If you struggle with anxiety, you might want to skip that second cup of coffee, new research suggests.
For some people, caffeine may help with concentration and provide an energy boost, but it can cause problems for those with general anxiety disorder, said Dr. Julie Radico, a clinical psychologist with Penn State Health.
“Caffeine is not the enemy,” she said in a university news release. “But I encourage people to know healthy limits and consume it strategically because it is activating and can mimic or exacerbate the symptoms of anxiety.”
Low doses of caffeine are in the range of 50 to 200 milligrams. Consuming more than 400 milligrams at once may lead to feeling overstimulated and anxious and bring on symptoms such as racing heart, nausea or abdominal pain.
Anxiety is a common problem, but many patients and their doctors don’t think about caffeine as a potential contributing factor, said Dr. Matthew Silvis, vice chair of clinical operations in the division of family medicine at Penn State Health.
“We want people to consider whether there may be a connection between their caffeine consumption and anxiety,” he said.
As well as being a potential problem for people with anxiety, caffeine can interact negatively with medications for seizure disorders, liver disease, chronic kidney disease, certain heart conditions or thyroid disease, Silvis noted.
“Medical disorders that a patient may already have can become more difficult to control,” he said.
In terms of amounts of caffeine, an average cup of home-brewed coffee has about 100 milligrams, compared with 250 milligrams in a tall Starbucks coffee and as much as 400 milligrams in energy drinks.
A can of Mountain Dew has 55 milligrams while a can of Coca-Cola has 35 milligrams.
Many vitamin and sports or nutritional supplements also contain caffeine, but many people don’t think to check the labels of those products, Silvis added.
A simple one-legged stand can help strengthen your lower body, ultimately improving your balance and reducing the risk of falls. (Courtesy Spectrum Health Beat)
Bad balance is a common cause of dangerous falls, especially among older adults.
Falls send more than 2 million adults to the emergency room every year and often result in lengthy rehab stays.
Preventing falls is a priority for staying healthy and preventing painful broken bones as you age. Easy strength and balance exercises that you can do anytime, anywhere, such as tai chi and yoga, can help you stay steady on your feet.
But first it’s important to know how good (or lacking) your balance is.
Grab a friend or loved one, a sturdy chair and a stopwatch to check your balance with a quick test called the single leg stance. It basically involves standing on one leg. Doctors use it to predict who might be at risk of falling.
Stand barefoot in front of the chair but don’t touch it. Cross your arms. Lift one leg up off the floor and start the timer. As you feel yourself start to sway, immediately steady yourself with the chair and stop the timer.
Here are the average times that indicate good balance when you stand on one leg based on age:
Ages 18-39: 43 seconds for men and women
Ages 40-49: 40 seconds for men and women
Ages 50-59: 36 seconds for women, 38 for men
Ages 60-69: 25 seconds for women, 28 for men
Ages 70-79: 11 seconds for women, 18 for men
Ages 80-99: 7 seconds for women, 5 seconds for men
If you become unsteady before your specific time, talk to your doctor. Illness, medication and even footwear can throw you off balance. Together, you and your doctor can find solutions.
You can improve your balance by practicing the one-leg stance, but as a training exercise, hold onto a chair and don’t let go.
Lift one leg for 15 seconds, rest and repeat three times, then switch legs.
The stronger your lower body, the steadier you’ll be on your feet.
For safety reasons, always have someone with you when trying a balance exercise for the first time. Or consider a group balance class.
Many community centers offer fun fitness programs to help adults prevent falls.
By understanding the implications of both numbers in a blood pressure reading, you may gain more understanding of your risk for heart disease and stroke. (Courtesy Spectrum Health Beat)
When it comes to blood pressure readings, the “top” number seems to grab all the attention.
But a large, new study confirms that both numbers are, in fact, critical in determining the risk of heart attack and stroke.
Blood pressure measurements are given as a “top” and “bottom” number. The first reflects systolic blood pressure, the amount of pressure in the arteries as the heart contracts. The second reflects diastolic blood pressure, the pressure in the arteries between heart muscle contractions.
For years, systolic blood pressure has been seen as the one that really matters. That’s based on studies—including the famous Framingham Heart Study—showing that high systolic blood pressure is a stronger predictor of heart disease and stroke.
At the same time, though, doctors measure both systolic and diastolic blood pressure—and treatment guidelines are based on both. So just how important is that diastolic number?
“The idea behind this new study was to address the confusion,” said lead researcher Dr. Alexander Flint, an investigator with Kaiser Permanente Northern California’s division of research.
Using medical records from 1.3 million patients, his team confirmed that, yes, high systolic blood pressure was a stronger risk factor for heart attack and stroke.
But those risks also climbed in tandem with diastolic pressure. And people with normal systolic readings were still at risk if their diastolic pressure was high.
“There’s been a common belief that systolic blood pressure is the only one that matters,” Flint said. “But diastolic definitely matters.”
He and his colleagues reported the findings in a recent issue of the New England Journal of Medicine.
The definition of high blood pressure has gotten a revamp in recent years. Guidelines issued in 2017 by the American College of Cardiology and other heart groups lowered the threshold for diagnosing the condition—from the traditional 140/90 mm Hg to 130/80.
The fact that treatment guidelines include a diastolic pressure threshold implies that it’s important.
And indeed it is, said Dr. Karol Watson, a member of the ACC’s prevention section and leadership council.
In fact, she said, doctors once thought that diastolic blood pressure was the more important one, based on research at the time. Then came the studies showing that systolic pressure was generally a better predictor of people’s risk of heart disease and stroke.
In addition, Watson said, high systolic blood pressure is more prevalent, because of natural changes in blood pressure as people age.
“As we get older, systolic blood pressure keeps marching up,” she explained. Diastolic blood pressure, on the other hand, generally peaks when people are in their 40s to 60s—and then it declines.
But it’s clear, Watson said, that while systolic and diastolic blood pressure are different they both deserve attention.
In the latest study, cardiovascular risks rose with each “unit increase” in systolic pressure above 140, by about 18% on average. Meanwhile, each increase in diastolic blood pressure above 90 was tied to a 6% increase in heart disease and stroke risk.
The researchers saw a similar pattern when they looked at blood pressure increases above the 130/80 threshold. That, Flint said, supports the 2017 guideline shift.
The findings are based on over 1.3 million patients in the Kaiser Permanente health system who had roughly 36.8 million blood pressure readings taken from 2007 through 2016. Over eight years, more than 44,000 patients had a heart attack or stroke.
According to Flint, it’s the largest study of its kind to date.
The bottom line for patients, Watson said, is that they should care about both blood pressure numbers.
In her experience, she noted, patients often point to the number that’s in the normal range and say, “But look how good this is.”
Flint agreed, saying that no one should “ignore” the diastolic number.
“It’s important not only in blood pressure treatment, but on the side of diagnosis, too,” he said.
As caregivers and clinicians navigate the various phases of cancer survivorship, it spotlights the ever-present need for resources that optimize care. (Courtesy Spectrum Health Beat)
More Americans are surviving cancer and their numbers could top 22 million in another decade, the American Cancer Society says.
Currently, thanks to better screening and treatment, more than 17 million Americans who had cancer remain alive, the society said in a report.
While this is good news, it comes with a cautionary note.
Cancer survivors often have long-term difficulties. Many must also overcome barriers to get the treatments they need, the researchers said.
“People with a history of cancer have unique medical, psychosocial and economic needs that require proactive assessment and management by health care providers,” said report co-author Robin Yabroff. She’s senior scientific director of health services research for the cancer society.
“Although there are growing numbers of tools that can assist patients, caregivers and clinicians in navigating the various phases of cancer survivorship, further evidence-based resources are needed to optimize care,” Yabroff said in a society news release.
The report estimated that 8 million men and nearly 9 million women have a history of cancer.
Among the survivors, 68% had their cancer diagnosed five or more years ago and 18% at least 20 years ago.
Also, while nearly two-thirds of survivors are 65 or older, nearly 66,000 survivors are 14 and younger. Close to 48,000 are 15 to 19 years old.
Because of the growing and aging population, survivorship is increasing even though the number of women who develop cancer remains stable and the number of men with cancer declines, the researchers found.
The most common cancers among men are prostate, colon cancer and melanoma. Among women they are breast, uterine and colon cancer.
The report was published in the journal CA: A Cancer Journal for Clinicians.
Bad eating habits begin at a young age in American children, a new study finds.
Researchers analyzed data from more than 1,200 babies (aged 6 to 11 months) and toddlers (12 to 23 months) between 2011 and 2016.
They found that 61% of babies and 98% of toddlers consumed added sugars in their typical daily diet, mainly in flavored yogurt and fruit drinks.
Infants consumed about 1 teaspoon of added sugars daily (about 2% of their daily calorie intake) and toddlers consumed about 6 teaspoons (about 8% of their daily calories).
The main sources of added sugar for infants were yogurt, snacks and sweet bakery products. For toddlers, the top sources were fruit drinks, sweet baked products and candy.
Asian toddlers consumed the fewest added sugars (3.7 teaspoons) and blacks the most (8.2 teaspoons).
The study was published online recently in the Journal of the Academy of Nutrition and Dietetics.
“This has important public health implications since previous research has shown that eating patterns established early in life shape later eating patterns,” lead investigator Kirsten Herrick said in a journal news release. She’s a researcher with the Division of Health and Nutrition Examination Surveys at the U.S. Centers for Disease Control and Prevention.
The findings did bring some good news: The percentage of babies and toddlers whose daily diets include added sugars declined, as did the amounts they consumed.
But consumption of added sugars remains high among young children.
Herrick noted that a previous study found that 6-year-olds who had consumed any sugar-sweetened drink before their first birthday were more than twice as likely to drink such beverages every day than those who had not.
“Previous research into the diets of children over 2 years old associated sugar consumption with the development of cavities, asthma, obesity, elevated blood pressure and altered lipid profiles,” Herrick said.
Only one U.S. health organization—the American Heart Association—offers guidelines on sugar consumption for children under age 2, researchers noted.
“Our study’s findings about infant and toddler diets should raise awareness among health organizations and practitioners and inform future guidelines and recommendations,” Herrick said.
She advised parents to be cautious about added sugars in the foods they give babies when weaning them.
Parents should talk to a health care provider about which solid foods to introduce, and check the nutrition information on food labels.
A typical workout doesn’t give you license to eat whatever you want.
Even a full hour of vigorous skiing burns just 600 calories—less than the amount in a super-sized fast food sandwich. That’s why it’s important to think of exercise as just one part of a shape-up plan.
Exercise works the cardiovascular system and builds muscle, but it takes calorie restriction to also lose weight. Small diet tweaks that you can make when you’re building a healthier body through exercise will maximize your efforts.
Here’s what you need to know about nutrition when you work out regularly.
You don’t need to fuel up like a marathon runner, but give your body some nourishment about two hours before every workout to make exercise more effective. Have a small meal with healthy carbs and protein and some fat. If eating two hours in advance doesn’t work with your schedule, aim for a small snack about an hour before your workout.
