Monthly Archives: September 2024

Is It Better to Measure Exercise in Minutes or Steps? Research Finds Both Methods Equally Effective

In the modern era of smartwatches, keeping track of step counts has become increasingly accessible; however, the prevailing guidelines for physical activity do not specifically endorse particular step counts for health benefits. Recent research conducted by Brigham and Women’s Hospital, a foundational entity within Mass General Brigham, has indicated that both step counts and time-based exercise targets are comparably linked with a reduced risk of premature death and cardiovascular disease. Consequently, the choice between adopting a time-based or step-based goal might hinge more on individual preference than on distinct health advantages. These findings have been documented in JAMA Internal Medicine.

Physical activity is a proven deterrent against chronic diseases and infections and is a significant contributor to increased longevity. The current guidelines in the U.S., updated last in 2018, suggest that adults should engage in at least 150 minutes of moderate to vigorous physical activity per week, such as brisk walking, or 75 minutes of vigorous activity like jogging. Historically, much of the evidence for these recommendations was derived from studies relying on participants’ self-reported activity levels. At the time, limited data existed concerning the health impacts of specific step counts. Now, in an era where wearable technology is commonplace, step tracking has emerged as a popular feature on numerous fitness platforms. This shift prompted researchers to examine how goals based on time compare with those based on steps.

The study’s lead author, Rikuta Hamaya, MD, PhD, MS from the Division of Preventive Medicine at Brigham and Women’s Hospital, noted that while existing physical activity guidelines emphasise duration and intensity, they do not offer guidance on step counts. With a growing number of people utilising smartwatches for health monitoring, understanding how step-based measurements stack up against time-based goals in terms of health outcomes became a pivotal area of study.

Data for this research were gathered from 14,399 women participating in the Women’s Health Study, all of whom were free from cardiovascular disease and cancer at the outset. Between 2011 and 2015, these participants, who were aged 62 years and older, were instructed to wear research-grade wearable devices for seven consecutive days, removing them only for sleeping or water-based activities. Throughout the study, annual questionnaires were used to track health outcomes, particularly deaths from any cause and cardiovascular conditions, with follow-up continuing until the end of 2022.

Findings revealed that at the time they wore the devices, the women engaged in a median of 62 minutes of moderate-to-vigorous physical activity weekly and averaged 5,183 steps per day. Over a median follow-up period of nine years, about 9% of the participants died, and roughly 4% developed cardiovascular disease. Notably, higher activity levels, whether measured in steps or time spent in moderate-to-vigorous activity, were linked with significant reductions in the risks of death and cardiovascular disease. The most active women experienced risk reductions of 30-40% compared to those who were least active. Moreover, those in the top three activity quartiles lived an average of 2.22 to 2.36 months longer than those in the lowest quartile over the nine years, with this survival benefit persisting across different BMI categories.

Hamaya explained that both step and time measurements are valuable for assessing health status, but each has its advantages and limitations. For instance, while step counts are a straightforward metric, they might not entirely reflect differences in fitness levels; a 20-year-old and an 80-year-old might accrue different step counts from a 30-minute moderate-intensity walk. However, step tracking does capture incidental movements that are part of daily life, which are especially relevant for older adults.

“For some individuals, particularly the younger cohort, activities like tennis, soccer, walking, or jogging can be readily tracked with steps. For others, activities such as cycling or swimming might be easier to monitor by duration. Therefore, it’s essential for physical activity guidelines to offer varied avenues to achieve health goals. Movement differs for everyone, and almost all types of physical activity are beneficial,” Hamaya added.

The study authors acknowledge that this research is based on a single assessment of time and step-based physical activity metrics and predominantly includes white women of higher socioeconomic status. Being observational, it cannot establish causality. Looking forward, Hamaya plans to conduct a randomised controlled trial to delve deeper into the relationship between different exercise metrics and health outcomes.

More information: Rikuta Hamaya et al, Time- vs Step-Based Physical Activity Metrics for Health, JAMA Internal Medicine. DOI: 10.1001/jamainternmed.2024.0892

Journal information: JAMA Internal Medicine Provided by Brigham and Women’s Hospital

Engaging in Games, Puzzles, and Reading May Delay Cognitive Deterioration in the Elderly, Including Those with Mild Cognitive Impairment

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The process of ageing often leads to a reduction in cognitive abilities among older adults. Furthermore, statistics indicate that around 10 per cent of individuals diagnosed with mild cognitive impairment progress to Alzheimer’s disease or other types of dementia annually.

Despite limited research, some studies suggest that activities like assembling jigsaw puzzles may serve as a protective measure against cognitive ageing. This potential to delay or prevent cognitive decline through such activities offers a ray of hope, inspiring optimism in the face of cognitive challenges.

