Aging

Colorectal cancer is the second most common cause of cancer-related death in the United States.

The incidence of EO-CRC, which refers to when people under 50 years of age develop the condition, has increased markedly in several wealthy countries.

One 2020 article in CA: A Cancer Journal for Clinicians suggested that over the course of the year, about 150,000 U.S. individuals would receive a diagnosis of colorectal cancer and about 53,200 would die as a result.

The authors also predicted about 18,000 cases of individuals younger than 50 years of age receiving a diagnosis of colorectal cancer, with 3,640 forecasted deaths in this population.

Compared with adults born in the U.S. around 1950, those born around 1990 have twice the risk of developing colon cancer and four times the risk of developing rectal cancer.

A new study in the journal Gut links drinking two or more SSBs per day in adulthood with a doubling in the risk of bowel cancer before the age of 50 years.

Researchers found that each daily SSB serving among adult women may be associated with a 16% higher risk of developing EO-CRC.

Also, the study found that each additional SSB serving per day among individuals aged 13–18 years may be linked to a 32% increase in the risk of developing EO-CRC.

Examples of SSBs include soft drinks, pre-packaged fruit drinks, energy drinks, and sports drinks. Sugary drinks are the leading source of added sugars in the American diet.

In fact, from 1977 to 2001, energy intake from SSBs increased by a whopping 135%.

Unique epidemiologic evidence

For this study, the researchers used data from 95,464 participants in the Nurses’ Health Study II. This is an ongoing monitoring study of 116,430 U.S. registered nurses, all women, who were aged 25–42 years when they enrolled in 1989.

Every 4 years beginning in 1991, the women in the study reported on what they ate and drank using validated food frequency questionnaires.

In 1998, researchers asked the participants to recall their health status and lifestyle habits as teenagers.

Also, 41,272 of the women reported on what they typically ate and drank as well as on the quantities of these items between 1960 and 1982. They were aged 13–18 years at this point.

The participants also gave information on potentially influential factors, including their family history of bowel cancer, their lifestyle habits, and any regular use of aspirin, nonsteroidal anti-inflammatory drugs, or vitamin supplements.

Over 24 years of monitoring, 109 women developed bowel cancer before the age of 50 years.

The study authors write that their findings “add unique epidemiologic evidence that SSB intake may partly contribute to the rapid increase of CRC in younger adults.”

Notes on the study

It is important for researchers to understand what is behind this increase, said study co-author Dr. Jeffrey Meyerhardt. He is the clinical director of the Gastrointestinal Cancer Center at the Dana-Farber Cancer Institute in Boston, MA.

“It is presumed that exposures early in life are contributing to this rise,” Dr. Meyerhardt told Medical News Today. “Studying exposures that can be prevented is [essential] to getting control of this rising health issue.”

Substituting SSBs with reduced-fat milk or whole milk appears to be beneficial, according to study co-author Dr. Yin Cao. She is an associate professor of surgery at the Washington University School of Medicine in St. Louis, MO.

“In this study,” she told us, “we showed [that] replacing one daily serving (8 oz) of SSBs with an equivalent amount of reduced-fat milk or total milk was associated with a 35–36% lower risk of EO-CRC.”

“During the second half of the 20th century, for which average U.S. per capita soft drink consumption has dramatically increased by ~500%, milk consumption has declined by half. Milk is a good source of calcium, a mineral found to be protective of colorectal cancer.”

“We postulate [that] low milk consumption could be plausibly linked with the increased risk of EO-CRC, and further research on this topic is in the pipeline.”

The researchers point to several limitations of their study. First, they caution that this was an observational study, which can only establish correlation, not cause. They also note that the majority of the participants were white women, so the findings may not apply to men or other ethnic groups.

Even so, the study provides insight into possible actions that public health leaders might take, Dr. Cao explained.

“Particularly in adolescence,” she wrote, “the immature and rapidly growing organs could be more susceptible to exposures that could lead to cancer development.”

“Campaigns, education programs, and interventions targeting the young population to reduce SSB intake and/or replace SSBs with other healthier beverages could help reduce the accrual of time at risk and convert this window of increased susceptibility into an opportunity for better health outcomes later in life.”

People who wish to look after their heart health are aware that regularly eating vegetables is key.

A new study from Edith Cowan University (ECU) in Joondalup, WA, in Australia finds that leafy greens and other vegetables high in nitrates in particular confer significant cardiovascular benefits.

Researchers found that daily consumption of a cup of vegetables rich in nitrates is associated with better heart health.

“Our results have shown that, by simply eating 1 cup of raw (or half a cup of cooked) nitrate-rich vegetables each day, people may be able to significantly reduce their risk of cardiovascular disease.”

– lead author Dr. Catherine Bondonno from ECU’s Institute for Nutrition Research

Green leafy vegetables high in nitrates include spinach, lettuce, arugula (also known as rocket), Chinese cabbage, and parsley. Non-leafy vegetables with strong nitrate content include radishes, fennel, and beet.

The researchers estimate that cooking reduces a vegetable’s nitrate content by about 50%, but that is still enough to promote heart health.

Dr. Bondonno said, “The greatest reduction in risk was for peripheral artery disease — 26% — a type of heart disease characterized by the narrowing of blood vessels of the legs. However,” she added, “we also found people had a lower risk of heart attacks, strokes, and heart failure.”

