Mind-body practices and the self: yoga and meditation do not quiet the ego, but instead boost self-enhancement

Mind-body practices enjoy immense public and scientific interest. Yoga and meditation are highly popular. Purportedly, they foster well-being by “quieting the ego” or, more specifically, curtailing self-enhancement. However, this ego-quieting effect contradicts an apparent psychological universal, the self-centrality principle. According to this principle, practicing any skill renders it self-central, and self-centrality breeds self-enhancement. 

A new study examined those opposing predictions in the first tests of mind-body practices’ self-enhancement effects. Experiment 1 followed 93 yoga students over 15 weeks, assessing self-centrality and self-enhancement after yoga practice (yoga condition, n = 246) and without practice (control condition, n = 231). Experiment 2 followed 162 meditators over 4 weeks (meditation condition: n = 246; control condition: n = 245). Self-enhancement was higher in the yoga (Experiment 1) and meditation (Experiment 2) conditions, and those effects were mediated by greater self-centrality. Additionally, greater self-enhancement mediated mind-body practices’ well-being benefits. Evidently, neither yoga nor meditation quiet the ego; instead, they boost self-enhancement.

Related article:

People’s egos get bigger after meditation and yoga

Transcendental Meditation enhances brain functioning and reduces psychological distress in school administrators and staff

Psychological stress adversely affects organizational commitment, work engagement, and productivity, and contributes to poor mental and physical health. This adds up to a significant loss of value for an organization. While psychological stress takes a toll, conversely, healthy brain functioning is associated with increased performance and well-being.

A new randomized control study published in Brain and Cognition involved 96 central office staff at the San Francisco Unified School District. Researchers also observed brain patterns of 79 of the subjects using Electroencephalogram (EEG) recording. The study found that over a four-month period, those practicing the Transcendental Meditation (TM) technique experienced significant improvements in psychological distress and brain functioning, as compared to controls. This study is the largest randomized control trial investigating the impact of TM on brain functioning.

These findings are consistent with past research showing a reduced response to stress factors and more integrated brain functioning resulting from TM practice. This and previous studies suggest the experience during TM affects perceptual processing and supports one's ability to deal with challenges.

The primary outcomes in the study were the Profile of Mood States (POMS) and Brain Integration Scale (BIS), which is designed to show the level of connectivity between brain areas. At posttest, TM participants showed a significant decrease on the POMS Total Mood Disturbance and anxiety, anger, depression, fatigue, and confusion subscales, and a significant increase in the POMS vigor subscale. TM participants in the EEG-subgroup significantly increased in BIS scores.

"Management performance and organizational effectiveness are directly compromised by psychological distress and lack of healthy brain functioning," said Laurent Valosek, coauthor of the study and Executive Director of the Center for Wellness and Achievement in Education. "This research indicates that TM can be used as a tool for improving psychological health and brain integration, important foundational factors that contribute to leadership competency."

Connection between brain functioning and overcoming challenges
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This study and past research support the idea that the experience of transcending created during Transcendental Meditation systematically transforms inner experience and brain functioning, leading to changes in how one faces challenges. The challenges will continue, however one becomes increasingly resilient and effective in overcoming them.

These results have implications for organizations interested in improving the mental health, emotional competency, and resilience of their employees.

A significant proportion of older adults are deficient in vitamin B12 and folate

A new study by researchers from The Irish Longitudinal Study on Ageing (TILDA) at Trinity College Dublin, Ireland, has shown for the first time that a substantial number of adults over 50 are at risk of deficiency in vitamin B12 and folate (the natural vitamin linked to the dietary supplement, folic acid).
The researchers found that one in eight adults in Ireland are deficient in vitamin B12; one in seven are deficient in folate; and there are variations in deficiency across different provinces in Ireland, in addition to variations dependent on health, lifestyle and the time of year measured.

The findings form part of the largest representative study of its kind conducted among older persons in Ireland and have just been published in the prestigious journal, British Journal of Nutrition.

Both vitamin B12 and folate are essential for nerve function, brain health and the production of red blood cells and DNA. Numerous studies have shown that low nutritional status of folate and B12 are linked to poor long-term health, especially among older people.

In Ireland, fortification of food products is voluntary and some foods (such as ready-to-eat cereals) are enriched with micronutrients such as folic acid, though this is inconsistent between products fortified and over time, resulting in haphazard exposure. There have been repeated calls for an official policy of mandatory fortification of staple foods such as bread, with folic acid, to reduce the occurrence of neural tube defects in babies. Such a policy would also reduce the prevalence of folate deficiency in older adults who are most at risk. Before this can occur, however, comprehensive information is needed on the prevalence and determinates of deficiency.

Our study suggests that the current custom of voluntary food fortification is ineffective in preventing deficiency or low status of these vitamins among older people. The results are of relevance not just for Ireland but for all countries that do not have mandatory fortification.