Recent research from Texas A&M University School of Public Health provides new insights into this area. The study reveals that elderly individuals with mild cognitive impairment who frequently participate in activities like word games and hobbies display enhanced capabilities in memory, working memory, attention, and processing speed compared to those less engaged in such activities.

Dr Junhyoung “Paul” Kim, an associate professor of health behaviour at Texas A&M, underscores the urgency of addressing cognitive decline. He notes, “Currently, nearly six million people in the United States have dementia, a number expected to surge to approximately 14 million by 2060, disproportionately impacting minority groups.” He adds that the study aims to bridge the knowledge gap regarding cognitive decline.

In their research, published in the Journal of Cognitive Enhancement, Dr. Kim and his team from the University of Southern Mississippi and Indiana University analysed data from 5,932 participants aged 50 and above with mild cognitive impairment. These participants were part of the Health and Retirement Study (HRS) from 2012 to 2020, which gathered information through self-reported surveys and detailed phone interviews. The team evaluated responses to seven questions about the frequency of involvement in cognitively stimulating activities like reading, gaming, and pursuing hobbies. They then categorised the levels of participation into low, mid, and high, based on criteria established in prior studies, and performed a repeated-measures multivariate analysis of covariance.

The findings indicated that those in the high-level participation group consistently demonstrated superior cognitive function throughout the study period and maintained levels of cognitive function comparable to other groups. Specifically, individuals in the high-level group exhibited better memory, working memory, attention, and processing speeds than those in the mid-and low-level groups. Meanwhile, participants in the mid-level group showed improved working memory and processing speeds compared to the low-level group.

The study also identified significant variances in all three cognitive functions across different years, with a declining trend, although the variances between 2014 and other years were not statistically significant.

Dr. Kim and his colleagues are optimistic that these findings will have a significant impact on healthcare recommendations. They hope that healthcare providers will be encouraged to recommend that older adults with mild cognitive impairment regularly engage in games, reading, and other stimulating activities at least three to four times a week, thereby reaping the practical benefits of the research.

Moreover, Dr. Kim hopes that barriers such as lack of caregiver support and financial limitations can be mitigated through enhanced public care services and community support networks, facilitating more significant participation in cognitively enriching activities among older adults.

More information: Jungjoo Lee et al, A Longitudinal Analysis of the Relationship Between Different Levels of Cognitively Stimulating Leisure Activity and Cognitive Function Among Older Adults with MCI, Journal of Cognitive Enhancement. DOI: 10.1007/s41465-024-00293-2

Journal information: Journal of Cognitive Enhancement Provided by Texas A&M University

Scientists Uncover Novel Route to Inducing Cancer Cell Death

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Chemotherapy has been known to kill cancer cells by damaging their DNA, leading to cell death. However, new research from the Netherlands Cancer Institute, led by Thijn Brummelkamp, has revealed a previously unknown way cancer cells die. The key to this discovery is the gene Schlafen11 (SLFN11). For almost a century, chemotherapy has been used to treat cancer patients, but this pathway to cell death has never been observed before. Brummelkamp notes that further investigation is required to understand where and when this mechanism occurs in patients, but it could have significant implications for cancer treatment.

Typically, cells with irreparable DNA damage trigger their death through a process regulated by the protein p53, a mechanism often taught in biology. p53 is responsible for repairing damaged DNA and, if the damage is too severe, initiating cell suicide to prevent tumour formation. However, this process isn’t always foolproof. Brummelkamp points out that more than half of tumours have dysfunctional p53, meaning the protein plays no role in those cancers. Yet, cancer cells without functioning p53 still die when exposed to chemotherapy or radiation, which puzzled researchers and led to this study.

Brummelkamp and his team and colleague Reuven Agami sought to uncover why cancer cells without p53 still die after DNA damage. In their laboratory experiments, they administered chemotherapy to genetically modified cells, searching for a genetic change that could allow the cells to survive. By selectively switching off genes, they discovered a new pathway to cell death involving the SLFN11 gene. This pathway bypasses p53 entirely, with SLFN11 shutting down the cells’ protein factories, causing significant stress and leading to cell death.

The SLFN11 gene has been studied before, particularly in chemotherapy resistance. In patients whose tumours do not respond to chemotherapy, SLFN11 is often inactive. Brummelkamp’s research now explains this link: without SLFN11, cells do not die after DNA damage, allowing cancer to persist. This discovery highlights a potential new target for cancer therapies to overcome chemotherapy resistance by activating or restoring SLFN11 function in cancer cells.

While this breakthrough is promising, many questions remain. The discovery was made using lab-grown cancer cells, and researchers now need to investigate how this pathway operates in actual patients. Key questions include where and when the SLFN11 pathway occurs in patients and whether it interacts with existing treatments like immunotherapy. If this new form of cell death proves to be significant in patients, it could change the way certain cancers are treated and potentially reduce the side effects of cancer therapy.