It’s also important to eat a small meal with carbs and protein within two hours after your workout to give your body the nutrients it needs.
Keep in mind that “calories in and calories out” is a balancing act that varies from person to person.
So whether you’re trying to lose weight or maintain, keep a journal that records the amount of calories you get from food as well as the amount of calories burned off during workouts to see if your intake needs to be adjusted up or down.
Beware of so-called training supplements. These products aren’t regulated and their claims may not have any science behind them.
If you’re getting a good amount of whole foods in your diet—that is, unprocessed and unpackaged foods—you shouldn’t need any of these aids.
Finally, it can’t be stated often enough: Drink water as needed before, during and after exercise to stay hydrated, especially in hot and humid conditions.
Bullied teens are more likely to develop mental health problems—and people with mental health problems are also more likely to become bullies, researchers report.
Even though many studies have shown that being bullied can leave mental scars, “no studies to date” have tested the notion that mental health issues might also help drive bullying, explained study author Marine Azevedo Da Silva. She’s a postdoctoral researcher in Columbia University’s Mailman School of Public Health, in New York City.
For the study, the researchers analyzed data from 13,200 U.S. youth, aged 12 to 17, and found that:
79% said they’d never bullied others
11% said they’d bullied others over a year ago
10% said they’d bullied others in the past year
16% said they’d bullied others over a month ago
5% said they’d bullied others in the past month
Youth who said they’d been bullies were more likely to have a moderate to high rate of mental health problems than those who said they hadn’t bullied others.
The study also found that teens with moderate to high rates of mental health problems were more likely to bully others, compared to those without such issues.
In other words, the link between mental health issues and bullying “is likely to be bidirectional,” Azevedo Da Silva said in a school news release.
According to study senior author Dr. Silvia Martins, the findings suggest that efforts to stem bullying “should consider how to take into account and handle negative feelings and mental health problems” of young perpetrators.
Martins directs the Substance Abuse Epidemiology Unit at Mailman.
It’s estimated that between 18% and 31% of U.S. youth are involved in bullying, the researchers noted.
The study was published recently in the Journal of Adolescent Health.
Older women, beware: New research warns that drinking a lot of diet sodas or artificially sweetened fruit juices may increase your risk for stroke.
In a study that tracked nearly 82,000 postmenopausal women, those who drank two or more diet drinks per day saw their overall stroke risk rise by 23 percent, compared with those who consumed diet drinks less than once a week.
Blocked arteries were often the main culprit, with heavy diet drink consumption linked to a 31 percent greater risk for an ischemic stroke, which is triggered by a clot, the study findings showed.
Study author Yasmin Mossavar-Rahmani acknowledged that an “association does not imply causation.” But she stressed that the findings held up even after taking into account the nutritional value of each participant’s overall diet.
So, “we can’t assume these diet drinks are harmless, particularly when consumed at high levels,” Mossavar-Rahmani said.
“The take-home message is that these findings give us pause,” she added. “We need to do more research on why we are seeing these associations. What are the scientific mechanisms? Is there something about the artificial sweeteners, for example, that affect the bacteria in the gut and lead to health issues?”
Mossavar-Rahmani is an associate professor in the department of epidemiology and population health’s division of health promotion and nutrition research at Albert Einstein College of Medicine, in New York City.
The study authors pointed out that the American Heart Association has recently underscored the lack of sufficient research into the cardiovascular impact of diet sodas. Until more work is done, the AHA says the jury remains out on whether artificially sweetened beverages do or do not hasten heart disease.
Women in the latest study were between 50 and 79 when they first enrolled in the Women’s Health Initiative trial between 1993 and 1998.
Investigators tracked the general health of all the enrollees for an average of nearly 12 years. During that time—at the three-year mark—all the women were asked to indicate how frequently they consumed diet sodas and diet fruit drinks over a three-month period.
The researchers did not take note of which brands of artificially sweetened drinks the women drank and so did not know which artificial sweeteners were being consumed.
That said, nearly two-thirds of the women consumed diet sodas or drinks very infrequently, meaning less than once a week or never. Only about 5 percent were found to be “heavy” consumers of artificially sweetened drinks.
After taking into consideration a variety of stroke risk factors—including blood pressure status, smoking history and age—the study team concluded that heavy consumption of diet drinks did appear to be tied to cardiovascular risks in a number of ways.
For example, those women who drank two or more diet beverages a day saw their overall risk for developing heart disease increase by 29 percent. They were also 16 percent more likely to die prematurely from any cause.
Certain groups fared even worse: Among obese women and black women with no history of heart disease or diabetes, a diet drink habit pushed clot-driven stroke risk up by roughly twofold and fourfold, respectively, the researchers reported.
Whether or not the findings would apply to either men or younger women remains unclear, the study authors noted.
The findings were published online recently in the journal Stroke.
Lona Sandon is program director of the department of clinical nutrition at the University of Texas Southwestern Medical Center in Dallas.
She agreed that more research is needed to further explore a possible diet drink-heart disease connection. But for now Sandon offered simple advice: diet or regular, sodas offer no nutritional value other than calories.
“If they replace other drinks, such as milk and 100 percent fruit or vegetable drinks, then these women miss out on valuable nutrition for protecting the heart and vascular system,” Sandon warned.
“The nutrition you are missing because you are drinking artificially sweetened beverages instead may be the real problem,” she said.
A group representing the artificial sweetener industry offered another caveat about the findings — that many women who drink diet drinks are already struggling with weight issues.
“It is likely study subjects were already at a greater health risk and chose low-calorie sweetened beverages to manage their calorie and sugar intake as these products are proven safe and beneficial for those managing their weight and blood glucose levels,” said Robert Rankin, president of the Calorie Control Council.
“The contribution of reverse causality, meaning that individuals already at a greater risk of stroke and cardiovascular events chose low-calorie sweetened beverages, is very likely the cause of the associations presented by these researchers,” the council added in a statement.
Studies have found associations between artificially sweetened beverages and increased risk of stroke and heart disease. (Courtesy Spectrum Health Beat)
The health risks of sugary drinks, from juice to soda, are well known.
They can lead to overweight and diabetes, stroke and other problems in the brain, including poorer memory and smaller brain volume.
But diet sodas aren’t the answer.
A number of studies have found an association between artificially sweetened beverages and an increased risk of stroke, heart disease, heart attack and other heart-related deaths in women.
The most recent was published earlier this year in the journal Stroke, with researchers suggesting that, even without identifying a specific cause and effect, people should seriously consider the potentially harmful effects of artificially sweetened drinks.
And there’s more.
Researchers at the Boston University School of Medicine followed 4,000 people of both sexes over 10 years.
Using MRI tests, they linked just one artificially sweetened soda a day to brain changes that can lead to dementia, as well as the type of stroke caused by a blockage in a blood vessel.
These risks were triple those of people who don’t drink diet sodas.
It didn’t seem to matter which common artificial sweetener—saccharin, aspartame or sucralose—was consumed.
While some people see diet soda as a way of weaning off regular soda, it may be healthier in the long run to skip this type of transition.
If you like soda’s carbonation more than the better option of water, flavor plain seltzer with a squeeze of your favorite citrus fruit, a few crushed berries or both.
For variety, try freshly grated ginger, chopped mint or a teaspoon of vanilla. Also consider replacing soda with a glass of milk—you’ll get important protein and a shot of calcium in the bargain.
Canola, grapeseed and safflower oils are suitable for high-temperature cooking because they have a high smoke point. Olive oil and avocado oil are better for sauteing at medium heat. (Courtesy Spectrum Health Beat)
Oils are one of the most widely used ingredients in cooking and are healthy alternatives to butter and margarine.
All cooking oils, including olive, canola and peanut oil, contain 14 grams of total fat per tablespoon and roughly 120 calories.
So measure amounts carefully because even though some fat is essential for good health and these are excellent choices, they’re still high in calories.
For high-temperature cooking like stir-fries or when searing meat, use high smoke-point oils like canola, grapeseed and safflower oils. For sauteeing vegetables at medium heat, use extra virgin olive oil or avocado oil, which has gotten popular in recent years.
Since baking uses gentle heat, you can go with any oil you like. For cake and brownie recipes, try replacing butter with light olive oil, which has much less saturated fat but is still light in flavor.
Though all oils are great for salad dressings, try aromatic nut oils, like walnut oil or hazelnut oil, and seed oils, such as pumpkin seed oil and flaxseed oil, for a flavor twist. Keep them refrigerated to prevent them from going rancid—they’re very delicate.
Let them come to room temperature if they thicken in the fridge.
Here’s an easy dressing recipe that you can use on any side salad or over cold, chopped vegetables. It works especially well on peppery-flavored watercress.
Watercress Salad
2 tablespoons walnut oil
1 teaspoon Dijon mustard
1/4 teaspoon garlic salt
1 tablespoon balsamic vinegar
8 ounces watercress
16 walnut halves, coarsely chopped
Whisk oil, mustard and garlic salt in a large bowl. Add the vinegar
and whisk again. Add the watercress and toss well. Divide among four
plates and top with equal amounts of chopped nuts.
It’s far better for your long-term mental health if you accept your negative emotions, rather than passing judgment on yourself. (Courtesy Spectrum Health Beat)
Studies done at the University of California, Berkeley, have found that acknowledging a blue mood—and not berating yourself for it—can help you work through it more easily.
It turns out that accepting negative emotions is better for your long-term mental health than constantly passing judgment on yourself, which can cause your feelings of negativity to snowball.
Putting pressure on yourself to feel upbeat can make you feel even more downbeat, according to the research.
It turns out that the people who let feelings like sadness, disappointment and even resentment run their course had fewer mood disorder symptoms than people who judged themselves for having them or who tried to bury them.
Accepting negative emotions seems to help you better cope with your stressors.
There’s one important caveat, however.
While it helps to acknowledge the normalness of negative emotions and not think you can—or need—to feel happy 24/7, it’s also important not to ignore a persistent and deep blue mood and other signs that could signal depression.
Symptoms of depression include a loss of interest in things that you used to enjoy and deep feelings of worthlessness and hopelessness that last for three or more months.
Unlike a blue mood, depression needs treatment, such as counseling, medication or both.
The rise in colon cases among younger adults that’s been seen in the United States is also occurring in wealthier nations worldwide, new research shows.
In the decade leading up to 2014, the number of cases of colon cancer among people under 50 increased by 3% a year in Denmark, New Zealand, Australia and Canada and by 1% per year in Britain.
The increase was most pronounced among those aged 20 to 29, noted a team led by Dr. Marzieh Araghi, from International Agency for Research on Cancer in Lyon, France.
Among twenty-somethings, colon cancer cases rose by 18% a year in Denmark and 11% in Norway, according to the study published in The Lancet Gastroenterology & Hematology.
“Although the incidence of colorectal cancer in adults younger than 50 years remains much lower compared with that in older age groups, our findings are of concern and highlight the need for action to counteract the rising burden of the disease in younger people,” Araghi said in a journal news release.
The increase in cases among the young runs counter to declines in colon cancer among people over 50, the researchers pointed out.