Key findings:

• One in eight adults over 50 were low to deficient in vitamin B12 while one in seven were low to deficient in folate
• The prevalence of low or deficient folate increased with age, from 14% among those aged 50-60 years to 23% among people over 80 years old. Low folate status was also more common in smokers, the obese, and those who lived alone
• Low or deficient vitamin B12 was more common in smokers (14%), people who lived alone (14.3%) and those from lower socio-economic backgrounds (13%)
• Use of both vitamin B12 and folic acid supplementation was low, with higher rates among women than men but less than 4% overall taking supplements of either vitamin

Commenting on the significance of the research, lead author of the study and Research Fellow at TILDA, Dr Eamon Laird, said:

"This is the largest representative and most comprehensive study of vitamin B12 and folate status in older adults ever conducted in Ireland. There are striking differences in the prevalence of deficiency across different lifestyle factors such as obesity and smoking - both of which are modifiable risk factors. Our findings will provide useful data to help inform public health policy -particularly regarding the proposition of mandatory folic acid and/or vitamin B12 fortification. To place our findings in context, in a country such as the United States where mandatory folic acid fortification occurs, rates of low folate status are around 1.2% in older adults compared with 15% in Ireland."

Professor Anne Molloy, senior author of the study noted:

"This study shows a surprising level of inadequate folate among older persons, despite many years of voluntary folic acid fortification of certain foods on the Irish market. Concerns relating to excessive folic acid intake, particularly in older people, have been at the heart of current debates regarding the risks of population-wide folic acid fortification. However, in countries such as the US, mandatory folic acid food fortification for the past 20 years has prevented millions of cases of folate deficiency without any proven adverse effects. Irish public health authorities need to act on the facts from studies such as ours."

Professor Rose Anne Kenny, Principal Investigator of TILDA, said:

"The high rates of B-vitamin deficiency seen in the older adult population are of concern and, given that this can be easily treated with fortification, this has significant policy and practice implications for Government and health services. TILDA has consistently assisted policy makers by providing strong evidence based data on which to make recommendations but also by assisting with information of most vulnerable people and therefore those who should be targeted."

In women, even mild sleep problems may raise blood pressure

It is well known that chronic sleep deprivation can affect cardiovascular health. But according to a new study from Columbia University Irving Medical Center, even mild sleep problems, such as having trouble falling asleep, can raise blood pressure in women.

Nearly one-third of adults don't get enough sleep. For women, the problem may be even bigger. Studies suggest that women are at greater risk for sleep problems, with some researchers reporting that chronic insomnia may be twice as common in women as in men.

"That's concerning, since studies have shown that sleep deprivation and milder sleep problems may have a disproportionate effect on cardiovascular health in women," says Brooke Aggarwal, EdD, a behavioral scientist in the Department of Medicine at Columbia University Vagelos College of Physicians and Surgeons and lead author of the study.

The new study examined blood pressure and sleep habits in 323 healthy women. Mild sleep disturbances--poor-quality sleep, taking longer to fall asleep, and insomnia--were nearly three times more common than severe sleep disturbances, such as obstructive sleep apnea.

Women who had mild sleep problems--including those who slept for seven to nine hours a night, as measured by a wristwatch-like device--were significantly more likely to have elevated blood pressure.
Some of the women allowed the researchers to extract a few endothelial cells from inside an arm vein to look for a pro-inflammatory protein that is implicated in the development of cardiovascular disease. The researchers, led by Sanja Jelic, MD, associate professor of medicine at VP&S and senior author of the study, found an association between endothelial inflammation and mild sleep disturbances.
"Our findings suggest that mild sleep problems could possibly initiate the vascular endothelial inflammation that's a significant contributor to cardiovascular disease," says Aggarwal. "Results of an ongoing clinical trial may confirm these results. In the meantime, it may be prudent to screen women for milder sleep disturbances in an effort to help prevent cardiovascular disease."

Exercise may be just as crucial to a depression patient's good health as finding an effective antidepressant

A new study of nearly 18,000 participants found that those with high fitness at middle age were significantly less likely to die from heart disease in later life, even if they were diagnosed with depression.
The research - a collaboration between UT Southwestern and The Cooper Institute - underscores the multiple ways in which depression may ultimately impact health and mortality. It also highlights the importance of overcoming a common dilemma among patients: How does one cope with hopelessness and still find motivation to exercise?
"Maintaining a healthy dose of exercise is difficult, but it can be done. It just requires more effort and addressing unique barriers to regular exercise," says Dr. Madhukar Trivedi, co-author of the study and Director of the Center for Depression Research and Clinical Care, part of the Peter O'Donnell Jr. Brain Institute at UT Southwestern.
Doctor's Tips: How to Stay Fit While Treating Depression
Dr. Madhukar Trivedi cites previous research showing that depressed patients can often perform about three-fourths of the exercise they're asked to do. He recommends patients take several steps to boost their chances of success:

• Set aside a consistent time to exercise every day, but do not get discouraged by stretches of inactivity. Resume activities as soon as possible.
• Keep a log to track progress.
• Vary the exercises to avoid monotony. Keep the workout interesting and fun.
• Exercise with a friend.
• Task someone with holding you accountable for maintaining the exercise regimen.

