Monthly Archives: August 2024

Scientists Create Enhanced Framework to Assess Fish Consumption Risks and Benefits

Researchers have developed a new model that could significantly enhance public health guidelines by providing more nuanced advice about fish consumption, particularly during pregnancy. The findings, detailed in a paper published in The American Journal of Epidemiology, were a collaborative effort by scientists from Brigham and Women’s Hospital—a founding member of Mass General Brigham—Harvard T.H. Chan School of Public Health, University of Rochester Medical Center, and Cornell University. The study introduces a novel framework that assesses the average mercury content in fish consumed, offering a balanced view of the harmful effects of mercury and the beneficial impacts of nutrients found in fish. This model was applied to a population in Massachusetts, where researchers observed that eating more fish with low mercury levels during pregnancy generally supported neurodevelopment while consuming fish with higher mercury levels proved detrimental.

Senior author Susan Korrick, MD, of Brigham’s Channing Division of Network Medicine and Division of Pulmonary and Critical Care Medicine, noted that public advisories about fish intake can be ambiguous, often leading to reduced consumption. Dr. Korrick, affiliated with the Harvard Chan-NIEHS Center for Environmental Health, highlighted fish consumption guidelines’ confusion. Lead author Sally Thurston, PhD, of the University of Rochester Medical Center, echoed these sentiments, emphasising the importance of considering the type of fish consumed rather than merely reducing fish intake. She pointed out that low mercury fish intake benefits neurodevelopment during pregnancy, whereas high mercury levels can be harmful.

The study also delves into the neurodevelopmental risks associated with Methylmercury (MeHg) exposure, contrasting them with the neurodevelopmental benefits of essential nutrients found in fish, such as polyunsaturated fatty acids, selenium, iodine, and vitamin D. Traditional studies often measure mercury exposure through hair samples, which does not allow for differentiation between the effects of mercury and the benefits of nutrient intake. By using a more sophisticated statistical approach and considering the estimated average mercury content in the fish consumed, the researchers aimed to overcome these limitations. Data for the study were gathered from the New Bedford Cohort (NBC), which has been tracking the neurodevelopment of children born to mothers living near the New Bedford Harbor Superfund site in Massachusetts. Alongside analysing hair samples, the researchers utilised survey data from food frequency questionnaires completed by the mothers shortly after childbirth.

The findings reveal that children whose mothers consumed more fish with lower levels of mercury exhibited better neurodevelopmental outcomes, including in areas such as IQ, language, memory, and attention. Conversely, higher mercury levels in fish consumed during pregnancy were linked to poorer neurodevelopmental outcomes. However, the authors acknowledged several limitations to their study, such as the imprecise estimates of mercury levels in fish and the dietary survey measures. Additionally, the study was confined to participants from the New Bedford area and focused solely on neurodevelopmental outcomes without considering variations in the nutrient content of the consumed fish.

Dr. Korrick expressed hope that this study would improve the estimation of the risks and benefits of fish consumption, which is crucial for informed dietary choices in many health-conscious diets. The team anticipates that future research will refine this model by incorporating both the average mercury content and the nutritional profile of fish, thereby enabling more accurate public health recommendations.

More information: Sally W Thurston et al, A Novel Approach to Assessing the Joint Effects of Mercury and Fish Consumption on Neurodevelopment in the New Bedford Cohort, American Journal of Epidemiology. DOI: 10.1093/aje/kwae149

Journal information: American Journal of Epidemiology Provided by Brigham and Women’s Hospital

Uncertain Impact of New Alzheimer’s Medications on Population Health, Researchers Indicate

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Researchers from Cambridge have raised concerns about the efficacy of new amyloid immunotherapy drugs in significantly reducing the impact of Alzheimer’s disease. Published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, the team from Cambridge Public Health highlights several significant hurdles that could curtail the benefits of these treatments. These include a questionable risk-benefit ratio, limited patient eligibility, and the substantial costs of widespread implementation. Alzheimer’s disease accounts for approximately 70% of the 55 million dementia cases globally, though its precise definition remains contentious. A hallmark of the disease is the accumulation of amyloid proteins, which form plaques in the brain. According to the cascade hypothesis, which is a leading theory, this accumulation triggers a series of events that culminate in dementia symptoms.

The development of treatments aimed at reducing these symptoms and slowing the disease’s progression has been sluggish. However, recent breakthroughs in amyloid immunotherapy involving using the immune system to clear amyloid plaques have generated significant interest. Results from two completed phase III randomised controlled trials showed that these drugs could reduce the rate of cognitive and functional decline. However, the reductions were statistically significant but clinically minimal. Despite these findings, the Cambridge researchers point out that the differences in decline between patients on the drug and those on placebo were minimal, making it difficult for physicians to discern any real advantage after 18 months. Moreover, the trials revealed severe side effects such as brain swelling and bleeding. In one study of the drug donanemab, three deaths were attributed to the treatment.

