Medical Articles

Category description for “Medical Articles”

Medical Articles

Category description for “Medical Articles”

The Crux of Low Back Pain

October 5, 2019Sparks Educational Videos Health Information Medical Articles 2480

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Type 2 diabetes and sugary drinks

October 5, 2019Sparks Health Information Medical Articles

Diabetes is a major cause of many complications such as stroke, heart attack, kidney failure, blindness, and lower limb amputation. At least 1.6 million people had died due to diabetes in 2016. Insulin resistance is a driving factor that leads to type 2 diabetes, which in itself can lead to a plethora of complications including cardiovascular disease, kidney damage, vision loss, and neuropathy.

Type 2 diabetes is a chronic condition that happens when the pancreas does not produce adequate amounts of insulin, or the body can’t effectively utilize the insulin it produces. Across the globe, there are an estimated 422 million people who have diabetes in 2014, up from 108 in 1980.

There are many factors that can contribute to the development of type 2 diabetes, and scientists are still uncovering more. Now, a team of researchers at the Harvard T.H. Chan School of Public Health has released a study suggesting that drinking more than two artificially sweetened or sugary soft drinks each day increases the risk of diabetes.

What are sugary drinks?

Sugary drinks, also called sugar-sweetened drinks or soft drinks, are beverages containing added sugar and other sweeteners, such as fruit juice concentrates, sucrose, and high fructose corn syrup. Included in the sugary drink category are cola, tonic, pop, soda, lemonade, and fruit punch, to name a few.

Collectively, these drinks are the single largest source of added sugar and calories in the U.S. diet. In other countries, the consumption of sugary drinks is increasing significantly due to widespread beverage marketing and urbanization.

Published in the journal Diabetes Care, the study aims to look for the long-term effects in the consumption of artificially-sweetened beverages (ASBs) and sugar-sweetened beverages (SSBs), and its connection with the risk of developing type 2 diabetes.

The team found that drinking more artificially-sweetened beverages, as an alternative to sugar-sweetened beverages, such as soda and fruit juices, increases the risk of type 2 diabetes, which is a chronic condition wherein the blood sugar level elevates.

Sugary drinks and type 2 diabetes link

The study revealed that those who increase their sugary beverage consumption may have a greater risk of having type 2 diabetes. There are two types of sugar drinks – sugar-sweetened beverages (SSBs) such as sodas and fruit juices, and artificially-sweetened beverages (ASBs), such as diet drinks.

The researchers discovered that those who drank more SSBs had a higher risk of type 2 diabetes. The increase in risk was even true for those who drank ASBs, often branded as diet drinks. The risk of diabetes reduced when one daily serving of the sugary drink was replaced with water, tea, or coffee.

For the study, the team recruited 192,000 adults who are participants in three long-term studies – the Health Professional’s Follow-up Study, Nurses’ Health Study, and the Nurses’ Health Study II.

They divided the participants into three groups, the first group had type 2 diabetes, the second group had an uncommon type of diabetes, also called latent autoimmune diabetes in adults (LADA), which is characterized to have the symptoms and hallmarks of both type 1 and type 2 diabetes. The last group had no diabetes and were healthy.

They also tracked the participants’ changes in sugary drink consumption for a long period through a food frequency tool answered every four years.

The team of researchers found that those who drank more than two sugary drinks each day were twice as likely to develop diabetes. However, they found that the link was weaker in those who have LADA. Specifically, they found that a high consumption of sweetened beverages by about 4 ounces each day for four years is tied to an 18-percent increase in the risk of diabetes.

Hence, replacing sugary drinks with water, tea, or coffee can help reduce the risk by 2 to 10 percent.

The study results are in line with current recommendations to replace sugary beverages with noncaloric beverages free of artificial sweeteners. Although fruit juices contain some nutrients, their consumption should be moderated.”

Frank Hu, Study Author & Professor of Nutrition and Epidemiology

How sweet are these drinks?