The study published in the Journal of the American Medical Association Psychiatry utilized a Cooper Institute database of participants who had their cardiorespiratory fitness measured at an average age of 50 years. Researchers used Medicare administrative data to establish correlations between the participants' fitness at midlife to rates of depression and heart disease in older age. Among the findings, participants with high fitness were 56 percent less likely to eventually die from heart disease following a depression diagnosis.
Dr. Trivedi says the findings are just as relevant to younger age groups, in particular college-age adults who are just entering the workforce.
"This is the age where we typically see physical activity drop off because they're not involved in school activities and sports," Dr. Trivedi says.
"The earlier you maintain fitness, the better chance of preventing depression, which in the long run will help lower the risk of heart disease."
Depression has been linked to several other chronic medical conditions such as diabetes, obesity, and chronic kidney disease, which studies show can affect whether antidepressants are likely to help. For patients with these conditions, the more appropriate treatment may be exercise.
Dr. Trivedi says the reasons behind this may partly be connected to the general health effects of physical activity, including the fact that exercise decreases inflammation that may cause depression. By reducing inflammation, the risk for depression and heart disease are lowered.
"There is value to not starting a medication if it's not needed," says Dr. Trivedi, who's leading a national effort to establish biological tests for choosing antidepressants. "Being active and getting psychotherapy are sometimes the best prescription, especially in younger patients who don't have severe depression."
Dr. Trivedi cites previous research showing that depressed patients can often perform about three-fourths of the exercise they're asked to do. He recommends patients take several steps to boost their chances of success:

• Set aside a consistent time to exercise every day, but do not get discouraged by stretches of inactivity. Resume activities as soon as possible.
• Keep a log to track progress.
• Vary the exercises to avoid monotony. Keep the workout interesting and fun.
• Exercise with a friend.
• Task someone with holding you accountable for maintaining the exercise regimen.

Dr. Trivedi has organized large studies to further solidify the cause and effect among fitness, depression, and heart disease. One example is RAD, Resilience in Adolescent Development, a 10-year study that will enroll 1,500 participants who are at risk to develop depression but have not done so. The study's primary aim is to examine whether personal factors such as lifestyle and biology influence a teenager's ability to resist mood disorders. But researchers will also document fitness levels and track whether depression and heart issues arise in later years.
"There is enough evidence to show that the effect of low fitness on depression and heart disease is real," Dr. Trivedi says. "But further study is needed to establish the mechanism by which this effect happens."

Consuming walnuts = half the risk of developing type 2 diabetes

A new epidemiological study representing more than 34,000 American adults suggests that those who consume walnuts may have about half the risk of developing type 2 diabetes compared to adults who do not eat nuts.1 According to the study from the University of California, Los Angeles (UCLA), the average intake among walnut consumers was approximately 1.5 tablespoons per day.

Doubling walnut consumption (eating 3 tablespoons) was associated with a 47% lower prevalence of type 2 diabetes. This amount of walnut intake is close to the recommended serving size of walnuts, which is one ounce or four tablespoons. The researchers did not look at the impact of increasing walnut consumption beyond doubled intake.

"These findings provide more evidence for food-based guidance to help reduce the risk for diabetes," says Dr. Lenore Arab of the David Geffen School of Medicine at The University of California, Los Angeles. "The strong connection we see in this study between walnut consumers and lower prevalence of type 2 diabetes is additional justification for including walnuts in the diet. Other research has shown that walnuts may also be beneficial for cognitive function and heart health."

Researchers looked at data from the National Health and Nutrition Examination Survey (NHANES), which draws from a large sampling of the U.S. population. In this study, 34,121 adults ages 18-85 years old were asked about their dietary intake, as well as if they had been diagnosed with diabetes or if they were taking medications for diabetes. Individuals were also assessed for diabetes using common laboratory measurements including fasting plasma glucose and hemoglobin A1c.

Those who reported consuming walnuts showed a lower risk for type 2 diabetes compared to those who did not consume any nuts regardless of age, gender, race, education, BMI, and amount of physical activity.

Individuals with diabetes often have elevated blood pressure, cholesterol, or triglycerides, which can increase the risk for heart disease and stroke. Previous studies have examined the association between walnut consumption and cardiovascular health as well as diabetes. Findings from this study provide additional support for the role of walnuts as part of a healthy diet that may help reduce the risk for diabetes.