The authors note that their findings are consistent with four earlier studies.

Worldwide, roughly 17.9 million people die of heart disease each year. In the United States, it is the leading cause of death for “men, women, and people of most racial and ethnic groups,” according to the Centers for Disease Control and Prevention (CDC).

About 655,000 people in the U.S. die of heart disease every year — one out of every four deaths in the country.

The study appears in the European Journal of Epidemiology.

A long-term study

The researchers analyzed 23 years of data for 56,468 residents of Denmark who participated in the Danish Diet, Cancer, and Health Study. All individuals filled out a food frequency questionnaire, and the resulting data was cross-referenced against public health records.

Analysis revealed that people in the highest fifth of intake of vegetable nitrates exhibited a 2.58 mm Hg, or millimeters of mercury, lower systolic blood pressure — which is the first value in a blood pressure reading — compared with those in the lowest intake group (after adjustments for possible confounding differences between the groups).

The higher the nitrate intake, the greater the fall in blood pressure. The top intake group ate an average of 141 milligrams (mg) of nitrate per day. This is equivalent to 2–2.5 cups of leafy vegetables daily.

In contrast, the impact of nitrate intake on hospitalizations across all types of cardiovascular disease (CVD) plateaued at 59 mg per day. It did not increase with further nitrate intake.

Overall, there was a 15% reduction in CVD admissions over the 23 years of follow-up, compared with those with the lowest nitrate intake, which was 23 gm per day. The greatest reduction in risk — at 26% — was seen in hospitalizations for peripheral artery disease.

Speaking to Medical News TodayDr. Edo Paz of K Health, who was not involved in the research, said he considers the study significant due to its large sample size and lengthy follow-up period.

“However,” he noted, “this is an observational study, and there are some key limitations as a result.” He explained:

“In particular, it is highly likely that people who eat vegetables have other healthy behaviors that are different than those people who do not eat vegetables. For instance, these participants may be more likely to maintain a healthy weight, exercise more, smoke less, etc. Even though the authors try to account for these variables, this is still a key limitation inherent to observational studies in general.” – Dr. Edo Paz

Just a cup

The study suggests that the equivalent of a cup of raw or half a cup of cooked green leafy vegetables of this kind a day is just about the right amount for long-term heart health. “We did not see further benefits in people who ate higher levels of nitrate-rich vegetables,” said Dr. Bondonno.

“People don’t need to be taking supplements to boost their nitrate levels,” Dr. Bondonno said, “because the study showed that one cup of leafy green vegetables each day is enough to reap the benefits for heart disease.

Dr. Paz told MNT: “It’s important to remember that everything should be eaten or consumed in moderation. If extreme amounts of nitrate are ingested, it could lead to methemoglobinemia, which is a condition in which red blood cells have reduced ability to carry oxygen.”

“Fortunately, methemoglobinemia is relatively rare and is more commonly caused by nitrate contamination of drinking water.”

Dr. Bondonno does not recommend juicing vegetables if you want to enjoy the optimal nitrate benefit, since juicing removes pulp and fiber.

On the other hand, blending vegetables is fine. She recommends including a cup of spinach in a berry smoothie as an easy, enjoyable way for people to consume their vegetables.

The unmistakable taste and smell of coffee — not to mention its ability to perk people up in the morning — have made it one of the world’s most popular beverages.

Better still, observational studies indicate that coffee may protect against cardiovascular disease, diabetes, Parkinson’s disease, and certain cancers.

Prospective studies, which follow people over time, have provided evidence that drinking this beverage is safe for most people and is associated with lower mortality rates.

However, a new study suggests that some of the supposed health benefits of coffee for cardiovascular health may have been overblown. The research was limited to white British participants.

As a result of the caffeine that coffee contains, excessive consumption can cause unpleasant symptoms such as tachycardia (a fast resting heart rate) and palpitations.

Drinking coffee can also lead to a moderate, temporary increase in blood pressure.

So it may come as a surprise that regular coffee drinkers either have normal or reduced blood pressure compared with people who do not drink coffee.

One explanation may be that coffee drinkers develop a physiological tolerance for the effects of caffeine.

But a new study suggests that people with a high genetic risk of cardiovascular disease unconsciously reduce how much they drink to avoid unpleasant cardiovascular symptoms.

The research found that individuals with high blood pressure, angina, or arrhythmia drank less caffeinated coffee and were more likely to drink decaffeinated coffee.

Crucially, there was strong evidence that their genetic vulnerability to cardiovascular disease led to their reduced consumption of coffee.

This rules out the alternative explanation that consuming less coffee made them more vulnerable to cardiovascular disease.

Researchers at the University of South Australia in Adelaide conducted the study, which appears in The American Journal of Clinical NutritionTrusted Source.

Guided by genetics

“Whether we drink a lot of coffee, a little, or avoid caffeine altogether, this study shows that genetics are guiding our decisions to protect our cardio health,” Professor Elina Hyppönen, who led the research and directs the Australian Centre for Precision Health at the university.

“If your body is telling you not to drink that extra cup of coffee, there’s likely a reason why,” she adds. “Listen to your body — it’s more in tune with your health than you may think.”

In observational studies, this effect could give the false impression that coffee prevents high blood pressure and protects the heart.

