‘5-a-day’ serving recommendation

Rather than being an interventional study, in which researchers directly implement variables and analyze the effects, this study was observational. As a result, it is not possible to conclude that the trends present in this study indicate a causal relationship.

Regardless, there is plentiful evidence that highlights the benefits of a balanced diet containing plenty of fruits and vegetables. The present conclusions also correspond to findings from similar observational studies on the associations between fruit and vegetable intake and disease.

The findings of this study conform to the overall current dietary guidelines to eat at least 5 servings of fruits and vegetables a day. Additionally, it provides further insight into the specificities and benefits of fruit and vegetable intake.

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Mental health conditions can cause changes in thinking, emotions, behavior, or all of these, impairing interpersonal relationships and daily functioning. They can be temporary or chronic.

Approximately 26% of adults in the United States will experience a mental health condition within a given year, with close to 9.5% having a serious condition, such as major depression or bipolar disorder.

Although pharmacologic and psychosocial treatment options for psychiatric illnesses can be safe and effective, there are cases in which the treatments may cause significant adverse effects in some individuals, potentially leading to discontinuation. In addition, some illnesses are treatment-resistant.

One possible reason why current standard-of-care treatments have varying efficacy is that they do not target the disruption to neural circuits that researchers have associated with mental illness.

Researchers can use functional MRI (fMRI), a noninvasive neuroimaging tool that measures brain activity through changes in cerebral blood flow, to comprehend the neurobiological changes accompanying psychiatric illness.

In the new study, the researchers used rtfMRI-NF, which incorporates biofeedback, to teach the participants how to control their own brain neural activity instantaneously while in a scanner. Biofeedback is a treatment that healthcare professionals sometimes use to control involuntary bodily processes.

Novel treatment method

Although some studies using rtfMRI-NF experimentally to treat a wide range of mental illnesses have demonstrated benefits, rtfMRI-NF is costly, and it requires extensive setup for real-time analysis.

Researchers at the University of Rochester Medical Center in New York conducted a meta-analysis of 17 relevant studies to determine the effectiveness of rtfMRI-NF in modulating brain activity and behavioral outcomes.

They have published their findings in Neuroscience & Biobehavioral Reviews.

Study co-author Dr. David Dodell-Feder, an assistant professor at both the Department of Psychology in the School of Arts and Sciences at the University of Rochester and the Department of Neuroscience at the University’s Medical Center, comments on the objectives of the review:

“Ultimately, we want people to be able to take what they learn in the scanner during the training sessions to use in their day-to-day life. If they can do that, it shows that the neurofeedback is meaningful, that they are taking something away from it, and that they can now apply that experience — even without neurofeedback.”

The meta-analysis evaluated whether rtfMRI-NF led to voluntary control of brain activity during training, whether the effects persisted after training (in the absence of neurofeedback), and whether treatment resulted in improved outcomes.

The studies that the team analyzed included 410 participants, of whom 234 received rtfMRI-NF. The study participants were 34 years old, on average, and there were almost equal numbers of males and females. About 53% of the participants took psychotropic medications.

The studies included participants with diagnoses such as:

  • depressive disorders
  • schizophrenia and other psychotic disorders
  • neurodevelopmental disorders
  • substance-related and addictive disorders
  • trauma and stressor-related disorders
  • anxiety disorders

The study participants completed an average of two sessions with a total regulation time of about 24 minutes across sessions. Most studies compared active neurofeedback with a sham feedback control group.

The area of the brain targeted most often as the source of the neurofeedback signal was the amygdala. The amygdala is part of the brain’s limbic system, and it is responsible for processing strong emotions, such as fear and pleasure.

Additionally, most studies provided explicit instructions for regulating the neural signal, measured the percent signal-change that a task triggered, provided continuous neurofeedback, and included a transfer task to measure whether the participant could perform the previously learned regulation during the period of no neurofeedback.

Some positive results

The meta-analysis found that rtfMRI-NF produced a moderate effect on the brain activity of targeted regions during training and a large effect after training in the absence of neurofeedback.

However, rtfMRI-NF demonstrated only a small effect on symptoms and cognitive impairment.

Emily Dudek, lead author and a clinical research coordinator at the Brain Injury Research Center of Mount Sinai in New York City, comments on the results:

“We believe this provides relatively strong evidence that volitional control over neural processes that are specifically targeted during training is possible. This volitional control was also present in contexts in which no feedback was provided,” she notes.

The possibility of publication bias — the influence of nonpublished studies that failed to find an effect — that the team detected during analyses may further decrease the measured effect of rtfMRI-NF on symptoms.

Limitations of the meta-analysis include small study sample sizes leading to potential underpowering and decreased validity of results.

Further research involving adequately powered, high quality studies is necessary to elucidate specifically how and for whom rtfMRI-NF demonstrates effectiveness to optimize potential clinical benefits. Future studies may be crucial to proving the clinical utility of rtfMRI-NF outside a research setting.

Prof. Dodell-Feder, Dr. J. Steven Lamberti, from the Department of Psychiatry at the University of Rochester Medical Center, and a graduate student team have set out to conduct a rtfMRI-NF research study aiming to teach people with schizophrenia to self-regulate areas of the brain responsible for social information processing.

The trial is ongoing, and, hopefully, the results of the study will provide some much-needed answers.

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