Among the numerous properties in walnuts that may be providing health benefits, walnuts are a rich source of recommended polyunsaturated fat (13 grams per ounce), which includes the plant-based omega-3 fatty acid alpha-linolenic acid (2.5 grams per ounce).

As with any scientific research, some study limitations should be considered. Participants were asked about their dietary choices over the course of one to two days, which may not be representative of usual consumption patterns. In addition, because of the cross-sectional nature of the study, the findings cannot prove causality.

Funding for this research was provided by the California Walnut Commission (CWC). The CWC has supported health-related research on walnuts for more than 25 years. While the CWC does provide funds and/or walnuts for various projects, the actual studies are conducted independently by researchers who design the experiments, interpret the results and write the manuscripts.

Vacation time recharges US workers, but positive effects vanish within days

Taking time off helps the majority of U.S. workers recover from stress and experience positive effects that improve their well-being and job performance, but for nearly two-thirds of working adults, the benefits of time away dissipate within a few days, according to a survey released by the American Psychological Association.

Nearly a quarter of working adults (24 percent) say the positive effects of vacation time - such as more energy and feeling less stress - disappear immediately upon returning to work, the survey found. Forty percent said the benefits last only a few days.

APA's 2018 Work and Well-Being survey (PDF, 4.19 MB) was conducted online by The Harris Poll from Feb. 15 to March 1, 2018, among 1,512 U.S. adults who reported being employed full time, part time or self-employed.

"People need time off from work to recover from stress and prevent burnout," said David W. Ballard, PsyD, MBA, who heads APA's Center for Organizational Excellence. "But employers shouldn't rely on the occasional vacation to offset a stressful work environment. Unless they address the organizational factors causing stress and promote ongoing stress management efforts, the benefits of time off can be fleeting. When stress levels spike again shortly after employees return to work, that's bad for workers and for business. Employers can do better."

The Work and Well-Being Survey provides a snapshot of the U.S. workforce, including employee well-being and attitudes and opinions related to workplace policies and practices. Among other things, this year's survey explored the effect of time off - paid and unpaid - on employee well-being and work.
The majority of working Americans reported positive effects of taking vacation time and said when they return to work their mood is more positive (68 percent) and they have more energy (66 percent) and motivation (57 percent) and feel less stressed (57 percent). Additionally, working adults reported that, following time off, they were more productive (58 percent) and their work quality was better (55 percent).
Despite this, about one in five (21 percent) said they feel tense or stressed out while on vacation, more than a quarter (28 percent) said they wind up working more than they planned to and 42 percent reported that they dread returning to work.
"Websites and magazine articles offer plenty of tips on how to make the most of time out of the office, but often put the onus on the individual employee and ignore important organizational factors. A supportive culture and supervisor, the availability of adequate paid time off, effective work-life policies and practices, and psychological issues like trust and fairness all play a major role in how employees achieve maximum recharge," Ballard said. "Much of that message comes from the top, but a culture that supports time off is woven throughout all aspects of the workplace."
Only 41 percent of U.S. workers reported that their organization's culture encourages employees to take time off, and just 38 percent said their supervisor encourages the same. And in workplaces that do support time off, it's more than the employees who benefit.
When an organization's culture encourages time off, employees are more likely to benefit from vacation time and those benefits last longer. Upon returning from vacation, employees who said their organization's culture encourages time off were more likely to report having more motivation (71 percent) compared to employees who said their organization doesn't encourage time off (45 percent). They were also more likely to say they are more productive (73 percent vs. 47 percent) and that their work quality is better (70 percent vs. 46 percent). Overall, they were more likely to say they feel valued by their employer (80 percent vs. 37 percent), that they are satisfied with their job (88 percent vs. 50 percent) and that the organization treats them fairly (88 percent vs. 47 percent). They were similarly more likely to say they would recommend their organization as a good place to work (81 percent vs 39 percent).
In organizations where time off is encouraged, 64 percent of employees said their employer provides sufficient resources to help them manage their stress. Only 18 percent of employees said the same in workplaces where time off is not encouraged. Overall, more than a third of working Americans (35 percent) reported experiencing chronic work stress saying during their workday they typically feel tense or stressed out, and just 41 percent said their employer provides sufficient resources to help employees manage their stress.
Nearly half of U.S. workers (49 percent) said low salaries are a significant source of work stress. Other reported sources of stress: lack of opportunity for growth or advancement (46 percent), too heavy of a workload (42 percent) and unrealistic job expectations and long hours (39 percent each).
The survey also looked at the effect of employees having access to adequate mental health resources. Overall, just half of workers (50 percent) say their employer provides the resources necessary to help them meet their mental health needs. When adequate resources are provided, only 33 percent of workers said they typically feel tense or stressed out during the workday, compared to 59 percent of those who said their employer doesn't provide sufficient mental health resources. When it comes to overall well-being, nearly three-fourths of employees supported with mental health resources (73 percent) say their employer helps them develop and maintain a healthy lifestyle, compared to 14 percent who say they don't have the resources.
"Chronic work stress, insufficient mental health resources, feeling overworked and under supported - these are issues facing too many workers, but it doesn't have to be this way," Ballard said.