In reality, people vulnerable to high blood pressure may simply avoid drinking coffee because, for them, the caffeine is more likely to cause unpleasant symptoms.

The scientists drew on information about 390,435 white British participants aged 39–73 years who are part of a medical and genetic database called UK Biobank.

On recruitment, participants reported their regular coffee consumption. Researchers also measured their blood pressure and heart rate and noted any cardiovascular symptoms.

Participants with high blood pressure, angina, or arrhythmia consumed less caffeinated coffee compared with those without these symptoms.

To determine whether regular coffee consumption caused the symptoms, or whether the symptoms triggered a reduction in coffee consumption, the researchers used a statistical technique called Mendelian randomization.

This technique exploits the random inheritance of genetic variants that increase a person’s risk of a particular outcome later in life — in this case, the association between blood pressure and heart rate with habitual coffee consumption.

Because factors, such as lifestyle or diet, cannot change a person’s genetic sequence, any associations that the researchers discovered must be due to the gene variants rather than any other factors.

When they analyzed the data, it showed that having a particular genetic variant determined how much coffee a person drank.

“What this means is that someone who drinks a lot of coffee is likely more genetically tolerant of caffeine, as compared to someone who drinks very little,” says Prof. Hyppönen.

“Conversely, a noncoffee drinker, or someone who drinks decaffeinated coffee, is more likely prone to the adverse effects of caffeine and more susceptible to high blood pressure,” she adds.

Psychological effects

Medical News Today asked Prof. Hyppönen whether the psychological effects that some people experience when they drink a lot of coffee, such as anxiety and agitation, could also play a role.

“This is not something that we looked at in our study, but any unpleasant sensation that an individual feels in response to coffee consumption is likely to reduce their wish to drink coffee,” said Prof. Hyppönen.

MNT asked Dr. Edo Paz, a doctor atdigital primary care platform K Health, about the effects of drinking too much coffee.

He responded:

“[D]rinking too much coffee can result in headache, anxiety, tremors, and difficulty sleeping. With regards to the heart, in particular, excess coffee intake can result in palpitations and may trigger events in the heart, such as abnormal heart rhythms, in susceptible individuals.”

The problem of reverse causation

The findings of the new research suggest that observational studies that found an association between coffee consumption and better health may have fallen prey to “reverse causation.”

In other words, heart health issues led people to drink less coffee, rather than the other way round.

Prof. Hyppönen said Mendelian randomization studies had cast doubt on other apparent protective effects.

For example, epidemiological studies have led people to infer that moderate alcohol consumption protects against cardiovascular disease, and that having excess weight reduces mortality compared with moderate weight.

“According to [Mendelian randomization] studies, there does not appear to be any benefit for having [excess weight] versus [slim or moderate] weight, with the possible exception for smokers,” she said.

Smoking reduces appetite and hence weight, but it also has links with a wide range of negative effects on health.

“Also for alcohol, [the] evidence suggests linear increases in blood pressure and stroke risk, with no benefit for light alcohol consumption,” she added.

While further studies are necessary using a more diverse population, this study suggests using a considered, personalized approach when promoting high coffee intakes.

There have been numerous investigations into a possible role for vitamin D in preventing both SARS-CoV-2 infections and COVID-19 complications.

These studies have drawn conflicting conclusions. Now, a study from researchers in Brazil provides a more robust answer to at least one key question: can vitamin D help prevent COVID-19 complications in particularly ill hospitalized patients? According to the results, the answer appears to be no.

The study found that high doses of vitamin D administered to hospital patients with moderate or severe COVID-19 did not affect the course of the disease.

“In vitro studies or trials with animals had previously shown that in certain situations, vitamin D and its metabolites could have anti-inflammatory and antimicrobial effects, as well as modulating the immune response,” explains Rosa Pereira, principal investigator for the study.

“We decided to investigate whether a high dose of the substance could have a protective effect in the context of an acute viral infection, reducing either the inflammation or the viral load.”

Based on the study’s results, says Pereira, “So far, we can say there’s no indication to administer vitamin D to patients who come to the hospital with severe COVID-19.”

The research appears in JAMA.

COVID-19 and vitamin D

Scientists at the University of São Paulo’s Medical School (FM-USP) in São Paulo, Brazil, conducted the randomized, double-blind, and placebo-controlled clinical trial. The researchers say this study is the first of its kind.

The team tracked the experiences of 240 volunteers receiving treatment for COVID-19 symptoms at FM-USP’s Hospital das Clínicas and the Ibirapuera Park field hospital in São Paulo City, from June to August 2020. All participants had tested positive for SARS-CoV-2 using a polymerase chain reaction test or via antibody testing.

All of them received treatment with standard COVID-19 protocols that include antibiotic and anti-inflammatory medications. The researchers then divided them into two equal groups at random.

The scientists gave participants in the first group a single 200,000-unit dose of vitamin D3 dissolved in peanut oil. They gave those in the second group unaltered peanut-oil placebos.

The design of the study was to discover whether a high dose of vitamin D was associated with a shorter hospitalization — the researchers found that it was not.

The investigation also found no evidence that vitamin D made a person less likely to be admitted to the intensive care unit or less likely to need intubation.