The long-term impacts of these drugs, beyond the duration of the trials, remain largely unknown. Long-term placebo-controlled trials would be challenging, particularly as some drugs have already been approved. The US Food and Drug Administration has approved two such drugs. At the same time, the European Medicines Agency has recommended against approving one (lecanemab) due to the marginal benefits not outweighing the risks. The UK’s Medicines and Healthcare Products Regulatory Agency is poised to decide on these drugs.

Edo Richard, a professor of neurology at Radboud University Medical Centre in the Netherlands and co-author of the study, expressed concern about the enthusiasm surrounding these drugs. He stressed the importance of providing balanced information to help patients make informed decisions, especially given the desperation many feel when facing early-stage Alzheimer’s. Media reports suggest these drugs are suitable for all Alzheimer’s patients; however, the trials only included participants with early symptomatic Alzheimer’s and excluded those with other contributing conditions. These trial participants represent a tiny fraction—less than 8%—of the early Alzheimer’s population typically seen in health services, who are usually a decade or more older.

Dr Sebastian Walsh, NIHR Doctoral Fellow in Public Health Medicine at Cambridge Public Health and lead author, noted that even if approved, the drugs would only be suitable for a small subset of Alzheimer’s patients. Potential users would need extensive assessments before gaining access, and the benefits observed in trials were minimal. Effective administration would require identifying and treating patients at the earliest stages of the disease when symptoms are mild, a process that can be difficult.

The logistical and resource challenges of deploying such treatments are formidable. Even if the drugs are approved for a limited number of patients, many more would need assessments to determine their eligibility. This requirement would place additional strain on already stretched health services. Professor Carol Brayne, Co-director of Cambridge Public Health, highlighted the difficulty of rolling out these treatments on a large scale, even in high-income countries, and pointed out that most dementia occurs in low- and middle-income countries, where resources are even scarcer.

She also mentioned the potential for a more significant impact from addressing inequalities and health experiences throughout life, noting that the complexity of dementia often extends beyond a single protein issue. The team concludes that the current evidence does not support the use of amyloid immunotherapy in significantly reducing the suffering caused by dementia at a community level. As such, ongoing research into alternative approaches remains critical. With the global population ageing, finding effective support mechanisms for those living with dementia is more urgent than ever. Still, the promise shown by amyloid immunotherapies for select groups is insufficient to tackle the broader risk of dementia.

More information: Sebastian Walsh et al, Considering challenges for the new Alzheimer’s drugs: Clinical, population, and health system perspectives, Alzheimer s & Dementia. DOI: 10.1002/alz.14108

Journal information: Alzheimer’s & Dementia Provided by University of Cambridge

Research indicates that hepatitis E could be transmitted sexually

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A new study conducted by researchers at Ohio State University has uncovered that the hepatitis E virus (HEV), found associated with sperm in pigs, might indicate that the virus could be transmitted sexually and may be linked to male infertility. HEV is primarily recognized as the leading cause of acute viral liver infections in humans globally, particularly prevalent in regions with poor sanitation. Interestingly, in the United States, the virus is endemic among pigs, residing primarily in organs rather than muscle tissue, and can be eliminated by cooking the meat thoroughly.

Given the associations between HEV and severe complications during pregnancy, as well as instances of male infertility in less developed areas, the research team explored the virus’s behaviour in pigs due to their reproductive anatomy’s resemblance to that of humans. After introducing HEV to pigs, the study observed that the virus circulated in the bloodstream and was excreted in faeces, suggesting that the pigs were infected but exhibited no clinical symptoms. This condition is often asymptomatic in humans as well. Crucially, the researchers discovered HEV on the heads of sperm cells, which could infect and replicate within human liver cells in laboratory settings.

Kush Yadav, the study’s lead author and a PhD student at Ohio State’s Center for Food Animal Health, highlighted the significance of their findings, stating, “This is the first study to demonstrate an association of the hepatitis E virus with sperm cells. Our future research will focus on understanding this relationship more deeply and determining through further animal model studies whether sexual transmission of the virus occurs, as its presence in human settings remains uncertain.” This groundbreaking research was recently published in the journal PLOS Pathogens, shedding light on a potentially new route of HEV transmission.

Sexually transmitted organisms, including HEV, can find a protective environment in the testicles, shielded by a blood-testis barrier that immune cells cannot breach. In addition to reproductive disorders, HEV is also suspected to cause pancreatic and neurological disorders in humans. Historically, HEV infections, even among pregnant individuals, were thought to be solely due to fecal-oral transmission routes.