"Psychological research points the way in how employers can adopt effective workplace practices that go a long way in helping their employees thrive and their business grow."

Why being left-handed matters for mental health treatment

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Treatment for the most common mental health problems could be ineffective or even detrimental to about 50 percent of the population, according to a radical new model of emotion in the brain.

Since the 1970s, hundreds of studies have suggested that each hemisphere of the brain is home to a specific type of emotion. Emotions linked to approaching and engaging with the world -- like happiness, pride and anger -- lives in the left side of the brain, while emotions associated with avoidance -- like disgust and fear -- are housed in the right.
But those studies were done almost exclusively on right-handed people. That simple fact has given us a skewed understanding of how emotion works in the brain, according to Daniel Casasanto, associate professor of human development and psychology at Cornell University.
That longstanding model is, in fact, reversed in left-handed people, whose emotions like alertness and determination are housed in the right side of their brains, Casasanto suggests in a new study. Even more radical: The location of a person's neural systems for emotion depends on whether they are left-handed, right-handed or somewhere in between, the research shows.
The study, "Approach motivation in human cerebral cortex," is published in Philosophical Transactions of the Royal Society B: Biological Sciences.
According to the new theory, called the "sword and shield hypothesis," the way we perform actions with our hands determines how emotions are organized in our brains. Sword fighters of old would wield their swords in their dominant hand to attack the enemy -- an approach action -- and raise their shields with their non-dominant hand to fend off attack -- an avoidance action. Consistent with these action habits, results show that approach emotions depend on the hemisphere of the brain that controls the dominant "sword" hand, and avoidance emotions on the hemisphere that controls the non-dominant "shield" hand.
The work has implications for a current treatment for recalcitrant anxiety and depression called neural therapy. Similar to the technique used in the study and approved by the Food and Drug Administration, it involves a mild electrical stimulation or a magnetic stimulation to the left side of the brain, to encourage approach-related emotions.
But Casasanto's work suggests the treatment could be damaging for left-handed patients. Stimulation on the left would decrease life-affirming approach emotions. "If you give left-handers the standard treatment, you're probably going to make them worse," Casasanto said.
"And because many people are neither strongly right- nor left-handed, the stimulation won't make any difference for them, because their approach emotions are distributed across both hemispheres," he said.
"This suggests strong righties should get the normal treatment, but they make up only 50 percent of the population. Strong lefties should get the opposite treatment, and people in the middle shouldn't get the treatment at all."
However, Casasanto cautions that this research studied only healthy participants and more work is needed to extend these findings to a clinical setting.

Higher blood vitamin D levels = lower colorectal cancer risk

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A new study authored by scientists from the American Cancer Society, the Harvard T.H. Chan School of Public Health, the U.S. National Cancer Institute, and more than 20 other medical centers and organizations finds that higher circulating vitamin D concentrations are significantly associated with lower colorectal cancer risk. This study strengthens the evidence, previously considered inconclusive, for a protective relationship. Optimal vitamin D concentrations for colorectal cancer prevention may be higher than the current National Academy of Medicine recommendations, which are based only on bone health. The study appears online in the Journal of the National Cancer Institute.

Vitamin D, known for its role in maintaining bone health, is hypothesized to lower colorectal cancer risk via several pathways related to cell growth and regulation. Previous prospective studies have reported inconsistent results for whether higher concentrations of circulating 25-hydroxyvitamin D, the accepted measure of vitamin D status, are linked to lower risk of colorectal cancer. The few randomized clinical trials of vitamin D supplementation and colorectal cancer completed thus far have not shown an effect; but study size, supplementation duration, and compliance may have contributed to their null findings.

"To address inconsistencies in prior studies on vitamin D and to investigate associations in population subgroups, we analyzed participant-level data, collected before colorectal cancer diagnosis, from 17 prospective cohorts and used standardized criteria across the studies," said Stephanie Smith-Warner, PhD, an epidemiologist at the Harvard T.H. Chan School of Public Health and co-senior author on the article. The analysis included over 5,700 colorectal cancer cases and 7,100 controls from the United States, Europe, and Asia. A single, widely accepted assay and laboratory was used for new vitamin D measurements and calibration of existing vitamin D measurements. "In the past, substantial differences between assays made it difficult to integrate vitamin D data from different studies," explained Regina G. Ziegler, PhD, a National Cancer Institute epidemiologist and co-senior author on the article. "This calibration approach enabled us to systematically explore risk over the broad range of vitamin D levels seen internationally."

