Author Archives: support

How Deep Sleep Benefits Memory Retention

For nearly two decades, it has been understood that slow, synchronous electrical waves in the brain during deep sleep facilitate memory formation. The precise reasons for this phenomenon had remained elusive until a recent study by researchers from Charité – Universitätsmedizin Berlin, published in Nature Communications, proposed a compelling explanation. They suggest that these slow waves enhance the receptivity of the neocortex—the region responsible for storing long-term memories—making it particularly amenable to retaining information. This insight holds significant potential for refining treatments designed to augment memory formation externally.

Memory consolidation is believed to occur during sleep through replaying daily events. This process transfers information from short-term storage in the hippocampus to long-term storage in the neocortex. Central to this process is the “slow waves,” or slow, synchronous oscillations of electrical voltage in the cortex, evident during the deep sleep phase. These can be detected through electroencephalogram (EEG) testing, where the electrical voltage across numerous neurons rises and falls in unison about once per second.

Prof. Jörg Geiger, director of the Institute of Neurophysiology at Charité and study leader, notes that these voltage fluctuations have long been recognized as instrumental in memory development. Enhancing slow-wave sleep externally has been shown to improve memory. Still, the internal mechanics—how the brain’s information flows during this phase—have been challenging to pinpoint due to the complexities of studying human brain activity directly.

The recent breakthroughs in this area have come from the analysis of intact human brain tissue, a rarity in neurological research. The study team examined neocortical tissue samples from 45 patients who underwent neurosurgery for epilepsy or brain tumours at various medical centres. By simulating the typical voltage fluctuations of slow brain waves during deep sleep on these tissues and measuring neuronal responses with precision, using glass micropipettes and the multipatch technique—a method involving multiple “pipette feelers” to monitor inter-neuronal communication—they were able to observe how slow waves affect synaptic strength and neuron receptivity in the neocortex.

The researchers discovered that synaptic connections between neurons in the neocortex are maximally strengthened at a precise moment during voltage fluctuations. Franz Xaver Mittermaier, a researcher at the Institute of Neurophysiology at Charité and the study’s primary author, explained that synapses are most efficient immediately after the voltage spikes from low to high. This brief period is when the cortex appears to be in an enhanced state of readiness. If the brain replays a memory at this exact moment, it is particularly effectively transferred to long-term memory. Thus, slow-wave sleep not only facilitates memory formation but does so by making the neocortex uniquely receptive during these fleeting intervals.

This newfound understanding has profound implications for improving memory, particularly in conditions like mild cognitive impairment among older adults. Researchers globally are exploring how to employ transcranial electrostimulation or acoustic signals to modulate slow waves during sleep. Although these stimulation techniques have traditionally been developed through trial and error, insights from this study about optimal timing could revolutionize these approaches, enabling the targeted development of memory enhancement methods. Prof. Geiger highlighted that these findings pave the way for more efficient, evidence-based strategies in memory treatment, potentially transforming therapeutic practices and improving cognitive health outcomes.

More information: Franz X. Mittermaier et al, Membrane potential states gate synaptic consolidation in human neocortical tissue, Nature Communications. DOI: 10.1038/s41467-024-53901-2

Journal information: Nature Communications Provided by Charité – Universitätsmedizin Berlin

Your Diet’s Impact Reaches Beyond Generations: Research Connects Unhealthy Eating to Multi-Generational Health Concerns

The old saying goes, “You are what you eat,” but recent findings from Tulane University suggest that deficiencies in one’s diet might affect not only one but also future generations’ health.

Emerging research has long supported the notion that famines affecting one generation can have detrimental genetic repercussions for the following one. However, the depth of these effects across multiple generations has remained a question, particularly under conditions of nutritional adversity.

A pivotal study conducted by Tulane University and published in the journal Heliyon provides new insights. The research involved pairs of mice subjected to a low-protein diet, and the findings were concerning: over the next four generations, the offspring exhibited significantly reduced birth weights and smaller kidneys—leading indicators for chronic kidney disease and hypertension.

The study highlighted a persistent issue: Even when dietary interventions were made in the offspring, there was no positive alteration in outcomes. Subsequent generations continued to display low nephron counts—a crucial component of the kidneys responsible for filtering waste from the blood. While more research is needed to confirm if these findings apply to humans, they highlight the enduring impact that food insecurity and malnutrition could have on health outcomes spanning decades.

The lead researcher, Giovane Tortelote, an assistant professor of paediatric nephrology at Tulane University School of Medicine, likened the situation to an avalanche. He noted that despite dietary corrections in the first generation, the following generations—up to the great-great-grandchildren—might still suffer from lower birth weights and reduced nephron counts, even if they never experienced direct starvation or protein-deficient diets.
Interestingly, the study also showed that these transgenerational effects occurred regardless of whether the mother or the father had a deficient diet, underscoring the role of maternal and paternal nutrition in fetal development. This introduces a novel aspect to epigenetics, which examines how environmental factors influence gene expression without altering the DNA sequence.