Vitamin D also seemed to have no effect on mortality, although Pereira cautions that a larger study with more participants is required before researchers can draw final conclusions.

More vitamin D studies needed

The study conclusively rules out vitamin D as a “magic bullet” for treating COVID-19.

Co-author Bruno Gualano, a researcher at FM-USP, says, “But that does not mean continuous use of vitamin D cannot have beneficial effects of some kind.”

Having suggested that a single high dose of vitamin D is not a solution to severe COVID-19, Pereira is now leading a new study to determine whether a vitamin D deficiency has any effect on a person’s ability to overcome SARS-CoV-2.

Pereira is also looking to establish the amount of vitamin D a person should have in their bloodstream to promote good health. This threshold will vary depending on an individual’s characteristics. Younger, generally healthy people should have at least 20 nanograms per milliliter of blood (ng/ml). Whereas for older people, for example, and those with osteoporosis, the minimum is 30 ng/ml.

Pereira says, “The ideal approach is case-by-case analysis, if necessary dosing the substance periodically by means of blood work, with supplementation if a deficiency is detected.”

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

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

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

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

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

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

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

1. Parkinson’s only affects movement

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

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

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

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

2. Treatment only works for a few years

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

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

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

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

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

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

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

3. Levodopa makes symptoms worse

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

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

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

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

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

4. Tremor always signifies Parkinson’s

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

5. Doctors can always provide an accurate outlook

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

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

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

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

6. Everyone with Parkinson’s has tremor

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

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

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

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

7. People might experience ‘flare-ups’

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

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

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

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

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

8. Beyond drugs, nothing can help

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

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

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

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

9. Parkinson’s is fatal

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

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

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

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

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

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

Moving forward

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

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

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

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

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

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A recent article in JAMA discusses why older adults appear to be coping better with loneliness and social isolation than younger adults during the COVID-19 pandemic.

Pandemics are stressful, and the loneliness that comes with isolation takes a toll on mental health.

Surveys from the Centers for Disease Control and Prevention (CDC) conducted between June 24 and June 30, 2020, found that 40.9% of respondents experienced at least one mental or behavioral health condition. These ranged from symptoms of anxiety, depression, and trauma to starting or increasing substance use.

While all humans need social contact, some cope better with less contact than others.

Young and old

Social deprivation, the reduction or prevention of levels of social interaction considered normal depending on culture, is particularly harmful for adolescents.

2020 review of studies investigating social isolation and loneliness, published between January 1, 1946, and March 29, 2020, found that these factors strongly predicted later depression in children, adolescents, and young adults.

Additionally, loneliness correlated with an increased risk of mental health problems up to 9 years later in life.

An April 2020 article from the European Paediatric Association investigated adolescent mental health during the COVID-19 pandemic. The researchers reviewed data from preliminary studies in China and found that those aged 3–18 were more clingy, distracted, irritable, and fearful of asking coronavirus-related questions. They also had trouble sleeping, poor appetites, and separation problems.

Young adults are also vulnerable to the psychological effects of social isolation. An October 2020 studyfound that in a group of 564 adults aged 22–29 years, 60.7% of whom were female, loneliness increased between January and April–May. This effect was more prevalent in females, as were increased symptoms of depression.

Social isolation can also cause physical symptoms, such as a weakened immune system, an increased risk of diabetes, and an increased risk of death.

2016 study found a strong link between a poor social life and an elevated risk of inflammation during adolescence.

In older adults, a lack of social interaction is linked to a greater risk of hypertension, compared with diabetes.

The CDC cite 2020 estimates that one-third of adults aged 45 or older feel lonely, and almost 1 in 4 adults 65 or older are socially isolated. This is associated, they report, with health risks, including higher rates of depression, anxiety, and suicide.

However, while older adults may be experiencing significant social isolation from loved ones, this may not necessarily translate into worsening mental health, according to a recent Viewpoint article in JAMA.

Older adults less severely affected

A group of researchers at institutions in Massachusetts, California, and Pennsylvania looked at early data from several global studies on older adults and mental health during the pandemic.

While older adults are considered a vulnerable population for severe COVID-19 and related mortality, the researchers found that these adults were less negatively affected by mental health strain than younger adults.

One report from the CDC, for example, concluded that older adults were less likely to start or increase substance use and less likely to think about suicide.

Of course, these findings do not apply to every older adult. In the same report, the CDC acknowledge that adults from marginalized groups or low-income households, and those who provided unpaid caregiving services were more likely to experience adverse health effects.

This is consistent with other evidence of higher levels of anxiety, depression, stress, and post-traumatic stress disorder in people of color, compared with white people, during the COVID-19 pandemic.

Factors affecting resiliency in older adults

Based on the evidence, the authors suggest that older adults better withstand the mental health strains of the pandemic thanks to increased resilience and a drive to stay connected with others.

They explain that some global studies have shown that resilience is linked to maintaining meaningful relationships with others and access to mental health care.

“However, despite this early resilience, older adults expressed concerns about their longer-term physical and financial well-being,” the authors caution.

Resilience might also be linked with wisdom. The analysis found that having wisdom is associated with higher levels of compassion and less loneliness.

Improving resiliency

The researchers observe that increased access to technology could improve resiliency in some older adults who do not have smartphones, for example.