Compared to participants with circulating vitamin D concentrations considered sufficient for bone health, those with deficient concentrations of vitamin D had a 31% higher risk of colorectal cancer during follow-up, which averaged 5.5 years (range: 1 -- 25 years). Similarly, concentrations above bone health sufficiency were associated with a 22% lower risk. However, risk did not continue to decline at the highest concentrations. These associations persisted even after adjusting for known colorectal cancer risk factors.

Protective associations were seen in all subgroups examined. However, the association was noticeably stronger in women than men at concentrations above bone health sufficiency. The lifetime risk of colorectal cancer is 4.2% (1 in 24) in women and 4.5% (1 in 22) in men. Colorectal cancer is the third most common cancer and third leading cause of cancer-related deaths in both men and women in the United States, with about 140,250 new cases and 50,630 deaths expected during 2018.

"Currently, health agencies do not recommend vitamin D for the prevention of colorectal cancer," said Marji L. McCullough, ScD, American Cancer Society epidemiologist and co-first author of the study. "This study adds new information that agencies can use when reviewing evidence for vitamin D guidance and suggests that the concentrations recommended for bone health may be lower than would be optimal for colorectal cancer prevention."
Vitamin D can be obtained in the diet, particularly from fortified foods, from supplements, and from sun exposure. Experts recommend vitamin D be obtained through diet whenever possible because excessive ultraviolet radiation is a major risk factor for skin cancer.

One-third of US adults may unknowingly use medications that can cause depression

A new study from University of Illinois at Chicago researchers suggests that more than one-third of U.S. adults may be using prescription medications that have the potential to cause depression or increase the risk of suicide, and that because these medications are common and often have nothing to do with depression, patients and health care providers may be unaware of the risk.

The researchers retrospectively analyzed medication use patterns of more than 26,000 adults from 2005 to 2014, which were collected as part of the National Health and Nutrition Examination Survey. They found that more than 200 commonly used prescription drugs -- including hormonal birth control medications, blood pressure and heart medications, proton pump inhibitors, antacids and painkillers -- have depression or suicide listed as potential side effects.

Published in the Journal of the American Medical Association, the study is the first to demonstrate that these drugs were often used concurrently and that concurrent use, called polypharmacy, was associated with a greater likelihood of experiencing depression. Approximately 15 percent of adults who simultaneously used three or more of these medications experienced depression while taking the drugs, compared with just 5 percent for those not using any of the drugs, 7 percent for those using one medication and 9 percent for those taking two drugs simultaneously.

The researchers observed similar results for drugs that listed suicide as a potential side effect. These findings persisted when the researchers excluded anyone using psychotropic medications, considered an indicator of underlying depression unrelated to medication use.

"The take away message of this study is that polypharmacy can lead to depressive symptoms and that patients and health care providers need to be aware of the risk of depression that comes with all kinds of common prescription drugs -- many of which are also available over the counter," said lead author Dima Qato, assistant professor of pharmacy systems, outcomes and policy in the UIC College of Pharmacy. "Many may be surprised to learn that their medications, despite having nothing to do with mood or anxiety or any other condition normally associated with depression, can increase their risk of experiencing depressive symptoms, and may lead to a depression diagnosis."

Qato notes that the study also shows an important trend of increasing polypharmacy for medications with depression, particularly suicidal symptoms, as a potential adverse effect. This makes the need for awareness of depression as a potential side effect even more pressing.

The researchers found use of any prescription medication with a potential depression adverse effect increased from 35 percent in the 2005 to 2006 period to 38 percent in the 2013 to 2014 period.
Approximate use of antacids with potential depression adverse effects, like proton pump inhibitors and H2 antagonists, increased from 5 percent to 10 percent in the same period. Use of three or more drugs concurrently increased from 7 percent to 10 percent, approximately.

For prescription drugs with suicide listed as a potential side effect, usage increased from 17 percent to 24 percent, and use of three or more drugs concurrently increased from 2 percent to 3 percent.

"People are not only increasingly using these medicines alone, but are increasingly using them simultaneously, yet very few of these drugs have warning labels, so until we have public or system-level solutions, it is left up to patients and health care professionals to be aware of the risks," Qato said.

Qato says that solutions worth further study may include updating drug safety software to recognize depression as a potential drug-drug interaction, so that health care professionals, including pharmacists, are more likely to notice if a patient is using multiple medications that may increase risk. Or, including evaluation of medication use in the depression screening and diagnostic tools used by doctors and nurses and recommended by the U.S. Preventive Services Task Force, especially when it comes to persistent or treatment-resistant depression.

