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A new study has found that genetics and cardiovascular health can combine to increase the risk of developing dementia. Based on this, the authors suggest that people can mitigate some of the effects of their genes by improving their cardiovascular health.

New research has found that cardiovascular health and genetics can jointly increase the risk of dementia.

The research, published in the journal Neurology, suggests that even if someone is genetically predisposed to develop dementia, maintaining good cardiovascular health can help reduce this risk.

According to the National Institute on Aging (NIA), dementia describes a person’s loss of cognitive functioning, which affects their ability to think, remember, and reason. Various issues can cause this, the most common of which is Alzheimer’s disease.

Mild dementia may present as increasing forgetfulness or momentary confusion, accompanied by at least one other area of poor functioning, such as losing your way home (visuospatial problems) or not knowing how to pay a bill (executive function).

As it becomes moderate or severe, it can result in changes in personality, a failure to recognize family or friends, and an almost complete dependence on others for basic life activities.

Dementia occurs when a significant number of neurons — key cells in the brain — no longer function properly and ultimately die.

According to the NIA, this can happen in Alzheimer’s disease due to a combination of genetic, environmental, and lifestyle factors.

There is currently no cure for dementia. So understanding how these factors interrelate is the best way to help clinicians advise patients on what they can do to minimize their chances of developing this condition.

Genetics vs. cardiovascular health

In the present research, the researchers drew on data from the Framingham Heart Study (FHS) — a long-term study organized by the National Heart, Lung, and Blood Institute — to look at the relationship between genetics, cardiovascular health, and dementia.

The investigators assessed the data of 1,211 participants from the FHS, analyzing their relative cardiovascular health and genetic risk score for dementia.

The researchers found that participants with high genetic risk scores were 2.6 times more likely to develop dementia than those with low-risk scores.

They also found that good cardiovascular health can reduce a person’s chances of developing dementia by 55% across the follow-up period, an average of 8.4 years. Having relatively poor cardiovascular health increased a person’s risk of developing dementia.

Finally, the study made it clear that genetic predisposition and poor cardiovascular health can jointly increase a person’s risk of developing dementia.

According to Dr. Sudha Seshadri, of The University of Texas Health Science Center at San Antonio and a co-author of the research, “[t]he connection between heart health and brain health becomes clearer with each finding.”

“We hope that the results of this study will send the public a message, and that message is to exercise, reduce stress, and eat a healthy diet. Then, regardless of your genes, you have the potential to lower your risk of dementia.” – Dr. Sudha Seshadri

Adding to this, co-author Dr. Claudia Satizabal noted, “[i]t is imperative to start today. [F]rom our findings, having favorable cardiovascular health mitigates the risk of dementia in persons with high genetic risk.”

While there are many unknowns around dementia, the study contributes to a growing body of research demonstrating that staying physically active and eating well can make a meaningful difference to cognitive health issues.

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Medical experts have warned that non-communicable diseases (NCDs) such as hypertension, diabetes, cancer, cardiovascular diseases are responsible for the majority of Coronavirus disease (COVID-19) deaths in the country.

President, NCD Alliance Nigeria, Olorogun Dr. Sonny F. Kuku, in his opening remarks during a webinar on, “Non-communicable Diseases and COVID-19 in Nigeria – The response”, held Tuesday, July 21, 2020, said: “… We are only seeing the tip of the iceberg and unfortunately, people with NCDs are at greater risk. It is impacting the poorest people and most vulnerable. People with hypertension, diabetes and heart disease are the most vulnerable. We are now seeing stroke as symptom. This means COVID-19, which is an infectious disease is manifesting as an NCD in the form of stroke…”

Vice President, Scientific Affairs, NCDs Alliance Nigeria, Dr. Kingsley Akinroye, has said blamed the situation on the nation’s years of lack of commitment to the course of NCDs. The cardiologist said NCDs account for 29 per cent of deaths in Nigeria.

Akinroye, at the launch of the New Civil Society Solidarity Fund on NCDs in response to COVID-19, harped on the need to strengthen the healthcare system, intensify awareness, increase access to care and treatment, and vote more money for NCDs care and management.

However, the NCD Alliance Nigeria and 19 other global and national NCD Alliances have been awarded $300,000.

Akinroye added that regional and national NCD Alliance including NCD Alliance Nigeria would get $15,000 to address the critical needs of people living with NCDs during the pandemic through advocacy and communication activities that would support stronger organisational stability and resilience

According to the cardiologist, COVID-19 shows many connections between it and NCDs stating that people living with NCDs are more vulnerable to COVID-19 with a substantially higher risk o becoming severely ill or dying from the virus.

The expert said that actions taken to control NCDs in Nigeria include the launch o the First Multi-Sectoral Action Plan or Prevention and Control o NCDs by the Federal Ministry of Health (FMoH) and the NCD Alliance Nigeria Publication of the Handbook on Civil Society Organisation in NCDs.

“Activities in Nigeria will include the development of a database of people living with NCDs in Lagos, Osun, and Federal Capital Territory and by NCD area of focus. Also, establishment and support for people living with NCDs with skills and knowledge, and connect them to NCD Alliance Nigeria, federal Ministry o Health, World Health Organisation and State Ministry of Health in the four states,” he added.

Akinroye further stated that they would build capacity for people living with NCDs on advocacy for their rights to health, prevention, access to treatment and care; provision of support and empowerment

He explained that NCD Alliance Nigeria would develop a directory and a database in the states by area of focus cardiovascular disease, diabetes, cancer, sickle cell disease, respiratory diseases and mental health and also develop advocacy communication materials targeting Lawmakers, Policymakers and opinion leaders that are persuasive and effective to improve prevention, care and access to treatment for people living with NCDs.

The expert, however, tasked the Presidential Taskforce on COVID-19 to mobilise for more testing and awareness amongst the grassroots and also provide free hypertensive and diabetic drugs or the vulnerable population.