Sugary drinks typically contain 7 to 10 teaspoons full of sugar. To put this in perspective, a teaspoon of sugar is around 4.2 grams.

Aside from sodas, energy drinks also contain added sugars. These drinks contain as much sugar as sodas, but also contain caffeine that can increase the blood pressure. Some products even contain unknown ingredients whose long-term health effects have not yet been explored or identified.

The take-home message? Skip sugary drinks and drink more water.

Written by Angela Betsaida B. Laguipo, BSN

Journal reference:

Drouin-Chartier, J. P., et al. (2019). Changes in Consumption of Sugary Beverages and Artificially Sweetened Beverages and Subsequent Risk of Type 2 Diabetes: Results From Three Large Prospective U.S. Cohorts of Women and Men. Diabetes Care. DOI: 10.2337/dc19-0734

Taller people at lower risk for type 2 diabetes

September 12, 2019Sparks Health Information Medical Articles

A new German study has found that taller people are at a lower risk of developing type 2 diabetes. The study titled, “Associations of short stature and components of height with incidence of type 2 diabetes: mediating effects of cardiometabolic risk factors,” was published in the latest issue of the journal Diabetologia.

For this large study the team included participants who were part of the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study that recruited 27,548 participants with 16,644 women and 10,904 men between 1994 and 1998. The women were between ages 35 and 65 years and the men were aged between 40 and 65 years. A sub population was derived from the study population comprising of 2,500 individuals. Of these 2,029 were free of diabetes at the start of the study.

Over a seven years of follow up they found that there were 820 new cases of diabetes among the individuals. The researchers took into account not only the height of the patients but also their age, body weight, waist circumference, lifestyle habits and factors that may affect risk of type 2 diabetes. They looked at total body height as well as components of height such as sitting height and leg length as well in association with incidence of type 2 diabetes. The participants were provided with questionnaires every two to three years for assessment.

For the assessment the blood samples of the participants were assessed for “total cholesterol, HDL-cholesterol, triacylglycerols and CRP; erythrocyte levels of HbA1c; and activity of γ-glutamyl transferase (GGT)”. Fatty liver index (FLI) was measured using “BMI, waist circumference, GGT and triacylglycerols”, the team wrote.

The researchers have found that for each 10 cm increase in height of an individual, there was a 41 percent and 33 percent reduction in the risk of type 2 diabetes among men and women respectively. They also noted that leg length was associated with a lowered risk of type 2 diabetes among both men and women. When adjusted for total height however, the benefit of longer legs was only seen among men and was nullified among women.

Among overweight individuals, every additional 10 cm in height meant 36 percent and 30 percent reduction in risk of type 2 diabetes among men and women respectively, the researchers found. The team wrote, “This may indicate that a higher diabetes risk with larger waist circumference counteracts beneficial effects related to height, irrespective of whether larger waist circumference is due to growth or due to consuming too many calories.”

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According to the authors this is the first study that connects height of an individual with the risk of long term health conditions. A similar study few months back showed raised risk of cancers among tall persons. The experts have said that since the number of cells in tall persons is greater, they may be at a greater risk of cancers. What is baffling is the raised risk of type 2 diabetes among shorter individuals.

According to the researchers, raised liver fat content among persons who are shorter could be one of the reasons behind the raised diabetes risk. On the other hand those who are taller have a better “cardiometabolic profile” the team wrote. They added, “Our findings suggest that short people might present with higher cardiometabolic risk factor levels and have higher diabetes risk compared with tall people. Our study also suggests that early interventions to reduce height-related metabolic risk throughout life likely need to focus on determinants of growth in sensitive periods during pregnancy, early childhood, puberty and early adulthood, and should take potential sex-differences into account.”

They had taken into consideration the liver fat of the participants as well as “triacylglycerols, adiponectin and C-reactive protein”. When these features of liver fat and other parameters were considered, the benefit of height and risk of type 2 diabetes was found to be nullified said the researchers. This was especially true among women, the researchers wrote.

