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Tuesday, May 14, 2024
Stroke

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New research has identified a possible mechanism for blood clotting issues in some COVID-19 patients.

A new study suggests a possible mechanism for the elevated presence of blood clots in COVID-19 patients.

The research, published in the journal Circulation, may help clinicians develop more effective treatments for COVID-19.

The sudden emergence and rapid global spread of the new coronavirus have meant clinical responses have focused on supporting those with severe infections, supplemented with emergency societal interventions, such as widespread social distancing, to reduce infection rates.

Because SARS-CoV-2 is a new virus, previous treatments developed for similar strains will not necessarily work. Instead, possible therapies need to be identified in theory, tested and, once safe, implemented in the real world. However, this all takes time.

SARS-CoV-2 is mainly a danger because for some patients — particularly those with certain underlying health conditions, compromised immune systems, or who are later in life — a type of severe acute respiratory syndrome can develop, similar to pneumonia.

COVID-19, the disease caused by the virus, makes a person’s lungs inflamed.

COVID-19 and coagulation

According to an interview in The Guardian with Prof. John Wilson, president-elect of the Royal Australasian College of Physicians, if this inflammation is severe, inflammatory material can collect in the bottom of a person’s lungs. This can make it difficult for them to gain enough oxygen into their blood, cause organs to shut down, and potentially lead to death.

However, in addition to this pneumonia-like reaction, clinicians have also noticed that patients with COVID-19 can develop organ damage in a way not directly linked to a lack of oxygen in the blood. This is particularly common in the kidneys and heart.

There is some evidence that a problem with blood coagulation causes this organ damage. Coagulation is the process where a person’s blood thickens. It is crucial in stopping a person from bleeding if they get a cut.

However, if a person’s blood coagulates too much or too little, they can have serious issues: too little, and they can develop internal or external bleeding, as seen in hemophilia. Too much and they could develop blood clots that can cause a stroke or heart attack.

The authors of the recent study note that COVID-19 may increase coagulation in some people’s blood, which consequently causes organ damage as blood vessels become blocked. However, it is not yet clear how or why this occurs, which impedes the development of effective treatments.

Neutrophils and platelets

In the study, the researchers studied 62 patients, including autopsies on five of whom had died. Of these individuals, 38 had confirmed COVID-19.

After conducting multidimensional flow cytometry — a way of measuring the presence of particular cells in a fluid — and comparing these results to the control groups, the researchers identified a significant number of neutrophils and platelets in the subjects.

Neutrophils are a type of immune cell that combat pathogens entering the body, such as the SARS-CoV-2 virus, while platelets are a type of blood cell necessary for coagulation.

The researchers found that these two cells seemed to react to and activate one another, resulting in excessive coagulation, blockage of blood vessels, and serious damage to nearby tissue.

Furthermore, when activated, the neutrophils exude web-like structures designed to help them trap bacteria, but experts believe they exacerbate the blocking of blood vessels.

According to Dr. Konstantin Stark, of the University Hospital Ludwig-Maximilian-University Munich, Germany, and a co-author of the paper:

“These findings contribute to a better understanding of the pathophysiology that underlie disease progression in COVID-19. The study also identifies immunothrombosis as a promising target for the prevention and treatment of lung failure and thrombotic complications that arise in cases of COVID 19.”

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Many people get less than the recommended amount of sleep, and many do not consume the recommended amounts of important vitamins and minerals. A new study suggests the two factors may be connected.

The research is based on data from the National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of United States (U.S.) adults.

Compared with people who got more than seven hours of sleep per night—the amount the Centers for Disease Control and Prevention recommends for adults—scientists found that people who got fewer than seven hours of sleep per night on average consumed lower amounts of vitamins A, D, and B1, as well as magnesium, niacin, calcium, zinc and phosphorus.

The study also found a greater number of nutrients were associated with poor sleep in women than in men. This number was reduced if women took dietary supplements, suggesting that supplements can help fill the gaps where a person’s diet is not providing the necessary nutrients.

“This work adds to the body of growing evidence associating specific nutrient intakes with sleep outcomes,” said lead study author Chioma Ikonte, director of nutrition science at Pharmavite, LLC. “Our findings suggest that individuals with short sleep duration might benefit from improving their intake of these nutrients through diet and supplementation.”

Ikonte presented the research at Nutrition 2019, the American Society for Nutrition annual meeting, held June 8-11, 2019 in Baltimore. In addition to the findings on sleep duration, the research suggests nutrients may also play a role in sleep disorders, poor sleep quality and trouble falling asleep.