For example, between 2004 and 2014 cases of colon cancer fell each year among people over 50—by 2% in Australia and Canada, 3% in New Zealand and 1% annually in the U.K.
Colon cancer remains a huge global killer.
According to the research team, in 2018 alone nearly 2 million cases of colon cancer were diagnosed and the disease claimed 881,000 lives worldwide.
But why the surge among the young? According to Araghi, the increase is likely driven in part by increases in certain risk factors, specifically obesity and poor diet.
On the other hand, he said, the decrease in colon cancer among people over 50 is most likely due to better screening stool tests or colonoscopy that catches tumors early.
Dr. David Bernstein is chief of hematology and a gastrointestinal specialist at Lenox Hill Hospital in New York City. Reviewing the new report, he said similar data has already changed medical practice in the United States.
“The U.S. findings have led to updated (American Cancer Society) colon cancer screening guidelines, which now recommend the initiation of colon cancer screening at age 45, as opposed to previous guidelines recommending the initiating of screening at age 50,” Bernstein noted.
Early screening and detection could bring colon cancer numbers down again among the young, he said.
Dr. Elena Ivanina is a gastroenterologist at Lenox Hill Hospital in New York City. She believes younger Americans need to pay more heed to avoiding colon cancer risk factors.
“This includes things like obesity, diet, smoking and other carcinogens,” she said. “Patients should discuss their colon cancer risk with their physician and not ignore any symptoms like rectal bleeding, no matter what their age.”
In the meantime, Bernstein said, “perhaps the more important question is ‘why in high income countries is the incidence of colorectal cancer increasing among young adults, and what factors are leading to this?’” Bernstein said. “Significant work needs to be done to answer this critical question.”
Studies have shown differences in the brains of fibromyalgia sufferers, sometimes with areas of lower blood flow than expected. Similar problems have been seen in people with diabetes. (Courtesy Spectrum Health Beat)
Fibromyalgia is a mysterious and misunderstood illness, but researchers may have uncovered at least one key to the disease’s origin: insulin resistance.
The new research compared a small group of people with fibromyalgia to two groups of healthy people and noted that a long-term measure of blood sugar levels was higher in the people with fibromyalgia.
Insulin resistance develops when the body starts to struggle with breaking down sugar.
To see if treating those higher blood sugar levels might help, the researchers gave people who had blood sugar levels in the pre-diabetic range or higher a diabetes medication called metformin.
People taking metformin reported significantly lower pain scores, according to the study.
“We combined metformin with standard drugs used for fibromyalgia and saw a much greater degree of pain relief,” said study author Dr. Miguel Pappolla. He is a professor of neurology at the University of Texas Medical Branch at Galveston.
In fact, Pappolla said, the additional pain relief was so significant that the researchers actually called patients on different days to re-check their pain scores.
Because this is a preliminary finding, the researchers aren’t sure how insulin resistance might contribute to fibromyalgia or how metformin might reduce pain. “Metformin may have some analgesic (pain-relieving) activity on its own,” Pappolla said.
Fibromyalgia is a condition that causes widespread pain, fatigue, sleep problems and distress, according to the U.S. Centers for Disease Control and Prevention.
Even celebrities aren’t spared from this painful condition—Lady Gaga reportedly had to cancel concerts on her tour due to pain from fibromyalgia.
Though the cause of the disorder isn’t clear, it appears that people with fibromyalgia may be more sensitive to pain than other people—what the CDC calls abnormal pain processing.
Pappolla said that studies have shown differences in the brain between people with fibromyalgia and those without, such as areas with a lower blood flow than expected.
The researchers noted that similar problems have been seen in people with diabetes.
The study included 23 people with fibromyalgia.
The researchers compared their hemoglobin A1c levels to large groups of healthy people from two other studies.
Hemoglobin A1c is a simple blood test that measures what someone’s blood sugar levels were during the past two or three months. A level of 5.7% to 6.4% is considered pre-diabetes, according to the American Diabetes Association. A level of 6.5% or higher means a person has diabetes.
Only six of those with fibromyalgia had normal blood sugar levels. Sixteen had levels considered pre-diabetes and one met the criteria for diabetes.
When the researchers compared the average blood sugar levels of the fibromyalgia group to healthy age-matched people in the other studies, they saw that the blood sugar levels were higher in the people with fibromyalgia, suggesting insulin resistance.
The findings were published online recently in the journal PLOS ONE.
Dr. Edward Rubin, an anesthesiologist and pain management specialist at Long Island Jewish Medical Center, said, “It’s interesting that there’s a possible connection between fibromyalgia and blood sugar. We’ve been attacking the symptoms of fibromyalgia, but we don’t have a good understanding of the root cause of fibromyalgia.”
Rubin, who wasn’t involved in the study, said there may be enough evidence here to try metformin along with other medications used for fibromyalgia for people whose blood sugar levels fall outside of the normal range, to see if they have a positive response.
Dr. Bharat Kumar, from the University of Iowa Hospitals and Clinics, said this study shows people with the disease that there is hope.
“People with fibromyalgia are often told (falsely) that they have a disease that simply cannot be managed. This article shows that it’s not true. Although it’s unclear if metformin will work for every person suffering from fibromyalgia, there is active research into finding solutions for this frustrating and overlooked condition,” he said.
Kumar said it’s biologically plausible that insulin could have an effect on pain.
“We know that other hormone abnormalities can cause fibromyalgia-like symptoms, so (this finding) is not too surprising,” he added.
Still, he said, he didn’t expect that metformin would be a “silver bullet” for all fibromyalgia pain. He said there are likely a number of causes of the disease.
Finances are often a source of misery at the holidays. To save money, try giving one meaningful gift to someone, rather than a barrage of soon-forgotten items. (Courtesy Spectrum Health Beat)
Stress abounds during the holiday season, but you can ease it, an expert says.
The way to manage stress is to recognize it and take steps to minimize it so it doesn’t overwhelm you, according to Cinnamon Stetler, an associate professor of psychology at Furman University, in Greenville, S.C.
One way to ease holiday stress is to avoid unrealistic expectations, such as believing the holidays will change people and family relationships.
“If your stress stems from other people’s actions, that’s largely out of your control. What you can do is limit your exposure,” Stetler said in a university news release.
Don’t obsess about family holiday traditions.
“Reflect on why that tradition is so important to you and what about it carries the meaning. See if there’s a way to adapt the tradition while still maintaining the important pieces of it,” Stetler said. “While it is good to maintain traditions, they can cause extra stress if you feel you have to do it the same way no matter what.”
Change your approach to gift-giving, which can cause financial worries.
For example, instead of buying a person several gifts, choose just one or two that will be especially meaningful.
And remember that material things provide only short-term happiness, while doing things for others and appreciating what you have can bring lasting happiness.
Take care of yourself during the holidays.
Get plenty of sleep, watch your diet, exercise regularly and find some time for yourself each day.
“Try to maintain as much of your normal routine as you can. You can treat yourself and indulge in small ways. The holidays are not the time to make big changes,” Stetler said. “Try to get a little bit of physical activity in, even if it’s a 10-minute walk around the neighborhood.”
A little pinot noir now and then might help keep the bacteria in your tummy healthy and happy.
As little as one glass of red wine a week can increase the diversity of the good bacteria in your microbiome, which can help lower bad cholesterol and keep your weight down, researchers say.
“The more people drink, the higher the diversity. But even small amounts, such as one glass of red wine every week, shows a benefit,” said study first author Caroline Le Roy. She’s a research associate in the department of twin research and genetic epidemiology at King’s College London.
Le Roy cautioned that while the findings in the study were robust, they can’t prove that red wine improves the microbiome, only that the two are associated.
It’s not the alcohol that has this effect, but rather the polyphenols in red wine. Polyphenols help feed the good bacteria in the microbiome, the researchers explained.
Polyphenols are also found in fruits and vegetables, and include antioxidants.
For the study, Le Roy and her colleagues looked at the effect of beer, cider, red wine, white wine and whiskey on the gut microbiome of 916 female twins.
Only red wine resulted in a more diverse microbiome, the investigators found.
The microbiome is a collection of bacteria in the gut that has an important role in health. A healthy microbiome helps digest food and keeps some diseases at bay.
An unhealthy microbiome can lead to poor functioning of the immune system, weight gain and high cholesterol, Le Roy said.
A microbiome with lots of different bacteria is a healthy microbiome, she added.
Le Roy’s team found that red wine improved the number of different bacteria in the microbiome, compared with those who didn’t drink wine.
The researchers were able to confirm their findings in three other groups in Britain, the Netherlands and the United States, which brought the total number of participants to nearly 3,000.
Moreover, the results remained constant even after accounting for factors such as diet, socioeconomic status and age.
Samantha Heller, a senior clinical nutritionist at NYU Langone Medical Center in New York City, thinks that drinking red wine may be a marker of a healthy lifestyle, so the health benefits may be due to other factors.
“Do they, in general, lead healthier lives, such as not smoking, eating more of a plant-based diet and exercising?” she asked.
Wine comes from grapes, which like a lot of plant foods, are rich in polyphenols, Heller said.
But polyphenols are also found in vegetables, fruits, grains, nuts, legumes and teas that don’t contain alcohol, she noted.
“In addition, plants are our only source of dietary fiber, which is the favorite food for the microbes that live in our gut. When they are healthy, they help keep our bodies healthy,” Heller said.
While drinking small amounts of red wine has apparent health benefits, there are also unhealthy effects of drinking too much, such as liver disease, certain cancers, pancreatitis and a depressed immune system, she said.
“Guzzling red wine, or any alcoholic beverage, is not the miracle we have been led to believe,” Heller said.
For those who drink, the American Heart Association recommends an average of one to two drinks per day for men, and one drink per day for women (one 12-ounce beer, 4 ounces of wine, 1 ounce of 100 proof spirits).
“Let’s be honest, most of us probably drink more than that. If you do not drink alcohol, there is no reason to start,” Heller said.
The report was published recently in the journal Gastroenterology.
Having a type of inflammatory arthritis called gout may worsen heart-related outcomes for people being treated for coronary artery disease, according to new research.
The study, published in The Journal of the American Heart Association, sought to clarify older research on the link between cardiovascular disease and gout, which occurs in people with high levels of uric acid in the blood.
In the U.S., gout affects nearly 6 million men and 2 million women, or about 4 percent of the population, according to the Arthritis Foundation.
The buildup of uric acid can form needle-like crystals in a joint and cause sudden pain, tenderness, redness, warmth and swelling, often in the big toe. But it’s also associated with a greater risk of kidney disease, diabetes, cancer and sleep apnea.
Researchers from Duke University studied data from more than 17,000 patients, including 1,406 who had gout at the start of the study and were being treated for cardiovascular risk factors. After following patients for an average of 6.4 years, researchers found that “in spite of aggressive medical therapy,” the gout was linked to worse outcomes and death.
“Among patients who had gout at the beginning of the study or who developed it during follow-up, their risk of either dying of cardiovascular disease or having a heart attack or stroke was 15 percent higher than patients who never developed gout,” said the study’s lead author, Dr. Neha Pagidipati, a cardiologist and assistant professor at Duke University School of Medicine in Durham, N.C.