The study also employed fluorescence microscopy to investigate pig semen 84 days after HEV inoculation, where Yadav detected viral particles on approximately 19% of the sperm cells collected from the infected pigs. He noted, “It’s unclear whether the viruses are on the outside or inside of the sperm cells or if hepatitis E can complete a replication cycle in the sperm head, so it appears sperm may be more of a carrier rather than a susceptible cell.” This discovery also showed a correlation between the presence of HEV and sperm damage, which could alter their structural integrity and decrease their motility, potentially leading to fertility issues.

Scott Kenney, an associate professor of veterinary preventive medicine and Yadav’s supervisor, emphasized the broader implications of their findings, suggesting that “Between 20 and 50% of male infertility cases remain unexplained. Hence, we are advocating for more extensive screening for the hepatitis E virus as a potential cause for these cases.” Additionally, the results of this study suggest that sexual partners of pregnant women who test positive for HEV should also be screened. However, the evidence for sexual transmission in humans has yet to be established conclusively.

Moreover, these findings have significant implications for the swine industry, where most pig litters are produced through artificial insemination, and donor sperm is distributed widely from extensive breeding facilities. Kenney remarked, “This could be part of the problem with HEV being endemic across the country and raises questions about whether it causes a reduction in the reproductive capacity of the pigs. While HEV doesn’t cause enough damage to pigs to limit production profitability, if we could implement some cost-effective screening or vaccination at these upstream boar facilities, maybe we could reduce the introduction of the virus into new herds.” This research opens new avenues for understanding HEV transmission and its broader impact on human and animal health.

More information: Kush K. Yadav et al, Infectious hepatitis E virus is associated with the mature sperm head, PLoS Pathogens. DOI: 10.1371/journal.ppat.1012240

Journal information: PLoS Pathogens Provided by Ohio State University

Regular Exercise of 2-3 Sessions Weekly Significantly Reduces Current Risk of Insomnia

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Regular engagement in exercise, occurring 2-3 times weekly over a decade, correlates with a decreased risk of current insomnia and enhances the likelihood of achieving the advisable 6-9 hours of sleep nightly, as detailed in a comprehensive 10-year international study published in the open access journal BMJ Open. This study reinforces the well-established link between regular physical activity and improved overall health, highlighting that exercise not only enhances sleep quality but could also alleviate symptoms of chronic insomnia. The analysis, however, noted that the impact of variables such as gender, age, body mass index (BMI), overall fitness levels, general health, and the type of exercise on this relationship remains somewhat ambiguous.

The researchers left no stone unturned in their quest to understand the relationship between exercise and sleep. They meticulously assessed weekly exercise frequency, duration, and intensity, along with symptoms of insomnia, actual sleep duration, and daytime sleepiness among middle-aged adults across 21 centres in nine European countries. Drawing participants from the European Community Respiratory Health Survey, the study included 4399 individuals (2085 men and 2254 women) who provided data on their physical activity habits at the start (ECRHS II; 1998-2002) and ten years later (ECRHS III; 2011-2014). They also provided information on insomnia symptoms using the Basic Nordic Sleep Questionnaire, sleep duration, and daytime sleepiness assessed by the Epworth Sleepiness Scale.

Among the participants, 37% remained inactive over the ten years, 18% became active, 20% became inactive, and 25% consistently engaged in physical activity. Notably, participants in Norway exhibited the highest rates of consistent activity, whereas those in Spain and Estonia showed the highest inactivity rates. Consistently active participants typically were younger men with slightly lower body weight who were less likely to smoke and more likely to be employed.

After adjusting for factors like age, gender, BMI, smoking status, and location, those consistently active were significantly less likely to experience difficulties in falling asleep by 42%, showed a 22% reduced risk of any insomnia symptoms, and had a 40% lower likelihood of reporting multiple insomnia symptoms. Moreover, other factors such as age, being female, and higher body weight were also independently linked to insomnia symptoms.

Regarding total nightly sleep hours and daytime sleepiness, after adjustments, those who were consistently active were more likely to maintain regular sleep patterns. In contrast, those persistently inactive were more likely to experience disrupted sleep. Specifically, consistently active individuals were 55% more likely to be normal sleepers and significantly less likely to experience extremely short (less than 6 hours) or long (more than 9 hours) sleep durations. Meanwhile, those who transitioned from inactive to active status showed a 21% improvement in achieving standard sleep patterns compared to those who remained inactive.

Despite some limitations, including the inability to objectively measure changes in physical activity levels between the two-time points and reliance on self-reported data, the study’s findings have practical implications for individuals struggling with insomnia. The researchers concluded that consistent physical activity has a beneficial effect on insomnia symptoms, underscoring the importance of maintaining exercise habits over time. This aligns with previous research that emphasizes the positive effects of physical activity on insomnia symptoms, providing individuals with actionable insights to improve their sleep quality.