Executive Director, NCD Alliance Nigeria, Prof. Akin Osibogun, also presented a paper on “NCDs in Nigeria and COVID-19: The Nigerian experience.”

Osibogun is a consultant public health physician/epidemiologist, a member of Lagos State COVID-19 Response Team and former Chief Medical Director (CMD), Lagos University Teaching Hospital (LUTH) Idi Araba.

Member, Nutrition Committee, Nigerian Heart Foundation (NHF) and Food Scientist, Prof. Isaac Adebayo Adeyemi, spoke on “COVID-19 and Nutrition: Gathering evidence.”

Akinroye delivered a paper on “People Living with NCDs in Nigeria and COVID-19.”

Adeyemi, who is Vice chancellor of Bells University of Technology Ota, Ogun State, and the pioneer Deputy Vice-Chancellor, Ladoke Akintola University of Technology (LAUTECH), Ogbomoso, Oyo State, said functional foods are important to boost the immune system.

Adeyemi said that a well functioning immune system is key to providing robust defence against pathogenic organisms. Adeyemi noted that mortality in people living with NCDs is likely the result of immune decline or impaired immune response.

The expert said that energy is required to fight the virus likewise, protein to produce essential antibodies.

He encouraged intake of Phytochemicals like quercetin from onions, phloretin and also Epigallocatechin gallate (EGCG) as well as conventional foods containing bioactive food compounds like vegetables, fruits, grains, dairy, fish and meat.

“Eat fresh and unprocessed food every day like fruits and vegetables, legumes and whole grains and animal products. Eat a moderate amount o fats and oils. Eat at home to reduce your rate of contact with other people,” he added.

Adeyemi urged the consumption of plant food such as grains, legumes and oilseeds, fruits and vegetables containing vitamins, minerals, fibre and phytochemicals.

He, however, stressed on the need to avoid the intake of caffeine, trans fat while also limiting the intake of salt because they are predisposing factors that contribute to morbidity o patients with COVID-19.

According to a study published in Scholars Journal of Applied Medical Sciences and titled “COVID-19 and Nutrition: Review of Available Evidence”, nutritional support is indicated for depleted patients with respiratory diseases because it provides not only supportive care, but direct intervention through improvement in respiratory and peripheral skeletal muscle function and in exercise performance.

The researchers noted: “A combination of oral nutritional supplements and exercise or anabolic stimulus appears to be the best approach to obtaining significant functional improvement. Patients responding to this treatment even demonstrated a decreased mortality. Furthermore, weight loss and malnutrition opens the door of infection reoccurrence. Poor response was related to the effects of systemic inflammation on dietary intake and catabolism.

“Dietary management of pre-existing diseases has been suggested as a strategy to minimise the potential risk of COVID-19 infection in conditions such as irritable bowel syndrome, Crohn’s and Colitis. WHO, dietetic associations and dietitians have been calling for patients with pre-existing conditions to continue abiding by their dietary advice and nutritional therapy steps received from their dietician if tested positive for COVID-19.”

Meanwhile, according to a World Health Organisation (WHO) survey, prevention and treatment services for NCDs have been severely disrupted since the COVID-19 pandemic began. The survey, which was completed by 155 countries during a three-week period in May, confirmed that the impact is global, but that low-income countries are most affected.

This situation is of significant concern because people living with NCDs are at higher risk of severe COVID-19-related illness and death.

Director-General of the WHO, Dr. Tedros Adhanom Ghebreyesus, said: “The results of this survey confirm what we have been hearing from countries for a number of weeks now.

“Many people who need treatment for diseases like cancer, cardiovascular disease and diabetes have not been receiving the health services and medicines they need since the COVID-19 pandemic began. It’s vital that countries find innovative ways to ensure that essential services for NCDs continue, even as they fight COVID-19.”

The main finding is that health services have been partially or completely disrupted in many countries. More than half (53 per cent) of the countries surveyed have partially or completely disrupted services for hypertension treatment; 49 per cent for treatment for diabetes and diabetes-related complications; 42 per cent for cancer treatment, and 31 per cent for cardiovascular emergencies.

Rehabilitation services have been disrupted in almost two-thirds (63 per cent) of countries, even though rehabilitation is key to a healthy recovery following a severe illness from COVID-19.

In the majority (94 per cent) of countries responding, ministries of health staff working in the area of NCDs were partially or fully reassigned to support COVID-19.

The postponement of public screening programmes (for example for breast and cervical cancer) was also widespread, reported by more than 50 per cent of countries. This was consistent with initial WHO recommendations to minimize non-urgent facility-based care whilst tackling the pandemic.

But the most common reasons for discontinuing or reducing services were cancellations of planned treatments, a decrease in public transport available and a lack of staff because health workers had been reassigned to support COVID19 services. In one in five countries (20 per cent) reporting disruptions, one of the main reasons for discontinuing services was a shortage of medicines, diagnostics and other technologies.

Unsurprisingly, there appears to be a correlation between levels of disruption to services for treating NCDs and the evolution of the COVID-19 outbreak in a country. Services become increasingly disrupted as a country moves from sporadic cases to community transmission of the coronavirus.

Globally, two-thirds of countries reported that they had included NCD services in their national COVID-19 preparedness and response plans; 72 per cent of high-income countries reported inclusion compared to 42 per cent of low-income countries. Services to address cardiovascular disease, cancer, diabetes and chronic respiratory disease were the most frequently included. Dental services, rehabilitation and tobacco cessation activities were not as widely included in response plans according to country reports.

Seventeen percent of countries reporting have started to allocate additional funding from the government budget to include the provision of NCD services in their national COVID-19 plan.