The discovery also underscores the importance of fundamental research in advancing cancer treatment. Brummelkamp’s team used haploid cells containing only one copy of each gene to deactivate genes and identify their functions precisely. This method has led to important discoveries in cancer research, including viral entry into cells and immune system regulation. By continuing to investigate the SLFN11 pathway and different mechanisms of cell death, researchers hope to develop more effective, personalised cancer treatments in the future.

More information: Nicolaas Boon et al, DNA damage induces p53-independent apoptosis through ribosome stalling, Science. DOI: 10.1126/science.adh7950

Journal information: Science Provided by Netherlands Cancer Institute

Rejuvenating the Elderly Brain: Researchers Revitalise the Brain’s Waste Removal Mechanism

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Alzheimer’s, Parkinson’s, and various other neurological conditions are often referred to as “dirty brain” diseases. These diseases are characterised by the brain’s diminishing capacity to eliminate harmful waste. This issue becomes more pronounced with age as the brain’s efficiency in removing toxic build-up decreases. However, recent studies in mice have shown promising results in reversing these age-related impairments and reinstating the brain’s waste-clearing capabilities.

Douglas Kelley, PhD, a professor of Mechanical Engineering at the University of Rochester Hajim School of Engineering and Applied Sciences, shared insights into this groundbreaking research. “Our findings indicate that by restoring the function of cervical lymph vessels, we can significantly improve the brain’s ability to expel waste accumulating with age,” Kelley explained. The research, which Dr Kelley co-authored and was published in the journal ‘Nature Aging’, also involved Maiken Nedergaard, MD, DMSc, co-director of the University’s Center for Translational Neuromedicine.

The study builds on the discovery of the glymphatic system, first identified by Nedergaard and her team in 2012. This unique waste removal system in the brain leverages cerebrospinal fluid (CSF) to flush out surplus proteins that cells in the brain produce during regular activity. These findings have opened new avenues for potentially treating diseases like Alzheimer’s and Parkinson’s, which are linked to the accumulation of specific protein wastes in the brain. In younger and healthier brains, the glymphatic system effectively eliminates these toxic proteins; however, its efficiency wanes with age, predisposing individuals to these neurological diseases.

The recent study also provided a detailed description of the pathway through the cervical lymph vessels in the neck, which facilitates the expulsion of half of the CSF-containing protein waste from the brain. The researchers employed advanced imaging and particle tracking techniques to map this route and observed the rhythmic pulsing of lymph vessels that aid in drawing CSF out of the brain. Unlike the cardiovascular system, which relies on the heart as a central pump, the lymphatic system uses a network of small lymphangions. These are equipped with valves to prevent backflow and are connected sequentially to form lymph vessels.

The study revealed that as mice age, the contraction frequency of these lymphangitis diminishes, and their valves are prone to failure. This considerably slows the rate at which waste-laden CSF is expelled from the brain—by as much as 63 per cent in older mice compared to their younger counterparts.

To tackle this slowdown, the researchers experimented with prostaglandin F2α, a hormone-like compound routinely used in medical settings to induce labour and known for enhancing smooth muscle contractions. When applied to the cervical lymph vessels in older mice, this drug significantly increased the frequency of lymphangion contractions and the flow rate of CSF, restoring it to levels observed in younger mice.

Kelley expressed optimism about the implications of these findings, “Given the accessibility of these vessels just beneath the skin and their proven significance, this research not only deepens our understanding but also showcases a viable method to boost their function.” He speculated that this strategy, possibly in combination with other interventions, could lay the groundwork for future treatments aimed at combatting these “dirty brain” diseases.

More information: Ting Du et al, Restoration of cervical lymphatic vessel function in aging rescues cerebrospinal fluid drainage, Nature Aging. DOI: 10.1038/s43587-024-00691-3

Journal information: Nature Aging Provided by University of Rochester Medical Center

Research Identifies Promising New Approach to Treating Persistent Lyme Disease Symptoms

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Researchers at Tulane University have made significant strides in developing a promising new strategy to address persistent neurological symptoms linked to Lyme disease. This groundbreaking study offers new hope for patients suffering from the long-term effects of bacterial infection, even after receiving standard antibiotic treatment. The research findings were recently published in the prestigious journal Frontiers in Immunology.

Lyme disease is caused by the bacterium Borrelia burgdorferi and is transmitted primarily through tick bites. This infection can manifest symptoms that predominantly affect the central and peripheral nervous systems. While the majority of patients respond well to antibiotics, effectively eradicating the infection, a subset continues to experience debilitating symptoms such as memory loss, fatigue, and chronic pain. These ongoing issues are often classified as post-treatment Lyme disease syndrome.