Patients who had gout at any point during the study had a twofold increased risk of heart failure death compared to people who never developed gout.
While past research showed people with gout have an increased risk of cardiovascular disease, “a lot of those studies were done decades ago, before modern preventative therapy like statins became extremely common,” Pagidipati said. “We wanted to take a more contemporary look at the relationship between gout and future heart disease in patients with known coronary artery disease.”
Many patients don’t even realize a link exists between gout and heart problems, she said, and the new findings show the need for patients to talk to their physicians about added risks.
“Also, from a physician’s perspective, it’s important to consider that patients with gout may be at increased risk for cardiovascular disease even if they’re already treating them with all the standard therapies. It’s something to have on their radar,” Pagidipati said.
Although it’s unclear why gout might increase the risk of cardiovascular disease, she said possible reasons include increased oxidative stress and inflammation.
“We know that people who have a high level of inflammation are at an increased risk for cardiovascular disease, and we also know gout is characterized by periods of acute inflammation: The link may have to do with that,” she said.
Dr. Jasvinder Singh, who was not involved in the study, said the new research may help the public understand how insidious gout can be.
“Gout is not just a disease of the joints: It’s a disease that causes inflammation in the joints and in the body. It’s not just a pain in the toe, it affects other organs, too, including the heart,” said Singh, a gout researcher and professor of medicine and epidemiology at the University of Alabama at Birmingham.
Singh said the new study underscores the potential dangers of ignoring even occasional episodes of gout.
“Patients may say, ‘I have an attack every two years, so shouldn’t I wait (for treatment) until it becomes more frequent?’ But in light of studies such as this one,” he said, “patients might want to take that into account and know that leaving gout untreated might be affecting their cardiovascular health.”
While the biological processes are still a bit murky, researchers suspect a proper night’s rest gives your brain a chance to rid itself of toxic molecules. (Courtesy Spectrum Health Beat)
The deep stages of sleep may give the brain a chance to wash itself free of potentially toxic substances, a new study suggests.
Researchers found that during deep sleep, the “slow-wave” activity of nerve cells appears to make room for cerebral spinal fluid to rhythmically move in and out of the brain—a process believed to rinse out metabolic waste products.
Those waste products include beta-amyloid—a protein that clumps abnormally in the brains of people with dementia, said researcher Laura Lewis, an assistant professor of biomedical engineering at Boston University.
Lewis stressed that the findings, reported in a recent issue of Science, do not prove that deep sleep helps ward off dementia or other diseases.
But the ultimate goal of research like this is to understand why poor sleep quality is linked to higher risks of various chronic conditions, from dementia to heart disease to depression, she said.
Researchers have known that cerebral spinal fluid helps clear metabolic byproducts from the brain, so that they do not build up there.
They’ve also known that the process appears to amp up during sleep.
But various “hows” and “whys” remained.
So the investigators recruited 11 healthy adults for a sleep study using noninvasive techniques: advanced MRI to monitor fluid flow in the brain and electroencephalograms to gauge electrical activity in brain cells.
Sleep is marked by REM and non-REM cycles.
During REM sleep, breathing and heart rates are relatively higher and people often have vivid dreams.
Non-REM sleep includes stages of deep—or slow-wave—sleep. During those stages, there’s a slow-down in brain cell activity, heart rate and blood flow, and research has found that deep sleep may aid memory consolidation and allow the brain to recover from the daily grind.
“There are all these fundamental things your brain is taking care of during deep sleep,” Lewis said.
Her team found that housecleaning may be one.
When study participants were in deep sleep, each pulse in slow-wave brain activity was followed by oscillations in blood flow and volume, which allowed cerebral spinal fluid to flow into fluid-filled cavities in the central brain.
The spinal fluid moved in “large, pulsing waves” that were seen only during deep sleep, Lewis explained.
Based on what’s known about the work of cerebral spinal fluid, experts said it’s reasonable to conclude that slow-wave sleep promotes the flushing of waste from the brain.
The study “elegantly” illustrates the importance of deep sleep, according to Dr. Phyllis Zee, a sleep medicine specialist not involved in the work.
It “helps to explain how and why sleep is important for keeping neurons healthy—facilitating the removal of toxic molecules,” said Zee, a professor of neurology at Northwestern University Feinberg School of Medicine, in Chicago.
“One can think of sleep as a top way to take care of your brain,” she said.
Another sleep medicine specialist agreed.
“There is growing evidence, with this study and others, that sleep plays a role in clearing toxins from the brain,” said Dr. Raman Malhotra, an associate professor of neurology at Washington University in St. Louis.
Other research has suggested that sleep loss can promote the buildup of “unwanted proteins” in the brain, said Malhotra, who also serves on the board of directors of the American Academy of Sleep Medicine.
A recent government study, for instance, found that one night of sleep deprivation triggered an increase in beta-amyloid in the brains of healthy adults.
“As we learn more about this role of sleep,” Malhotra said, “it may help explain why individuals who don’t get enough sleep, or suffer from sleep disorders, are at higher risk of certain chronic health conditions.”
The latest study involved younger adults with no health problems.
Lewis said that it will be important to find out whether healthy older adults, or people with certain health conditions, show any differences in cerebral spinal fluid dynamics during deep sleep.
A big question for future research, she said, will be whether alterations in those dynamics precede the development of disease.
Reprinted with permission from Spectrum Health Beat.
A large new study adds to questions about whether your “good” HDL cholesterol levels really affect your risk of heart disease.
The study, of nearly 632,000 Canadian adults, found that those with the lowest HDL levels had higher death rates from heart disease and stroke over five years. But they also had higher death rates from cancer and other causes.
What’s more, there was no evidence that very high HDL levels—above 90 mg/dL—were desirable.
People with HDL that high were more likely to die of noncardiovascular causes, compared to those with HDL levels in the middle, the study found.
The fact that low HDL was linked to higher death rates from all causes is key, said lead researcher Dr. Dennis Ko.
That suggests it’s just a “marker” of other things, such as a less healthy lifestyle or generally poorer health, he said.
That also means it’s unlikely that low HDL directly contributes to heart disease, added Ko, a senior scientist at the Institute for Clinical Evaluative Sciences in Toronto.
“This study is going against the conventional wisdom,” he said.
But the reality is, doctors are already shifting away from the conventional wisdom, said cardiologist Dr. Michael Shapiro.
Shapiro, who was not involved in the study, is a member of the American College of Cardiology’s Prevention of Cardiovascular Disease Section.
“Many people know that HDL is the ‘good’ cholesterol,” he said. “But they may not know that the medical community is moving away from the idea that we’ve got to raise low HDL.”
That’s in part because of the results of several clinical trials that tested the vitamin niacin and certain medications that boost HDL levels.
The studies found that while the treatments do raise HDL, they make no difference in people’s risk of heart trouble.
On top of that, Shapiro said, research has shown that gene variants associated with HDL levels have no connection to the risk of cardiovascular disease.
No one is saying that doctors and patients should ignore low HDL levels. Levels below 40 mg/dL are linked to a heightened risk of heart disease.
“That is a consistent finding,” Shapiro said. “So we can reliably use it as a marker to identify patients at higher risk and see what else is going on with them.”
Causes of low HDL include a sedentary lifestyle, smoking, poor diet and being overweight. And it’s probably those factors—not the HDL level itself—that really matter, Shapiro said.
The current findings are based on medical records and other data from nearly 631,800 Ontario adults ages 40 and up. Over five years, almost 18,000 of them died.
Ko’s team found that men and women with low HDL levels were more likely to die during the study period, versus those with levels between 40 and 60 mg/dL.
But they had increased risks of not only heart disease death, but also death from cancer or other causes.
People with low HDL tended to have lower incomes, and higher rates of smoking, diabetes and high blood pressure. After the researchers accounted for those factors, low HDL was still linked to higher death rates.
“But we couldn’t account for everything,” Ko said. And he believes that factors other than HDL number—such as exercise and other lifestyle habits—are what count.
“When you see that something (low HDL) is associated with deaths from many different causes, it’s probably a ‘generic’ marker of risk, rather than a cause,” Ko said.
At the other end of the spectrum, people with very high HDL—topping 90 mg/dL—faced increased risks of dying from noncardiovascular causes.
Shapiro called the finding “very interesting,” but the reasons for it are unclear.
Alcohol can raise HDL. So that raises the question of whether heavy drinking helps explain the link, said Dr. Robert Eckel, a professor of medicine at the University of Colorado Denver, Anschutz Medical Campus.
Regardless, there is no reason for people to try to send their HDL skyward using niacin or other medications.
“Raising HDL with drugs is not indicated,” Eckel said.
Shapiro stressed the importance of lifestyle: “Don’t smoke, get regular aerobic exercise, lose weight if you need to.”
Those things may, in fact, boost your HDL, Shapiro noted. But it’s not the number that matters, he said, it’s the healthy lifestyle.
The findings were published in the Journal of the American College of Cardiology.
Final exams–and the ensuing all-night study sessions they cause–are looming large for many students across the country. But reaching for energy drinks to perk up those drooping eyelids and boost study performance could do more harm than good.
Recent research shows just one energy drink can affect blood vessel function. And other studies have shown these caffeine-and-herbal concoctions can increase stress hormones and are linked to changes in blood pressure and the heart’s electrical activity.
“What I say to people who are studying is to avoid energy drinks. And to people who are exercising, avoid them,” said Dr. John Higgins, chief of cardiology at Lyndon B. Johnson Hospital, a sports cardiologist and a professor at McGovern Medical School at UTHealth in Houston.
Higgins led a study that looked at the effects of energy drinks on blood vessel function on 44 non-smoking, healthy medical students who were in their 20s. He and his colleagues tested the students’ blood vessel, or endothelial, function and then tested it again 90 minutes after they had consumed a 24-ounce energy drink.
The preliminary results, presented earlier this month at the American Heart Association’s Scientific Sessions conference, suggest the drink reduced by about half how much the participants’ blood vessels were able to dilate, or expand.
“During exercise or under stress, your arteries have to open up because they need to get blood to the muscles, heart and brain,” Higgins said. “If there is impairment during exercise or mental stress, it could lead to adverse effects.”
The market for caffeine-infused energy drinks has grown during the last decade, with new blends adding vitamins and other ingredients touting everything from memory enhancement to concentration benefits. According to research company Statista, energy drink sales reached $2.8 billion in 2016, with consistent increases since 2011. A 2016 Statista survey of 18- to 69-year-olds showed 1 in 4 people had an energy drink almost every day.
Coffee and its caffeine have gotten the green light, in moderation, from the U.S. Department of Agriculture. Federal dietary guidelines published every five years as a go-to source for nutrition advice say three to five cups a day, which can be up to 400 milligrams a day of caffeine, can be part of a healthy diet.
But Higgins said energy drinks are more than just caffeine.