Encouraging findings of the survey were that alternative strategies have been established in most countries to support the people at the highest risk to continue receiving treatment for NCDs. Among the countries reporting service disruptions, globally 58 per cent of countries are now using telemedicine (advice by telephone or online means) to replace in-person consultations; in low-income countries, this figure is 42 per cent. Triaging to determine priorities has also been widely used, in two-thirds of countries reporting.

Also encouraging is that more than 70 per cent of countries reported collecting data on the number of COVID-19 patients who also have an NCD.

Director of the Department of NCDs at WHO, Dr. Bente Mikkelsen, said: “It will be some time before we know the full extent of the impact of disruptions to health care during COVID-19 on people with NCDs.

“What we know now, however, is that not only are people with NCDs more vulnerable to becoming seriously ill with the virus, but many are unable to access the treatment they need to manage their illnesses. It is very important not only that care for people living with NCDs is included in national response and preparedness plans for COVID-19 – but that innovative ways are found to implement those plans. We must be ready to ‘build back better’- strengthening health services so that they are better equipped to prevent, diagnose and provide care for NCDs in the future, in any circumstances.”

According to the WHO, NCDs kill 41 million people each year, equivalent to 71 per cent of all deaths globally. Each year, 15 million people die from an NCD between the ages of 30 and 69 years; more than 85 per cent of these “premature” deaths occur in low- and middle-income countries.

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The federal government has received $890 million as grants from the Global Fund to fight HIV/AIDS, tuberculosis and malaria.

The Minister of Health, Dr. Osagie Ehanire, said yesterday that the fund would be used to implement programmes aimed at eradicating the diseases over a three year period, from 2021 to 2023.

Ehanire said that the Global Fund also approved a grant of US$21.9 million to support Nigeria’s COVID-19 response.

He said: “The purpose of this press briefing today is to announce the receipt of a grant, made to the Federal Republic of Nigeria by The Global Fund to fight HIV/AIDS, tuberculosis and malaria, amounting to $890 million, over an implementation period of three years, beginning from 2021 to 2023.”

The minister noted that the grant, which is the largest given to any country in this funding cycle, is sequel to a successful funding request made by the Nigeria Country Coordination Mechanism (CCM).

The Global Fund for the fight against HIV/AIDS, Tuberculosis and Malaria (GF) is an innovative international financing mechanism that was established by the United Nations in 2002, with its headquarters in Geneva, Switzerland.

The fund is made up of global partnership of governments, civil societies and private donors and established for the purpose of attracting, leveraging and investing resources to fund public health interventions that would accelerate the eradication of HIV, tuberculosis and malaria in affected high burden countries to further goals of Sustainable Development Goals (SDGs).

The Global Fund has committed the sum of USD$2.586 billion since 2002 to operations in Nigeria, which are split into four program areas: HIV/AIDS, tuberculosis, malaria and the Resilient Systems Strengthening for Health, (RSSH).

Nigeria has accessed $2.436 billion, which represented 94 percent of the committed amount.

The minister said the grant would complement the investment of the government of Nigeria and of other Development Partners in HIV/AIDS, tuberculosis and malaria programmes, including the Resilient and Sustainable System for Health, over the period 2021-2023.

He said the approval of the grant came following the review of the proposal that the CCM Nigeria submitted on March 23, 2020, which was adjudged to be technically sound and strategically focused by the independent Technical Review Panel of the Global Fund.

Ehanire said: “This grant will support access to malaria prevention, diagnostic and treatment services in 13 states. The States include Adamawa, Delta, Gombe, Jigawa, Kaduna, Kano, Katsina, Kwara, Niger, Ogun, Osun, Taraba and Yobe States.

“Access to HIV/AIDS and tuberculosis services across all the 36 states and the FCT; Improvements in our health system, particularly, provision of infrastructure for warehousing and distribution of health commodities, laboratory services, data management and capacity building for our healthcare providers, including support to community system.”

The minister said the implementation of the grant would specially target the poor, the most vulnerable and disadvantaged, and those at higher risk of the target diseases, to promote equity in access to health care services.

He further said: “With regard to Nigeria’s COVID-19 response effort, The Global Fund gave approval to repurpose the sum of US$6.2 million out of our on-going grants for HIV, tuberculosis and malaria to support the implementation of our initial Incident Action Plan (IAP) for COVID-19.

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A panic attack is a sudden, intense episode of overwhelming fear and anxiety. There are several ways to help a person who is having a panic attack. These include using grounding techniques and helping them get their breathing under control.

In this article, we discuss how to help someone during a panic attack. We cover grounding tips, early warning signs, and when to get help.

How to help someone during a panic attack

Due to the extreme nature of the symptoms, it is important to understand how to react when someone has a panic attack, as they may feel as though they are dying during an episode.

Certain strategies and methods can help alleviate panic, ease the situation, and even stop the symptoms from getting worse. The ways a person can help include:

Remaining calm

Panic attacks are unpredictable and happen for different reasons. Among those who experience panic attacks, some may only have a couple of attacks in their lifetime, while others have recurrent attacks. One 2016 report shows that most people who have one panic attack will likely have more.

As panic attacks come without warning, they can be very scary, and it is important for everyone else to stay calm. A panicked response can make the situation worse.

Symptoms of a panic attack typically reach peak intensity in 10 minutes. So it is important that people act quickly to help alleviate the symptoms where possible.

Making conversation and positive affirmations

What a person says in response to someone having a panic attack is just as important as what they do. Engaging in conversation can distract from the extreme symptoms and help the person regulate their breathing. It is important to ask whether a person requires help rather than just assuming that they do. Here are some guidelines on what to say and do:

  • Ask questions: Introduce yourself and ask if the person needs help. If so, ask them if they think that they are having a panic attack and whether they have had one before. This prompt may remind them about previous attacks and how they recovered.
  • Stay or go: Let the person know that they do not have to stay where they are. Leaving a certain situation can take the pressure off someone having a panic attack. Find out what makes them feel most comfortable.
  • Kind words: Staying positive and nonjudgmental is important. Help the person understand that you are there to assist them, they are safe, and they are going to get through this. Remind them that the panic attack is only temporary.
  • Have a friendly conversation: An engaging chat can help distract a person from their symptoms. If you are a friend, gently bring up a topic that they are interested in to help them think of something else.