According to the researchers as a person achieves his or her full adult height, this parameters is unmodifiable. This means that in order to reduce the risk of heart disease and diabetes among shorter individuals, there should be appropriate monitoring and screening for diabetes. In addition liver fat seems to play an important role in raising the risk of diabetes among shorter individuals. Therapeutic measures as well as lifestyle factors that reduce the liver fat could be adopted for shorter individuals to lower their risk of type 2 diabetes, the authors wrote.

The authors concluded, “We observed inverse associations between height and risk of type 2 diabetes, which was largely related to leg length among men. The inverse associations may be partly driven by lower liver fat content and a more favourable cardiometabolic profile.”

Review:Dr. Ananya Mandal, MD

Image Credit: Montri Thipsorn / Shutterstock

Journal reference:

Wittenbecher, C., Kuxhaus, O., Boeing, H. et al. Diabetologia (2019). https://doi.org/10.1007/s00125-019-04978-8, https://link.springer.com/article/10.1007%2Fs00125-019-04978-8

Too much vitamin D may reduce bone density, say scientists

September 12, 2019Sparks Health Information Medical Articles 2

Vitamin D is essential for strong bones. This is universally agreed upon. We also know vitamin D is manufactured in our skin cells when exposed to as little as 10-15 minutes of the summer sun over most of the body surface.

However, for people in cold northern climes, this kind of sun is rare for six or more months of winter, leading to possible vitamin D deficiency. This means that they take supplements instead, to prevent bone weakening.

The recommended daily intake for vitamin D by Health Canada is 600 IU (International Units) up to the age of 70 years, after which it goes up to 800 IU. However, some experts disagree, suggesting that people with osteoporosis, a condition in which the bone becomes thinner, need anywhere from 400 to 2000 IU a day.

Health Canada recommendations are aimed at preventing bone disease due to vitamin D deficiency but do not provide the optimal dose. As a result, it’s unclear whether taking more of vitamin D contributes to better health, as many believe.

The current study (Examining the effects of excessive vitamin D supplementation on bone health) examined the question: Can you take too much vitamin D? And if so, how much is too much?

The study looked at the bone health of 300 volunteers aged 55-70 years for three years, with an average age of 62 years. The participants were randomly allocated one of three groups: those who got 400 IU vitamin D, those on 4000 IU and those on 10 000 IU.

The estimated addition of 200 IU on average through the diet brought up all three groups to the recommended dose or above. Calcium citrate at up to 600 mg elemental calcium was also given to achieve a daily intake of about 1200 mg calcium on average.

The study aimed to examine bone strength and density at higher doses of vitamin D to test if the health benefits increased with increasing doses of vitamin D.

At the beginning of the study, a new scan called high-resolution computed tomography was carried out to assess bone density and bone health at the wrist and ankle. This is called the XtremeCT and is available only in research laboratories. The advantage of using this is the detailed visualization of bone microarchitecture that it offers.

Another tool called dual X-ray absorptiometry (DXA) was also used to assess bone density at the initiation of the study, and then at 6, 12, 24 and 36 months. Yearly urine samples were also taken.

Bone mineral density (BMD) is calculated from the concentration of calcium and other minerals in a bit of bone. A higher BMD reduces fracture risk, however, BMD typically goes down with age.

Findings from the study

The study found a small decline in BMD over the three years using DXA scans. However, when XtremeCT was used, it proved to be much more sensitive, reflecting a significant bone loss in all three groups.

In the 400 IU, 4000 IU and 10 000 IU groups, the BMD went down by 1.4%, 2.6%, and 3.6% respectively, mainly at the radius, but also in the tibia at the highest dose. Bone strength was not significantly decreased in any group.

The increased sensitivity of XtremeCT compared to DXA held no surprises for the researchers, but the finding that higher doses of vitamin D were linked to the greatest bone loss was surprising. This could be due to increased bone resorption with suppressed secretion of parathyroid hormone (which is important for new bone formation).

Previous studies have shown that high doses of vitamin D did result in increased resorption of bone unless calcium was also supplemented. The active form of vitamin D called calcitriol increases the production of osteoclasts which enhance bone resorption.