More information: Erla Bjornsdottir et al, Association between physical activity over a 10-year period and current insomnia symptoms, sleep duration and daytime sleepiness: a European population-based study, BMJ Open. DOI: 10.1136/bmjopen-2022-067197

Journal information: BMJ Open Provided by BMJ Group

Consuming Entire Small Fish May Extend Lifespan, According to Japanese Research

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A study conducted by Dr. Chinatsu Kasahara alongside Associate Professor Takashi Tamura and Professor Kenji Wakai at the Nagoya University Graduate School of Medicine in Japan has uncovered compelling evidence that links the consumption of small fish, eaten whole, with a notable reduction in mortality from all causes and cancer, particularly in Japanese women. The research, published in Public Health Nutrition, explores the life-extending benefits of regularly consuming small fish such as whitebait, Atlantic capelin, Japanese smelt, and small dried sardines. These fish are typically eaten whole, including their heads, bones, and organs, providing a rich source of micronutrients like calcium and vitamin A.

Dr. Kasahara, the study’s lead researcher, mentioned that the protective effects of fish consumption on health and mortality risks are well-documented. Yet, few studies have focused explicitly on the impact of small fish consumption on health outcomes. Driven by a lifelong personal practice of eating small fish—a habit she now passes on to her children—Dr. Kasahara was mainly motivated to investigate this area further.

The study encompassed a large cohort of 80,802 Japanese individuals, comprising 34,555 men and 46,247 women aged between 35 and 69, from various regions across Japan. At the study’s outset, participants’ frequency of small fish consumption was meticulously gauged using a food frequency questionnaire. Over an average follow-up period of nine years, the researchers recorded 2,482 deaths, of which around 60% (1,495 deaths) were attributed to cancer.

Among the study’s key findings was the significant decrease in all-cause and cancer-related mortality observed among women who regularly consumed small fish. Women who ate small fish once to three times a month, one to two times a week, or three times or more per week experienced 0.68, 0.72, and 0.69 times the risk of all-cause mortality, respectively, and 0.72, 0.71, and 0.64 times the risk of cancer mortality compared to those who seldom ate small fish.

After adjusting for potential confounding factors such as age, smoking and alcohol habits, BMI, and other dietary nutrients and foods, it became clear that women who frequently consumed small fish had a lower likelihood of dying from any cause. These findings advocate for integrating small fish into daily diets as a straightforward yet potent strategy to enhance longevity in women.

Conversely, while a similar trend was observed in men, the results were not statistically significant. The researchers speculated that this could be due to a smaller sample size among men or other unmeasured factors, such as the portion sizes of small fish consumed. They also considered that differences in the types of cancer-causing mortality between the sexes might reflect a gender-specific association.

Despite these promising results being specific to the Japanese population, Dr. Kasahara believes these findings have broader implications. She expressed enthusiasm about the potential relevance of their findings to other nationalities. She highlighted the need for further research to explore the mechanisms underlying these associations and to validate these findings in different populations.

Furthermore, the study reiterates the importance of small fish as an affordable and nutrient-rich food source, particularly in developing countries where nutrient deficiencies are prevalent. Dr Kasahara emphasised the unique nutrients and physiologically active substances found in small fish that could be crucial in maintaining health, underscoring the inverse relationship between small fish intake and mortality risk in women.

Associate Professor Tamura noted that while eating small fish is generally limited to coastal or maritime nations like Japan, there is a growing suspicion that it could universally extend life expectancy. However, additional evidence is needed to fully understand the potential role of small fish intake in reducing mortality risk.

More information: Chinatsu Kasahara et al, Association between consumption of small fish and all-cause mortality among Japanese: the Japan Multi-Institutional Collaborative Cohort Study, Public Health Nutrition. DOI: 10.1017/S1368980024000831

Journal information: Public Health Nutrition Provided by Nagoya University

Research Indicates Fear of Falls and Related Injuries Troubles Constant Wheelchair and Motorized Scooter Users

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The research community has traditionally concentrated on studying falls among ambulatory individuals suffering from ailments like multiple sclerosis or Parkinson’s disease. However, the incidence of falls among those who utilise wheelchairs or motorised scooters has been relatively underexplored, according to a recent publication in the journal Disability and Rehabilitation. This new study highlights the vulnerabilities that full-time users of these mobility aids face, including frequent falls, associated injuries, and persistent fear of subsequent falls.

The U.S. Census Bureau reports that approximately 5.5 million Americans depend on wheelchairs or motorised scooters for mobility. These individuals, particularly those using these aids for 40 or more hours a week, often face physical barriers that impede their movement and pose significant risks of falls. This insight comes from the work of Laura A. Rice, a professor of health and kinesiology at the University of Illinois Urbana-Champaign. Rice, alongside University of Illinois graduate student Sahel Moein and Elizabeth W. Peterson, a clinical professor of occupational therapy at the University of Illinois Chicago, has led this groundbreaking study.