Suggesting grounding techniques

When a person has lost control of themselves and their surroundings, grounding techniques can help them come back to the present moment. These techniques include:

  • Sitting down: Relaxing in a comfortable chair sounds simple, but it can be extremely effective. With the feet comfortably on the floor, a person should focus on breathing in and out slowly and how it feels sitting on the chair.
  • The 5-4-3-2-1 technique: Focusing on other things in the room and different senses can distract the person from the panic attack. They can focus on identifying five items to see, four objects to touch, three noises to hear, two different smells, and one taste.
  • Simple maths: Counting from one to 10 out of order or performing simple mathematical calculations, such as times tables, provides something else on which to concentrate.
  • Focus: Ask the person what day of the week it is, who they are with, and where they are.

Providing ongoing help

Some people may feel embarrassed about having a panic attack, as well as finding it stressful. Continuing support and engagement will help ease their anxiety. Reach out by checking in now and again. Finding out more about the condition may also help if the situation happens again.

How to help someone breathe during a panic attack

When a person is experiencing a panic attack, it is important that they get their breathing under control. Someone trying to help should not give them a paper bag to inhale and exhale from, as this could make them pass out.

Instead, it is better not to bring attention to their breathing and to keep calm and breath normally so that they can mirror this pattern. This method should hopefully get their breathing back under control.

What not to do when someone is having a panic attack

Helping someone who is having a panic attack can be very stressful, so it is important that a person is mindful of what actions could make a panic attack worse.

Actions that could make a panic attack worse include:

  • Saying “calm down”: While getting a person to talk is vital, phrases such as “calm down,” “don’t worry,” and “try to relax” could make the symptoms worse.
  • Becoming irritated: Remain patient to help a person deal with a panic attack and do not belittle their experience. The focus should be on them, for however long it takes the symptoms to pass.
  • Making assumptions: Always ask a person what help they need, rather than assuming or guessing the correct advice.

Warning signs and when to get help

While a panic attack can happen very suddenly, the person will often experience warning signs. These may include:

  • shortness of breath
  • feelings of terror or dread
  • shaking and dizziness
  • heart palpitations
  • feeling as though they are dying

Someone having a panic attack may not feel comfortable asking for help. However, the symptoms could last for hours with one panic attack rolling into another, so a person should get medical assistance if they feel that it is necessary.

Pain in the arms or shoulders is also a concern, as the symptoms of a heart attack and panic attack can be similar. If a person has not had a panic attack before, has chest pain, and is vomiting, dial 911 immediately.

Learn more about the differences between a heart attack and a panic attack here.

People who frequently have panic attacks may wish to consider joining a support group or, if possible, relying more on family members and friends to help prevent panic attacks from reoccurring.

Panic attack symptoms

Panic attacks can start without warning, and they can be frightening. An attack can happen when a person is relaxed or even asleep. While the symptoms vary, common ones include:

  • rapid heart rate
  • sweating, trembling, or shaking
  • shortness of breath
  • feeling sick or nauseated
  • a loss of control
  • sense of impending danger
  • chest pain and stomach cramps
  • lightheadedness or faintness

People who have panic attacks may receive a diagnosis of panic disorder. According to the Anxiety and Depression Association of America, statistics show that panic disorder affects about 6 million adults in the United States, or 2.7% of the population.

Summary

Panic attacks are scary for everyone involved, especially when they happen suddenly.

As the person’s stress levels rise, it is essential for others to stay calm and empathetic. How they respond to the person experiencing the attack can influence its severity.

If a person is experiencing other symptoms, such as nausea and vomiting, they may be having a heart attack. In this case, it is essential to dial 911 immediately.

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Yellow pills forming shape to Zn alphabet on wood background

A review of the evidence on zinc suggests the mineral could have protective effects against COVID-19 by boosting anti-viral immunity and curbing inflammation.

Diet and health have many links, including immune system function. Good nutrition supports the immune system to fight pathogens and helps to avoid chronic inflammation following an infection.

Many people know that vitamin C has significant effects on the immune system. Deficiency in the vitamin has associations with a higher risk of infections, such as pneumonia.

During the COVID-19 pandemic, interest in dietary supplements to support the function of the immune system has intensified. Although no specific food or supplement can prevent a person from contracting COVID-19, certain nutrients can help support the immune system’s function.

A recent review has focused on the benefits of zinc against COVID-19. Zinc is a mineral found in many different food types.

The findings suggest that zinc could have protective effects against COVID-19 by supporting anti-viral immunity and reducing inflammation. A team of researchers at Sechenov University in Moscow, Russia, led the review and published it in the International Journal of Molecular Medicine.

An essential mineral

Zinc is an essential mineral with a wide range of roles in the human body, including supporting the function of over 300 enzymes. The body needs zinc to carry out normal metabolism and ensure the proper function of the reproductive, cardiovascular, and nervous systems.

Foods high in zinc include animal products, such as meat, shellfish, chicken, and fortified breakfast cereal. However, beans, nuts, and seeds also contain zinc. Phytates in vegetables and grains can reduce the absorption of zinc and, therefore, vegetarians and vegans may need 50% more zinc in their diet.

Deficiency in zinc has associations with delayed growth in children, as well as increased risk of infection. It is also a significant risk factor for the development of pneumonia, which can be a consequence of COVID-19.

“According to the current estimates, the risk of zinc deficiency is observed in more than 1.5 billion people in the world,” explains lead author of the review Prof. Anatoly Skalny, who heads the Laboratory of Molecular Dietetics at Sechenov University.