Micronutrients are vitamins and minerals that our bodies require but do not produce. As a result, they must come from our diet. Globally, billions of people suffer from at least one micronutrient deficiency.

Previous studies have demonstrated important roles for micronutrients in growth and development, disease prevention and healing, and normal bodily functions, including sleep. Magnesium, for example, helps the body produce melatonin and other compounds involved in sleep. Some studies suggest zinc plays a role in sleep regulation.

However, the researchers cautioned that the study was a retrospective analysis, not a randomized controlled study, so cannot prove cause and effect.

“Whether chronic short sleep causes nutrient insufficiency or the nutrient insufficiency causes short sleep still needs to be determined,” said Ikonte.

“A clinical study that investigates [impacts of] supplementation with these nutrients on sleep outcomes is needed to demonstrate cause and effect.”

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A study finds that hyperglycemia makes it more difficult for people to increase their aerobic capacity.

Regular aerobic exercise provides various health benefits, which heighten as a person increases their aerobic capacity. Doctors recommend this form of exercise to help control diabetes, but people with diabetes often have trouble improving this capacity.

Now, scientists at the Joslin Diabetes Center, an affiliate of Harvard Medical School, in Boston, MA, have published a new study that may explain why.

Hyperglycemia, or higher-than-normal levels of blood sugar, may prevent people from increasing their aerobic capacity and gaining the health benefits that this type of exercise can provide.

The researchers have observed this diminished effect of aerobic exercise in humans with chronic hyperglycemia when blood sugar levels are within the prediabetes range, as well as in mouse models.

Prof. Sarah Lessard is the senior investigator of the study, which has been published in the journal Nature Metabolism.

Hyperglycemic mice

“The idea behind this study was to see: If we induce high blood sugar in mice, will we impair their ability to improve their aerobic fitness?” says Prof. Lessard.

In designing the study, the researchers hoped to learn more about the mechanisms behind this potential effect, in an effort to find new ways to help people with hyperglycemia boost their fitness levels.

Initially, Prof. Lessard and colleagues increased blood sugar levels in two groups of mice:

  • The first group received a Western diet high in saturated fat and sugar. The mice became hyperglycemic and gained weight.
  • The second group consumed a diet with less sugar and fat and did not gain weight. However, these mice acquired hyperglycemia as a result of modifications that caused them to produce less insulin.

The mice in both groups exercised equally, running roughly 500 kilometers, or about 311 miles, over the course of the study.

Still, compared with a control group that had lower blood sugar levels, both sets of hyperglycemic mice failed to gain significant aerobic capacity.

The fact that both groups developed the condition suggests that the effect is related to blood sugar, not obesity or the effects of insulin.

Mouse muscles

According to Prof. Lessard, muscle tissues typically change as a result of aerobic exercise, and muscle fibers become more efficient at using oxygen. “We also grow new blood vessels,” says Prof. Lessard, “to allow more oxygen to be delivered to the muscle, which helps to increase our aerobic fitness levels.”

However, the researchers saw no such muscle adaptation in the hyperglycemic mice.

They suggest that high levels of sugar are interrupting the remodeling of muscle by altering proteins in the space between muscle cells, where new blood vessels would typically have formed.

The study authors add that another possible factor may be a malfunctioning of the c-Jun N-terminal kinase (JNK) pathway. This signaling pathway may act as a molecular switch that programs a muscle to react to a particular type of exercise.

In earlier research using hyperglycemic mice, Prof. Lessard found that the JNK pathway may get this wrong. She determined that “The muscles of hyperglycemic animals have bigger fibers and fewer blood vessels, which is more typical of strength training, rather than aerobic training.”

People with hyperglycemia

Prof. Lessard and her team followed up with clinical tests in humans and found similar results. They also identified one group for whom the issue was particularly acute.

The researchers saw that individuals with impaired glucose intolerance — in which blood sugar levels rise with the consumption of glucose — had the least increases in aerobic capacity.

This was, at least in part, due to the malfunction of the JNK pathway. “Looking at how their muscles responded to a single bout of typical aerobic exercise, we also saw that those with the lowest glucose tolerance had the highest activation of the JNK signaling pathway, which blocks aerobic adaptations,” says Prof. Lessard.

Recommendations

“We often think of diet and exercise as separate ways to improve our health,” she adds.