Peterson explains that the factors contributing to falls among wheelchair and scooter users are multifaceted, encompassing physical, behavioural, environmental, and psychological elements. For instance, manoeuvring over uneven terrain, transitioning between different surfaces, or reaching beyond one’s stable base can significantly increase the risk of a fall. The repercussions of these falls vary, ranging from minor abrasions and bruises to more severe injuries like fractures. For those with reduced sensation, even minor injuries can escalate into significant complications, adds Rice.

This team of researchers revisited data from an earlier investigation involving 156 full-time wheelchair or scooter users who had reported at least one fall within the past three years. Through an online survey, participants provided detailed information regarding their demographic profiles, as well as their mental health status, including levels of anxiety and depression. The survey further explored the history and extent of their wheelchair or scooter usage, their experience with fall-prevention training, and the frequency of falls within the last year. Notably, a significant majority of respondents, 96% in fact, reported experiencing at least one fall in the preceding year, with 74% sustaining injuries and over 94% living with the fear of falling again.

The findings of this study underscore the complexity of the issues at hand. While falls are commonly associated with the elderly in the general population, this study found that younger wheelchair and scooter users reported a higher incidence of injuries, suggesting that riskier behaviours might be more prevalent in younger demographics. Peterson notes that while the study does not establish causation, there is an evident correlation between fear of falling and reduced physical activity, which can lead to a decline in physical capabilities and increased vulnerability to falls— a cycle she describes as a ‘disuse disability cycle’.

In response to these challenges, the researchers advocate for specific interventions to reduce the risk of falls among wheelchair and scooter users. These interventions should include an assessment of fall risk and comprehensive safety training. The team is currently piloting a targeted intervention designed to address these needs. The intervention employs self-management strategies, such as problem-solving and resource utilisation, physical exercises, transfer techniques, and wheelchair-handling skills, delivered by occupational or physical therapists. Participants also learn to develop proactive plans to manage falls should they occur.

As the findings of this study gain broader recognition, the hope is that caregivers and healthcare providers will become more attuned to the risks of falls in this demographic. Rice criticises a common misconception among healthcare providers who believe that merely providing a wheelchair or scooter is sufficient to prevent falls. She stresses the necessity for comprehensive training in using these devices and strategies to manage the accompanying challenges, highlighting the need for a paradigm shift in how mobility aids are integrated into those who rely on them. This research not only sheds light on the overlooked aspects of wheelchair and scooter use but also sets the stage for more informed, effective interventions that can enhance the safety and quality of life for millions of users.

More information: Sahel Moein et al, Factors associated with fear of falling and fall-related injuries among people who use wheelchairs and motorized mobility scooters: a cross-sectional study, Disability and Rehabilitation. DOI: 10.1080/09638288.2024.2365984

Journal information: Disability and Rehabilitation Provided by University of Illinois at Urbana-Champaign, News Bureau

Pesco-Vegetarian Diets Linked to Lower Mortality Rates in the Elderly

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A variety of vegetarian diets offer protection against mortality risks and associated conditions, with the pesco-vegetarian diet, which includes fish, standing out as particularly beneficial for elderly individuals. This finding comes from a study conducted by researchers at Loma Linda University Health, which indicates that vegetarian diets are linked to a lower risk of all-cause mortality and numerous specific-cause mortalities, especially notable among men and those in middle age. However, they also observed a slight increase in risk among vegetarians over the age of 80 for neurological issues such as stroke, dementia, and Parkinson’s Disease, though the pesco-vegetarian diet continued to offer significant advantages in reducing mortality risks compared to other diets.

As the principal investigator of the Study and a distinguished professor at the School of Public Health at Loma Linda University, Gary Fraser, MBCHB, PhD, provided valuable insights into the protective effects of vegetarian diets. He noted that these diets are effective up to middle age, after which the overall benefits tend to diminish for strict vegetarians. Fraser also expressed concern over the mild increase in neurological conditions among elderly vegetarians, suggesting that this area requires further attention to maintain the benefits of vegetarianism into later life.

The study, titled ‘Cause-specific and all-cause mortalities in vegetarian compared to non-vegetarian participants from the Adventist Health Study-2 cohort,’ was published in the American Journal of Clinical Nutrition. It utilized data from the Adventist Health Study-2, a large cohort of nearly 96,000 Seventh-day Adventists living in the USA and Canada. The study analyzed data from more than 88,000 participants and approximately 12,500 deaths within the cohort, categorizing dietary patterns into five groups: non-vegetarian, semi-vegetarian, pesco-vegetarian, lacto-ovo-vegetarian, and vegan.

The current study analyzed data from more than 88,000 participants and approximately 12,500 deaths within the cohort. Dietary patterns were identified through questionnaires and categorized into five groups: non-vegetarian, semi-vegetarian, pesco-vegetarian, lacto-ovo-vegetarian, and vegan. Fraser and his team found that Adventist vegetarians overall had about a 12% lower risk of death compared to Adventist non-vegetarians.