“We suspect it has to do with their blends,” he said. “They have lots of sugar and caffeine, but also taurine, an amino acid, guaranine (from a South American plant), another source of caffeine, and they sometimes have vitamins. But they have these substances at levels in excess of the recommended daily allowance, sometimes even 10 times or more.”
On campus, there’s a common pattern, said LaVelle Hendricks, an associate professor of counseling and a student affairs coordinator at Texas A&M University-Commerce, about an hour northeast of Dallas. When students are dealing with stress and lack of sleep, “when they get close to exam time, they turn to these drinks,” he said. “They get this boost of energy, but then they have headaches and they crash. As a way to re-energize and get that same boost, they repeat the cycle.”
The tough-but-true advice is there are no shortcuts.
“You have to stick to a regimen,” Hendricks said. “It entails going to class, studying, eating right, exercising right and getting the proper amount of sleep.”
A Journal of American College Health study in 2011 said the consumption of energy drinks has been associated with perceived stress levels of college students. Middlebury College in Vermont banned the on-campus sale of energy drinks. In Britain, many supermarkets have begun banning sales to children under 16, and the government is considering other restrictions.
Higgins said he’d like more short- and long-term studies that show how these energy drinks – and their blends of ingredients – work on the body. So far, the evidence has been inconsistent, he said, with some showing improved performance, some reduced and others no effect.
Higgins warns that some people are more at risk for the effects from energy drinks, including people under 18; people of small stature; people who don’t normally drink caffeine or are sensitive to it; pregnant or breastfeeding women; people taking stimulants for conditions such as attention deficit disorder; and people with certain medical or cardiovascular conditions.
For a healthy boost during studying, Higgins suggests high-intensity exercise, or even just a quick run up and down the stairs. Getting outside, “stretching the eyes” with relaxed nature-watching or a power nap also can help, he said.
“If you are really that tired and coffee isn’t keeping you awake, you should probably go to sleep. You aren’t going to remember anything for the test anyway.”
Offering more vegetarian choices in school cafeterias significantly cuts meat consumption without hurting overall sales, British researchers report.
In more than 94,000 college cafeteria choices studied, doubling vegetarian options (from 1 in 4 choices to 2 in 4) reduced purchases of meaty meals by 40-80%.
“Replacing some meat or fish with more vegetarian options might seem obvious, but as far as we know no one had tested it before,” said lead author Emma Garnett, a conservationist at the University of Cambridge in England. “Solutions that seem obvious don’t always work, but it would appear that this one does.”
Shifting to a more plant-based diet is one of the most effective ways to reduce the environmental impact of food production, she said.
When more vegetarian choices were available, they were popular at every meal and meat eaters who ate vegetarian dishes at lunch didn’t go all-meat at dinner, the researchers found.
Vegetarian options have been an “afterthought” on menus for too long, Garnett said in a university news release.
“Flexitarianism is on the rise,” she said, referring to the eating style emphasizing plant-based foods but also allowing for occasional meat and animal products. “Our results show that caterers serving more plant-based options are not just responding to but also reshaping customer demand.”
Simple changes such as increasing the proportion of vegetarian options could be “usefully scaled up, helping to mitigate climate change and biodiversity loss,” Garnett said.
The report was published recently in the Proceedings of the National Academy of Sciences.
Low-carb, vegetarian, Mediterranean—whatever your diet, it’s important to get enough protein.
Although research hasn’t yet pinpointed one perfect formula, experts say that the typical “recommended” daily minimums aren’t optimal and that it helps to factor in your weight and activity level to determine how much protein you personally need.
A good baseline for people who exercise at a moderate level is between one-half and three-quarters of a gram of protein per pound of bodyweight.
If you weigh 150 pounds, for example, eat between 75 and 112 grams of protein per day.
To lose weight, diets with higher amounts of protein—between 90 and 150 grams a day—are effective and help keep you from losing muscle along with fat.
Since the body uses protein most effectively when you have it at regular intervals, divide your daily intake into four equal amounts for breakfast, lunch, a snack and dinner.
If you work out at a high level, consider eating another 50 grams of protein before you go to bed to help with overnight muscle repair.
You might be familiar with calorie counting, but it’s also important to know how to tally your protein intake.
While one ounce of chicken weighs 28 grams, it contains only about 9 grams of protein. So it takes a 3-ounce portion to deliver 27 grams of protein, or about one-quarter of the average daily need.
27-gram protein portions
3 ounces of fish, turkey, chicken or lean beef
7 ounces plain Greek yogurt
3/4 cup cottage cheese
You can also get high-quality protein from some plant-based foods.
These include tofu, whole grains, legumes and nuts—all better options than eating extra red meat or any processed meats.
Familial hypercholesterolemia can be diagnosed with a simple blood test and a look at family history. Genetic testing can confirm the diagnosis. (Courtesy Spectrum Health Beat)
High cholesterol is a risk factor for heart disease, but not all forms of it are the same.
An underdiagnosed genetic condition called familial hypercholesterolemia can cause dangerously high levels of cholesterol at an early age.
While scientists have determined familial hypercholesterolemia is caused by genetic mutations that affect the body’s ability to remove LDL, or “bad” cholesterol, they haven’t pinned down all the genes involved for nearly 1 in 3 people who have it.
But that may be beginning to change.
Scientists presented preliminary research at the American Heart Association’s Vascular Discovery conference in Boston this week showing more clues to the genetic roots of familial hypercholesterolemia.
National Heart, Lung, and Blood Institute researchers screened 19,114 genes and identified transgelin as one of the genes of interest. Previous studies have found this gene could be associated in LDL metabolism.
When researchers disabled the gene in cells, some cells tried to compensate.
“The cell tries to make more cholesterol because cholesterol is vital for the cell to survive,” said Diego Lucero, the study’s lead author and a postdoctoral fellow at the institute. “Understanding this is important because it might have impacts on the magnitude of the clinical presentation of the disease.”
People with familial hypercholesterolemia are exposed to chronically high levels of LDL from an early age and their risk for premature heart disease is 20 times greater than the general population, according to the Familial Hypercholesterolemia Foundation.
Over time, the condition can lead to atherosclerosis—the buildup of plaque and narrowing of artery walls. As a result, signs of heart disease can show up decades earlier in people with familial hypercholesterolemia compared to the general population.
The condition affects approximately 1 in 250 U.S. adults. Yet, it remains largely underdiagnosed and undertreated.
“Less than 10 percent of those who have (familial hypercholesterolemia) have actually been diagnosed, which leads to a lot of premature morbidity and mortality,” said Dr. Samuel Gidding, chief medical officer for the foundation.
Someone who carries the altered gene has a 50% chance of passing it on to their children.
Yet, the challenge is diagnosing familial hypercholesterolemia.
Health care providers may not understand the difference between general high cholesterol and familial hypercholesterolemia and may not screen high-risk people, said Gidding, who was not involved in the new study.
Familial hypercholesterolemia can be diagnosed with a simple blood test and a reported family history of cardiovascular disease. Doctors look for LDL levels over 190 in adults and over 160 in children, and onset of heart disease before age 60 in men and before 50 in women. Genetic testing can confirm the diagnosis.
Once identified, there are effective ways to treat the condition, Gidding said. Early treatment with medications, as well as maintaining a heart-healthy lifestyle, can lower the risk of premature heart attacks and strokes.
The new research and further work identifying new genes involved in the development of familial hypercholesterolemia could lead to better diagnosis and treatment, Gidding said.
“Anytime an individual gene like this could help explain variations in lipid level, it could be a drug target.”
A blood test may seem like a simple thing, but it can do so much.
It can diagnose disease, reveal how well your organs work and whether a course of treatment is effective or not, experts say.
Some blood tests require patients to fast before the blood is drawn. It’s crucial that you avoid eating before such tests, which require blood that is clear of nutrients, such as fats and sugars.
Glucose and lipid testing are the most common types of fasting blood tests, said Carole Andrews of Penn State Health in Hershey, Pa., where she’s a supervisor in the department of pathology and laboratory medicine.
“The amount of fats and glucose (sugars) will increase in the blood if a person has recently eaten,” Andrews explained in a Penn State news release. “This will affect the results of these specific tests.”
You may also wonder why technicians take so many blood samples.
Vials used to collect samples may contain additives that keep blood from clotting before the lab can test it. Tubes are color-coded according to the type of test. For example, a purple-colored vial is used for a blood count and a green-colored vial may be used for a chemistry profile, Andrews said.
How much blood is collected depends on the number and type of tests ordered by your doctor.
And there’s no need for concern if multiple vials of blood are taken. Most people have between 4,500 to 5,700 milliliters of blood.
“Even if you had 10 tubes of blood taken, that’s less than 60 milliliters,” Andrews said. “It’s not going to make an impact because your body is designed to replace what is lost.”
You can make the process easier by drinking plenty of fluids beforehand, she suggested. This will make it easier for the technician to poke into a vein.
“Also, it is easier if the patient is relaxed and comes in with a good attitude,” Andrews said. “If they tense up too much, it can make the venipuncture difficult.”
New guidelines for ADHD treatment emphasize the need for ongoing medical care and coordination within the school and community. (Courtesy Spectrum Health Beat)
Attention-deficit hyperactivity disorder is in the news a lot and now newer research has prompted a leading pediatricians’ group to update its guidelines for diagnosing and treating the disorder for the first time since 2011.
Dr. Mark Wolraich, lead author of the guidelines, noted that there weren’t any dramatic differences between these and previous guidelines.
But, he said, these latest updates keep the American Academy of Pediatrics guidelines in sync with the same diagnostic and treatment criteria used by child and adolescent psychiatrists.
ADHD “is not a ‘new’ diagnosis. It’s a real diagnosis that needs treatment,” Wolraich said.
“There are two forms of treatment effective for ADHD: medications, especially stimulant medications, and behavioral treatments. Neither treatment is curative,” he said, but they can help manage the symptoms.
Wolraich is an emeritus professor at the University of Oklahoma, in Oklahoma City.
More than 9% of U.S. children between the ages of 2 and 17 have been diagnosed with ADHD, according to the guideline authors.
Boys are more than twice as likely as girls to be diagnosed with the disorder. Kids with ADHD often have symptoms of another mental disorder—such as depression or anxiety—and they may also have learning and language problems.
Updates to the guidelines include:
Changing the age at which symptoms need to have first started. Previously, symptoms needed to begin before age 7. That’s now been raised to age 12.
In patients older than 17, fewer problem behaviors are needed to make an ADHD diagnosis. Wolraich said as children get older, symptoms can change and behaviors such as hyperactivity usually diminish.
Emphasizing the need to rule out other causes of ADHD-like symptoms and to identify other conditions that may occur with ADHD, such as depression, anxiety, substance use, autism or trauma.
Highlighting the need for ongoing medical care and coordination within the school and community.
Recommending parent training in behavior management as a first-line treatment for preschoolers. Wolraich said behavior modification is an effective treatment that generally has two phases of treatment. The positive phase rewards a child for appropriate behavior—and the reward may just be praising, such as, “Johnny, I like the way you’re sitting in your chair.” The second phase includes consequences, such as “time-out.” But, he said, if you don’t have the positive side of treatment, time-out isn’t as helpful.