“Many older adults do not have the resources required to deal with the stress of COVID-19. This may include material (e.g., lack of access to smart technology), social (e.g., few family members or friends), or cognitive or biological (e.g., inability to engage in physical exercise or participate in activities or routines) resources.”

Increasing access to technology and related education may help older adults maintain social relationships and boost their engagement with mental health services.

673710881 Image credit: Daniel Kaesler / EyeEm / Getty Images.

Encouraging people to eat more dried fruit — without added sugar — could be an effective way to boost their intake of vital nutrients, researchers have concluded.

Low consumption of fruit in the United States and other countries is a major contributor to diet-related disease and disability, according to a recent analysis.

Fruit is a good source of nutrients, such as fiber and potassium, that many people lack in their diet. It also contains bioactive nutrients that provide extra health benefits, including polyphenols and carotenoids.

Research suggests that eating fruit is associated with a lower risk of cardiovascular disease, cancer, and type 2 diabetes.

However, only about 24% of females and 14% of males in the U.S. eat the recommended daily amount of fruit, according to the National Cancer Institute.

Several factors might contribute to people’s low intake of fresh fruit, including limited availability, high cost, and perishability.

Recommending that people eat more dried fruit could be one solution.

Healthful snack?

Dried fruit offers several advantages over fresh fruit in terms of cost, availability, and ease of storage and transport. It could also replace more unhealthful snack food that is high in sugar, salt, and saturated fat.

At the same time, however, there are concerns about overconsumption leading to excess calorie intake because dried fruit is such an “energy dense” form of fruit.

Previous observational studies have found that eating dried fruit is associated with health benefits. However, the evidence is inconclusive because people who eat more dried fruit may tend to have a more healthful diet and lifestyle overall.

The new study by researchers at Pennsylvania (Penn) State University in University Park aimed to get around this difficulty by comparing days when particular participants reported eating dried fruit with days when they ate none.

They found that people tended to consume more key nutrients on the days they ate dried fruit, including dietary fiber and potassium. However, they also consumed more calories.

“Dried fruit can be a great choice for a nutritious snack, but consumers might want to be sure they’re choosing unsweetened versions without added sugar,” says Valerie Sullivan of Johns Hopkins Bloomberg School of Public Health in Baltimore, MD, who was a grad student at Penn State when she led the study.

“Portion sizes can also be tricky because a serving of dried fruit is smaller than a serving of fresh since the water has been taken out. But the positive is that dried fruit can help people potentially consume more fruit because it’s portable, it’s shelf-stable, and can even be cheaper.”

The research appears in the Journal of the Academy of Nutrition and Dietetics.

Health and nutrition survey

For their analysis, the scientists drew on survey responses from 25,590 individuals who took part in the National Health and Nutrition Examination Survey (NHANES) 2007–2016.

The respondents provided information about the food they had consumed in the past 24 hours (called “dietary recalls”).

Dried fruit accounted for only 3.7% of all the fruit consumed. However, a total of 1,233 participants reported consuming dried fruit on one out of two dietary recalls, allowing the scientists to compare their intake on these days.

Data were also available on the participants’ health, including their body mass index (BMI), waist circumference, and seated resting blood pressure.

Even after adjusting for demographic and lifestyle factors, the participants who ate significant amounts of dried fruit tended to have better diets, a lower BMI, a smaller waist circumference, and lower systolic blood pressure compared with those who did not.

When the researchers compared the days when a participant ate dried fruit with those when they did not, they found that the average intake of total carbohydrate, dietary fiber, potassium, and polyunsaturated fat was greater on the days they ate dried fruit.

Active lifestyle

Taken together, the findings suggest that people who ate dried fruit expended more energy, compensating for the extra calories.

“In our study, people who consumed dried fruits had a higher calorie intake but a lower BMI and waist circumference, which suggests they were more physically active,” says co-author Penny Kris-Etherton, Evan Pugh University Professor of Nutritional Sciences at Penn State.

“So, when incorporating dried fruits, pay attention to calories and be sure to substitute out calories from low nutrient foods for dried fruits to get the greatest benefit of eating dried fruits,” she adds.

The researchers write that eating dried fruit tended to increase total fruit consumption, rather than replacing other forms of fruit. “Thus, increasing dried fruit consumption might help Americans achieve greater fruit intakes.”

The authors acknowledge that their study did not prove that eating dried fruit improves health, only that there seems to be an association. People who are likely to eat dried fruit may have better health for other reasons, such as taking more exercise or leading less stressful lives.

In addition, they note that the survey relied on the participants’ recollection of what they had eaten over the past 24 hours and their ability to estimate quantities accurately.

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A small study in mice suggests that a dosage of vitamin D five times the current recommended amount for older adults could slow the development of frailty. However, the researchers now need to confirm this finding in humans.

Doctors currently define a person as “frail” if they display three or more of the following five characteristics:

  • unexpected weight loss
  • weak grip strength
  • self-reported exhaustion
  • low levels of physical activity
  • slow walking speed

Frailty tends to increase with age, affecting around half of individuals aged over 85 years. It is associated with disability, loss of independence, and increased rates of mortality.

Research suggests that people who have low levels of vitamin D in their blood are more likely to become frail. This is a particularly pressing concern, as up to 1 billion people globally may have insufficient levels.