Study participants following a pesco-vegetarian diet experienced an 18% lower risk of death, while those on a lacto-ovo-vegetarian diet, which includes dairy and eggs, saw a 15% reduction. Vegans had a less than 3% decreased risk of death, with male vegans, in particular, showing significantly better outcomes than their non-vegetarian counterparts, a contrast to the outcomes seen in female vegans.

Fraser concluded that the study provides clear evidence that American vegetarians are generally better protected from premature death than non-vegetarians, emphasizing the potential health benefits of incorporating vegetarian and particularly pesco-vegetarian diets into dietary practices, especially as individuals age.

More information: Grace P Abris et al, Cause-specific and all-cause mortalities in vegetarian compared with those in nonvegetarian participants from the Adventist Health Study-2 cohort, American Journal of Clinical Nutrition. DOI: 10.1016/j.ajcnut.2024.07.028

Journal information: American Journal of Clinical Nutrition Provided by Loma Linda University Adventist Health Sciences Center

Anxiety about Being Left Out: A Crucial Risk Factor for Mental Well-being and Burnout in the Workplace

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Fear of Missing Out (FoMO) poses a significant risk to employee mental health and can escalate burnout, especially when combined with the challenges of information overload, according to recent research. Conducted by the University of Nottingham’s Schools of Psychology and Medicine, the study analysed survey data from 142 employees to examine the negative aspects of digital work environments. The results, published in SAGE Open, reveal that employees burdened with the fear of missing out on crucial information and an overload of data are more susceptible to stress and burnout.

Elizabeth Marsh, a PhD student at the School of Psychology who led the quantitative analysis, emphasised the importance of digital workspaces as strategic organisational assets. These platforms enhance worker productivity and adaptability, particularly in hybrid working contexts. However, she highlighted the potential negative impacts on employee well-being, exacerbated by the surge in digital communication tools and channels following the COVID-19 pandemic.

This study builds on previous research that mindfulness in digital workplaces can protect employees from stress, anxiety, and information overload. FoMO is defined in this study as the anxiety associated with missing essential updates and information, as well as opportunities for interaction and relationship building. Although FoMO has traditionally been linked to social media, this research demonstrates its significant impact in professional settings.

Participants in the study reported on their experiences with the ‘dark side’ of digital workplaces, including stress, overload, anxiety, and FoMO, and how these factors affected their well-being. The findings indicated that issues specifically linked to information—the fear of missing out on it and feeling overwhelmed—were particularly harmful. These issues directly affected well-being and amplified the overall stress associated with digital work.

Elizabeth Marsh further discussed the challenges posed by the constant flow of information through emails, intranets, and collaborative tools, which can overwhelm employees and make them feel left out. She advocates for a comprehensive approach to managing this information glut, optimising information management, and enhancing information literacy to alleviate the feeling of being overwhelmed. The research suggests that employers should invest in strategies to control the volume and distribution of information, which could also inform HR policies and training programs to help employees manage and utilise information more effectively.

Dr Alexa Spence, a Psychology professor, emphasised the importance of considering digital workplaces in job design to boost productivity and employee well-being. Inadequate attention to this aspect can lead to increased stress, burnout, and deteriorating mental health. The study highlights the information ecosystem within organisations as a critical area for internal policy focus and broader research engagement, underscoring the need for a balanced approach to digital work environments.

More information: Elizabeth Marsh et al, Overloaded by Information or Worried About Missing Out on It: A Quantitative Study of Stress, Burnout, and Mental Health Implications in the Digital Workplace, SAGE Open. DOI: 10.1177/21582440241268830

Journal information: SAGE Open Provided by University of Nottingham

Cleveland Clinic Research Associates Sugar Substitute with Higher Heart Attack and Stroke Risk

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Researchers at the Cleveland Clinic have discovered that higher concentrations of the sugar alcohol Xylitol are linked to an increased risk of cardiovascular incidents such as heart attacks and strokes.

Stanley Hazen, M.D., Ph.D., spearheaded the research, which was corroborated through extensive patient analysis, animal research models, and a clinical intervention study. The results were published in the European Heart Journal today.

Xylitol is widely used as a sugar replacement in sugar-free confections, chewing gums, baked items, and dental products like toothpaste. Over the last ten years, there has been a notable rise in the use of sugar alternatives in processed foods marketed as healthy options, including sugar alcohols and artificial sweeteners.

The same team of researchers previously identified a similar correlation between erythritol and cardiovascular risk. Although Xylitol is not as commonly used as erythritol in keto and sugar-free products in the U.S., it is frequently found in other nations.

Dr. Hazen, who holds the position of Chair of Cardiovascular and Metabolic Sciences at Cleveland Clinic’s Lerner Research Institute and also serves as Co-Section Head of Preventive Cardiology at the Heart, Vascular & Thoracic Institute, emphasized the urgent need to investigate sugar alcohols and artificial sweeteners further. He noted that while these findings do not suggest discarding toothpaste containing Xylitol, they do indicate that high consumption of products containing Xylitol could raise the risk of events related to blood clots.