The study also looked at whether high doses of vitamin D would cause any other adverse effects. The findings showed that the incidence of hypercalciuria (excessive levels of calcium in the urine) went up with higher doses, namely, 4000 IU and 10 000 IU daily. While 87 participants had hypercalciuria overall, the incidence was 17% in the first group, 22% in the second 22% and 31% in the third.

Hypercalciuria is relatively common in the population but increases the chances of kidney stones. In the study population, calcium intake in the diet was reduced in the 87 patients and this resulted in a reduction in urinary calcium on a second test.

The study concluded that taking vitamin D at doses above the recommended daily dose is really not useful in pushing up the bone density or increasing the bone strength. In fact, the bone density went down, as shown by the above figures, with the greatest loss seen in the group taking the highest dose.

Lessons from the study

“That amount of bone loss is not enough to risk a fracture over a three-year period, but our findings suggest that for healthy adults, vitamin D doses at levels recommended by Osteoporosis Canada (400-2,000 IU daily) are adequate for bone health.” Steve Boyd, Senior Author.
In researcher Emma Billington’s words, “Large doses of vitamin D don’t come with a benefit to the skeleton. For healthy adults, 400 IU daily is a reasonable dose. Doses of 4,000 IU or higher are not recommended for the majority of individuals.”

Source: Dr. Liji Thomas, MD

Picture: Leslie Samuel

Journal reference:

Effect of high-dose vitamin D supplementation on volumetric bone density and bone strength: a randomized clinical trial. Lauren A. Burt, Emma O. Billington, Marianne S. Rose, Duncan A. Raymond, David A. Hanley, & Steven K. Boyd. JAMA 2019;322(8):736-745. doi:10.1001/jama.2019.11889. https://jamanetwork.com/journals/jama/article-abstract/2748796

Sustained drop in cholesterol and blood pressure reduces lifetime risk of heart, circulatory diseases

September 12, 2019Sparks Health Information Medical Articles

Modest and sustained decreases in blood pressure and cholesterol levels reduces the lifetime risk of developing fatal heart and circulatory diseases, such as heart attack and stroke, according to research part-funded by the British Heart Foundation (BHF) and supported by the National Institute for Health Research (NIHR).

The findings are being presented at the European Society of Cardiology (ESC) Congress in Paris and published in the Journal of the American Medical Association (JAMA).

Researchers have found that a long-term reduction of 1 mmol/L low-density lipoprotein (LDL), or ‘bad’ cholesterol, in the blood with a 10 mmHg reduction in blood pressure led to an 80 per cent lower lifetime risk of developing heart and circulatory disease.

This combination also reduced the risk of death from these conditions by 67 per cent.

The team found that even small reductions can provide health benefits. A decrease of 0.3 mmol/L LDL cholesterol in the blood and 3 mmHg lower blood pressure was associated with a 50 per cent lower lifetime risk of heart and circulatory disease.

Scientists have previously found that lowering both blood pressure and the amount of ‘bad’ cholesterol in the blood are two ways which can prevent the onset of heart and circulatory disease. However, the risk, which accumulates over time, has not been quantified before.

In this study, Professor Brian Ference and his team studied 438,952 participants in the UK Biobank, who had a total of 24,980 major coronary events – defined as the first occurrence of non-fatal heart attack, ischaemic stroke or death due to coronary heart disease. They used an approach called Mendelian randomization, which uses naturally occurring genetic differences to randomly divide the participants into groups, mimicking the effects of running a clinical trial.

People with genes associated with lower blood pressure, lower LDL cholesterol and a combination of both were put into different groups, and compared against those without these genetic associations. Differences in blood LDL cholesterol and systolic blood pressure (the highest level that blood pressure reaches when the heart contracts), along with the number of cardiovascular events was compared between groups.

Professor Brian Ference now hopes that these findings can bring about change in the healthcare of people at greater risk of developing heart and circulation complications, and improved guidance for those requiring lifestyle changes.