Further observations from the research indicated that by the third and fourth generations, nephron counts in offspring began to approach normal levels, although it remains unclear which generation might fully revert to standard kidney development. The mechanisms behind this potential reversal are yet to be understood. Tortelote emphasised the need for additional research to pinpoint the exact generational shift where normal kidney development resumes and to understand why these traits are passed down initially.

The study not only sheds light on the mechanisms that could be contributing to chronic kidney disease—a significant cause of death in the U.S.—but also the vicious cycle of hypertension and kidney damage it entails. This underscores the public health crisis that could affect populations for decades, mirroring human life spans.

With these findings, two critical questions emerge: is it possible to reverse these effects, and if so, how? These questions highlight the urgent need for strategies to address and mitigate the long-term health impacts of dietary deficiencies across generations, presenting a profound challenge for public health policy and medical research moving forward.

More information: Fabiola Diniz et al, Morphometric analysis of the intergenerational effects of protein restriction on nephron endowment in mice, Heliyon. DOI: 10.1016/j.heliyon.2024.e39552

Journal information: Heliyon Provided by Tulane University

Cardiorespiratory Health Associated with Maintaining Cognitive Functions in Later Years

Higher cardiorespiratory fitness levels in older adults are associated with preserving various essential cognitive abilities that often decline with age, according to research recently published in the British Journal of Sports Medicine. This connection remains robust regardless of major cognitive decline risk factors: age and the presence of the high-risk APOE4 gene, as indicated by the study findings. Cardiorespiratory fitness, a physiological measure of aerobic capacity, can be enhanced through regular aerobic exercises. While previous studies have shown a link between cardiorespiratory fitness and a reduced risk of age-related cognitive decline and dementia, the specific cognitive functions affected were not clearly understood.

The research aimed to determine whether there was a correlation between cardiorespiratory fitness and fundamental cognitive performance areas in 648 cognitively healthy individuals aged between 65 and 80 (with an average age of 69). Cardiorespiratory fitness was evaluated based on the maximum oxygen uptake (VO2 max) recorded during an incremental treadmill running test. Meanwhile, cognitive capabilities were measured using a comprehensive set of validated neuropsychological tests conducted over two days. The assessments covered five cognitive domains: processing speed, working memory, visuospatial processing, episodic memory, and executive function/attentional control, which includes skills related to planning and organisation.

Most participants were women (461; 71%), with an average of 16 years of education. Approximately 15% reported using beta-blockers, medications typically prescribed for heart conditions. The average VO2max observed among the participants was 21.68 ml/kg/min. For context, a healthy VO2max range for men is typically between 30–40 ml/kg/min; for women, it is 25–35 ml/kg/min. Among the 640 participants whose genetic profiles were analysed, 174 (27%) were carriers of the APOE4 gene.

As anticipated, older age correlated with a decline in performance across all cognitive domains assessed, considering factors such as sex, years of education, and body mass index (BMI). Conversely, higher educational levels were linked to better performance. Significantly, a higher cardiorespiratory fitness level was consistently associated with improved performance across all cognitive domains evaluated, regardless of the participant’s age or APOE4 gene status.

The study also found that the positive impact of cardiorespiratory fitness on cognitive performance was more pronounced among women, individuals with fewer years of education, and those on beta-blockers, particularly in the domains of processing speed and executive function/attentional control. It is important to note that this study is observational; thus, it does not establish a cause-and-effect relationship. The researchers acknowledged that not all cognitive areas were evaluated—for instance, language abilities—and that all participants were relatively inactive, which limited the spectrum of fitness levels observed.

However, the researchers propose several mechanisms through which aerobic fitness might enhance cognitive function, including improved cerebral blood flow, reduced oxidative stress, new synaptic connections, neuron growth, and alterations to neurotransmitter systems and the structure of grey and white matter in the brain. Psychosocial factors related to cardiorespiratory fitness, such as enhanced mood, reduced fatigue, and better sleep quality, also play a role in cognitive functioning.

In conclusion, the study underscores the significance of cardiorespiratory fitness as a critical health factor in maintaining comprehensive cognitive function in older adults. Further exploring the factors moderating this relationship could provide insights for developing personalised exercise regimes to optimise mental health during ageing.

More information: Lauren E Oberlin et al, Cardiorespiratory fitness is associated with cognitive function in late adulthood: baseline findings from the IGNITE study, British Journal of Sports Medicine. DOI: 10.1136/bjsports-2024-108257

Journal information: British Journal of Sports Medicine Provided by BMJ Group

Study Links Higher Type 2 Diabetes Risk to Red and Processed Meat Consumption in Two Million Individuals

The consumption of meat, mainly processed meat and unprocessed red meat, has been linked to an increased risk of type 2 diabetes, as revealed in a comprehensive analysis of data from nearly two million participants, detailed in a new publication in The Lancet Diabetes and Endocrinology.