“Given the crucial role of zinc in regulation of immunity, one can propose that its insufficiency may be considered as a risk factor for infectious diseases.”

– Prof. Anatoly Skalny

Together with colleagues in Russia, Germany, Greece, Norway, and the United States, Professor Skalny put together a review of the scientific evidence on zinc’s role in preventing and treating respiratory infections, including COVID-19.

Zinc and the immune system

Zinc supports the production and maturation of white blood cells, which are the major players in the immune system. There are multiple types of white blood cells, some of which make antibodies, capture and destroy pathogens, and return the immune system to normal after an infection.

Zinc also helps to regulate inflammation. While an inflammatory response is necessary to fight infection, the overproduction of pro-inflammatory cytokines early in the infection is responsible for some of the worst symptoms of COVID-19.

The review describes evidence showing that zinc may have an anti-inflammatory effect in pneumonia, limiting the damage to lung tissue.

For decades, scientists have known that zinc can block the replication of rhinoviruses responsible for respiratory infections in people, including the common cold.

Higher levels of zinc in cells help block the reproduction of rhinoviruses and stimulate interferon alfa production. This signaling molecule prompts nearby cells to initiate their anti-viral defenses.

The review also found evidence specific to coronaviruses. One study showed that zinc blocks the enzyme responsible for replicating the coronavirus that led to the SARS outbreak of 2002.

Connection with chloroquine

Interestingly, chloroquine — which some people suggested as a treatment option early on in the pandemic – increases the cells uptake of zinc, which may underlie some of its positive effects.

A 2020 study showed that when doctors treated patients with zinc and hydroxychloroquine, they discharged more patients, and fewer people died from COVID-19.

However, the paper suggesting that hydroxychloroquine or chloroquine could treat COVID-19 has since been retracted. The latest advice from the Food and Drug Administration (FDA) warns against using either of these drugs due to the risk of severe side effects.

The researchers also clarify that, although the evidence suggests zinc reduces the risk of respiratory diseases and their complications, there is not enough data to make recommendations regarding zinc intake and COVID-19.

It is also worth noting that consuming excess zinc can have adverse effects, including nausea, loss of appetite, and stomach cramps. Over the long-term, too much zinc has associations with low immunity. The National Institutes of Health provide daily recommended amounts of zinc.

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Close up of woman hands using lancet on finger to check blood sugar level by Glucose meter. Use as Medicine, diabetes, glycemia, health care and people concept.

A study of more than 4,000 people shows that gut bacteria fluctuate throughout the day and that this occurs to a lesser extent in people with type 2 diabetes. Doctors could potentially use these patterns to predict and diagnose diabetes.

Circadian rhythms, which people sometimes refer to as the “body clock,” regulate patterns of sleep, alertness, temperature, and blood pressure, among other factors. These daily biological rhythms likely evolved to coordinate with light and food availability, but they also regulate internal metabolic processes.

Circadian rhythms are important to human health, and experts believe their long-term disruption to have various adverse consequences.

The possible health effects include obesity and type 2 diabetes. A growing body of evidence indicates a connection between circadian disruption and insulin resistance.

Building on this, a new study appearing in Cell Host & Microbe shows that diabetes is also associated with changes to the daily rhythms of the gut microbiome.

A team of researchers that the Technical University of Munich in Germany led showed that people with type 2 diabetes have fewer daily fluctuations in some of their gut bacteria and that these changes may serve to predict and diagnose the condition.

The rhythm of the microbiome

For many years, scientists have known that the circadian clock is crucial to human physiology. However, it is only recently that they have discovered its role in relation to the microbiome, which is the community of bacteria, viruses, and fungi that live in and on people — for instance, on the skin or in the gut.

Recent studies, for example, show that the community of gut bacteria fluctuates during the day, just like other circadian processes.

Some researchers believe that these regular changes to the microbiome are likely beneficial and that the loss of this daily rhythm could contribute to metabolic disorders, perhaps explaining the connection between circadian rhythms and diabetes.

To investigate this further, the team started by analyzing the microbiomes of almost 2,000 people over a period of 24 hours. Their results confirmed the regular oscillations of gut bacteria.

They then focused the study to include only the people with metabolic disorders, including obesity (defined as a body mass index, or BMI, of 30 or above), prediabetes, and type 2 diabetes.

They found that people with obesity and type 2 diabetes lost the rhythmic patterns of their gut bacteria. They also noted specific changes to the gut bacteria in people with diabetes.

A new diagnostic tool?

Using a dataset of 2,039 people, the team started to detect particular changes to the microbiome that could serve as biomarkers to diagnose type 2 diabetes.

“When certain gut bacteria do not follow a day-night rhythm, so if their number and function does not change over the course of the day, this can be an indicator for [type 2 diabetes],” – Silke Kiessling, co-author of the study

The researchers found 13 types of bacteria that did not change during the day in people with diabetes. They used these bacteria to train a mathematical model to detect whether a person has diabetes.

“Mathematical models also show that this microbial risk signature consisting of arrhythmic bacteria helps diagnosing diabetes,” explains first author Sandra Reitmeier.

When they tested the model on a new group of 699 people, it was able to predict not only who received a diagnosis of type 2 diabetes but also who was at risk of developing the condition.

The model was most effective in combination with BMI, which confirms the importance of obesity in diabetes onset.

“Apart from bacteria and their variations over the course of the day, other parameters, such as [BMI], play a role in being able to better predict a person’s future medical conditions,” adds senior author Prof. Dirk Haller.

Cause or effect?

The findings so far show a clear association between daily variations in the microbiome and type 2 diabetes, but they do not say anything about why the two are connected.

In the final part of their study, the researchers tried to answer this question by looking at changes to metabolism. They found 26 metabolic pathways that were associated with the lack of a microbial rhythm.