Professor Brian A Ference, lead researcher of the study at University of Cambridge, said:

Heart and circulatory diseases steal the lives of 168,000 people each year in the UK, which is just greater than the population of the city of Cambridge. It’s vital we do everything possible to help prevent people developing these life-threating conditions.

Even small reductions in both ‘bad’ cholesterol and blood pressure for sustained periods of time can pay very big health dividends, and dramatically reduce the lifetime risk of developing heart and circulatory disease.

We now plan to take the results from this study to create a lifetime cardiovascular risk calculator and to support the development of new prevention guidelines.”

Professor Sir Nilesh Samani, Medical Director of the British Heart Foundation said:

“This research again demonstrates that high blood pressure and raised cholesterol are key risk factors for heart attacks and strokes. But how many of us know our numbers for these, or have made sustained efforts to lower them? Hopefully, the findings reported today that the risk could be reduced by as much as 80 per cent, can act as a motivator for long-term change.

Millions of people are living with untreated high blood pressure or raised cholesterol, both of which can be lowered with lifestyle changes and medication. Huge numbers of heart attacks and strokes can be prevented simply by getting to know your numbers and taking your health into your own hands.

Simple devices are now available for measuring blood pressure. Also, everyone between the ages of 40-74 is eligible for a free NHS health check, which assesses your risk of developing heart and circulatory diseases, and includes cholesterol and a blood pressure reading. It’s important that we all take advantage of this.”

Source: British Heart Foundation
Reviewer: James Ives, M.Psych. (Editor)

Key factors in reducing the risk of heart and circulatory diseases

September 7, 2019Sparks Health Information Medical Articles

Modest and sustained decreases in blood pressure and cholesterol levels reduce the lifetime risk of developing fatal heart and circulatory diseases, such as heart attack and stroke, according to research part-funded by the British Heart Foundation (BHF) and supported by the National Institute for Health Research (NIHR).

The findings are being presented at the European Society of Cardiology (ESC) Congress in Paris and published in the Journal of the American Medical Association (JAMA).

Researchers have found that a long-term reduction of 1 mmol/L low-density lipoprotein (LDL), or ‘bad’ cholesterol, in the blood with a 10 mmHg reduction in blood pressure led to an 80 percent lower lifetime risk of developing heart and circulatory disease.

This combination also reduced the risk of death from these conditions by 67 percent.

The team found that even small reductions can provide health benefits. A decrease of 0.3 mmol/L LDL cholesterol in the blood and 3 mmHg lower blood pressure was associated with a 50 percent lower lifetime risk of heart and circulatory disease.

Scientists have previously found that lowering both blood pressure and the amount of ‘bad’ cholesterol in the blood are two ways that can prevent the onset of heart and circulatory disease. However, the risk, which accumulates over time, has not been quantified before.

In this study, Professor Brian Ference and his team studied 438,952 participants in the UK Biobank, who had a total of 24,980 major coronary events – defined as the first occurrence of non-fatal heart attack, ischeamic stroke or death due to coronary heart disease. They used Mendelian randomization, which uses naturally occurring genetic differences to randomly divide the participants into groups, mimicking the effects of running a clinical trial.

People with genes associated with lower blood pressure, lower LDL cholesterol, and a combination of both were put into different groups and compared against those without these genetic associations. Differences in blood LDL cholesterol and systolic blood pressure (the highest level that blood pressure reaches when the heart contracts) and the number of cardiovascular events were compared between groups.

Professor Brian Ference now hopes that these findings can change the healthcare of people at greater risk of developing heart and circulation complications, and improve guidance for those requiring lifestyle changes.