Having adequate levels of vitamin D is associated with a wide range of health benefits, including healthier bones and teeth and stronger immunity to respiratory infections.

The body can synthesize its own vitamin D when the skin has exposure to the UV light in sunlight. However, during winter months in higher latitudes, and for people who spend most of their time indoors, the principal sources of vitamin D are diet and supplements.

Optimum intake

There is some uncertainty about the amounts of vitamin D a person should consume.

The National Academy of Medicine recommend a daily intake of 600 international units (IU) for adults aged 19–70 years and 800 IU per day for individuals aged 70+ years.

According to a research group at the Veterans Affairs Western New York Healthcare System and the University at Buffalo — both in Buffalo, NY — these recommendations are largely based on optimizing bone health.

They believe that much higher levels are necessary to maintain muscle strength and prevent frailty.

Their previous research in “middle-aged” mice suggests that a long-term insufficient intake of vitamin D in middle age may result in an impaired capacity for anaerobic exercise, decreased muscle mass, and increased amounts of adipose, or fat, tissue.

Their latest work in mice, which appears in the journal Nutrients, indicates that not getting enough of the vitamin in older age may accelerate the development of frailty.

“We found that in aged mice, low levels of vitamin D [resulted] in physical declines, such as reduced grip strength and grip endurance — the ability to sustain a grip — and that they started developing as soon as 1 month after reduction of vitamin D intake,” says first study author Kenneth L. Seldeen, Ph.D.

Crucially, vitamin D only protected the mice from these effects when intake was several times higher than the equivalent recommended intake for older adults.

“To slow the progression of frailty, it actually took greater amounts of vitamin D than what is currently considered sufficient for a human,” says Seldeen.

‘Hypersufficient’ intake

The scientists monitored mice aged 24–28 months, which equates to 65–80-year-old humans. At the start of the study, they divided the animals into three groups:

  • insufficient intake of vitamin D (defined as 125 IU per kilogram [kg] of feed)
  • sufficient intake (1,000 IU per kg of feed)
  • “hypersufficient” intake (8,000 IU per kg of feed)

Over the next 4 months, they assessed the animals’ physical performance and scored them on five tests of frailty equivalent to those that doctors use to assess humans.

By the end of the study period, the mice that had an insufficient or sufficient intake of vitamin D were significantly more frail than they had been at the start of the experiment.

By contrast, the mice with a hypersufficient intake were slightly more frail by the end of the study, but the increase was not statistically significant.

It is also worth noting that although there was an increase in frailty scores, by the 4-month endpoint, none of the groups of mice met the researchers’ definition of frail.

The researchers already recommend that older human adults take a minimum of 2,000 IU of vitamin D per day.

“This is particularly important for our frail geriatric patients,” says senior study author Dr. Bruce R. Troen, a professor of medicine. “But based upon our research, we believe that a lifetime of ample vitamin D supplementation will optimize long-term functional capacity and health.”

The new study suggests that a maximum daily dosage of 4,000 IU, which the National Academy of Medicine consider the safe upper limit, would be necessary to slow the progression of frailty in old age.

A dose of 1 IU is equivalent to 0.025 micrograms (mcg) of vitamin D in a supplement, so 4,000 IU is equivalent to 100 mcg.

Lack of research in humans

A single, brief, and very small study in male mice is limited evidence to address the question of the optimum dosage of vitamin D for older human adults.

Also, the complicated nature of the findings is highlighted by a lack of impact on measures such as muscle mass or treadmill performance.

However, a clinical investigation would need to run for at least 5 years to validate the results in humans, say the study authors. They add that it may not be safe to test persistently high or low levels of vitamin D over such a long period.

As Seldeen explains, “Using an animal model, we are able to examine these potentially riskier levels of vitamin D and the biological impacts during aging.”

“Also, doing so in genetically identical mice all living the same lifestyle, compared to the complexity of human diversity, allows greater focus on the specific effects caused by the different vitamin D levels.” – Kenneth L. Seldeen, Ph.D.

Nonetheless, human studies are accepted to be important in ensuring safe dietary guidelines for people, and the researchers do plan to pursue such studies in the future.

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A new study confirms that older men may lack the bodily cues that help younger men remain hydrated.

Smart thermostats have nothing on our hypothalamus. This is the gland that helps us maintain a healthy body temperature.

When we get too hot, the hypothalamus causes our skin to produce sweat that cools us down as it evaporates. We then become thirsty, and we should drink to replace the water that we lost through sweating.

However, if we sweat too much or do not drink water to replenish our fluids, we can become dehydrated.

Without enough water in the body, we lose the ability to cool ourselves with sweat, and the body can overheat. This increases our chance of experiencing heatstroke and other heat-related damage to our bodies.

As we age, the efficiency of our temperature regulation system declines. Although most research into the effects of dehydration focuses on young adults, a new study in The Journal of Physiology examines its role in the health of older adults.

Older adults may not feel as thirsty as young people and should take care to hydrate when they work or exercise and when the weather is hot.

Dehydration changes as we age

Researchers from the Human and Environmental Physiology Research Unit at the University of Ottawa in Canada explored the paradoxical risk associated with dehydration later in life.

On the one hand, during exercise, dehydration in older adults does not lead as readily to an increase in body temperature through a reduction in heat loss as it does in younger people.