“Our work shows that there is more interaction between these two lifestyle factors than what was previously known and suggests that we may want to consider them together in order to maximize the health benefits of aerobic exercise.” – Prof. Sarah Lessard, senior study author

To that end, the team recommends that individuals with hyperglycemia consider following a diet designed to lower blood sugar levels. In addition, diabetes drugs can help get these levels under control.

The researcher emphasizes that aerobic exercise has health benefits, even when taking into account the inhibiting effect of high blood sugar, saying:

“Regular aerobic exercise is still a key recommendation for maintaining health in people with or without hyperglycemia.”

Prof. Lessard also notes that other forms of exercise, such as strength training, can help with health and fitness.

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Findings from a new study suggest that inadequate consumption of fruits and vegetables may be a major factor in heart disease death.

Fruits and vegetables are rich in vitamins, fiber, potassium, magnesium, and antioxidants.

A diet that includes fruits and vegetables can lower blood pressure, reduce the risk of heart disease and cancer, and improve digestive health.

Previous research — part of the Harvard-based Nurses’ Health Study and Health Professionals Follow-up Study — confirmed that a diet containing lots of fruits and vegetables can even lower the risk of heart disease and stroke.

After analyzing these results and combining them with findings from other studies, researchers estimated that the risk of heart disease is 20 per cent lower among individuals who eat more than five servings of fruits and vegetables per day, compared with those who eat fewer than three servings per day.

The United States Department of Agriculture recommend that adults eat at least 1.5 to two cups per day of fruit and two– three cups per day of vegetables. According to another study by the Centers for Disease Control and Prevention (CDC), only around one in 10 adults meet these guidelines.

Now, a new study — the results of which the researchers presented at Nutrition 2019, the American Society for Nutrition annual meeting in Baltimore, MD — suggests that a low fruit intake can cause one in seven deaths from heart disease, and that a low vegetable intake can cause one in 12 deaths from heart disease.

Analyzing data from 2010, researchers found that low fruit consumption resulted in almost two million deaths from cardiovascular disease, while low vegetable intake resulted in one million deaths. The global impact was more significant in countries with a low average consumption of fruits and vegetables.

The data suggest that low fruit consumption results in more than one million deaths from stroke and more than 500,000 deaths from heart disease worldwide every year, while low vegetable intake results in about 200,000 deaths from stroke and more than 800,000 deaths from heart disease per year.

“Our findings indicate the need for population-based efforts to increase fruit and vegetable consumption throughout the world,” says study co-author Victoria Miller, a postdoctoral researcher at the Friedman School of Nutrition Science and Policy at Tufts University in Medford, MA. The researchers tracked the death toll by region, age, and sex using diet surveys and food availability data of 113 countries. They combined these with data on causes of death in each country and data on the cardiovascular risk linked to low fruit and vegetable intake.

The findings showed that fruit intake was lower in South Asia, East Asia, and Sub-Saharan Africa, while vegetable consumption was lower in Central Asia and Oceania. Countries in these regions have low average fruit and vegetable intakes and high rates of deaths from heart disease and stroke.

When the researchers analyzed the impact of inadequate fruit and vegetable consumption by age and sex, they found that the biggest impact was among young adults and males. Miller adds that females tend to eat more fruits and vegetables.

“These findings indicate a need to expand the focus to increasing availability and consumption of protective foods like , and legumes — a positive message with tremendous potential for improving global health.”

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Exercising women who struggle to consume enough calories and have menstrual disorders can simply increase their food intake to recover their menstrual cycle, according to a study accepted for presentation at ENDO 2020, the Endocrine Society’s annual meeting, and publication in the Journal of the Endocrine Society.

The study found that exercising women with menstrual disorders can start menstruating again by consuming an additional 300-400 calories a day.

“These findings can impact all exercising women, because many women strive to exercise for competitive and health-related reasons but may not be getting enough calories to support their exercise,” said lead researcher Mary Jane De Souza, Ph.D., of Penn State University.

By consuming enough calories, exercising women with menstrual disorders can avoid complications associated with a condition known as the Female Athlete Triad, De Souza said. This is a medical condition that starts with inadequate food intake that fails to meet the body’s needs. It leads to menstrual disorders and poor bone health. It is associated with a high incidence of stress fractures.

The study included 62 young, exercising women with infrequent menstrual periods. Thirty-two women increased their calorie intake an average of 300-400 calories a day, and 30 maintained their exercise and eating habits for the 12-month study. Women who consumed the extra calories were twice as likely to have their menstrual period during the study compared with the women who maintained their regular exercise and eating routine.