In their latest study, the researchers observed that elevated Xylitol levels in the bloodstream were associated with a higher risk of cardiovascular events over three years, based on data from over 3,000 patients across the U.S. and Europe. Individuals with the highest levels of Xylitol in their plasma were significantly more likely to suffer a cardiovascular event. The findings were validated through preclinical tests, which showed that Xylitol increased platelet clotting and the risk of thrombosis. Additionally, the study monitored platelet activity in individuals who consumed a Xylitol-sweetened beverage compared to those who drank a glucose-sweetened beverage, revealing a significant increase in clotting potential immediately after consuming the Xylitol but not the glucose.

More information: Marco Witkowski et al, Xylitol is prothrombotic and associated with cardiovascular risk, European Heart Journal. DOI: 10.1093/eurheartj/ehae244

Journal information: European Heart Journal Provided by Cleveland Clinic

Daily Routines May Not Provide Adequate Protection Against Stroke

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Research at the University of Gothenburg has demonstrated that routine activities carried out daily, whether at work or home, do not sufficiently guard against stroke. However, engaging in physical exercises during leisure and opting for active transportation methods can significantly lower stroke risk.

Adam Viktorsson, the study’s lead author and a researcher at the Sahlgrenska Academy at the University of Gothenburg, Sweden, emphasized the growing importance of physical activity outside work hours. He noted, “As many occupational and domestic tasks become more sedentary, incorporating physical activity into our leisure time and for commuting is crucial.”

The study followed 3,614 individuals from the Västra Götaland region over twenty years, during which 269 participants experienced a stroke. Three months post-stroke, 120 of these individuals either passed away or required assistance for daily activities.

Data on physical activity was collected through surveys, and some participants wore pedometers. The findings revealed a correlation between the leisure and transport-related physical activities recorded by the pedometers and reduced stroke risk. In contrast, work-related physical activities showed no protective effect.

Previous research has primarily focused on the health benefits of leisure physical activities. Still, recent studies suggest that physical exertion at work might have detrimental health effects, such as increasing cardiovascular disease risk.

Viktorisson highlighted the critical role of the context in which physical activity occurs, stating, “The timing and nature of physical activity are key in reaping health benefits. In our research, physical activity linked to leisure and transportation was beneficial, while activities during work hours or within the household offered no protection.”

He further explained that physically demanding jobs might be associated with stress, limited recovery opportunities, exposure to pollutants, and generally lower socioeconomic conditions, which could negate the health advantages of being active.

The study drew on data from the INTERGENE cohort at the University of Gothenburg, collected from 2001 to 2004, including clinical assessments and questionnaire responses. The researchers hope their findings will enhance awareness and influence public health policies to promote physical activity more broadly. Viktorisson advocates for a public health strategy that encourages everyday physical activities like walking, cycling, and other exercises to reduce stroke occurrences and improve outcomes for those affected.

More information: Adam Viktorisson et al, Domain-Specific Physical Activity and Stroke in Sweden, JAMA Network Open. DOI: 10.1001/jamanetworkopen.2024.13453

Journal information: JAMA Network Open Provided by University of Gothenburg

Liver Transplantation Surpasses Alternative Treatments for Metastatic Colorectal Cancer to the Liver

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Colorectal cancer frequently metastasizes to the liver, rendering surgical removal of liver tumours infeasible for some patients. A new study led by the Wilmot Cancer Institute and the University of Rochester Medical Center (URMC) has found that a select group of patients with metastatic colorectal cancer to the liver may benefit more from liver transplantation than from other standard therapies. Published in JAMA Surgery, the study highlights that patients who underwent liver transplants tended to enjoy more extended periods of cancer progression-free survival compared to those who opted for alternative treatments.

The significance of this study lies in its comparison of liver transplantation to other treatment options, which is the first in the field. Matthew Byrne, MD, a surgical resident at URMC and author of the study, emphasized the importance of comparing outcomes between patients who received the intervention and those who did not. He noted, “Without randomized, controlled trial data, this study offers the best evidence that is available to understand whether liver transplant provides better outcomes over other treatments.” The study was led by Roberto Hernandez-Alejandro, MD, chief of Abdominal Transplant and Liver Surgery at URMC, and it followed 33 patients whose colorectal cancer was under control but who had liver tumours that could not be surgically removed.

Of these patients, 20 chose to undergo liver transplantation, while the remaining 13 opted for classical therapies such as liver resection, chemotherapy, or liver-directed therapies. The results were striking: one year after transplantation, 90% of transplant patients showed no signs of cancer progression. This rate declined to 73% after two years and 36% after three years. In contrast, only 42% of patients undergoing conventional treatments were free of cancer progression after one year, with this figure falling to around 10% after two and three years.