Although this may seem to be a good thing, the lack of sweat and thirst means that the person loses important cues that suggest that it is time to rehydrate.

Without drinking enough water, dehydration in older adults may persist and quietly increase to dangerous levels.

Blood salinity

Scientists have suggested that the reason that older adults feel less thirsty is due to a reduced ability to detect and respond to the level of salt in their blood.

When the balance between water and salt in the blood tips toward salinity, the body of a younger adult responds with feelings of thirst.

The researchers wondered if the same reduced ability to track blood salinity, or “osmolality,” that reduces sensations of thirst may also be the driver behind the less extreme response to dehydration in older adults.

Ten younger men (18–30 years old) and 10 older men (54–67 years old) participated in exercise heat stress tests. The researchers asked them to abstain from consuming alcohol and engaging in strenuous exercise for 24 hours before each session. They also asked them to drink 500 milliliters of water the night before the experiments.

After screening, the men took part in two exercise sessions placed a week apart. At the start of each exercise session, the participants received an intravenous saline solution to increase blood osmolality before entering a heated, whole-body direct-air calorimeter for 1 hour of stationary cycling.

The calorimeter measured the participants’ whole-body evaporative and dry heat loss, and other measurements tracked a range of body indicators of temperature and rate of heat loss.

Analysis of these data revealed a substantive difference in the regulation of body temperature between the younger and older men.

The researchers found that for older men, an increase in blood salinity did not trigger the body’s responses to dehydration as it did in the younger men.

An incomplete picture

Further research will be necessary to help scientists gain a full understanding of heat regulation in older adults.

As first study author Robert Meade says, “While our research design allowed us to test the independent effect of osmolality on heat loss, the effect of reduced blood volume (termed hypovolemia) on sweating in older adults is currently unknown.”

Because the study explored the effects of blood osmolality in physically active participants without any known chronic conditions, it is unclear whether or not the same finding would apply to older adults with common age-related conditions such as type 2 diabetes.

However, Meade concludes:

“Given that common age-related chronic health conditions such as type 2 diabetes are associated with less efficient regulation of body temperature and hydration status, future research should be conducted to see whether our findings translate to or are exaggerated in those populations.”

Welcome to the latest edition of our Medical Myths series. Today, to mark World Alzheimer’s Day, we will be tackling myths relating to both Alzheimer’s disease and dementia at large.

Today, an estimated 5.8 million people aged 65 years or older in the United States have dementia.

Due to the fact that the average lifespan of people in the U.S. has increased over recent decades, some experts project that by 2050, the number of older adults with dementia could reach 13.8 million.

Figures of this stature spark justifiable fear, and, as we have found in previous Medical Myths articles, fear tends to breed misconceptions.

In this article, we aim to dispel 11 of these myths.

1. Dementia is inevitable with age

This statement is not true. Dementia is not a normal part of aging.

According to a report that the Alzheimer’s Association published, Alzheimer’s disease, which is the most common form of dementia, affects 3% of people aged 65–74 years in the U.S.

As a result of the risk increasing as we age, 17% of people aged 75–84 years and 32% of people aged 85 years and older have a dementia diagnosis.

2. Dementia and Alzheimer’s disease are the same thing

This is not quite correct. Alzheimer’s is a type of dementia, accounting for 60–80% of all dementia cases. Other types of dementia include frontotemporal dementia (FTD), vascular dementia, mixed dementia, and Lewy body dementia.

The National Institute on Aging define dementia as “the loss of cognitive functioning — thinking, remembering, and reasoning — and behavioral abilities to such an extent that it interferes with a person’s daily life and activities.”

Although dementias share certain characteristics, each type has a distinct underlying pathology.

Alzheimer’s disease is associated with a buildup of so-called plaques and tangles in the brain. These structures interfere with brain cells, eventually killing them. In contrast, brain cell death in vascular dementia occurs due to a lack of oxygen, which can result from a stroke, for instance.

FTD, as another example, occurs when abnormal protein structures form in the frontal and temporal lobes of the brain, causing the brain cells in these regions to die.

3. A family member has dementia, so I will get it

A common myth is that dementia is purely genetic. In other words, if a person’s family member has a dementia diagnosis, they are guaranteed to develop dementia later in life. This is not true.

Although there is a genetic component to some forms of dementia, the majority of cases do not have a strong genetic link.

As we learned above, rather than genetic factors, the most significant risk factor for dementia is age. However, if a parent or grandparent developed Alzheimer’s when they were younger than 65 years, the chance of it passing on genetically is higher.

Early-onset Alzheimer’s is relatively uncommon, though. It occurs in about 5.5% of all Alzheimer’s cases.

As the majority of dementia cases are Alzheimer’s disease, this means that most dementia cases are not hereditary. FTD, which is much less common, has a stronger genetic link, but if a parent or grandparent develops the condition, it does not mean that children or grandchildren are guaranteed to develop it.

Today, FTD affects an estimated 15–22 in every 100,000 people. Of these individuals, 10–15% have a strong family history of the condition.

4. Dementia only affects older adults

Age is a risk factor for dementia, but dementia can affect younger adults in rare cases. Some scientists estimate that, in people aged 30–64 years, 38–260 people in 100,000 — equivalent to 0.038–0.26% — develop early-onset dementia.