“This strategy is easy to implement with the help of a nutritionist. It does not require a prescription and avoids complications from drug therapy,” De Souza said. “The findings will encourage healthcare providers to try to help exercising women with menstrual disorders who consume too few calories to eat more, and this may help them to be healthier athletes and avoid bone complications.”

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These are unprecedented times. Given the real and tangible threat of the coronavirus pandemic on personal, community, and societal levels, it is normal to experience anxiety and sleep problems. Sleep is a reversible state marked by a loss of consciousness to our surroundings, and as members of the animal kingdom, our brains have evolved to respond to dangers by increasing vigilance and attention — in other words, our brains are protecting us, and by doing so it’s harder for us to ignore our surroundings.

Despite the threat of the coronavirus and its rapid and pervasive disruption to our daily lives, many of us are an in a position to control our behaviors and dampen the impact of the emerging pandemic on our sleep. Cultivating healthy sleep is important; better sleep enables us to navigate stressful times better in the short term, lowers our chance of developing persistent sleep problems in the longer term, and gives our immune system a boost.

Daytime tips to help with sleep
Keep a consistent routine. Get up at the same time every day of the week. A regular wake time helps to set your body’s natural clock (circadian rhythm, one of the main ways our bodies regulate sleep). In addition to sleep, stick to a regular schedule for meals, exercise, and other activities. This may be a different schedule than you are used to, and that is okay. Pay attention to your body’s cues and find a rhythm that works for you and that you can maintain during this “new normal.” Make this a priority for all members of your household.

Get morning light. Get up, get out of bed, and get some light. Light is the main controller of the natural body clock, and regular exposure to light in the morning helps to set the body’s clock each day. Natural sunlight is best, as even cloudy days provide over double the light intensity of indoor lighting. If you are living in an area with shelter-in-place, try to expose yourself to natural light by stepping outside, at a distance from others, for at least 20 minutes.

Exercise during the day helps improve your sleep quality at night, reduces stress, and improves mood. Fit in exercise as best as you can. If you need to go outside for exercise, maintain proper social distancing at least six feet away from others. Avoid any group exercise activities, especially contact sports. Many gyms and yoga studios are now “at home” and offering virtual programs at low or no cost.

Don’t use your bed as an escape. While the gravity of the pandemic certainly makes us all tired, try not to spend too much time in bed during the day, especially if you are having trouble sleeping at night. If you must take a nap, try to keep it short — less than 30 minutes.

Avoid caffeine late in the day
Helping others may help with feelings of uncertainty or unease. Even if you do not work in an “essential” industry, your role in maintaining physical distance is critical in our fight against coronavirus. If you would like to be more actively involved in helping people, seek out ways to contribute your skills, donate money, or leverage your social capacity locally, such as providing virtual social connection to your loved ones by checking in on elderly family members or a friend, or providing in-kind donations. Doing altruistic acts may provide a sense of purpose, reduce helplessness, and alleviate some of the uncertainty contributing to sleep problems.

Nighttime tips to help with sleep
Prepare for bedtime by having a news and electronic device blackout. Avoid the news and ALL electronics at least one hour before bedtime. Avoid the news and ALL electronics at least one hour before bedtime. (Yes, it’s so important, I am saying this twice!) The nonstop news cycle seldom provides new information in the evening hours that you can’t wait until morning to hear, and will likely stimulate your mind or incite fear, making it harder to fall and stay asleep. Remind yourself by setting a timer or putting your television on the sleep setting. Make a pact with your family members to respect these parameters.

Cell phones, tablets, and all electronic devices make it harder for your brain to turn off, and the light (even dim light) from devices may delay the release of the hormone melatonin, interfering with your body clock. If you need something to watch to help you unwind, watching something that you find relaxing on TV from far away and outside the bedroom is likely okay for a limited time. You can also curl up with a book or listen to music.

Minimize alcohol intake. While alcohol can help people fall asleep, it leads to more sleep problems at night.

Set a regular bedtime. There are certain times at night that your body will be able to sleep better than others. If you feel sleepy but your brain is busy thinking, it can’t shut off and go to sleep. It may be helpful to sit down with a pen and paper in the evening and write down the things that worry you; you can review this list in the morning and attend to any important concerns. If you have a bed partner, enlist their support to helping you stick to your schedule.