Dr Geetha Parthasarathy, a leading researcher and assistant professor of microbiology and immunology at the Tulane National Primate Research Center, has identified a potentially transformative treatment involving fibroblast growth factor receptor inhibitors. These inhibitors, previously researched primarily in the context of cancer, have shown promising results in reducing inflammation and preventing cell death in brain and nerve tissue samples infected with Borrelia burgdorferi. This discovery suggests that targeting the FGFR pathways could be a viable therapeutic approach to combat the persistent neuroinflammation experienced by patients with post-treatment Lyme disease syndrome.

Dr Parthasarathy elaborated on the significance of their findings, stating, “Our research opens up new pathways for scientific inquiry that could lead to effective support and relief for patients enduring the lasting impacts of Lyme disease. By focusing our efforts on the underlying inflammation that contributes to these chronic symptoms, we aim to develop targeted treatments that can significantly improve the quality of life for those affected by this challenging condition.”

In their experimental setup, the Tulane research team treated nerve tissue cultures with either live or inactivated Borrelia burgdorferi, followed by the administration of FGFR inhibitors. The results were compelling, showing a significant reduction in inflammatory markers and cell death, indicating the potential efficacy of FGFR inhibitors in treating Lyme disease-related neurological symptoms.

The implications of this research are profound, as they offer a new avenue for treatment and deepen our understanding of Lyme disease and its long-term effects on the body. Despite the promising results, further research is essential to translate these findings into practical clinical treatments. The study represents a crucial step forward in addressing the complex and often overlooked aftermath of Lyme disease, potentially paving the way for novel therapeutic strategies that could benefit thousands of patients suffering from its long-term consequences.

As the scientific community continues to explore and validate these findings, the hope is that future research will bring us closer to effective treatments that can alleviate the burdensome symptoms of post-treatment Lyme disease syndrome, ultimately improving patient outcomes and quality of life. This study highlights the innovative approaches at Tulane University and underscores the importance of continued research and investment in understanding and treating complex infectious diseases like Lyme disease.

More information: Geetha Parthasarathy et al, Fibroblast growth factor receptor inhibitors mitigate the neuropathogenicity of Borrelia burgdorferi or its remnants ex vivo, Frontiers in Immunology. DOI: 10.3389/fimmu.2024.1327416

Journal information: Frontiers in Immunology Provided by Tulane University

How Does the Time of Day You Exercise Impact Your Health?

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Researchers from the University of Sydney, Australia, have discovered that engaging in physical activity during the evening offers the most significant health benefits for individuals with obesity. This finding emerged from a long-term study tracking 30,000 participants over nearly eight years.

The study utilized data from wearable devices to segment physical activities into morning, afternoon, and evening categories. It revealed that participants who performed most of their moderate to vigorous aerobic exercises—activities that increase heart rate and induce breathlessness—between 6 p.m. and midnight exhibited the lowest risk of premature death and cardiovascular disease.

Interestingly, the study highlighted that the frequency of evening physical activity in sessions lasting at least three minutes was more crucial for health outcomes than the total daily amount of physical activity. This pattern of exercise, measured in short but intense bursts, was deemed particularly beneficial.

The research, published in Diabetes Care, was conducted by the Charles Perkins Centre at the University of Sydney. Dr Angelo Sabag, a lecturer in Exercise Physiology at the university, noted the broader context of obesity in Australia. Approximately two-thirds of the population is overweight or obese, significantly increasing the risk of significant health issues like heart attacks, strokes, and premature death. While exercise alone is not a solution to obesity, timing physical activity effectively can significantly mitigate health risks.

This study is significant due to its scale, the objective measurement of physical activity through wearable technology, and its focus on complex outcomes such as premature death. Dr Matthew Ahmadi, a joint first author and a postdoctoral research fellow at the National Heart Foundation, emphasized that the study did not solely focus on structured exercises but included any vigorous continuous activity sustained for three minutes or more. This could range from power walking to more vigorous tasks like climbing stairs or even active house cleaning.

The research methodology involved data from the UK Biobank, which encompassed 29,836 obese adults over 40, including 2,995 participants with Type 2 diabetes. Participants were grouped based on the most frequent times of aerobic exercise, tracked via a wrist accelerometer, and worn continuously for a week at the start of the study. The health outcomes of these participants were then monitored for almost eight years, during which 1,425 deaths and several cardiovascular and microvascular dysfunction events were recorded.

To ensure the reliability of their findings, the researchers adjusted for various factors, including age, sex, lifestyle habits, total physical activity, and pre-existing health conditions. Despite these precautions, the study’s observational nature means it cannot definitively establish causality, particularly concerning potential reverse causation where lower activity levels could be symptomatic of undiagnosed diseases.