While the guidelines didn’t specifically recommend behavior management training for teachers and parents in high school students with ADHD, they noted that studies have found some value in this treatment for older kids.
Dr. Victor Fornari, vice chair of child and adolescent psychiatry at Zucker Hillside Hospital in Glen Oaks, N.Y., said it’s important for pediatricians to be familiar with the up-to-date guidelines, because “as many as 10% of all kids meet the criteria for ADHD and many children with mild to moderate symptoms can be evaluated and treated by their pediatrician.”
Fornari said if treatment doesn’t go smoothly or there are ongoing behavior problems or other mental health concerns, pediatricians can often collaborate with a child and adolescent psychiatrist to get additional guidance.
Both Wolraich and Fornari said pediatricians play a vital role in ADHD diagnosis and treatment because they already have an established relationship with the child and family.
“People may not fully appreciate that ADHD that’s untreated can lead to adverse outcomes. Failing to treat can lead to academic and conduct disturbances, and earlier substance use disorders. Children who are identified earlier and treated are more successful,” Fornari said.
The new guidelines were published online recently in the journal Pediatrics.
Age-related macular degeneration, or AMD, is an incurable eye disease that affects millions of older Americans, but there are a number of things you can do to reduce your risk, a vision expert says.
AMD causes blurred central vision due to damage to the macula—a small area at the back of the eye—and it is most common after age 60, according to the U.S. National Eye Institute.
AMD is also more common in women and whites. At-risk patients should get regular eye exams, advised Dr. Julie Rosenthal, a retina specialist.
She said there are a number of things people can do to help slow or possibly prevent AMD. If you smoke, try to quit. Smoking may double the risk of AMD.
Find out if you have a family history of the disease.
People with a first-degree relative with AMD have a much greater risk of developing it. If you have a family history of the disease, watch for potential symptoms such as difficulty recognizing faces, struggling to adapt to low light and seeing straight lines that appear wavy.
Eat lots of spinach, kale, Swiss chard and other leafy greens, which are high in antioxidant vitamins that help protect against cellular damage from free radicals, which can contribute to eye disease, according to Rosenthal.
If you have a poor diet, consider taking multivitamins. People at risk of advanced AMD should ask their doctor about a specialized blend of supplements called AREDS. This is “not a treatment or cure but can decrease your risk of getting the more severe forms of AMD,” Rosenthal said in a university news release.
When outside, wear sunglasses that provide protection from UV and blue light that can cause retinal damage. Sunglasses with a “UV 400” label are recommended by the American Macular Degeneration Foundation.
Maintain healthy blood pressure and weight. Poor blood circulation due to high blood pressure can restrict blood flow to the eyes, thus contributing to AMD. Losing weight is a proven way to lower blood pressure.
Use a tool called an Amsler grid to check for vision problems related to macular damage.
When staring at the grid, if you notice that the central part of your vision in one eye has become darker or the grid lines are wavy, call your doctor, Rosenthal said. Keep the grid in a place that reminds you to use it daily.
If life looks gray and cloudy when you smoke, you might not be imagining it.
Heavy smoking may actually damage color and contrast vision, researchers report.
They looked at 71 healthy people who smoked fewer than 15 cigarettes in their lives and 63 people who smoked more than 20 cigarettes a day. The participants were aged 25 to 45 and had normal or corrected-to-normal vision.
But the heavy smokers showed significant changes in their red-green and blue-yellow color vision and also had greater difficulty discriminating contrasts and colors than nonsmokers.
“Our results indicate that excessive use of cigarettes, or chronic exposure to their compounds, affects visual discrimination, supporting the existence of overall deficits in visual processing with tobacco addiction,” said co-author Steven Silverstein, director of research at Rutgers University Behavioral Health Care.
“Cigarette smoke consists of numerous compounds that are harmful to health and it has been linked to a reduction in the thickness of layers in the brain, and to brain lesions, involving areas such as … the area of the brain that processes vision,” he added in a university news release.
He also noted, “Previous studies have pointed to long-term smoking as doubling the risk for age-related macular degeneration and as a factor causing lens yellowing and inflammation.”
Nicotine and smoking harm the body’s circulatory system. These findings indicate they also damage blood vessels and neurons in the retina, according to Silverstein.
He said the results also suggest that research into vision problems in other groups of people, such as those with schizophrenia who often smoke heavily, should take into account their smoking rate.
About 34 million adults in the United States smoke cigarettes, according to the U.S. Centers for Disease Control and Prevention, and more than 16 million have a smoking-related disease, many of which affect the cardiovascular system.
The study was published recently in the journal Psychiatry Research.
Kratom is often marketed as a safe alternative to opioid painkillers, but this unregulated substance poses a significant health risk. (Courtesy Spectrum Health Beat)
Calls to U.S. poison control centers related to the herbal drug kratom have skyrocketed, increasing more than 50-fold in a matter of six years, a new study shows.
Back in 2011, poison centers received about one call a month regarding someone who’d taken too much kratom, a plant that is purported to produce mild opioid-like effects.
These days, nearly two calls a day are received concerning kratom exposures, researchers report in a recent issue of the journal Clinical Toxicology.
“We’re now getting literally hundreds of cases a year versus 10 or 20,” said researcher Henry Spiller, director of the Central Ohio Poison Center at Nationwide Children’s Hospital in Columbus. He noted that kratom reports underwent a “relatively big spike” sometime between 2015 and 2016.
The researchers identified 11 deaths associated with kratom use, including two in which kratom was used by itself and nine where kratom was used with other drugs.
Unfortunately, kratom is being promoted as a safe alternative to opioid painkillers for people with chronic pain, Spiller said.
“Because it’s a plant and it’s natural, at this point it’s unregulated,” Spiller said. “A lot of people have been Google-searching it for use in chronic pain and other things and we’ve started to see a really significantly increased use and, in many cases, abuse of it.”
But taking too much kratom can cause some unintended health problems, including agitation, seizures, rapid heart rate and high blood pressure, Spiller said. In extreme cases, kratom overdose can put a person into a coma, stop their breathing or cause kidney failure.
“Just because it’s natural doesn’t mean it’s harmless,” Spiller said.
The U.S. Food and Drug Administration has issued a warning to consumers against using kratom and the U.S. Drug Enforcement Agency has listed it as a “drug of concern.”
Kratom has not been approved for any medical use by the FDA.
For this study, researchers analyzed calls to U.S. Poison Control Centers between 2011 and 2017, finding more than 1,800 reports related to kratom use.
The annual number of calls increased dramatically, going from 13 calls in 2011 to 682 calls in 2017, researchers found.
About two of every three of these calls occurred recently, in either 2016 or 2017.
About a third of the calls resulted in a person needing hospitalization and more than half resulted in serious medical outcomes, the researchers said.
“The belief that kratom is harmless because it is classified as an herbal supplement is directly challenged by the findings in this report—and policy efforts need to address this knowledge gap,” said Dr. Harshal Kirane, director of addiction services at Staten Island University Hospital.
Most dangerous kratom exposures occurred among males (71 percent), adults aged 20 and older (89 percent), in a home (86 percent) and involving intentional abuse or misuse (60 percent), findings show.
Although kratom appears confined to adult use for now, children and teenagers could be exposed to the herb if its popularity keeps increasing, said Kirane, who wasn’t involved with the study.
“The dramatic increase in the rate of reported kratom exposures in recent years suggests a growing demand for this substance,” Kirane said. “Increasing prevalence of kratom use may place young children in dangerous situations, particularly if regulatory measures are not in place to ensure childproof packaging and consistency in quality of kratom.”
Idaho and Oregon are the states with the most reported kratom poisonings, while Delaware and Wisconsin had the lowest rates.
Using kratom with another substance significantly raised a person’s chances of poisoning, nearly tripling the odds that they’d land in a hospital and more than doubling the risk of having a serious medical outcome.
Of the nine deaths involving a mixture of kratom with another substance, kratom was the first-ranked substance in seven, researchers said. The deaths involved kratom used alongside antihistamines, alcohol, benzodiazepines (such as Valium or Xanax), caffeine, fentanyl or cocaine.
“Though the drug claims to cure anxiety and depression, there are very few ‘cure-alls’ in the medical world and anything that claims to alter an individual’s mental state should be taken with the utmost seriousness,” said Dr. Teresa Amato. She is chair of emergency medicine at Northwell Health’s Long Island Jewish Forest Hills in New York City.
“We, as doctors, are unable to tell patients how this ‘medication’ might affect them and cannot in good conscience advise the use of this medicine without a thorough FDA investigation,” said Amato, who had no part in the study.
People should be aware that kratom can interact with medications or illicit drugs in harmful ways and could exacerbate existing health problems, Spiller said.
There’s also a concern that because it’s unregulated, people may be getting kratom that either varies in potency or is mixed with other substances, he added.
“I’d be cautious,” Spiller said. “At this point, we’re not sure of everything kratom does.”
Pregnant women in particular should be careful with kratom.
The researchers identified seven babies who had been exposed to kratom in the womb, three of whom required admission to a critical care unit after birth.
Five of the babies experienced withdrawal symptoms from their mothers’ kratom use and four of those had been exposed to kratom alone.
“I would very much caution pregnant women,” Spiller said. “You can have a real impact on your child.”
Researchers say new drug therapies can target certain genes that play a role in the growth and spread of prostate cancer. (Courtesy Spectrum Health Beat)
A drug that targets faulty gene repair may buy more time for some men with advanced prostate cancer, a new clinical trial finds.
Experts called the study “landmark,” because it zeroed in on men with particular gene mutations that can be targeted with newer drug therapies.
It’s an approach that is already used in treating breast, ovarian and lung cancers.
Specifically, the trial tested a drug called Lynparza (olaparib), which is currently approved to treat certain patients with breast or ovarian cancers linked to mutations in the BRCA genes.
When BRCA is working properly, it helps repair damaged DNA in body cells that can lead to cancer. When the gene is altered, those repair mechanisms go awry.
BRCA mutations do not only lead to breast and ovarian cancers, though. They also help drive some cases of prostate cancer.
In the new trial, researchers recruited men with advanced prostate cancer who had alterations in BRCA or certain other genes involved in DNA repair.
The investigators found that, compared with standard hormonal therapy, Lynparza delayed patients’ cancer progression for a median of about three months. That means half the patients saw a longer delay and half a shorter one.
Along with that delay, the drug slowed down patients’ pain progression.
“Delaying the cancer from growing is meaningful,” said Dr. Maha Hussain, who led the trial, which was funded by drug makers Astra Zeneca and Merck.
“At the end of the day, patients want to live longer—and also better,” added Hussain, a professor at Northwestern University Feinberg School of Medicine, in Chicago.
She was to present the findings at the annual meeting of the European Society for Medical Oncology, in Barcelona. Studies reported at meetings are generally considered preliminary until they are published in a peer-reviewed journal.
Lynparza is one of a newer class of drugs called PARP inhibitors, which block a protein that cancer cells need to keep their DNA healthy. Without it, those cells may die. Cancer cells with defects in DNA-repair genes are especially vulnerable to PARP inhibitors.