Global meat production has surged in recent years, and consumption levels in many countries now surpass the recommended dietary guidelines. Earlier studies have suggested that high intakes of both processed and unprocessed red meat could lead to a heightened risk of type 2 diabetes. However, these findings have often been inconsistent and inconclusive.

In contrast, poultry, including chicken, turkey, and duck, is frequently considered a healthier alternative to red and processed meats. Despite this common perception, relatively few studies have explored the link between poultry consumption and the risk of developing type 2 diabetes.

A research team from the University of Cambridge, collaborating under the global InterConnect project, analysed data from 31 cohort studies spanning 20 countries to address these gaps. Their thorough analysis considered various factors, including age, gender, health-related behaviours, caloric intake, and body mass index.

The findings revealed that regular consumption of 50 grams of processed meat per day — roughly equivalent to two slices of ham — was associated with a 15% increased risk of developing type 2 diabetes within the next decade. Similarly, consuming 100 grams of unprocessed red meat daily — about the size of a small steak — was linked to a 10% increased risk. Interestingly, consuming 100 grams of poultry per day was initially found to carry an 8% higher risk of type 2 diabetes. Still, this association weakened under further analysis, whereas the links for red and processed meats remained robust.

Professor Nita Forouhi of the Medical Research Council (MRC) Epidemiology Unit at the University of Cambridge, a senior author of the study, highlighted the significance of the findings: “Our research offers the most extensive evidence to date that there is a significant association between the consumption of processed and unprocessed red meat and the elevated risk of future type 2 diabetes. This supports dietary recommendations to limit intake of these types of meat to mitigate the prevalence of diabetes in the population.”

Professor Forouhi noted that while the evidence connecting poultry consumption with type 2 diabetes is more substantial than previously known, the relationship is still unclear and requires further investigation.

The InterConnect project facilitates the analysis of individual participant data from a variety of studies rather than relying solely on published results. This approach allowed the researchers to include 31 studies in their analysis, including 18 studies whose findings on meat consumption and type 2 diabetes had not been previously published. By incorporating these unpublished studies, the researchers were able to broaden the evidence base and reduce the potential for bias by excluding existing research.

Dr Chunxiao Li, lead author and also from the MRC Epidemiology Unit, explained the advantages of their methodology: “Unlike previous meta-analyses that pooled already published results, our analysis involved data from individual participants across studies. This allowed us to harmonise critical data like meat consumption and the onset of type 2 diabetes, and more accurately account for various factors, such as lifestyle and health behaviours, that could influence the meat consumption-diabetes link.”

Professor Nick Wareham, Director of the MRC Epidemiology Unit and another senior author on the paper, elaborated on the impact of the InterConnect project: “It enables us to study risk factors for obesity and type 2 diabetes across diverse populations worldwide, helping to include demographic groups often under-represented in traditional meta-analyses.” This global perspective is crucial for developing practical health guidelines tailored to different populations and dietary habits worldwide.

More information: Chunxiao Li et al, Meat consumption and incident type 2 diabetes: an individual-participant federated meta-analysis of 1·97 million adults with 100 000 incident cases from 31 cohorts in 20 countries, The Lancet Diabetes & Endocrinology. DOI: 10.1016/S2213-8587(24)00179-7

Journal information: The Lancet Diabetes & Endocrinology Provided by University of Cambridge

Olive, Grape, Garlic, Rosemary, and Saffron: Their Benefits in Combating Cardiovascular Diseases

Cardiovascular diseases remain the foremost cause of morbidity and mortality globally. Plant extracts laden with bioactive substances have substantially contributed to pharmaceutical development, presenting therapeutic prospects for various cardiovascular conditions. Despite their potential, the application of these extracts faces restrictions due to potential side effects, interactions with other drugs, and a deficiency of robust scientific data from high-quality preclinical and clinical research.

In the academic year of 2023/24, biologist Mateu Anguera Tejedor made a notable advancement in this arena with his final year project for a Biology degree at the Autonomous University of Barcelona (UAB), under the guidance of René Delgado, who was a postdoctoral researcher at the UAB’s Institute of Neuroscience (INc-UAB) and is now a lecturer at the Faculty of Pharmacy and Food Sciences at the University of Barcelona. His research was later encapsulated in a scientific paper published in the journal Food Bioscience, which detailed the action mechanisms and the scientific evidence supporting the use of bioactive compounds extracted from key Mediterranean flora integral to the Mediterranean diet.