Professor Emmanuel Stamatakis, the Mackenzie Wearables Research Hub Director at the Charles Perkins Centre, underscores the study’s importance. He points out that advancements in wearable technology are significantly enhancing our understanding of how specific activity patterns can influence health. These insights are vital for translating research findings into practical health advice and could impact future guidelines on managing obesity and Type 2 diabetes through targeted physical activity timing.

This study not only underscores the potential health benefits of timing physical activity but also showcases the evolving role of wearable technology in understanding and managing health conditions more effectively. Further research is needed to establish a causal relationship and integrate these findings into broader health care and preventative strategies.

More information: Angelo Sabag et al, Timing of Moderate to Vigorous Physical Activity, Mortality, Cardiovascular Disease, and Microvascular Disease in Adults With Obesity, Diabetes Care. DOI: 10.2337/dc23-2448

Journal information: Diabetes Care Provided by University of Sydney

Modest Adjustments to Diet Could Reduce Carbon Footprint by a Quarter

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A collaborative study between McGill University and the London School of Hygiene & Tropical Medicine has revealed that swapping some animal proteins for plant-based alternatives can extend life expectancy and lower greenhouse gas emissions. Published in Nature Food, this research utilized data from a Canadian national nutrition survey, analyzing dietary patterns to model the health, nutritional, and environmental impacts of replacing 25% to 50% of red and processed meats or dairy products with plant-based proteins such as nuts, seeds, legumes, tofu, and fortified soy beverages.

The findings underscore that minor dietary modifications can have significant ecological benefits. Specifically, replacing half of the red and processed meat consumption with plant-based proteins reduced an individual’s diet-related carbon footprint by 25%. In contrast, replacing dairy products resulted in smaller emission reductions, with a maximum decrease of up to 5%. Olivia Auclair, the study’s lead author and a recent PhD graduate from McGill’s Department of Animal Science, stated that achieving beneficial outcomes for both human and planetary health does not necessarily require drastic dietary changes but can be accomplished through simple partial substitutions.

The research also highlighted gender-specific health benefits of adopting more plant-based diets, traditionally associated with lower risks of heart disease, diabetes, and certain cancers. It is estimated that men could see a doubling in life expectancy gains compared to women if they replace half of their red and processed meat intake with plant proteins. However, replacing dairy with plant proteins showed only modest improvements in life expectancy and introduced a risk of increasing calcium inadequacy by up to 14%.

Senior author Sergio Burgos, Associate Professor at McGill’s Department of Animal Science and a researcher at the Research Institute of McGill University Health Centre, hopes the findings will help consumers make healthier and more sustainable food choices and inform future food policy in Canada. This study provides a practical roadmap for individuals seeking to improve their health and reduce their environmental impact without requiring major dietary overhauls.

Patricia Eustachio Colombo, co-author and Honorary Research Fellow at the London School of Hygiene & Tropical Medicine’s Centre on Climate Change & Planetary Health, emphasized that considerable benefits for health and the environment are achievable with relatively minor changes to the typical Canadian diet. Increasing the consumption of plant-based foods while reducing the intake of red and processed meats can lead to substantial health improvements and a notable reduction in carbon emissions.

As more people turn towards sustainable and health-conscious diets, this study serves as a valuable guide, empowering individuals to make informed choices that benefit both personal well-being and the planet. The implications of such dietary shifts are profound, offering a dual promise of enhanced health and a lighter ecological footprint.

More information: Olivia Auclair et al, Partial substitutions of animal with plant protein foods in Canadian diets have synergies and trade-offs among nutrition, health and climate outcomes, Nature Food. DOI: 10.1038/s43016-024-00925-y

Journal information: Nature Food Provided by McGill University

Does Consuming Red Meat Cause Inflammation?

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Inflammation serves as a critical risk factor for numerous chronic illnesses, including cardiovascular diseases, prompting considerable interest in the relationship between diet and inflammatory processes. Historically, guidelines advising reduced red meat intake have partially stemmed from earlier research indicating its potential to exacerbate inflammation. However, more contemporary studies have cast doubt on these findings.

Dr Alexis Wood, an associate professor of paediatrics – nutrition at the USDA/ARS Children’s Nutrition Research Center at Baylor College of Medicine and Texas Children’s Hospital, highlighted the inadequate exploration of the dietary impacts, including those of red meat, on inflammation and subsequent disease risks. According to Dr Wood, this research gap sometimes leads to public health guidelines lacking robust evidence. To address these concerns, Dr Wood and her team embarked on a detailed study leveraging metabolite profiles in the bloodstream, which offers a more direct gauge of the diet-health nexus.