In the 55–64 age bracket, this increases to close to 420 people in 100,000, or 0.4%.

5. Using aluminum pans causes Alzheimer’s

In the 1960s, scientists injected rabbits with high levels of aluminum. They found that the animals developed neurological lesions similar to those that form in the brains of people with Alzheimer’s.

Additionally, some studies have identified aluminum within the plaques associated with Alzheimer’s. However, aluminum also appears in the healthy brain, and researchers have not established a causal link between this element and the disease.

Following on from these studies, myths still circulate that drinking from aluminum cans or cooking with aluminum pots increases the risk of Alzheimer’s.

However, since those early experiments, scientists have not found a clear association between Alzheimer’s and using aluminum pots and pans.

Although researchers will, eventually, establish the precise relationship between aluminum and Alzheimer’s, consuming aluminum through the diet is unlikely to play a major role.

As the Alzheimer’s Society explain: “Aluminum in food and drink is in a form that is not easily absorbed into the body. Hence, the amount taken up is less than 1% of the amount present in food and drink. Most of the aluminum taken into the body is cleaned out by the kidneys.”

However, they also write that some research has found “a potential role for high dose aluminum in drinking water in progressing Alzheimer’s disease for people who already have the disease.”

6. Dementia signals the end of a meaningful life

Thankfully, this is not the case. Many people with a dementia diagnosis lead active, meaningful lives. Some people fear that if a doctor diagnoses them with dementia, they will no longer be able to go for a walk alone and will have to stop driving their vehicle immediately.

It is true that these adjustments may come in time as the condition progresses, but in mild cases of dementia, no changes may be necessary. As dementia worsens, changes to the way an individual leads their life are likely, but that does not mean that the person cannot lead a fulfilling life.

“Too many people are in the dark about dementia — many feel that a dementia diagnosis means someone is immediately incapable of living a normal life, while myths and misunderstandings continue to contribute to the stigma and isolation that many people will feel,” explains Jeremy Hughes, former Chief Executive of the Alzheimer’s Society.

“[W]e want to reassure people that life doesn’t end when dementia begins.” – Jeremy Hughes

7. Memory loss always signifies dementia

Although memory loss can be an early symptom of dementia, it does not necessarily signify the start of this condition. Human memory can be unpredictable, and we all forget things occasionally. However, if memory loss is interfering with everyday life, it is best to speak with a doctor.

Although memory issues tend to be an early sign of Alzheimer’s disease, that is not the case for other forms of dementia. For instance, early signs and symptoms of FTD can include changes in mood and personality, language difficulties, and obsessive behavior.MEDICAL NEWS TODAY NEWSLETTERStay in the know. Get our free daily newsletter

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8. Dementia is always preventable

This, unfortunately, is untrue. Importantly, though, certain factors can either reduce the risk of certain types of dementia developing or delay their onset.

For instance, the Lancet Commission’s 2020 report on dementia prevention, intervention, and care lists 12 factors that increase the risk of dementia:

  • less education
  • hypertension
  • hearing impairment
  • smoking
  • obesity
  • depression
  • physical inactivity
  • diabetes
  • low levels of social contact
  • alcohol consumption
  • traumatic brain injury
  • air pollution

Some of these factors are more difficult to modify than others, but working on changing any of them might help reduce the risk of developing dementia. The authors of the report explain:

“Together, the 12 modifiable risk factors account for around 40% of worldwide dementias, which consequently could theoretically be prevented or delayed.”

However, as Dr. Nancy Sicotte, a neurologist at Cedars-Sinai hospital in Los Angeles, CA, explains, “Reducing your risk requires starting these lifestyle changes from the get-go, not waiting until you’re 70.”

9. Vitamins and supplements can prevent dementia

Linked to the section above, this is also false. To date, there is no strong evidence that any vitamin or mineral supplements can reduce the risk of dementia. In 2018, the Cochrane Library conducted a review with the aim of answering this question.

Their analysis included data from more than 83,000 participants across the 28 included studies. Although the authors report “some general limitations of the evidence,” they conclude:

“We did not find evidence that any vitamin or mineral supplementation strategy for cognitively healthy adults in mid or late life has a meaningful effect on cognitive decline or dementia, although the evidence does not permit definitive conclusions.”

10. All people with dementia become aggressive

In some cases, people with dementia might find it increasingly hard to make sense of the world around them. This confusion can be frustrating, and some individuals might respond to the emotions in an angry manner. However, this is not the case for everyone.

In a study involving 215 people with dementia, 41% of the participants developed aggression during the 2-year study. When they looked at factors that increased the risk of developing aggression, the researchers identified two of the primary factors as physical pain and a low quality relationship between the person and their caregiver.

11. Dementia is never fatal

Unfortunately, dementia can be fatal. According to a recent study, which appears in JAMA Neurology, dementia may be a more common cause of death than experts have traditionally thought it to be. The authors “found that approximately 13.6% of deaths were attributable to dementia over the period 2000–2009.”

Dementia worries people, especially as they age, and this is justifiable in many ways. However, it is important to counter misinformation that might enhance concerns and stigma.

For now, researchers are working tirelessly to develop better ways to treat and prevent dementia. In the future, hopefully, science will reduce the impact of dementia and, therefore, the fear associated with the condition.