Reduce stress. The evening and bedtime hours are also a good time to perform some relaxation techniques, such as slow breathing or yoga. There are many free resources available for bedtime meditation.

Create a comfortable sleep environment, a place that is cool, dark, and quiet.

Don’t spend too much time in bed during the night (or the daytime). Minimize spending time in bed in which you are not sleeping. If you are having trouble going to sleep or staying asleep, don’t stay in bed for more than 20 minutes. Get out of bed and do a quiet activity — read a book, journal, or fold some laundry.

What if I am doing all these things and I still can’t sleep?
This may be a sign that you have a clinical sleep problem, such as insomnia disorder or sleep apnea. If you are doing all the right things, and still have trouble falling or staying asleep, you should discuss your sleep problems with your doctor.

What if I have been diagnosed with a sleep disorder?
If you have a history of insomnia and take sleep medications and can’t sleep, contact your doctor for medical advice, including questions about making changes in your medication. Many doctors are doing virtual visits now and they can review your current sleep problems and changes to management. You can also consider online programs for insomnia, such as Sleeping.

Remember, don’t stress out about sleep

Disrupted sleep is a normal response to stress, and it is okay to have a few nights of poor sleep as you adjust to new routines and big changes to your work and personal life. But with some simple measures you can preserve your sleep and improve your well-being during these uncertain times. We can’t control what’s happening in the world right now, but we can control our behaviors and dampen the impact of the emerging pandemic on our sleep.

*Dr. Suzanne Bertisch writes for Harvard Health Blog

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Caught these two cuddling in bed one morning. That Shiba Inu puppy is totally loving the attention!

Two distinct sleep stages appear to play vital, complementary roles in learning: one stage enhances overall performance, while the other stabilizes what we learned the previous day.

Scientists have long known that a good night’s sleep works wonders for our ability to learn new skills.

What has been less clear is the role of different sleep stages. In particular, there has been controversy over the relative contributions of rapid eye movement (REM) sleep, which is when most dreaming occurs, and non-REM sleep, which is mostly dreamless.

Now, a study by psychologists of the Department of Cognitive, Linguistic, and Psychological Sciences at Brown University in Providence, RI, provides important clues that could help resolve the debate.

Their experiment — which focuses on visual learning — suggests that rather than one stage being more important than the other for learning new skills, both play essential and complementary neurochemical processing roles.

They found that while non-REM sleep enhances our performance of newly acquired skills by restoring flexibility, REM sleep stabilizes those improvements, and prevents them from being overwritten by subsequent learning.

“I hope this helps people realize that both non-REM sleep and REM sleep are important for learning,” says corresponding author Yuka Sasaki, a professor of Cognitive, Linguistic, and Psychological Sciences at Brown.

Most REM sleep occurs in the final hours of sleep, so the finding reinforces the importance of not cutting short these later stages.

“When people sleep at night, there are many sleep cycles. REM sleep appears at least three, four, five times, and especially in the later part of the night. We want to have lots of REM sleep to help us remember more robustly, so we shouldn’t shorten our sleep.” – Prof. Yuka Sasaki

The research is published in the journal Nature Neuroscience.

Twin benefits

Psychologists have previously identified two distinct benefits of sleep for learning.

The first benefit, which they call “offline performance gains,” means the learning acquired before sleep is enhanced after sleep, without any additional training.

The second benefit, called “resilience to interference,” protects the skills learned before sleep from being disrupted or overwritten by subsequent learning after awaking.

To reap both benefits, there is a trade-off between flexibility and stability.

Learning during the day involves forming new synapses, which are the electrical connections between nerve cells, and the strengthening of existing synapses through repeated use.

While we sleep, the brain appears to streamline its operations to work more efficiently. According to a leading hypothesis, it does this by reactivating synapses that have been strengthened during the day, and then indiscriminately ‘downscales’ or weakens them all.

This restores flexibility, or plasticity, to the brain’s local connections and wider networks, to improve overall performance.

At the same time, during sleep, the brain must also stabilize key synapses to prevent what was learned the previous day from being eliminated by new learning experiences.

Visual learning task

To investigate when each of these processes occurs during sleep, the scientists gave volunteers a standard visual learning task. This involved identifying letters and the orientation of lines that pop up on a screen in two different tasks: one before sleep and one after sleep.

The letters and lines were displayed against a fixed background of horizontal lines for one group of volunteers, and vertical lines for another group.

Participants were then allowed to sleep for 90 minutes with their heads inside an MRI scanner.