Conclusively, limiting or avoiding meals that can increase the level of bad cholesterol is highly recommended. They include fried foods, red meat, baked foods, sausage, bacon, organ meats (liver, kidney), full-fat dairy products (whole milk, full-fat yoghurt, cheese)

Source:

British Heart Foundation

Reviewer:

James Ives

Popular pain medication associated with greater risk of hypoglycemia

August 29, 2019Sparks Educational Videos Medical Articles 113

Since its approval in 1995, the opioid tramadol (marketed as ConZip and Ultram) has become a widely prescribed remedy for osteoarthritis and other painful indications, in part because it presents a lesser risk for some side effects and has a lower abuse potential when compared to other opioids. It is currently ranked among the top five prescribed opioids and top 60 prescribed medications in the country.

But as tramadol has grown in popularity so too have documented cases of adverse effects among its users. In a new paper, published August 28, 2019 by Scientific Reports, researchers at Skaggs School of Pharmacy and Pharmaceutical Sciences at University of California San Diego show that patients who take tramadol are at greater risk for developing hypoglycemia, or abnormally low blood sugar.

The research team, led by senior author Ruben Abagyan, Ph.D., professor of pharmacy, analyzed more than 12 million reports from the FDA Adverse Effect Reporting System (FAERS) and Adverse Event Reporting System (AERS) databases, which chronicle voluntary reports of adverse effects while taking a medication. The period studied ranged from January 2004 to March 2019.

“The impetus was the recent dramatic surge in tramadol popularity and prescriptions,” said first author Tigran Makunts, PharmD, a researcher in Abagyan’s lab. “We wanted to have an objective data-driven look at its adverse effects and bumped into a dangerous, unlisted and unexpected hypoglycemia.”

Recognized adverse drug reactions associated with tramadol include dizziness, nausea, headaches and constipation—all common side effects of opioids. More serious but rarer adverse drug reactions include serotonin syndrome and increased seizure risk. The link to hypoglycemia is relatively new, though it had been previously suggested by case studies and animal model testing.

Hypoglycemia is often related to the treatment of diabetes, but can also occur in persons without diabetes. Untreated, hypoglycemia can lead to serious complications of its own, such as neurocognitive dysfunction, vision loss, greater risk of falls and loss of quality of life.

The researchers also looked at other widely prescribed opioids and similar acting, non-opioid medications, such serotonin and norepinephrine reuptake inhibitors (Cymbalta, Effexor XR) and NMDA receptors (ketamine and memantine). Only tramadol produced a significant risk of developing hypoglycemia in patients. In fact, there was a 10-fold greater risk of hypoglycemia using tramadol than virtually every other opioid. The only other drug identified with comparable effect was methadone, an opioid most commonly used to help persons reduce or quit addictions to heroin or other opiates.

While this study underscores an association between tramadol and hypoglycemia, a large, randomized, controlled clinical trial would be needed to definitively establish causality.

“The takeaway message is to warn physicians about the likelihood of low blood sugar (and/or high insulin content), in particular if the patient is predisposed to diabetes,” said Abagyan, “and to motivate research about the unique molecular mechanism leading to that side effect. It is particularly important for tramadol or methadone that are used widely and, often, chronically.”

More information: Scientific Reports (2019). www.nature.com/articles/s41598-019-48955-y

Journal information: Scientific Reports

Provided by University of California – San Diego

Secondhand effects of drinking

July 5, 2019Sparks Health Information Medical Articles

Each year, one in five U.S. adults — an estimated 53 million people — experience harm because of someone else’s drinking, according to new research in the Journal of Studies on Alcohol and Drugs.

Similar to how policymakers have addressed the effects of secondhand smoke over the last two decades, society needs to combat the secondhand effects of drinking, the authors state, calling alcohol’s harm to others “a significant public health issue.”

According to the study — an analysis of U.S. national survey data — some 21% of women and 23% of men, an estimated 53 million adults, experienced harm because of someone else’s drinking in the last 12 months. These harms could be threats or harassment, ruined property or vandalism, physical aggression, harms related to driving, or financial or family problems. The most common harm was threats or harassment, reported by 16% of survey respondents.

The specific types of harm experienced differed by gender. Women were more likely to report financial and family problems, whereas ruined property, vandalism, and physical aggression were more likely to be reported by men.