The same association existed for 19 of these pathways (73%) in a separate group of people with type 2 diabetes. These pathways included several that are known to influence sensitivity to insulin.

These common metabolic pathways suggest that the two states are functionally connected, although it is too early to say whether a disrupted microbiome actually causes diabetes.

While scientists do not yet fully understand the link between the microbiome and diabetes, the findings from this study suggest that a microbial risk score could be a new way to diagnose and predict the onset of type 2 diabetes.

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Close-up of scientist hands with microscope

A recent stem cell study has shown that SARS-CoV-2, the novel coronavirus, can infect heart cells via the same receptor present in the lungs. This may be responsible for the cardiac complications associated with COVID-19.

Experts initially thought that COVID-19 was a respiratory disease, with symptoms including cough, shortness of breath, and pneumonia. However, more recent evidence into COVID-19 shows that the disease can also cause neurological and cardiac symptoms.

Physicians have reported changes to the circulatory system in people with COVID-19, sometimes leading to blood clots, as well as cardiac complications, such as changes to the heart rhythm, damage to heart tissue, and heart attacks.

Although there is widespread agreement that COVID-19 is a risk to the heart, whether these symptoms are due to the virus directly or a consequence of other disease processes, such as inflammation, has been unclear.

In a new study appearing in the journal Cell Reports Medicine, scientists have helped resolve this mystery by showing that SARS-CoV-2 can infect heart cells and change their function.

Their findings, from experiments in human stem cells, suggest that the cardiac symptoms of COVID-19 may be the direct result of the infection of heart tissue.

SARS-CoV-2 behaviour in heart cells

The scientists used a type of stem cell called induced pluripotent stem cells (iPSCs) to generate heart cells.

Scientists can create iPSCs from a person’s skin cells and then reprogram them to become any cell type in the body. They provide a useful tool for research into human disease and a way to test new treatments.

In this study, the team programmed the iPSCs to become heart cells and later incubated them with SARS-CoV-2. Using microscopes and genetic sequencing techniques, the researchers found that SARS-CoV-2 could directly infect the heart cells.

They also showed that the virus can rapidly divide inside heart cells, which caused changes to the heart’s ability to beat after a period of under 3 days.

“We not only uncovered that these stem cell-derived heart cells are susceptible to infection by [the] novel coronavirus, but that the virus can also quickly divide within the heart muscle cells,” explains first study author Dr. Arun Sharma, a research fellow at the Regenerative Medicine Institute of Cedars-Sinai Medical Center in Los Angeles, CA.

The role of the ACE2 receptor

Additional experiments focused on the different genes expressed by heart cells before and after the virus infected them. These studies showed activation of the innate immune response and antiviral clearance pathways to help fight the virus.

However, how does the virus get into the heart in the first place? The researchers suggest that one way in which it gains access may be by using angiotensin-converting enzyme 2 (ACE2). This is the same receptor the virus uses to infect cells in the lungs.

Importantly, studies have shown that treatment with an ACE2 antibody can help stop SARS-CoV-2 from replicating and save cells in the heart.

“By blocking the ACE2 protein with an antibody, the virus is not as easily able to bind to the ACE2 protein, and thus cannot easily enter the cell. This not only helps us understand the mechanisms of how this virus functions, but also suggests therapeutic approaches that could be used as a potential treatment for SARS-CoV-2 infection.” – Dr. Arun Sharma

The importance of these findings

The researchers suggest that scientists could use stem cell-derived heart cells to screen new drugs and find compounds able to stop the infection of heart cells.

“This key experimental system could be useful to understand the differences in disease processes of related coronaviral pathogens SARS and MERS,” adds study author Dr. Vaithilingaraja Arumugaswami, an associate professor at the University of California, Los Angeles.

There are some limitations to this approach, however. These include the fact that stem cell-derived heart cells are not exactly the same as the real thing.

The researchers also studied the cells in a dish, an isolated system lacking the immune interactions that would occur in the human body.

Nevertheless, the experiments clearly showed that the cells became infected with SARS-CoV-2, which is in line with some clinical data showing the virus in the hearts of people who died from COVID-19.

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A new research published last week in the Journal of Physiology showed that 12 weeks of easy-to-administer passive stretching helps improve blood flow by making it easier for your arteries to dilate and decreasing their stiffness.

Passive stretching differs from active stretching in that the former involves an external force (another person or gravity) stretching you, whereas active stretching is performed on your own. The changes they observed in blood vessels could have implications for diseases, including the number one global killer, heart disease.

Researchers at the University of Milan assigned 39 healthy participants of both sexes to two groups. The control group didn’t undergo any stretching. The experimental group performed leg stretches five times a week for 12 weeks. Researchers evaluated the effect of passive stretching on the blood flow locally and in the upper arm. They found that the arteries in both the lower leg and upper arm had increased blood flow and dilation when stimulated, along with decreased stiffness.

Both of these changes may have implications for diseases such as heart disease, stroke and diabetes as they are characterized by changes in blood flow control, due to an impaired vascular system.

If this study is replicated in patients with vascular disease, it could indicate whether or not this training method could serve as a new drug-free treatment for improving vascular health and reducing disease risk, especially in people with lower mobility.

Moreover, stretching may also be used during hospitalisation or after surgical interventions, to preserve the vascular health when patients have low mobility. Carers or family members can also perform it at home.

An author on the paper, Emiliano Ce, said this new application of stretching is especially relevant in the current pandemic period of increased confinement to homes, where the possibility of performing beneficial training to improve and prevent heart disease, stroke and other conditions is limited.

Also, another research suggests that exercise can slow or prevent the development of macular degeneration and may benefit other common causes of vision loss, such as glaucoma and diabetic retinopathy.