The paper discusses six plants specifically: garlic (Allium sativum), which contains compounds such as diallyl trisulfide and allicin; the hawthorn shrub (Crataegus monogyna), noted for its quercetin and chlorogenic acid; saffron (Crocus sativus) with crocin and safranal; olive (Olea europaea), which includes oleic acid and hydroxytyrosol; rosemary (Salvia rosmarinus), rich in rosmarinic and carnosic acids; and the grapevine (Vitis vinifera), known for resveratrol. The review highlights their significant pharmacological properties, such as antioxidant, anti-inflammatory, and vasodilatory effects, and their role in regulating lipid metabolism, which is crucial in managing atherosclerosis and hypertension. These compounds could be key in developing treatments to reduce the incidence of heart attacks and strokes.

Furthermore, the study acts as a guide for future investigations by pinpointing existing knowledge gaps and proposing recommendations for the design of future preclinical and clinical studies. It emphasises the importance of exploring the long-term safety of these bioactive compounds, examining their synergistic effects within the Mediterranean diet, and standardising protocols in clinical trials. This could enhance the scientific understanding of these traditional remedies and foster their integration as active ingredients in new phytomedicines.

The research team, led by Francesc Jiménez Altayó, professor in the Department of Pharmacology, Therapeutics and Toxicology at the UAB and researcher at the Centre for Biomedical Research in Cardiovascular Diseases Network (CIBERCV) and the UAB Institute of Neuroscience (INc-UAB), also notes the potential influence of combined extract ingestion on therapeutic outcomes. They point out the “matrix effect,” where dietary components may alter the effectiveness of each extract, possibly enhancing or reducing their benefits. Understanding these interactions is critical for optimising the therapeutic application of plant extracts in dietary contexts.

The team warns that while natural extracts show promise, the label “natural” does not automatically equate to safety. This highlights the urgent need for thorough pharmacokinetic, toxicological, and clinical studies to establish their efficacy, safety, and efficiency compared to conventional medications. The study underscores an often-overlooked point: robust evidence on the impact of natural extracts on human health is scant, prompting a cautious approach towards their use in medicine.

This comprehensive research, contributed to by esteemed academics from Cuban and Chilean institutions renowned in the pharmacology of natural products, was conducted under the auspices of the María Zambrano programme during the 2022/23 academic year. This collaboration reflects the international effort in researching natural remedies and marks a significant step towards integrating traditional knowledge and modern medicine to combat cardiovascular ailments effectively.

More information: Mateu Anguera-Tejedor et al, Exploring the therapeutic potential of bioactive compounds from selected plant extracts of Mediterranean diet constituents for cardiovascular diseases: A review of mechanisms of action, clinical evidence, and adverse effects, Food Bioscience. DOI: 10.1016/j.fbio.2024.105487

Journal information: Food Bioscience Provided by Universitat Autonoma de Barcelona

Enabling Independence for Senior Citizens with Home-Care Robots

Advancements in medical science have led to prolonged human life spans. It is predicted that by 2030, one out of every six people worldwide will be over 60. This surge in the elderly population will increase the need for care, which might not be sufficiently met by family members or professional caregivers, especially given the notable shortage of nursing staff in many developed nations. This situation highlights the urgent need for innovative solutions to support the growing demands of elder care.

Robotic technologies offer a promising solution to bridge the care gap, enabling older adults to live independently in their homes for longer. However, adopting assistive home-care robots faces hurdles, including social acceptance in ageing societies and technical challenges in developing robots tailored to diverse needs that vary across cultural, ethical, and financial contexts.

In their latest research, scholars from Chiba University in Japan have explored factors influencing the acceptance and use of home-care robots. The study, published in Scientific Reports on 12 November 2024, was led by Professor Sayuri Suwa and included contributions from an international team comprising Dr Hiroo Ide from the Institute for Future Initiatives at the University of Tokyo, Dr Yumi Akuta from the Division of Nursing at Tokyo Healthcare University, Dr Naonori Kodate from UCD School of Social Policy, Social Work and Social Justice, Dr Jaakko Hallila from Seinäjoki University of Applied Sciences, and Dr. Wenwei Yu from the Center for Frontier Medical Engineering at Chiba University.

The research involved a detailed survey among care recipients and caregivers in Japan, Ireland, and Finland. The survey assessed aspects such as familiarity with robots, essential features of home-care robots, expected functionalities, and ethically acceptable applications. Analysis of responses from 525 Japanese, 163 Irish, and 170 Finnish participants helped identify both common and unique factors influencing their willingness to use home-care robots.
The findings indicated that enthusiasm for participating in robot research and development, interest in robot-related news, and a positive view of robots were universal factors across the three countries. Distinctively, the Japanese valued convenience, the Irish prioritised emergency notifications to family and support personnel, and the Finns emphasised design—a reflection of Finland’s globally recognised design ethos.

This study also underscores how historical, cultural, and demographic factors shape the development and implementation of robotic solutions in different countries. For instance, Japan is advancing its robot development through collaborative efforts from the government, industry, and academia. In contrast, Ireland is gradually acknowledging the role of robots in elderly care, integrating artificial intelligence and robotics into health and social services.