There is “considerable risk for women from heavy, often male, drinkers in the household and, for men, from drinkers outside their family,” the authors write.

Additional factors, including age and the person’s own drinking, were also important. People younger than age 25 had a higher risk of experiencing harm from someone else’s drinking. Further, almost half of men and women who themselves were heavy drinkers said they had been harmed by someone else’s drinking. Even people who drank but not heavily were at two to three times the risk of harassment, threats, and driving-related harm compared with abstainers. Heavy drinking was defined as drinking five or more drinks at a time for men or four or more drinks for women at least monthly.

To conduct the study, researchers led by Madhabika B. Nayak, Ph.D., of the Alcohol Research Group, a program of the Public Health Institute in Oakland, Calif., analyzed data from two telephone surveys conducted in 2015 — the National Alcohol’s Harm to Others Survey and the National Alcohol Survey. The current research, funded by the National Institute on Alcohol Abuse and Alcoholism, looked at data from 8,750 respondents age 18 and older and provides support for alcohol control policies, such as taxation and pricing to reduce alcohol’s harm to persons other than the drinker.

The freedom to drink alcohol must be counter-balanced by the freedom from being afflicted by others’ drinking in ways manifested by homicide, alcohol-related sexual assault, car crashes, domestic abuse, lost household wages, and child neglect.”

Timothy Naimi, M.D., M.P.H., of the Boston Medical Center

Naimi advocates for increased taxes on alcoholic beverages, noting that there is strong evidence that increased alcohol taxes decrease excessive drinking and reduce the harms to people other than the drinker.

In a second commentary, Sven Andréasson, M.D., of the Karolinska Institutet of Stockholm, Sweden, writes, in a similar vein, that setting minimum prices for alcohol is important for reducing the harms caused by drinking.

“There is now a growing literature on the effects of national alcohol policies to reduce not only consumption but also some of the secondhand harms from alcohol, notably the effects of price policies on all forms of violence — assaults, sexual violence, partner violence, and violence toward children,” Andréasson writes. “Recent research on the effects of minimum pricing is particularly relevant in this context, where studies in Canada find reductions in violence after the introduction of minimum pricing.”

Nayak agrees. “Control policies, such as alcohol pricing, taxation, reduced availability, and restricting advertising, may be the most effective ways to reduce not only alcohol consumption but also alcohol’s harm to persons other than the drinker,” she says.

Source:

Journal of Studies on Alcohol and Drugs

Journal reference:

Nayak, M.B. et al. (2019) Alcohol’s Secondhand Harms in the United States: New Data on Prevalence and Risk Factors. Journal of Studies on Alcohol and Drugs. doi.org/10.15288/jsad.2019.80.273.

Reviewer:

James Ives, M.Psych. (Editor)Jul 1 2019

Exercise performed in the morning and evening may have different effects

July 5, 2019Sparks Health Information Medical Articles 23

Researchers from the University of Copenhagen have learned that the effect of exercise may differ depending on the time of day it is performed. In mice they demonstrate that exercise in the morning results in an increased metabolic response in skeletal muscle, while exercise later in the day increases energy expenditure for an extended period of time.

We probably all know how important a healthy circadian rhythm is. Too little sleep can have severe health consequences. But researchers are still making new discoveries confirming that the body’s circadian clock affects our health.

Now, researchers from University of Copenhagen – in collaboration with researchers from University of California, Irvine – have learned that the effect of exercise may differ depending on the time of day it is performed. Studies in mice reveal that the effect of exercise performed in the beginning of the mouse’ dark/active phase, corresponding to our morning, differs from the effect of exercise performed in the beginning of the light/resting phase, corresponding to our evening.

There appears to be rather significant differences between the effect of exercise performed in the morning and evening, and these differences are probably controlled by the body’s circadian clock. Morning exercise initiates gene programs in the muscle cells, making them more effective and better capable of metabolizing sugar and fat. Evening exercise, on the other hand, increases whole body energy expenditure for an extended period of time.”