The research involved analysing cross-sectional data from around 4,000 elderly participants of the Multi-Ethnic Study of Atherosclerosis (MESA), with findings recently documented in The American Journal of Clinical Nutrition. Cross-sectional studies provide valuable insights as they observe dietary effects in free-living individuals without altering their habits, making the findings more applicable to general settings. The study not only took into account the self-reported nutritional intakes of participants but also examined various biomarkers and a broad spectrum of dietary intake metabolites found in the blood. These plasma metabolites reflect the dietary impact post-digestion and absorption.

Interestingly, the results indicated no direct correlation between the consumption of both unprocessed and processed red meats (such as beef, pork, or lamb) and inflammation markers once adjustments were made for body mass index (BMI). This suggests that it is body weight, rather than red meat intake, that might influence systemic inflammation levels. Notably, no association was found between red meat consumption and C-reactive protein (CRP), a critical inflammatory marker linked to chronic disease.

Dr Wood’s findings underscore the significance of utilising plasma markers like metabolites to trace the links between diet and disease risk rather than relying solely on self-reported dietary data. The study concluded that there isn’t enough evidence from observational research to link red meat consumption with increased inflammation.

She pointed out that observational studies are not designed to prove causation, hence the necessity for randomised controlled trials (RCTs) where individuals are randomly assigned dietary variations to conclusively determine the impact of red meat on inflammation. Several RCTs have already shown that lean, unprocessed beef can fit within heart-healthy diet regimens.

Dr Wood advocates for further research before any definitive recommendations regarding reducing red meat consumption and inflammation. This ensures that such dietary advice is founded on current scientific evidence. She emphasised the cultural significance and widespread consumption of red meat, arguing that any recommendations to limit its intake should be solidly supported by scientific proof, which is currently lacking.

More information: Alexis C. Wood et al, Untargeted metabolomic analysis investigating links between unprocessed red meat intake and markers of inflammation, American Journal of Clinical Nutrition. DOI: 10.1016/j.ajcnut.2023.08.018

Journal information: American Journal of Clinical Nutrition Provided by Baylor College of Medicine

Boosting Legume Consumption While Cutting Down on Red Meat Safely Maintains Bone Health and Protein Levels

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A study at the University of Helsinki revealed that substituting red and processed meat with food products based on peas and faba beans ensures adequate amino acid intake and does not adversely affect bone metabolism.

Docent Suvi Itkonen from the Faculty of Agriculture and Forestry stated that reducing red and processed meat intake to the upper limit recommended by the Planetary Health Diet while increasing the consumption of locally grown legumes, such as peas and faba beans, does not compromise protein nutrition or bone health. The research, known as the BeanMan study, involved 102 Finnish men who followed a specified diet for six weeks.

In the study, one group of participants consumed 760 grams of red and processed meat weekly, making up 25% of their total protein intake, aligning with Finnish men’s average protein consumption. Another group had legume-based products, primarily peas and faba beans, which accounted for 20% of their protein intake. Additionally, this group’s red and processed meat consumption was limited to 200 grams per week, adhering to the upper limit set by the Planetary Health Diet and constituting 5% of the total protein intake. Participants were instructed to maintain their usual diet but refrained from consuming any other red or processed meats or legumes outside of those provided by the study.

The researchers observed no significant differences between the two dietary groups regarding bone formation or resorption markers. Both groups’ calcium and vitamin D intakes were consistent with current dietary guidelines, and their intake of essential amino acids and proteins met the recommended levels.

Itkonen also highlighted the environmental benefits of reducing red meat consumption. With plant-based diets gaining popularity and the recent updates to the Nordic Nutrition Recommendations, there is an emphasis on limiting meat and moderating dairy consumption. Itkonen noted that while the study participants continued consuming dairy products as part of their usual diet, maintaining adequate calcium and vitamin D levels is crucial for bone health, significantly if dairy intake is reduced. Alternatives include plant-based beverages and yoghurt-like products fortified with these nutrients or, if necessary, dietary supplements to compensate for the reduced dairy consumption.

More information: Suvi T. Itkonen et al, Effects of partial replacement of red and processed meat with non-soya legumes on bone and mineral metabolism and amino acid intakes in BeanMan randomised clinical trial, British Journal Of Nutrition. DOI: 10.1017/S0007114523001514

Journal information: British Journal Of Nutrition Provided by University of Helsinki

Elderly Demographics: Healthcare Funding Relies on Public Perception of Benefits and Risks

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Healthcare is essential for all individuals and becomes increasingly critical as people age due to heightened health risks and associated costs. Many nations have implemented universal healthcare systems, funded predominantly through taxes and insurance, to ensure everyone can access necessary health services. However, with an ageing population resulting from declining fertility rates and extended life expectancy, the financial strain on these systems has intensified significantly. This scenario poses a formidable challenge to governments: convincing citizens to increase their contributions towards health insurance to maintain system viability.