After awakening, they were given 30 minutes to fully wake up before performing the same task, but with the opposite orientation of background lines.

Previous research has shown that switching the orientation of background lines interferes with performance gains on this learning task.

A third group of volunteers was not given any learning task before or after sleep.

The researchers used electrodes glued to subjects’ eyelids and scalps to detect when they entered different sleep stages.

They also used a technique called magnetic resonance spectroscopy to measure the relative concentrations of two neurotransmitters — glutamate and gamma aminobutyric acid (GABA) — in the parts of their brains that process visual information.

Glutamate transmits excitatory signals in the brain, whereas GABA transmits inhibitory signals. Neuroscientists believe that when glutamate concentrations are high relative to GABA, it reflects an increase in neural plasticity, whereas the opposite indicates an increase in stabilization.

Plasticity boost

When the scientists analyzed their results, they found that plasticity increased during non-REM sleep, which correlated with improved task performance after sleep.

Interestingly, plasticity increased during non-REM sleep even for the volunteers without any tasks to learn, which suggests there was an overall streamlining process going on in the brain.

Later in the sleep session, the plasticity of those in the learning task fell to below waking levels during REM sleep. This fall correlated with stabilization of the previous day’s learning: it appeared to prevent any performance gains from being lost.

In other words, the REM stage may make learning before sleep more resilient to interference from subsequent learning.

Unlike non-REM sleep, the sharp fall in plasticity during REM sleep was only seen among the volunteers with a task to learn.

This suggests that the stabilization that occurred during REM sleep was focused exclusively on synapses involved in learning this task.

Among participants who did not manage to get any REM sleep during their 90 minutes in the scanner, improvements in performance from their nap failed to materialize.

Overall, the results suggest both sleep stages are essential for learning new things. While our brains are “offline,” non-REM sleep improves performance on freshly learned tasks, but without REM sleep to stabilize the memories, these gains will be lost.

Universal principles?

The study focuses on a particular part of the brain and involved only one kind of learning task. Sasaki and her team hope to investigate whether the same principles apply to learning in general.

In addition, they want to explore the role of sleep when rewards are provided to motivate learning.

“Previously, we showed that rewards enhance visual learning through sleep, so we would like to understand how that works,” she says. “It is ambitious, but maybe we could expand this research to other types of learning so we could better remember and develop better motor learning, visual skills, and creativity.”

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An analysis of pooled data from 15 population studies around the world suggests that higher levels of trace lithium — a metal used in some psychiatric medicines — in public drinking water is associated with lower rates of suicide.

Lithium is primarily prescribed by doctors to help stabilize the moods of people with bipolar disorder and to reduce their risk of suicide.

Most rocks contain trace amounts of the element. Weathering washes it into groundwater and standing water, which is how the chemical finds its way into the public water supply.

Several studies over the years have found associations between relatively high amounts of lithium in drinking water and lower rates of suicide across various populations.

Recently, researchers at Brighton and Sussex Medical School and King’s College London, both in the United Kingdom, have now pooled data from 15 of these studies in a meta-analysis.

The studies included had been conducted in the United States, Austria, Greece, Italy, Lithuania, the U.K., and Japan, encompassing a total of 1,286 regions, counties, and cities.

The new meta-analysis suggests a clear relationship between higher levels of lithium in public drinking water and lower rates of suicide among these populations.

The research has been published in The British Journal of Psychiatry.

Individuals who take lithium as a mood stabilizer are monitored to prevent excess amounts from building up in the blood, which can have toxic effects. However, the amounts of lithium in drinking water are hundreds of times lower than those in medications.

“The levels of lithium in drinking water are far lower than those recommended when lithium is used as medicine, although the duration of exposure may be far longer, potentially starting at conception,” says Prof. Allan Young, the senior author of the new analysis and director of Centre for Affective Disorders at King’s College London.

Possibilities and ethical implications

Suicide is a major cause of preventable death around the world, and public health experts are searching for new ways to reduce the toll and address the underlying suffering of individuals and their loved ones.

The National Institute of Mental Health estimate that, in 2017, more than 47,000 people in the U.S. died by suicide. Among people ages 10–34 years old, suicide was the second leading cause of death after “unintentional injury.”

The World Health Organization (WHO) report that globally there are around 800,000 deaths by suicide every year, which is equivalent to one such death every 40 seconds.