The new study from the University of Virginia School of Medicine found that exercise reduced the harmful overgrowth of blood vessels in the eyes of lab mice by up to 45 per cent. This tangle of blood vessels is a key contributor to macular degeneration and several other eye diseases.

The study represents the first experimental evidence showing that exercise can reduce the severity of macular degeneration, a leading cause of vision loss, the scientists report. Ten million Americans are estimated to have the condition.

Researcher at the UVA’s Center for Advanced Vision Science, Dr. Bradley Gelfand, said: “There has long been a question about whether maintaining a healthy lifestyle can delay or prevent the development of macular degeneration. The way that question has historically been answered has been by taking surveys of people, asking them what they are eating and how much exercise they are performing.

“That is basically the most sophisticated study that has been done. The problem with that is that people are notoriously bad self-reporters … and that can lead to conclusions that may or not be true. This [study] offers hard evidence from the lab for very first time.”

Enticingly, the research found that the bar for receiving the benefits from exercise was relatively low — more exercise didn’t mean more benefit. “Mice are kind of like people in that they will do a spectrum of exercise. As long as they had a wheel and ran on it, there was a benefit,” Gelfand said. “The benefit that they obtained is saturated at low levels of exercise.”

An initial test comparing mice that voluntarily exercised versus those that did not found that exercise reduced the blood vessel overgrowth by 45 per cent. A second test, to confirm the findings, found a reduction of 32 per cent.

The scientists aren’t certain exactly how exercise is preventing the blood vessel overgrowth. There could be a variety of factors at play, they say, including increased blood flow to the eyes.

Gelfand, of UVA’s Department of Ophthalmology and Department of Biomedical Engineering, noted that the onset of vision loss is often associated with a decrease in exercise. “It is fairly well known that as people’s eyes and vision deteriorate, their tendency to engage in physical activity also goes down,” he said. “It can be a challenging thing to study in older people. … How much of that is one causing the other?”

The researchers already have submitted grant proposals in hopes of obtaining funding to pursue their findings further.

“The next step is to look at how and why this happens, and to see if we can develop a pill or method that will give you the benefits of exercise without having to exercise,” Gelfand said. “We’re talking about a fairly elderly population [of people with macular degeneration], many of whom may not be capable of conducting the type of exercise regimen that may be required to see some kind of benefit.” (He urged people to consult their doctors before beginning any aggressive exercise program.)

Gelfand, a self-described couch potato, disclosed a secret motivation for the research: “One reason I wanted to do this study was sort of selfish. I was hoping to find some reason not to exercise,” he joked. “It turned out exercise really is good for you.”

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Photo series of a virtual dinner date with video call during lockdown.

New research suggests that low-to-moderate alcohol consumption may reduce cognitive decline in older adults.

A new study has found that low-to-moderate alcohol consumption may slow cognitive decline in adults of middle age or older.

The research, which appears in the journal JAMA Open Network, lays the ground for future research to corroborate these findings and determine the underlying mechanism for the relationship.

Alcohol and health

Drinking alcohol is a central part of many cultures across the world. Beyond the immediate adverse effects of a hangover, drinking alcohol in excess has associations with various poor health outcomes.

According to the Centers for Disease Control and Prevention (CDC), excessive alcohol use includes heavy drinking (more than eight or 15 drinks a week for women and men, respectively), binge drinking (drinking four or five drinks in about 2 hours for women and men, respectively), or drinking while underage or pregnant.

The CDC define a drink as 14 grams of pure alcohol. This amount roughly equates to a 12-ounce (oz) can of 5% beer, a 5-oz glass of 12% wine, a 4-oz glass of 15% wine, or a single 1.5-oz shot of 40% distilled spirit or liquor.

The CDC note that excessive alcohol drinking is associated with various health problems. These include:

  • damage to the liver
  • inflammation of the pancreas
  • increased risk of cancer
  • hypertension
  • psychological disorders
  • unintentional injuries that a person sustained while drunk
  • harm to the fetus if a woman drinks while pregnant
  • sudden infant death syndrome
  • alcohol use disorder

Research has shown that the misuse of alcohol is a leading cause of illness and death and that any level of alcohol drinking, particularly in men who drink spirits, increases the risk of high blood pressure and stroke.

However, there is also evidence that low-to-moderate alcohol consumption — fewer than eight or 15 standard drinks in the United States per week for women and men, respectively — can have a beneficial effect on health, including various cardiovascular diseases.

The effects of low-to-moderate alcohol consumption on cognitive decline in later life have been mixed. Some research has found evidence that it may be protective, while other research suggests that it is probably not harmful. Conversely, some studies have found that it can exacerbate poor brain health.

The authors of the present study noted that previous studies exploring the relationship between alcohol consumption and cognitive decline are often limited in two ways.

First, they typically rely on single measures of cognitive decline, when it can present in a variety of ways. Second, they typically take into account net follow-up time to cognitive decline, despite the decline often being greater or lesser depending on age rather than general time passed.

As a consequence, the authors of the present research developed their study to take these factors into account, with the aim of better understanding the effects of low-to-moderate alcohol consumption on cognitive decline in older age.

About 20,000 participants

The authors drew on data from the Health and Retirement Study, which was a longitudinal study involving about 20,000 adults of middle age or older living in the U.S.

The sample that the researchers used was representative of the U.S. population, and they tracked the participants for an average time of 9.1 years.

The team regularly assessed the participants’ cognitive functioning during this time, focusing on three measures: total word recall, mental status, and vocabulary. They split the participants into those with persistently high scores across time and those with persistently low scores across time.

The participants also gave information on how many alcoholic drinks they consumed on average. During the data analysis, the researchers separated them into three groups: those who never drank, those who used to drink, and those who currently drink.

They then further classified drinkers as low-to-moderate drinkers (fewer than eight or 15 drinks per week for women and men, respectively), or heavy drinkers (more than moderate drinking).