Associate Professor Jonas Thue Treebak from the Novo Nordisk Foundation Center for Basic Metabolic Research

Morning exercise is not necessarily better than evening exercise

The researchers have measured a number of effects in the muscle cells, including the transcriptional response and effects on the metabolites. The results show that responses are far stronger in both areas following exercise in the morning and that this is likely to be controlled by a central mechanism involving the protein HIF1-alfa, which directly regulates the body’s circadian clock.

Morning exercise appears to increase the ability of muscle cells to metabolize sugar and fat, and this type of effect interests the researchers in relation to people with severe overweight and type 2 diabetes.

On the other hand, the results also show that exercise in the evening increases energy expenditure in the hours after exercise. Therefore, the researchers cannot necessarily conclude that exercise in the morning is better than exercise in the evening, Jonas Thue Treebak stresses.

‘On this basis we cannot say for certain which is best, exercise in the morning or exercise in the evening. At this point, we can only conclude that the effects of the two appear to differ, and we certainly have to do more work to determine the potential mechanisms for the beneficial effects of exercise training performed at these two time-points. We are eager to extend these studies to humans to identify if timed exercise can be used as a treatment strategy for people with metabolic diseases’, he explains.

Source:

University of Copenhagen The Faculty of Health and Medical Sciences

Journal reference:

Sato, S. et al. (2019) Time of Exercise Specifies the Impact on Muscle Metabolic Pathways and Systemic Energy Homeostasis. Cell Metabolism. doi.org/10.1016/j.cmet.2019.03.013.

Reviewer:

Alina Shrourou, B.Sc. (Editor)Jun 13 2019

Researchers identify molecular pathway underpinning exercise and improved motor learning

July 5, 2019Sparks Health Information Medical Articles 14

Led by Li Zhang, an associate professor in Jinan University at Guangzhou, China, the researchers zoned in on the mechanistic target of rapamycin (mTOR) pathway in mice. Previous research by other scientists had identified the molecular system as a potential key to understanding how exercise helps improve learning but hadn’t pinpointed the exact function.

The mTOR pathway is already known to be involved in learning and memory process. There are also reports indicating mTOR activation inside the brain after exercise training. However, our study, for the first time, provides direct in vivo evidence that exercise-activated mTOR is necessary for enhanced spinogenesis and neural plasticity.”

Li Zhang, associate professor in Jinan University, member of the Guangzhou Regenerative Medicine and Health Guangdong Laboratory.

Neurons have a hand-like protrusion on one end of their long body. The hand stretches, the fingers spread, waiting for incoming signals from other cells. The fingers are called dendrites, which can grow wispy spines–spinogenesis. The spines are memory incarnate; they store memory of a specific incoming signal that requires a quick reaction. It’s similar to how a body develops antibodies to quickly defeat pathogens that it has already encountered.

Zhang and the researchers exercised mice on treadmills for an hour a day for three weeks and compared their brains to mice who sat on a still treadmill for the same amount of time. The mice who exercised had significantly more evidence of spinogenesis and stronger neural connections in the motor cortex. mTOR appears to be a critical factor in growing the spines and in keeping the brain able to make new connections and continue to grow, according to Zhang.

“Our results identify one critical intracellular pathway for the exercise mediation of cognitive functions and address the long-standing question for the role of mTOR underlying structural and functional adaptations of neural networks in response to the exercise,” Zhang said. “We believe that the comprehensive understanding of mTOR pathway in exercised brain can provide us with objective targets and biomarkers for evaluating exercise efficiency.”

The team’s ultimate goal is to apply this information to benefit the clinical intervention of cognitive deficits in humans using exercise training.

Source:

Guangdong-Hongkong-Macau Institute of CNS Regeneration,Jinan University

Journal reference:

Chen, K. et al. (2019) Exercise training improves motor skill learning via selective activation of mTOR. Science Advances. doi.org/10.1126/sciadv.aaw1888.

Reviewer:

Alina Shrourou, B.Sc. (Editor)Jul 4 2019