“In these unprecedented times of the COVID-19 pandemic and the consequent increase in the incidence of mental health conditions, accessing ways to improve community mental health and reduce the incidence of anxiety, depression, and suicide is ever more important.” – Lead author Prof. Anjum Memon

The study authors say that the next step may be to investigate the effects of adding lithium in trace amounts to the water supplies of particular communities.

They suggest that the research could focus on communities or areas with a high risk of suicide and high prevalences of mental health problems, chronic substance abuse, and violent criminal behavior.

While this may seem like a promising way of controlling suicide rates at a community level, the notion is highly controversial from an ethical point of view.

In a study paper published in Public Health Ethics in 2019, Dr. Jared Ng, Dr. Manne Sjöstrand, and Prof. Nir Eyal discuss the idea of adding higher levels of lithium to the water sources serving allegedly at-risk communities and critique its ethical implications.

They discuss the potential harms and benefits and focus particularly on the ways in which it would bypass individual autonomy.

“Whether and how we should administer trace amounts of lithium depends in part on what future empirical evidence reveals,” they argue.

‘Grounds for further investigations’?

Commenting on the findings of the current study, Prof. Carmine Pariante, from the Royal College of Psychiatrists, in the U.K., who was not involved in the research, suggests that “This study shows that the boundaries between medication and nutritional interventions are not as rigid as we used to think, opening up the possibility of new treatments that span both domains.”

Speaking to the Science Media Centre, in London, Prof. Keith Hawton, director of the Centre for Suicide Research, at the University of Oxford, observes:

“Whether the results of this review truly indicate a potentially useful element for suicide prevention policy remains unclear. Nevertheless, there would appear to be grounds for further investigating whether supplementing lithium levels in domestic water supplies could help to prevent some deaths, especially in countries with higher suicide rates.”

While the idea of adding a mood-altering chemical to drinking water is controversial, there may be another argument in its favor: There is some evidence that microdoses of lithium may also help reduce the risk of Alzheimer’s disease.

Research in rat models of the disease suggests that lithium could stop the progression of the disease.

Clinical trials investigating the effects of lithium microdoses on the risk of dementia in people, however, have yet to be performed.

Still, an epidemiological study in Denmark found an association between higher levels of lithium consumed by populations in their drinking water and a lower risk of dementia.

Overall, the current findings contribute to an ongoing discussion about the merits and risks of lithium microdoses on mental and neurological health.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours per day at 800-273-8255. During a crisis, people who are hard of hearing can call 800-799-4889.

Click here for more links and local resources.

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Mature businessman examining documents at desk in office

A study suggests a sedentary job may provide better cognitive protection than a more physically active role.

Experts have long warned about the potential dangers of a sedentary lifestyle. Many studies suggest that being physically inactive increases the risk of health issues.

However, the connection between being physically active and maintaining cognitive health has been less clear. Now, a new study from the University of Cambridge in the United Kingdom further emphasizes this uncertainty.

The research has found that people with desk jobs are far less likely to experience cognitive decline than those with physically active roles.

“The often-used mantra ‘what is good for the heart, is good for the brain’ makes complete sense, but the evidence on what we need to do as individuals can be confusing,” says lead author Shabina Hayat.

“With our large cohort of volunteers, we were able to explore the relationship between different types of physical activity in a variety of settings,” she adds.

The research appears in the International Journal of Epidemiology.

Cognitive benefits of a desk job

The study is based on data from the Epic-Norfolk Cohort, a long-term project involving some 30,000 participants aged 40 to 79. It aims to investigate links between daily activities, diet, and cancer.

Across an average of 12 years, investigators assessed participants’ cognition, including attention, memory, and visual processing speed. Researchers also administered a reading-ability test that roughly captured each individual’s IQ.

Among the data collected was information regarding levels of physical activity during work hours and leisure time. Measurements of an individual’s physical activity in the Cambridge study combined the two.

A total of 8,585 individuals from the Epic-Norfolk study served as the cohort for the new Cambridge study.

The study reports that those with desk jobs — which are typically sedentary roles — have a lower risk of cognitive decline. Moreover, people with lifelong desk-based careers were most likely to be among the study’s top 10% of cognitive performers.

Conversely, people whose jobs involve manual work have nearly three times the risk of developing poor cognition.

Hayat proposes that it may be the job itself that provides the benefit. “Because desk jobs tend to be more mentally challenging than manual occupations, they may offer protection against cognitive decline,” Hayat says.

“Our analysis shows that the relationship between physical activity and cognitive [function] is not straightforward,” Hayat admits.