The study also found that the liver transplant group had higher overall survival rates than the standard therapy group, though the difference was not statistically significant. Three years post-transplant, 90% of transplant patients were still alive, compared to 73% of those who received other treatments. Despite these encouraging findings, the research underscores the need for more extensive clinical trials to fully understand the benefits of liver transplantation over other therapies for these patients and to determine better which patients are most likely to benefit.

Hernandez-Alejandro pointed out the limitations of liver transplantation, noting that it is not suitable for every patient with advanced metastatic disease in the liver. The success of such treatments depends on stringent criteria based on tumour biology, the behaviour of the tumours, and how well they respond to chemotherapy. Only patients likely to have a good outcome are considered for transplantation. URMC has established itself as a leader in living-donor liver transplants, which are critical given the scarcity of livers from deceased donors. Of the 20 liver transplant patients in the study, 17 received liver tissue from living donors.

As of July 2024, URMC’s liver transplant program has conducted more living-donor liver transplants for patients with colorectal liver metastases than any other centre in North America, totalling 24. “Right now, URMC is the largest centre in the country and the second largest in the world, doing liver transplant for colorectal liver metastases,” Hernandez-Alejandro stated, emphasizing the institution’s pioneering role in the field and its efforts to expand the living-donor liver transplant program. This study contributes to the existing literature on the benefits of liver transplantation and sets the stage for future research and treatment protocols that could potentially save more lives.

More information: Matthew M. Byrne et al, Progression-Free Survival for Liver Transplant vs Alternative Therapy in Unresectable Colorectal Liver Metastasis, JAMA Surgery. DOI: 10.1001/jamasurg.2024.2057

Journal information: JAMA Surgery Provided by University of Rochester Medical Center

Early Sedentary Behavior Can Lead to Liver Damage in Young Adults

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A new study reveals that children who remain sedentary for over six waking hours daily are at a substantially higher risk of developing severe fatty liver disease and liver cirrhosis by the time they reach young adulthood. This groundbreaking research will be presented at the upcoming ENDO 2024, the annual meeting of the Endocrine Society, held in Boston, Massachusetts, and concurrently published in Nature’s npj Gut and Liver journal.

Professor Andrew Agbaje, M.D., M.P.H., PhD, the University of Eastern Finland lead investigator in Kuopio, stated, “We’ve discovered that the link between a sedentary lifestyle and liver damage is likely causal.” Prof. Agbaje, also affiliated with the University of Exeter in England, emphasized the need for public awareness about the health risks sedentariness poses to children, adolescents, and young adults. He highlighted the potential outcomes of advanced fatty liver disease and liver cirrhosis, such as increased risk of liver cancer or the necessity for a liver transplant in the future.

The condition known as metabolic-associated steatotic liver disease (MASLD), previously termed fatty liver disease, occurs due to non-alcoholic factors but is associated with elements of metabolic syndrome. Prof. Agbaje’s research leveraged data from the Avon Longitudinal Study of Parents and Children (ALSPAC) or the “Children of the ’90s” study, involving 2,684 participants who were tracked from ages 11 to 24. These participants wore waist accelerometers to monitor their physical activity levels and underwent liver ultrasound scans and blood tests to check for liver health at ages 17 and 24.

Findings from the study indicated that the average child spent six hours per day being sedentary, a figure which increased to nine hours by young adulthood. However, the same amount of time was spent in light-intensity physical activity during childhood, which helped mitigate the harmful effects of sedentariness. The research further found that for every additional half-hour of sedentary behaviour beyond six hours, the likelihood of developing fatty liver disease before age 25 increased by 15%. Conversely, each additional half-hour of light-intensity physical activity reduced the odds of severe fatty liver disease by 33%.

Prof. Agbaje noted that changes in the balance between passive and active time were critical for disease development. By age 24, 20% of the participants had MASLD, a significant increase from the 2.5% prevalence at age 17, an eightfold increase in just seven years. Interestingly, engaging in light-intensity physical activity for at least three hours daily could reverse premature liver damage, though it was less effective against liver cirrhosis.

Prof. Agbaje stressed that while moderate-to-vigorous physical activity is widely promoted, the often-overlooked light-intensity activity is most beneficial. Such activities include playing outdoors, walking the dog, and other gentle forms of exercise, which are crucial for maintaining liver health and preventing early-onset liver damage. This finding challenges the conventional emphasis on more intense physical activity and underscores the importance of integrating lighter, more frequent physical activities into the daily routines of young individuals.

More information: Andrew O. Agbaje et al, Accelerometer-based sedentary time and physical activity with MASLD and liver cirrhosis in 2684 British adolescents, Gut and Liver. DOI: 10.1038/s44355-024-00002-y

Journal information: Gut and Liver Provided by The Endocrine Society