Professor Suwa’s insights from the study stress the importance of including potential users—older adults and caregivers—in the robot design process. Such collaborative development can enhance product acceptance and usability, leading to broader adoption of home-care robots and improved quality of life for older adults.

In conclusion, home-care robots can make the concept of ‘ageing in place’ a widespread reality by focusing on innovation, collaboration, and cultural sensitivity. This approach addresses the immediate needs of the ageing population and paves the way for future technological integrations in personal and healthcare environments.

More information: Hiroo Ide et al, A comparative study to elucidate factors explaining willingness to use home-care robots in Japan, Ireland, and Finland, Scientific Reports. DOI: 10.1038/s41598-024-79414-y

Journal information: Scientific Reports Provided by Chiba University

The Worldwide Gap Between Longevity and Wellness

Across the world, people are experiencing longer lifespans but not necessarily enjoying better health, as highlighted by research from the Mayo Clinic. A comprehensive study involving 183 World Health Organization (WHO) member nations reveals that these extra years are increasingly burdened with illness. The research, led by Andre Terzic, M.D., Ph.D., and Armin Garmany, uncovers a significant disparity between the duration of life and the quality of health, with their findings published in JAMA Network Open.

Dr Terzic, the senior researcher, points out that while people live longer, these additional years are not accompanied by a corresponding increase in healthy, disease-free life. “The data clearly illustrate that an increase in healthy years has not parallelled the extension in life expectancy. Ageing is becoming synonymous with an extended period of living with diseases,” he explains. This issue raises concerns about the declining quality of life with age and emphasizes the urgent need for healthcare policies to address the increasing divergence between lifespan and health span.

Dr. Terzic holds prestigious positions within the Mayo Clinic, including the Marriott Family Director of Comprehensive Cardiac Regenerative Medicine at the Center for Regenerative Biotherapeutics and the Marriott Family Professor of Cardiovascular Research.
The discrepancy between life expectancy and healthy years lived is most pronounced in the United States. According to WHO data, from 2000 to 2019, life expectancy for women rose from 79.2 to 80.7 years and men from 74.1 to 76.3 years. However, the duration of life spent in good health has not seen a similar improvement. By 2019, the average global gap between lifespan and health span reached 9.6 years, marking a 13% increase since the start of the millennium.

Particularly in the U.S., this gap is the largest globally, with Americans spending an average of 12.4 years of their life dealing with disability and chronic illness, up from 10.9 years in 2000. This increase coincides with America reporting the highest incidence of chronic diseases. Mental health issues, substance abuse, and musculoskeletal disorders are among the primary health burdens.

The study also highlights a significant gender disparity in health outcomes worldwide. Women face a 2.4-year more significant disparity between lifespan and health span compared to men, with neurological, musculoskeletal, and urinary-genital tract disorders contributing to extended periods of ill health among women.

Armin Garmany, the study’s lead author and a dual M.D./Ph.D. candidate at Mayo Clinic Alix School of Medicine and Mayo Clinic Graduate School of Biomedical Sciences, advocates for a shift towards proactive, wellness-focused healthcare systems. “This growing gap requires us to rethink our healthcare approaches, focusing on preventive measures and tailoring interventions to the specific health challenges of different regions and populations,” he asserts. This strategic shift is vital for narrowing the global health lifespan gap and improving overall health outcomes.

More information: Armin Garmany et al, Global Healthspan-Lifespan Gaps Among 183 World Health Organization Member States, JAMA Network Open. DOI: 10.1001/jamanetworkopen.2024.50241

Journal information: JAMA Network Open Provided by Mayo Clinic

Eating a Healthy Breakfast Lowers Cardiovascular Risk

Eating a well-balanced breakfast, accounting for roughly a quarter of one’s daily caloric intake, is crucial for reducing the risk of cardiovascular diseases, as evidenced by research from the Hospital del Mar Research Institute published in the Journal of Nutrition, Health and Aging. This study, part of the PREDIMED-Plus project—a randomised clinical trial that investigates the effects of combining a Mediterranean diet with physical activity against just dietary advice—monitored the health of 383 participants, focusing on how breakfast affects cardiovascular risk factors. Unlike previous research, this study measured the total energy consumed at breakfast and examined the nutritional quality of these first meals of the day.

The research introduced two pivotal aspects. First, it considered the proportion of daily energy intake consumed at breakfast, identifying 20-30% as an optimal range and comparing it with other quantities. Second, it evaluated the impact of a high-quality breakfast that effectively balances proteins, fats, fibres, and other nutrients. The findings demonstrated that a sufficient caloric intake at breakfast, when comprised of high-quality foods, significantly contributed to reducing cardiovascular risk factors.