The drug class is part of a wider trend in cancer treatment, toward “targeted therapies”—where medications are tailored to target certain molecules in cancer cells that help them grow and spread.
A range of targeted drugs are available for common cancers, such as breast and lung, but prostate cancer has “lagged behind,” Hussain said.
Dr. Eleni Efstathiou, of MD Anderson Cancer Center in Houston, described the new trial as landmark.
“Overall, these data show that, like breast and lung cancers, prostate cancer is not one but many different diseases,” Efstathiou said. “We need to start identifying different groups of patients and treating them with targeted therapy.”
She noted that only a fairly small percentage of prostate cancer patients would have alterations in DNA-repair genes—which can be inherited or arise as the cancer progresses.
And doctors do not routinely screen cancers for all those gene flaws.
Screening for inherited mutations is “becoming part of guidelines,” Efstathiou noted, but screening for non-inherited alternations is not yet done.
For the latest trial, the researchers screened 4,425 men with advanced prostate cancer that had spread to distant sites in the body and was not responding to standard hormonal therapy.
The investigators ended up with 245 patients with alterations in either BRCA or another gene called ATM. A second group of 142 patients had alterations in any of 12 other genes tied to flawed DNA repair.
Patients in both groups were randomly assigned to either take Lynparza tablets or start one of two newer hormonal therapies.
Overall, Lynparza patients saw their cancer advance more slowly, with the difference being clearer in the group with BRCA or ATM defects.
For those men, cancer progression was delayed by a median of 7.4 months, versus 3.5 months among patients on hormonal therapy. A preliminary analysis suggested their overall survival was also better—a median of 18.5 months, versus 15 months.
Lynparza does have side effects, including anemia and nausea, Efstathiou pointed out, which can make it difficult to stick with the drug. Just over 16% of Lynparza patients in the trial stopped treatment due to side effects.
The drug is not yet approved for prostate cancer, though some doctors use it “off-label” for certain patients, Hussain noted.
At this point, Efstathiou said, doctors may want to screen for DNA-repair mutations in the tumors of men with advanced prostate cancer, since “we now have evidence it can be successfully targeted.”
Like other targeted drugs, Lynparza carries a hefty price tag: Researchers have estimated that it costs more than $234,000 to extend a patient’s life by one year.
The old saying, “TV rots your brain,” could have some validity for folks as they age.
In a new study, middle-aged people who watched television for more than 3.5 hours a day experienced a decline in their ability to remember words and language over the next six years, British researchers found.
What’s worse, it appears that the more TV you watch, the more your verbal memory will deteriorate, researchers said.
“Overall, our results suggests that adults over the age of 50 should try and ensure television viewing is balanced with other contrasting activities,” said lead researcher Daisy Fancourt. She’s a senior research fellow at University College London.
For the study, researchers relied on data from a long-term study of aging involving more than 3,600 residents of England.
Participants reported the amount of hours of TV they watched daily. They also had their thinking and reasoning skills regularly tested as part of the study.
People who watched less than 3.5 hours of TV a day didn’t seem to suffer any deterioration in their brain power, Fancourt said.
But more than that amount, people became increasingly apt to struggle with words or language in tests conducted six years later.
The decline in language skills is similar to that experienced by the poor as they age, Fancourt said.
“We already know from a number of studies that being of low socio-economic status is a risk factor for cognitive decline,” Fancourt said. “If we compare the size of association for watching television for greater than 3.5 hours a day, it has a similar-sized association with verbal memory as being in the lowest 20 percent of wealth in the country.”
The worst deficits occurred in those people who watched more than seven hours of television daily, researchers found.
While only an association was seen in the study, there are a couple of potential reasons why this might happen.
“Due to the fast-paced changes in images, sounds and action, yet the passive nature of receiving these—i.e., television does not involve interaction as gaming or using the internet does—watching television has been shown in laboratory studies to lead to a more alert, but less focused, brain,” Fancourt explained.
Some TV viewing is also stressful and stress has been associated with a decline in brain power, she added.
The specific effect on verbal skills indicates that avid TV viewing could be replacing other activities that would be better for the brain, said Rebecca Edelmayer, director of scientific engagement at the U.S.-based Alzheimer’s Association.
“You’re spending more time not engaging with your family, your friends and having social conversations, because they’re specifically reporting a decrease in verbal recall,” Edelmayer said. “We know engagement with others in conversation is something that supports and protects verbal recall.”
People who want to protect their thinking skills need to socialize often and engage in other activities that “stretch” their brain, Edelmayer said.
In fact, a long-term study published just last week in the journal Neurology found that exercising both the brain and body during middle age may guard against dementia. Such mental exercise includes reading, playing music, sewing or painting, according to the report.
“The recommendation would always be to stretch yourself and stay as engaged as you can be, whatever the connection is,” Edelmayer said. “We’re asking you for best brain health to go outside your normal passive box.”
The new study was published recently in the journal Scientific Reports.
Too little sleep. Not enough exercise. Far too much “screen time.”
That is the unhealthy lifestyle of nearly all U.S. high school students, new research finds.
The study, of almost 60,000 teenagers nationwide, found that only 5 percent were meeting experts’ recommendations on three critical health habits—sleep, exercise and time spent gazing at digital media and television.
It’s no secret that many teenagers are attached to their cellphones, or stay up late, or spend a lot of time being sedentary. But even researchers were struck by how extensive those issues are among high school students.
“Five percent is a really low proportion,” said study leader Gregory Knell, a research fellow at University of Texas School of Public Health, in Dallas. “We were a bit surprised by that.”
In general, medical experts say teenagers should get eight to 10 hours of sleep at night and at least one hour of moderate to vigorous exercise every day. They should also limit their screen time—TV and digital media—to less than two hours per day.
The new findings show how few kids manage to meet all three recommendations, Knell said.
It’s easy to see how sleep, exercise and screen time are intertwined, he pointed out.
“Here’s one example: If kids are viewing a screen at night—staring at that blue light—that may affect their ability to sleep,” Knell said.
“And if you’re not getting enough sleep at night, you’re going to be more tired during the day,” he added, “and you’re not going to be as physically active.”
Ariella Silver is an assistant professor of pediatrics and adolescent medicine at Icahn School of Medicine at Mount Sinai, in New York City. She agreed there’s a lot of overlap in the three behaviors.
Silver, who was not involved in the study, also made this point: The two-hour limit on screen time may be tough for high school students, since their homework may demand a lot of computer time.
It’s not clear how much that may have played into the findings, Silver said.
Still, she sees screen time as possibly the “biggest factor” here. Silver agreed that it may hinder teenagers’ sleep. But another issue comes up when social media “replaces” face-to-face social interaction.
When kids do not go out with friends, they miss out on many experiences—including chances for physical activity, Silver said.
While no group of kids in the study was doing well, some were faring worse than others. Only 3 percent of girls met all three recommendations, versus 7 percent of boys.
Similarly, the rate was 2 percent to 4 percent among black, Hispanic and Asian American students, versus just over 6 percent of white kids, the findings showed.
The report was published online recently in the journal JAMA Pediatrics.
Silver offered some advice for parents:
Instead of telling kids to “get off the phone,” steer them toward alternatives, like extracurricular activities, community programs or family time. “Their screen time will go down by default,” she noted.
Be a good role model. Get off your phone and demonstrate healthy habits, including spending time being physically active with your kids.
Talk to teenagers about the importance of healthy habits. “Ask them, ‘How do you feel when you don’t get enough sleep?’” Silver suggested. “Ask, ‘How do you feel when you don’t get outside in the sun and get some exercise?’” It’s important, she said, that kids notice how their bodies feel when they do or don’t engage in healthy habits.
Set some clear rules around screen time, such as no devices in the two hours before bedtime. “Make sure your kids realize these devices are a privilege, and not a necessity to living,” Silver said.
The good news, Knell said, is that since sleep, exercise and screen time are interrelated, changing one habit could affect the others, too.
“There are certainly small changes you can make that may have a big impact,” he said.
In people with buildup of amyloid brain protein, regular aerobic activity might slow degeneration in the brain region tied to memory. (Courtesy Spectrum Health Beat)
For people at risk of Alzheimer’s disease, working out a couple of times a week might at least slow the onset of the illness, new research suggests.
Regular exercise over a year slowed the degeneration of the part of the brain tied to memory among people who had a buildup of amyloid beta protein in their brain.
These protein “plaques” are a hallmark of Alzheimer’s, noted researchers at the University of Texas Southwestern Medical Center in Dallas.
Aerobic exercise didn’t stop plaques from spreading, but it might slow down the effects of amyloid on the brain, especially if started at an early stage, the research team suggested.
“What are you supposed to do if you have amyloid clumping together in the brain? Right now doctors can’t prescribe anything,” lead researcher Dr. Rong Zhang said in a university news release.
However, “if these findings can be replicated in a larger trial, then maybe one day doctors will be telling high-risk patients to start an exercise plan,” he said. “In fact, there’s no harm in doing so now.”
One expert who wasn’t involved in the study agreed with that advice.
“Exercise is an excellent way to both prevent Alzheimer’s and to help patients with Alzheimer’s disease stay stable for longer periods of time,” said Dr. Gayatri Devi, a neurologist specializing in memory disorders at Lenox Hill Hospital in New York City.
“Aerobic exercise, three to four times a week, has been shown to help grow brain cells in the part of the brain called the hippocampus, the key area for both laying down new memories and for retrieving old ones,” she explained.
In the new study, Zhang and colleagues randomly assigned 70 people aged 55 and older to either half-hour workouts of aerobic exercise four to five days a week, or less strenuous flexibility training.
All of the patients had some amyloid plaque buildup in their brains at the beginning of the study and were classed as having “mild cognitive impairment,” often a precursor to Alzheimer’s.
Followed over one year, people in both groups maintained similar mental abilities in memory and problem solving, the researchers noted.
However, those in the aerobic exercise group showed less shrinkage of the brain’s hippocampus as seen on scans.
The hippocampus is an area of the brain important to memory and one of the first areas usually affected by Alzheimer’s, Zhang’s group explained.
“It’s interesting that the brains of participants with amyloid responded more to the aerobic exercise than the others,” Zhang said. “Although the interventions didn’t stop the hippocampus from getting smaller, even slowing down the rate of atrophy through exercise could be an exciting revelation.”
To further test the effect of exercise, Zhang is heading up a five-year trial that includes more than 600 older adults, aged 60 to 85, who are at risk for Alzheimer’s.
“Understanding the molecular basis for Alzheimer’s disease is important,” Zhang said. “But the burning question in my field is, ‘Can we translate our growing knowledge of molecular biology into an effective treatment?’ We need to keep looking for answers.”
Dr. Jeremy Koppel is associate professor of psychiatry and molecular medicine at the Litwin-Zucker Center for Alzheimer’s Disease & Memory Disorders, at Feinstein Institutes for Medical Research in Manhasset, N.Y.