Low-to moderate drinking may protect against cognitive decline

After analyzing the data, the researchers found that low-to-moderate drinking was associated with better cognitive outcomes across all three measures for middle-aged and older adults.

As other factors could be responsible for this association, the researchers took age, sex, race/ethnicity, educational level, marital status, and body mass index (BMI) into account in the analysis. The association between consistently high cognitive scores and low-to-moderate drinking persisted.

While this was true in general across the study, the researchers found that the association between low-to-moderate alcohol consumption and protection against cognitive decline was stronger for white participants than for Black participants. However, there were fewer Black participants, and this could account for the lack of strong association.

The researchers also noted that about 5% of women and 15% of men drank excessive amounts of alcohol, meaning that public health awareness campaigns that focus on this issue are still crucial. Drinking more than 14 drinks (self-defined) had worse cognitive outcomes for vocabulary, while more than 10 drinks impacted negatively on word recall.

Future research

While the study demonstrates an association between low-to-moderate alcohol drinking and protection against cognitive decline in later life, it is not yet clear why this is the case. According to study author Dr. Ruiyuan Zhang of the Department of Epidemiology and Biostatistics, University of Georgia College of Public Health, Athens, and his co-authors:

“The role of alcohol drinking in cognitive function may be a balance of its beneficial and harmful effects on the cardiovascular system. Among low-to-moderate drinkers, the beneficial effects may outweigh the harmful effects on the cardiovascular system.”

Future research to corroborate the study’s findings is important, given the previous conflicting research on the topic. In addition, if research conclusively demonstrates low-to-moderate alcohol consumption as protective against cognitive decline in older age, future research to help understand why this is the case is important so that clinicians can best advise their patients.

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A laboratory study has found that the asthma drug salbutamol prevents the formation of tangles of fibrous protein that are a hallmark of Alzheimer’s disease. The next step will be to test the drug in animal models of the disease.

About 50 million people worldwide have dementia, and every year, there are nearly 10 million new cases, according to the World Health Organization (WHO).

They note that the most common form of dementia is Alzheimer’s disease, which accounts for 60–70% of all cases.

In the United States, the National Institute on Aging estimate that more than 5.5 million people have Alzheimer’s disease. Most of them are over 65 years of age.

The disease is a neurological disorder in which the death of brain cells results in progressive memory loss and cognitive decline.

While existing drug treatments help reduce the symptoms of Alzheimer’s disease and improve people’s quality of life, they neither slow its progression nor cure it.

The brains of people with the condition contain distinctive plaques between nerve cells, as well as clumps of fibers known as neurofibrillary tangles inside the cells.

The plaques consist of a protein called beta-amyloid, while another protein called tau makes up the tangles.

Promising drug target

After clinical trials found that drugs that clear beta-amyloid from the brain failed to slow the disease’s progression, attempts to find a treatment have shifted to tau.

Researchers at Lancaster University in the United Kingdom believe that tau could be a more promising drug target for Alzheimer’s disease. They point to previous research, which found that in the absence of the tau neurofibrillary tangles, beta-amyloid does not seem to harm nerve cells.

Also, the number of tangles in the brain appears to be a much better indicator of the severity of the disease than the number of amyloid plaques.

In healthy brain cells, tau proteins help stabilize the internal network of microscopic tubes, or “microtubules,” that transports nutrients and other molecules around nerve cells.

In Alzheimer’s disease, these tau molecules break away from the microtubules and begin to stick together to form threads and, eventually, tangles. In turn, these disrupt the microtubule transport network.

The scientists from Lancaster University believe that compounds that prevent tau molecules from aggregating in this way could make promising treatments for Alzheimer’s disease.

Giant microscope

To screen more than 80 compounds for their ability to block the formation of tangles, the researchers used a powerful technique — synchrotron radiation circular dichroism — for imaging structural changes in proteins.

This technique involves illuminating samples with beams of light 10 billion times brighter than the sun. The U.K.’s Diamond Light Source (DLS) in Oxfordshire, which experts have likened to a giant microscope, generated this light for the study.

One of the compounds that the DLS identified was the hormone epinephrine, which stabilized tau proteins and prevented them from forming tangles.

The body rapidly metabolizes epinephrine, however, so the researchers went on to screen four existing drugs with very similar chemical structures.

Of these, two were effective: a drug called dobutamine, which doctors use to treat heart attacks and heart failure, and salbutamol (also known as albuterol), which is available under the brand name Ventolin for treating asthma.

The scientists ruled out dobutamine as a practical treatment for Alzheimer’s disease because it requires injection, and its effects are very short-lived.

Further tests on salbutamol suggested that it binds to individual tau molecules, preventing them from forming “nuclei” around which other protein molecules can aggregate.

The researchers published their findings in the journal ACS Chemical Neuroscience.

Early days

“This work is in the very early stages, and we are some way from knowing whether or not salbutamol will be effective at treating Alzheimer’s disease in human patients,” says Prof. David Middleton, one of the authors.

“However, our results justify further testing of salbutamol and similar drugs in animal models of the disease and, eventually, if successful, in clinical trials.”

Salbutamol is on the WHO’s Model Lists of Essential Medicines and is the 10th most commonly prescribed medication in the U.S.

Dr. David Townsend, who led the research, says that it demonstrated the potential benefits of finding new applications for existing drugs with proven safety records:

“Salbutamol has already undergone extensive human safety reviews, and if follow-up research reveals an ability to impede Alzheimer’s disease progression in cellular and animal models, this drug could offer a step forward, whilst drastically reducing the cost and time associated with typical drug development.”

The researchers note that only a small amount of salbutamol reaches the brain when people use asthma inhalers, which deliver the drug to the lungs.

If further research in animals proves successful, a new delivery method will be necessary.

Future research could also focus on other asthma drugs in the same class — beta-adrenergic agonists — that circulate in the bloodstream for longer.

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