The significance of a good breakfast extends to obesity management, as highlighted by the three-year follow-up results of the study’s participants, who were between 55 and 75 years old and categorised as overweight or obese. Several cardiovascular risk factors were assessed, including body weight, waist circumference (an indicator of abdominal obesity), cholesterol and triglyceride levels, blood pressure, and diabetes markers. The results were telling: those who consumed between 20-30% of their daily caloric intake for breakfast not only managed their body weight more effectively but also recorded a 2-3.5% reduction in body mass index and a 2-4% reduction in waist circumference by the study’s end. Moreover, these participants enjoyed significantly reduced triglyceride levels (9-18%) and increased HDL cholesterol levels (4-8.5%).

Furthermore, the study found that not just the quantity but also the quality of breakfast profoundly affects health. Participants who ate high-quality breakfasts also showed beneficial changes, including a 1.5% reduction in waist circumference, a 4% decrease in triglyceride levels, and a 3% increase in HDL cholesterol. As defined by the study, a high-quality breakfast includes appropriate amounts of protein, valuable fats, fibre, and essential minerals like potassium and iron while minimising added sugars and saturated fats.

Álvaro Hernáez, a researcher at the Hospital del Mar Research Institute and a professor at the Blanquerna Faculty of Health Sciences at Ramon Llull University, underscored the importance of breakfast by stating that it is indeed the most important meal of the day, with both the quantity and quality of food being pivotal. He highlighted that controlled portions and excellent nutritional composition are crucial, with their data demonstrating that better breakfast quality correlates with improved outcomes for cardiovascular risk factors.

Dr Montse Fitó, coordinator of the Cardiovascular Risk and Nutrition Research Group at the same institute, reiterated that maintaining energy adequacy and high food quality at breakfast is essential for preventing cardiovascular risks. She noted that the dietary recommendations focused on food quality have effectively improved the progression of risk factors over time among adults at high cardiovascular risk.

The researchers ensured that the study’s findings were adjusted to solely reflect the effects of breakfast’s energy and nutritional content, excluding other potential factors. This rigorous approach led Karla-Alejandra Pérez-Vega, another researcher involved in the study, to conclude that promoting healthy breakfast habits is a key strategy for fostering healthy ageing, reducing the risk of metabolic syndrome and associated chronic diseases, and thus enhancing the overall quality of life. This study not only underscores the importance of a nutritious breakfast in managing weight and reducing disease risk but also highlights the broader impact of diet on long-term health and well-being.

More information: Karla-Alejandra Pérez-Vega et al, Breakfast energy intake and dietary quality and trajectories of cardiometabolic risk factors in older adults, The journal of nutrition health & aging. DOI: 10.1016/j.jnha.2024.100406

Journal information: The journal of nutrition health & aging Provided by IMIM (Hospital del Mar Medical Research Institute)

Scorbutus: Not Merely a Disease of 18th-Century Mariners

Scurvy, also known as vitamin C deficiency, is not solely a historical ailment confined to 18th-century sailors, as illustrated by a case involving a 65-year-old woman with limited mobility and social isolation. This case is detailed in an article published in the Canadian Medical Association Journal (CMAJ), found at CMAJ. Medical professionals highlight the importance of considering scurvy as a possible diagnosis in patients who exhibit abnormal bleeding and nonspecific symptoms.

The individual in question sought medical help at an emergency department in a downtown Toronto hospital, presenting with symptoms such as leg pain and weakness, skin lesions, and discolouration. Her medical history included several chronic health conditions, and her physical disabilities severely limited her ability to shop for groceries, cook, and carry out other daily tasks. With minimal external support, her diet primarily consisted of canned soup and fish, devoid of fresh fruits or vegetables.

Dr. Sarah Engelhart, a general internist at Mount Sinai Hospital and the University of Toronto, expressed that this case exemplifies the complex nature of food insecurity leading to rare diagnoses. A comprehensive evaluation of the patient’s social and dietary history was crucial in reaching a conclusive diagnosis.

Despite common perceptions, vitamin C deficiency remains surprisingly prevalent in the modern era. In the United States, about 5.9% of the population is affected, and in certain socioeconomically disadvantaged groups in the United Kingdom, the rate may reach as high as 25%.

The challenge in diagnosing vitamin C deficiency is its vague symptoms, including fatigue, weakness, and shortness of breath. The patient’s smoking habit further exacerbated her deficiency. Following the initiation of vitamin C therapy, her symptoms improved significantly, and a subsequent blood test confirmed the deficiency.

Medical professionals are advised to remain vigilant for signs of vitamin C deficiency when evaluating patients, particularly among vulnerable groups such as children, elderly individuals living in isolation, those with restrictive eating habits like those seen in autism spectrum disorder or individuals subsisting on a ‘tea and toast’ diet, smokers, substance users, or those suffering from malabsorption syndromes. The study’s authors stress the importance of being aware of food insecurity, a significant risk factor that impacts approximately one in five Canadian households.