The pivotal study conducted by Associate Professor Tomoko Matsumoto and Junior Associate Professor Daiki Kishishita at the Tokyo University of Science, Japan, and published in the European Journal of Political Economy on 8 August 2024, holds significant implications for policymakers and governments. The study explores the potential of informing individuals about the personal future benefits they might reap from the healthcare system as a strategy for persuasion. The researchers were driven by the understanding that ageing-related health risks are universal, cutting across all socioeconomic groups. Despite this, there is a notable lack of public awareness about government fiscal policies related to healthcare and the personal advantages these policies provide. The team posited that enhancing individual knowledge about these personal benefits could bolster political support for higher healthcare contributions.

To investigate this, the researchers designed a two-period overlapping generations model. They hypothesized that increased awareness about future personal benefits could heighten public willingness to pay more towards health insurance. This hypothesis was tested against concerns about the fiscal sustainability of healthcare systems burdened by an ageing demographic. An online survey experiment was conducted with 4,367 participants in Japan, predominantly under the age of 75. Participants were randomly assigned to receive information about future personal benefits (Framing S) or current benefits to older adults (Framing N). Those in Framing S were further divided, with some receiving additional information about fiscal risks.

The results of the survey were revealing. In Framing S, where the focus was on future personal benefits, 81% of participants initially underestimated the benefits of the public healthcare system, indicating that their expectations might rise upon receiving accurate benefit information. However, overall, providing information about future benefits did not significantly sway participants towards supporting an increase in health insurance contributions. Notably, for those initially unaware of the fiscal challenges facing the system, learning about these challenges negated any initial increase in support caused by awareness of personal benefits.

In contrast, Framing N, which did not emphasize personal benefits, showed that merely informing participants about benefits without a personal focus had minimal impact on their willingness to support higher health insurance contributions. This was especially true for those aware of the system’s fiscal difficulties, where support decreased.

These findings have profound implications for policymakers and governments, especially in countries grappling with the challenges posed by an ageing population and strained public healthcare systems. The research suggests that for public support to increase for higher health insurance contributions, individuals must not only be informed about the future benefits they stand to gain but must also trust in the fiscal sustainability of the healthcare system. This trust could potentially be fostered through the implementation of robust fiscal consolidation policies aimed at stabilizing public finances. Drs. Matsumoto and Kishishita conclude that building confidence in the future benefits of the healthcare system, underpinned by sound fiscal policies, is crucial for securing broader public support for sustaining healthcare funding. This research provides a hopeful and optimistic guide for future policy decisions in the healthcare sector.

More information: Daiki Kishishita et al, Self-benefits, fiscal risk, and political support for the public healthcare system, European Journal of Political Economy. DOI: 10.1016/j.ejpoleco.2024.102597

Journal information: European Journal of Political Economy Provided by Tokyo University of Science

Reducing Processed Meat Consumption Yields Numerous Health Advantages

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According to new research, reducing processed meat consumption by approximately one-third could help prevent over 350,000 cases of diabetes in the US within a decade.

A research team’s findings suggest that reducing processed meat intake among US adults by 30%—equivalent to about ten slices of bacon weekly—could also significantly decrease cardiovascular disease and colorectal cancer cases.

This team, comprising experts from the University of Edinburgh’s Global Academy of Agriculture and Food Systems and the University of North Carolina at Chapel Hill, has devised a simulation tool to assess the health impacts of lowering the consumption of processed and unprocessed red meat.

Historically, numerous studies have established a correlation between high processed meat consumption and an increased risk of chronic diseases; however, few have assessed the impact across multiple health outcomes. Although some earlier studies have indicated that unprocessed red meat might contribute to the risk of chronic diseases, the evidence remains inconclusive.

Using data from the Centers for Disease Control and Prevention (CDC) national health survey, the researchers created a simulated, representative sample of the US adult population through a technique known as microsimulation.

This innovative microsimulation is the first to estimate the health effects of varying reductions in the consumption of processed and unprocessed red meat—ranging from 5 to 100%—on various health outcomes across the US.

The study quantified the potential reductions in adults’ risk of developing diabetes, cardiovascular disease, colorectal cancer, and even death from these conditions. The analysis was conducted on the overall population and examined separately by age, sex, household income, and ethnicity.

The research found that a 30% reduction in processed meat consumption could not only prevent over 350,000 diabetes cases but also reduce cardiovascular disease and colorectal cancer cases by 92,500 and 53,300, respectively, over ten years.

Particularly notable health benefits were observed among white males and individuals with annual household incomes ranging from $25,000 to $55,000.

The study also explored the effects of solely reducing unprocessed red meat intake and the combined reduction of both meat types.

A 30% decrease in processed and unprocessed red meat consumption could prevent an estimated 1,073,400 diabetes cases, 382,400 cardiovascular disease cases, and 84,400 colorectal cancer cases.