Reading over the new findings, he said that, on the whole, the study was “disappointing” because exercise “did not have any specific effect on tests of memory, mental flexibility or amyloid deposition in patients with mild cognitive impairment.”
While the finding regarding hippocampus size was interesting, “this was not the primary outcome measure of the study,” Koppel noted.
So, “it may be that aerobic exercise interventions are best targeted at those not suffering already from cognitive impairment,” he said.
The report was published recently in the Journal of Alzheimer’s Disease.
Early studies of an experimental contraceptive have shown it can safely reduce hormones that are key to sperm production. (Courtesy Spectrum Health Beat)
A male contraceptive pill, long a goal of men—and women—everywhere, may be one step closer to reality, U.S. researchers report.
They say their experimental pill appears to be safe while reducing levels of hormones key to sperm production.
“Our results suggest that this pill, which combines two hormonal activities in one, will decrease sperm production while preserving libido,” said study co-senior investigator Dr. Christina Wang. She’s professor of medicine at Los Angeles Biomed Research Institute at Harbor-UCLA Medical Center in Torrance, Calif.
But no one should hold their breath while waiting for the pill to reach the market: “Safe, reversible hormonal male contraception should be available in about 10 years,” Wang said in a news release from the Endocrine Society.
Her team presented the findings at the society’s annual meeting in New Orleans.
The study “shows promise for a future reversible male contraceptive,” agreed Dr. Tomer Singer, who directs reproductive endocrinology and infertility at Lenox Hill Hospital in New York City. He wasn’t involved in the new research and stressed that “more studies, including prospective randomized trials, are needed in order to confirm these initial findings.”
The new research involved 40 healthy men who received either a placebo or the experimental birth control pill, which is for now called 11-beta-MNTDC.
As Wang’s group explained, the pill is a modified form of testosterone that delivers the combined actions of both a male hormone and a female hormone (progesterone).
The men took the placebo or drug once a day for 28 days.
Among the men who took the birth control pill, average circulating testosterone levels dropped as low as that which occurs in a state of androgen (male hormone) deficiency.
However, the men did not experience any severe side effects, such as major loss of libido, as can occur in a typical state of androgen deficiency.
Any side effects that did occur were few and mild and included fatigue, acne or headache, Wang’s group reported.
Five of the men who took the birth control pill reported slight declines in their sex drive, while two reported mild erectile dysfunction. However, none of this affected their sexual activity, which did not decrease. None of the men stopped taking the drug because of side effects, and they all passed safety tests.
In men who took the birth control pill, levels of two hormones required for sperm production dropped greatly compared to those who took the placebo. And the drug’s effects were reversible after the men stopped taking the pill.
Wang stressed that the drug would take at least three 60- to 90-day regimens to begin to affect sperm production, so the 28 days of treatment in the study was too short to achieve maximum sperm suppression.
However, her team plans longer studies and—if they show that the drug is effective—the next phases will be larger studies.
Finally, the pill would be tested in sexually active couples, Wang said.
Singer agreed that longer trials are key to knowing if this pill will be successful.
“We know that in order to produce a healthy sperm—which has a life cycle for approximately 3 months—there has to be secretion of both FSH and LH, which are two hormones secreted by the pituitary gland,” he explained. Those two hormones “act on the testicular cells to produce sperm in one (type of cell) and secrete testosterone in the other,” Singer added.
However, “the main challenge is that suppressing the hormones—testosterone, LH and FSH—by taking hormonal treatment may result in a decease in libido, erection and ejaculation,” Singer said. This early, phase 1 clinical trial shows promise, he said, but only larger, longer trials will prove if 11-beta-MNTDC is both safe and effective.
Because the findings were presented at a media meeting, they should also be considered preliminary until published in a peer-reviewed journal.
Taking medication for high blood pressure or high cholesterol can reduce the odds of stroke. Researchers also suspect improvements in diet, exercise and lifestyle are contributing to better outcomes. (Courtesy Spectrum Health Beat)
Starting in the late 1980s, stroke rates among older Americans began to fall—and the decline shows no signs of stopping, a new study finds.
The researchers found that between 1987 and 2017, the rate of stroke incidence among Americans aged 65 and older dropped by one-third per decade.
The pattern has been steady, with no leveling off in recent years.
It’s not completely clear why, according to researcher Dr. Josef Coresh, a professor at Johns Hopkins School of Public Health, in Baltimore.
Over time, fewer older adults in the study were smokers, which is a major risk factor for stroke. On the other hand, some other risk factors—such as high blood pressure and Type 2 diabetes—became more common.
Of course, those conditions can be treated. And it’s known that for any one person, getting high blood pressure, high cholesterol and diabetes under control can cut the risk of stroke, Coresh said.
“However,” he added, “at the population level, we found that the decline (in strokes) was larger than what would be predicted from risk factor control alone.”
That suggests something else is going on, Coresh said.
The findings are based on data from a long-running heart health study that began in 1987. At the outset, it recruited almost 15,800 adults aged 45 to 64 from communities in four U.S. states.
A previous study found that the stroke rate among the participants fell between 1987 and 2011—a decline seen only among people aged 65 and older.
The new analysis, published online recently in JAMA Neurology, shows that the trend continued between 2011 and 2017.
Over 30 years, Coresh’s team found, there were 1,028 strokes among participants aged 65 and older. The incidence dropped by 32% over time.
In more recent years, many more older adults were on medication for high blood pressure or high cholesterol, versus the late 1980s. But risk factor control did not fully explain why the stroke rate dropped so much, according to Coresh.
He said that other factors not measured in the study—including exercise, salt intake and overall diet—might be involved.
Dr. Larry Goldstein, a spokesperson for the American Heart Association/American Stroke Association, made another point: The study could not account for exactly how well-controlled people’s blood pressure and other risk factors were.
That could go a long way toward explaining the decline in stroke incidence, according to Goldstein, who is also a professor of neurology at the University of Kentucky.
But while the latest findings are good news, there are also more sobering stroke statistics, Goldstein said. Although strokes are most common among people aged 65 and older, they strike younger adults, too, and the incidence of stroke among younger people has been inching up in recent years.
Plus, Goldstein said, the death rate from stroke—which had been declining—has recently “stalled” and is starting to reverse course.
“It might be because folks are now having more severe strokes,” Goldstein noted.
It’s critical, he added, that people be aware of the signs of stroke and get help quickly if they think they, or a family member, is having one.
Some of the warning signs include a drooping or numbness on one side of the face; arm weakness or numbness; slurred speech; sudden confusion or difficulty seeing or walking; or, as Goldstein described it, “the worst headache of your life.”
His advice: “Don’t delay getting help. Time saved is brain saved.”
Exercise is a great way to stay youthful and even turn back the clock on aging.
If you’re new to exercise or simply want a fitness reboot, here are ideas by the decade.
In your 20s
Experiment with different workouts to find what you enjoy. Make exercise a regular habit that you won’t want to give up, even when career and family make heavy demands on you.
In your 30s
Short on time? Try three 15-minute walks spread throughout the day. To stay fit and retain muscle, do cardio just about every day and strength training two or three times a week. If you’re new to exercise, take classes or have a personal trainer create a program for you.
In your 40s
Enhance your weekly routine by doing both low-intensity exercise, like yoga for stress relief and flexibility, and high-intensity workouts, like interval training or a spin or kettlebell class, to boost calorie burn and muscle elasticity. Expect longer recovery times after high-intensity workouts, so make sure to get enough sleep.
In your 50s
Regular exercise remains a must, but ask your doctor for modifications if you have any chronic conditions. Varying your workouts or taking up a new sport will engage your brain as well as different muscles. Get in at least one or two high-intensity workouts a week and try to take active vacations that include favorite pastimes like biking, hiking or even walking tours.
In your 60s and beyond
Stay fit and strong to stay independent longer, and stay socially engaged by taking group classes. Stick with strength training, but consider using machines rather than free weights for more control. Water workouts may be easier on joints, too, especially if you have arthritis. But always keep moving. Try tai chi for flexibility and balance, and go dancing for fun and fitness.
The electronic babysitter is alive and thriving in the new digital age.
A new study says it all: Children under the age of 2 spend twice the amount of time in front of a screen each day—almost three hours, to be exact—as they did 20 years ago.
Kids are being exposed to far more screen time than recommended by pediatric experts, the researchers added.
That screen was most often a TV set, with the television viewing of toddlers rising fivefold between 1997 and 2014, the study findings showed.
Children aged 3 to 5 actually spent less time on screens than younger kids, around two-and-a-half hours per day, with no significant change between 1997 and 2014, according to the report.
The American Academy of Pediatrics discourages all media use for kids younger than 2 and recommends limiting screen time for children aged 2 to 5 to just one hour a day of high-quality programming.
The researchers found it “surprising” that television still served as the screen of choice for young children, even four years after the debut of the iPad in 2010, said lead researcher Weiwei Chen, an assistant professor with the Florida International University College of Public Health and Social Work, in Miami.
Kids aged 2 and younger spent an average of 2.6 hours a day watching TV in 2014 and children 2 to 5 watched an average of 2.1 hours a day. On average, both groups spent a half-hour daily on mobile devices, Chen said.
“It’s possible they are using it in good ways, like for educational purposes,” Chen said. “But also remember that looking at this young age, it’s before they are attending school, so I would think these are not children that are using that for homework.”
For their study, the researchers used data from the Panel Study of Income Dynamics, the world’s longest-running household survey. The study has been tracking U.S. family trends since 1968.
The findings were published online recently in the journal JAMA Pediatrics.
TV might have become an easier option by 2014 because streaming services and on-demand programming had largely replaced video tapes and DVDs, said Pamela Rutledge, director of the Media Psychology Research Center.
“By 2014, there were many more choices in children’s television programming following in Sesame Street’s example and with lots of cable channels to fill,” Rutledge said.
“Some shows intentionally build in interactivity that reinforces learning, such as ‘Dora the Explorer’ and ‘Blue’s Clues.’ However, not all programming is suitable for children and not all children’s programming is truly educational,” she added.
It’s likely parents still are using the time-honored strategy of using TV as a babysitter, said Sarah Domoff, director of the Family Health Lab at Central Michigan University.
“Research my collaborators and I have conducted indicates that TV may be used to help manage children’s behaviors and allow parents to accomplish tasks at the home,” Domoff said. “Some households frequently leave TV on in the background throughout the day, which may also increase a child’s screen time.”
Domoff recommends limiting screen time for young children to educational content alone, with active parental involvement at all times.
“We know that having a TV in a child’s bedroom increases a child’s risk for sleep issues and obesity,” Domoff said. “Additionally, research has also indicated children hear fewer words from caregivers and have fewer conversations when TV or other electronic media is on, compared to when it is not on. Therefore, excessive screen time may interfere with important activities or routines essential for a child’s development.”
Chen also pointed out that it’s very likely that tablets and mobile devices have become more used among kids 5 and younger since 2014.
“In 2014, it was still a relatively early stage for those products. It’s understandable at that time, they weren’t as common as today,” Chen said. “Now you see we have many more tablets and devices and all kinds of things.”