More information: Kevin R. Murray et al, Scurvy in a 65-year-old woman with severely limited function and social supports, Canadian Medical Association Journal. DOI: 10.1503/cmaj.240769

Journal information: Canadian Medical Association Journal

Deciphering Time: Circadian Rhythms and Their Impact on Inflammatory Bowel Diseases

This study highlights the critical role of the body’s circadian clock in modulating immune responses and digestive functions, illustrating its significant influence on the onset and progression of inflammatory bowel diseases (IBDs) such as Crohn’s disease and ulcerative colitis. The findings indicate that disturbances in circadian rhythms can exacerbate inflammation, suggesting that synchronising treatment approaches with these inherent biological cycles could improve patient outcomes. The research advocates for a personalised approach to medicine that incorporates individual chronotypes alongside lifestyle interventions such as sleep hygiene and meal timing and employs real-time biological monitoring. This approach promises to revolutionise therapy for IBD, tackling both the physical and emotional burdens of these chronic conditions.

Insights from a review by Prof. Oren Froy of Hebrew University and Prof. Yael Weintraub from Schneider Children’s Medical Center and Tel Aviv University shed light on the crucial link between the body’s circadian clock and IBD. This connection opens up new avenues for innovative therapeutic strategies. The study demonstrates that both immune system activity and digestive functions are regulated by daily rhythms driven by the circadian clock. The disruption of this internal timing system is linked to increased inflammation, underscoring its pivotal role in the exacerbation and development of IBD.

Despite advancements in understanding the molecular mechanisms controlling the circadian clock, translating this knowledge into practical clinical applications remains challenging. Prof. Froy highlights the complexity of applying theoretical insights to practical treatment solutions, indicating the need for further research to bridge this gap.

Inflammatory bowel diseases, including Crohn’s disease and ulcerative colitis, impact approximately 10 million people worldwide, with their prevalence steadily increasing across both developed and developing countries. These conditions severely disrupt patients’ lives by causing symptoms such as abdominal pain, persistent diarrhoea, fatigue, and malnutrition, which significantly impair their quality of life. Beyond the physical symptoms, IBDs impose substantial emotional and financial burdens on sufferers, often leading to anxiety, depression, and limitations in work or social activities.

The study authors advocate for well-designed studies to deepen our understanding of how the circadian clock influences inflammation and IBD. Such research is crucial for developing personalised treatment strategies that consider individual chronotypes—natural preferences for activity and sleep patterns—and utilise wearable devices for monitoring circadian rhythms.
Looking ahead, the study outlines several key points and future directions for IBD management: personalised medicine that tailors therapies to individual patient needs, biological sampling and monitoring to gain insights into circadian impacts on inflammation, lifestyle interventions to reset the circadian clock, and the development of tools to evaluate circadian system performance. These strategies could enhance current treatments’ effectiveness and offer a new paradigm in IBD therapy.

Dr. Weintraub concludes, “This research opens doors to integrating circadian biology into IBD management, offering hope for therapies that not only address symptoms but also align with the body’s natural rhythms.” The promise of these rhythm-based therapies could significantly change the landscape of IBD treatment, providing relief and improved quality of life for millions affected by these challenging conditions.

More information: Yael Weintraub et al, The circadian clock in inflammatory bowel diseases, Trends in Molecular Medicine. DOI: 10.1016/j.molmed.2024.11.008

Journal information: Trends in Molecular Medicine Provided by The Hebrew University of Jerusalem

Assessing Unhealthy Alcohol Consumption Before It’s Too Late

A recent study suggests that a blood test could be a more effective method of identifying liver disease compared to traditional inquiries about a person’s alcohol consumption.
The common practice among clinicians when screening for potential alcohol-related liver damage involves simply questioning patients about their drinking habits. Despite its frequency of use, this approach might not be the most reliable. Researchers are now pointing towards a blood test as a superior alternative for detecting whether alcohol consumption is affecting the liver, potentially allowing for timely medical intervention to prevent severe damage.

At the University of California, San Francisco, experts have identified a biomarker known as phosphatidylethanol (PEth), which could offer a more accurate assessment of a person’s alcohol intake and its impact. This biomarker helps in understanding the risk of liver fibrosis, a condition characterized by the accumulation of scar tissue in the liver, which can progress to cirrhosis, liver failure, and even liver cancer if left untreated.

“The direct measurement of alcohol’s impact through PEth is a clearer and more direct method than the subjective accounts from patients about their drinking,” explains Judy Hahn, PhD, a professor in the Division of HIV, Infectious Diseases and Global Medicine at UCSF. She likens this approach to how clinicians handle other health indicators: “We don’t simply ask someone how much fatty food they eat – we measure their cholesterol. Similarly, we don’t ask people to estimate their weight – we measure it.”