Reducing unprocessed red meat intake by 30%—equivalent to consuming one fewer quarter-pound beef burger per week—could reduce over 732,000 diabetes cases and decrease cardiovascular disease and colorectal cancer cases by 291,500 and 32,200, respectively.

The findings highlighted that more excellent disease prevention could be achieved by reducing unprocessed red meat intake rather than processed meat. This is likely because the average daily consumption of unprocessed red meat is higher than that of processed meat—47 g per day compared to 29g per day.

Given the relatively sparse data on the impact of unprocessed red meat on chronic disease risk, the researchers caution that these findings should be interpreted carefully and underscore the need for further research.

The study, published in The Lancet Planetary Health journal, received funding from The Wellcome Trust.

Professor Lindsay Jaacks, Personal Chair of Global Health and Nutrition at the University of Edinburgh and co-author of the study, emphasised that cutting meat consumption is recommended by national and international organisations, such as the Climate Change Committee in the UK and the United Nations Intergovernmental Panel on Climate Change (IPCC), to mitigate greenhouse gas emissions. She noted that the research supports the notion that dietary changes could confer substantial health benefits in the US, thus presenting a dual benefit for human health and the environment.

More information: Joe Kennedy et al, Estimated effects of reductions in processed meat consumption and unprocessed red meat consumption on occurrences of type 2 diabetes, cardiovascular disease, colorectal cancer, and mortality in the USA: a microsimulation study, The Lancet Planetary Health. DOI: 10.1016/S2542-5196(24)00118-9

Journal information: The Lancet Planetary Health Provided by University of Edinburgh

Depression Relief Through Walking, Jogging, Yoga, and Strength Training

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An evidence review published by The BMJ today suggests that walking, jogging, yoga, and strength training may be among the most effective exercises for alleviating depression, whether practised alone or combined with established treatments like psychotherapy and medication. Even lower-intensity activities such as walking or yoga have shown benefits, but the findings indicate that more vigorous exercise may yield more significant improvements in mood. The authors caution that confidence in results could be higher, necessitating further high-quality research. Nonetheless, they propose that these forms of exercise should be considered as core treatments for depression alongside other therapeutic interventions.

The World Health Organization estimates that over 300 million people worldwide suffer from depression, and exercise is often recommended in conjunction with psychotherapy and drugs. However, treatment guidelines and previous reviews of the evidence have not always been consistent in recommending the best way to prescribe exercise for depression. To resolve this uncertainty, researchers analysed databases, searching for randomised trials comparing exercise as a treatment for depression with established therapies such as SSRI antidepressants and cognitive behavioural therapy, active control groups like usual care, and untreated control groups.

The review identified 218 trials involving 14,170 participants, all assessed for bias. Information on the exercise interventions’ type, intensity, and frequency was recorded. At the same time, other potentially influential factors, such as sex, age, baseline levels of depression, and existing conditions, were considered. The results revealed significant reductions in depression for dance and moderate reductions for walking or jogging, yoga, strength training, mixed aerobic exercises, tai chi, and qigong, compared with active controls. Additionally, exercise combined with SSRIs or psychotherapy produced moderate, clinically meaningful benefits, suggesting an added advantage when exercise is used alongside these treatments.

Interestingly, walking and jogging were effective for both men and women. At the same time, strength training appeared more beneficial for women, and yoga or qigong was more effective for men. The analysis also showed that yoga benefited older adults, while strength training worked best for younger individuals. While lighter activities like walking and yoga provided clinically meaningful improvements, more vigorous exercises, such as running and interval training, produced more significant benefits. These effects were consistent across individuals with different health conditions and varying levels of depression.

Despite the positive findings, the authors note that the quality of the evidence remains low, and only a few trials monitored participants for periods longer than a year. They also acknowledge that many patients with depression may face barriers to participating in exercise, whether due to physical, psychological, or social factors. Nevertheless, the authors suggest that the combination of social interaction, mindfulness, and exposure to green spaces may play a role in the positive effects observed. They argue that their findings support the inclusion of exercise, particularly vigorous activity, in clinical guidelines for treating depression.

In a linked editorial, Juan Ángel Bellón from the University of Malaga highlights that primary care clinicians can now recommend exercise, psychotherapy, or antidepressants as standalone options for adults with mild to moderate depression. He acknowledges that engaging in regular exercise can be incredibly challenging for people with depression and calls for further studies using real-world data to evaluate the effectiveness of physical activity programmes for this population. Bellón also points out that the European Union has recently committed to promoting exercise across member states and urges health services, local authorities, and national governments to ensure that individualised and supervised exercise programmes are accessible to everyone.

More information: Michael Noetel et al, Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials, The BMJ. DOI: 10.1136/bmj-2023-075847

Journal information: The BMJ Provided by BMJ Group