“While regular physical activity has considerable benefits for protection against many chronic diseases, other factors may influence future poor cognition.”

Seeking other connections

The researchers also looked at the potential impact of education level on cognition, but found little evidence that it was relevant. Hayat says that “people who have less active jobs — typically office-based, desk jobs — performed better at cognitive tests regardless of their education.”

The team also looked into the relationship between leisure physical activity and cognition. They were unable to draw any strong associations, at least partially, because such activities were “confounded by education, social class, and occupation.”

Confusingly, the data also suggest that leisure physical activity may offer some cognitive protection, though this seems to contradict the study’s main finding that work-related physical activity does not.

The data “reveals a differential in the association between cognition and inactivity during work and leisure,” says the study. Though exactly what that is remains unclear, particularly in light of the lower leisure-time activity levels reported by those with physical jobs.

People who were physically active during work were less likely to be similarly active during their time off.

The study concludes with an argument for additional research:

“Further studies are needed, in particular, on inequalities across socio-economic groups and the impact of lower education, poor-quality work (shortage of beneficial physical and mental stimulation), particularly for manual labor, and the lack of opportunity and space to be physically active for leisure. All these are key drivers that provide fewer opportunities to build cognitive reserve to protect for cognitive impairment and dementia in later life.”

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A review suggests smoking and vaping could increase the severity of COVID-19 due to blood vessel damage and a higher risk of stroke.

“There is a growing body of evidence to suggest that, as well as the respiratory symptoms of COVID-19, the disease can also cause, among others, neurological effects.”

A recent report from a neurological hospital in the United Kingdom identifies cases of delirium, brain inflammation, nerve damage, and stroke in COVID-19 patients.

Reports of stroke in COVID-19 are particularly prevalent. Some reports estimate that 30% of critically ill COVID-19 patients experience blood clots. And if they occur in the brain, they may trigger a stroke.

Researchers from Texas Tech University Health Sciences Center previously found that smoking and vaping increases the risk of viral infection. They have now published a review on how these activities might affect the risk of neurological dysfunction in COVID-19, particularly from damage to blood vessels in the brain.

They found that both smoking and vaping could increase the risk of stroke in COVID-19 due to damage to the blood-brain barrier and a higher risk of blood clots.

The details are published in the International Journal of Molecular Sciences.

Higher risk of blood clots

Smoking causes well-known damage to the lungs and respiratory system. Previous research has shown that it also makes a person more vulnerable to influenza.

Smoking can also affect the vascular system in the brain, prompting the researchers to review the evidence on how this activity might influence the neurological symptoms of people who contract COVID-19.

They first looked at the evidence on SARS-CoV-2 and neurological disorders, including stroke. They found one study which showed that 36.4% of COVID-19 patients had neurological symptoms. Another paper found five cases of sudden stroke in COVID-19 patients aged 30–40 years due to abnormal blood clotting in their large arteries.

But how does this relate to smoking? The researchers explain that when the body is deprived of oxygen, which occurs with smoking, the amount of clotting factors in the blood increase.

In combination with COVID-19, which also increases blood-clotting proteins, the risk of stroke rises.

“COVID-19 seems to have this ability to increase the risk for blood coagulation, as does smoke. This may ultimately translate in higher risk for stroke.” – Luca Cucullo, Ph.D., Center for Blood-Brain Barrier Research, Texas Tech University Health Sciences Center

What about vaping?

Although there is less evidence around vaping, the authors found studies that show vape aerosol components can harm blood vessels in the brain.

Vaping also appears to affect the blood-brain barrier, the defensive structure which protects the brain from toxins and pathogens in the blood.

The researchers also found specific evidence that long-term vaping may increase the risk of stroke.

Vaping may also make a person more vulnerable to COVID-19 by increasing the number of ACE2 receptors expressed in the body, which are used by the novel coronavirus to infect cells. Smoking can also increase expression of the ACE2 receptor, and damages the blood-brain barrier.

More research needed

The authors conclude that smoking and vaping may increase the severity of COVID-19 by increasing expression of the ACE2 receptor, which allows the virus to infect more cells. They were also found to damage the blood-brain barrier, which increases the risk of neurological complications.

There is an elevated risk of stroke in COVID-19 patients who smoke due to increased blood clotting factors in the blood.

However, the authors say more research is needed, including comparisons of autopsy samples from COVID-19 patients who did or did not smoke, and further animal studies.

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