The study, published in the American Journal of Gastroenterology, compared PEth levels with another liver disease risk indicator, the Fibrosis 4 (FIB-4) score. FIB-4 is calculated using a person’s age and results from several other blood tests. The findings indicate that while PEth levels closely correlate with FIB-4, the association between FIB-4 and self-reported alcohol consumption was considerably weaker. This discrepancy could be attributed to participants underreporting or forgetting the quantity of alcohol they consume.

This extensive study, which included over 4,000 participants from the United States, Russia, Uganda, and South Africa, is the largest to date to examine the relationship between PEth levels and liver fibrosis risk. It is also the first to assess the effectiveness of PEth compared to self-reported alcohol use in predicting fibrosis risk.

The progression of liver fibrosis can be slowed or even reversed with lifestyle changes, mainly through reducing alcohol consumption and improving diet. Early detection is vital to managing the condition effectively before it develops into more advanced stages of liver disease.

The researchers propose that PEth screening could become part of routine blood tests that check for cholesterol and blood sugar levels. “To effectively prevent and manage liver fibrosis, it’s crucial to accurately understand how much alcohol a person consumes,” states Pamela Murnane, PhD, MPH, an assistant professor of epidemiology and biostatistics and the lead author of the study. “Self-reports are proving insufficient for this purpose.” This advancement in medical screening could revolutionize how clinicians approach the diagnosis and treatment of liver disease related to alcohol consumption.

More information: Murnane, Pamela M. et al, Using Phosphatidylethanol as an Adjunct to Self-Reported Alcohol Use Improves Identification of Liver Fibrosis Risk, The American Journal of Gastroenterology. DOI: 10.14309/ajg.0000000000003178

Journal information: The American Journal of Gastroenterology Provided by University of California – San Francisco

Social Inequality Tied to Declining Brain Health in the Elderly and Dementia Cases

Researchers at Trinity College Dublin have engaged in a groundbreaking collaborative effort with global partners to investigate whether societal inequality impacts brain health. Their findings are detailed in a research paper published in Nature Aging today, Friday, December 27th. The study was conducted by an international team from the Multipartner Consortium to expand dementia research in Latin America (ReDLat), the Latin American Brain Health Institute (BrainLat), the Global Brain Health Institute (GBHI) at Trinity College Dublin, and other centres worldwide. It establishes a clear correlation between structural inequalities, such as socioeconomic disparities measured by the country-level GINI index, and alterations in brain structure and connectivity typical of ageing and dementia.

The research particularly highlights how societal inequities are biologically embedded, mainly affecting underrepresented groups in Latin America and the United States. The study presents several critical findings:

Firstly, the researchers observed that greater levels of inequality correlate with diminished brain volume and disrupted connectivity, particularly affecting the temporal-posterior and cerebellar regions crucial for memory and cognitive functions. These impacts were notably more severe in Latin America, underscoring the particular susceptibility of these populations to broad socioeconomic stressors.

Secondly, the study disclosed that Latinos suffering from Alzheimer’s disease endure the most drastic effects. This suggests that the environmental pressures associated with structural inequality might intensify neurodegeneration in ageing populations. In contrast, the milder impacts noticed in cases of frontotemporal lobar degeneration suggest a more substantial genetic influence in this condition. It is important to note that reduced brain volume and connectivity, standard in dementia patients, are linked with the progression and severity of the disease.

Furthermore, the research established that these associations persisted even after accounting for individual factors such as education, age, sex, and cognitive ability. This underscores the independent influence of macro-level factors on brain health, demonstrating that living in an environment of widespread inequality impacts brain health irrespective of one’s specific socioeconomic status. Thus, the research reveals the extensive effects of societal disparities on brain function.

Dr Agustina Legaz, PhD from the ReDLat consortium and the study’s first author, emphasised the critical need to incorporate both individual social determinants of health and broader exposome factors, like social and physical variables, into global brain health research. She highlighted that these findings pave the way for future studies exploring the biological mechanisms linking aggregate inequality to ageing and neurodegeneration.

Dr Agustín Ibáñez, a professor in global brain health at Trinity College and director of BrainLat, also the corresponding author, remarked on the significant role of structural inequality in shaping brain health. He pointed out that with dementia rates rising, particularly in low- and middle-income countries, the study’s findings stress the need for targeted interventions to address the root causes of brain health disparities, which are specific to each region.

The study advocates for a multi-level approach to achieving brain health equity, which involves exploring the biological embedding of other macro-level exposome factors beyond socioeconomic inequality. These could include democratic governance, air pollution, migration, climate change, and access to green spaces. By identifying and addressing these region-specific modulators, targeted interventions could be developed to slow down brain ageing and reduce the burden of dementia in disadvantaged communities.

More information: Agustina Legaz et al, Structural inequality linked to brain volume and network dynamics in aging and dementia across the Americas, Nature Aging. DOI: 10.1038/s43587-024-00781-2

Journal information: Nature Aging Provided by Trinity College Dublin