"With depression as one of the leading causes of disability and increasing national suicide rates, we need to think innovatively about depression as a public health issue, and this study provides evidence that patterns of medication use should be considered in strategies that seek to eliminate, reduce or minimize the impact of depression in our daily lives," Qato said.

Mediterranean-style eating with lean, unprocessed red meat improves heart disease risk

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Adopting a Mediterranean-style eating pattern improves heart health, with or without reducing red meat intake, if the red meat consumed is lean and unprocessed, according to a Purdue University nutrition study.

"This study is important because it shows that red meat can be part of a heart-healthy eating pattern like a Mediterranean-style eating pattern," said Wayne W. Campbell, professor of nutrition science. "This study was not designed to promote red meat intake, and we are not encouraging people who otherwise consume a vegetarian-style eating pattern to begin consuming red meat."

The study is published online at the American Journal of Clinical Nutrition. It was funded by the Beef Checkoff and the Pork Checkoff, with support from the National Institutes of Health's Indiana Clinical and Translational Sciences Institute and a National Institutes of Health pre-doctoral training grant through the Ingestive Behavior Research Center at Purdue.

"Most healthy eating pattern recommendations include a broad statement to reduce red meat intake,'" said Lauren E. O'Connor, lead author and recent doctoral degree recipient. "Our study compared Mediterranean-style eating patterns with red meat intake that is typical in the United States, about 3 ounces per day, versus a commonly recommended intake amount that is 3 ounces twice per week.

]Overall, heart health indicators improved with both Mediterranean-style eating patterns. Interestingly, though, participants' LDL cholesterol, which is one of the strongest predictors we have to predict the development of cardiovascular disease, improved with typical but not lower red meat intake."

The study assessed the health-promoting effects of a Mediterranean-style eating pattern, without intended weight loss, for adults who are overweight and at risk for developing heart disease. All 41 study participants -- 28 females and 13 males -- completed three study phases. The phases included a five-week period of consuming a Mediterranean-style eating pattern containing three ounces per day of lean, unprocessed red meat, an amount of red meat the typical United States resident consumes; a five-week return to their regular eating pattern; and a five-week period of consuming a Mediterranean-style eating pattern with less red meat, three ounces twice weekly, which is commonly recommended for heart health. The order of the typical and lower red meat interventions were randomly assigned among participants.

"It's also very encouraging that the improvements these people experienced -- which included improvements in blood pressure, blood lipids and lipoproteins -- were noticeable in five weeks," Campbell said.

The Mediterranean-style eating pattern, which was ranked No. 1 by Consumer Reports, is recommended by the Dietary Guidelines for Americans. A Mediterranean-style eating pattern has clinically proven effects on health especially related to heart health and risks for heart disease such as heart attack or stroke.

"The composition of a Mediterranean-style eating pattern varies across countries and cultures," Campbell said. "What is common across most Mediterranean regions is consumption of olive oil, fruit, vegetables and legumes, but protein sources depend on what country and geographic region. If they live on the coast, they will eat more seafood, but if they live inland they will eat more red meat."
The American Journal of Clinical Nutrition is published by the American Society for Nutrition.

Greater levels of vitamin D associated with decreasing risk of breast cancer

Researchers at University of California San Diego School of Medicine suggest higher levels of vitamin D are associated with decreasing risk of breast cancer. Their epidemiological study is published in the June 15 online issue of PLOS ONE, in collaboration with Creighton University, Medical University of South Carolina and GrassrootsHealth, an Encinitas-based nonprofit organization that promotes vitamin D research and its therapeutic benefits. The scientists pooled data from two randomized clinical trials with 3,325 combined participants and a prospective study involving 1,713 participants to examine the association between risk of female breast cancer and a broad range of serum 25-hydroxyvitamin D (25(OH)D) concentrations, which was chosen as the marker because it is the main form of vitamin D in blood.
All women were age 55 or older. The average age was 63. Data were collected between 2002 and 2017. Participants were free of cancer at enrollment and were followed for a mean period of four years. Vitamin D levels in blood were measured during study visits.
Over the course of the combined studies, 77 new cases of breast cancer were diagnosed for an age-adjusted incidence rate of 512 cases per 100,000 person-years.
Researchers identified the minimum healthy level of 25(OH)D in blood plasma to be 60 nanograms per milliliter, substantially higher than the 20 ng/ml recommended in 2010 by the Institute of Medicine, now the National Academy of Medicine, a health advisory group to the federal government. Some groups, such as GrassrootsHealth, have advocated higher minimums for health blood serum levels of vitamin D, as much as 50 ng/ml. The matter remains hotly debated.
"We found that participants with blood levels of 25(OH)D that were above 60 ng/ml had one-fifth the risk of breast cancer compared to those with less than 20 ng/ml," said principal investigator and co-author Cedric F. Garland, DrPH, adjunct professor in the UC San Diego Department of Family Medicine and Public Health. Risk of cancer appeared to decline with greater levels of serum vitamin D.
Multivariate regression was used to quantify the association between 25(OH)D and breast cancer risk, with the results adjusted for age, body mass index, cigarette smoking and intake of calcium supplements, said first author Sharon McDonnell, an epidemiologist and biostatistician for GrassrootsHealth. "Increasing vitamin D blood levels substantially above 20 ng/ml appears to be important for the prevention of breast cancer."
Garland, who has previously studied connections between serum vitamin D levels and several types of cancer, said the study builds upon previous epidemiological research linking vitamin D deficiency to a higher risk of breast cancer. Epidemiological studies analyze the distribution and determinants of health and disease, but it has been argued that they do not necessarily prove cause-and-effect.
"This study was limited to postmenopausal breast cancer. Further research is needed on whether high 25(OH)D levels might prevent premenopausal breast cancer," Garland said. The population was also mainly white women so further research is needed on other ethnic groups.
"Nonetheless, this paper reports the strongest association yet between serum vitamin D and reduction in risk of breast cancer," Garland said.
Garland and others have advocated the health benefits of vitamin D for many years. In 1980, he and his late brother Frank C. Garland, also an epidemiologist, published an influential paper that posited vitamin D (produced by the body through exposure to sunshine) and calcium (which vitamin D helps the body absorb) together reduced the risk of colon cancer. The Garlands and colleagues subsequently found favorable associations of markers of vitamin D with breast, lung and bladder cancers, multiple myeloma and adult leukemia.
To reach 25(OH)D levels of 60 ng/ml, said Garland, would generally require dietary supplements of 4,000 to 6,000 international units (IU) per day, less with the addition of moderate daily sun exposure wearing very minimal clothing (approximately 10-15 minutes per day outdoors at noon). He said the success of oral supplementation should be determined using a blood test, preferably during winter months.
The current recommended average daily amount of vitamin D3 is 400 IU for children up to one year; 600 IU for ages one to 70 years (including pregnant or breastfeeding women) and 800 IU for persons over age 70, according to the National Academy of Medicine.
A 2009 paper published in the Annals of Epidemiology by Garland and colleagues recommended a healthy target level of serum 25(OH)D of 40 to 60 ng/ml, based on an expert consensus panel. This statement was published in Annals of Epidemiology (2009). Oral doses of vitamin D are often not specified since different individuals require different intakes to achieve targeted serum range. Except under medical supervision and monitoring, intake of vitamin D3 must not exceed 10,000 IU per day. Blood serum levels exceeding 125 ng/ml have been linked to adverse side effects, such as nausea, constipation, weight loss, heart rhythm problems and kidney damage.

Probiotics can protect the skeletons of older women

For the first time in the world, researchers at the University of Gothenburg, Sweden, have demonstrated that probiotics, dietary supplements with health-promoting bacteria, can be used to affect the human skeleton. Among older women who received probiotics, bone loss was halved compared to women who received only a placebo. The research opens the door to a new way to prevent fractures among the elderly.
Brittleness of the bones, or osteoporosis, is characterized by porous and weak bones, which can cause them to break even when subjected to low loads, such as a fall from standing height. The proportion of the population with osteoporosis increases with age, and a majority of women over 80 years of age have the disease.
"Today there are effective medications administered to treat osteoporosis, but because bone fragility is rarely detected before the first fracture, there is a pressing need for preventive treatments," says Mattias Lorentzon, who is a chief physician and professor of geriatrics at Sahlgrenska Academy, University of Gothenburg.
This is the first time that researchers have shown that it is possible to cut age-related bone loss in elderly women in half if they receive health-promoting bacteria, known as probiotics.
Double-blind, randomized study
The study was conducted at Sahlgrenska University Hospital in Mölndal, Sweden, and its results of the study are now being published by the Journal of Internal Medicine. Ninety elderly women, 76 years old on average, ingested a powder that contained either health-promoting bacteria or a placebo every day for a whole year. A random method determined which women received the active treatment with the Lactobacillus reuteri 6475 bacteria and which received powder without bacteria. Neither the researchers nor the women knew who received the active powder during the study.
"When we finished the study after a year, we measured the women's bone loss in their lower legs with a CT scan and compared it with the measurements we made when the study began. The women who received the powder with active bacteria had lost only half as much bone in the skeleton compared with those who received inactive powders," says Anna Nilsson, a chief physician and associate professor at Sahlgrenska Academy, University of Gothenburg. "Another positive outcome from the study was that the treatment was well tolerated and did not produce more side effects than those experienced by women who received the placebo."
A paradigm shift
Research has shown that intestinal bacteria affect the skeleton in mice, but this is the first study in which probiotics were used to reduce bone loss in older people. The discovery could have important implications in the future: "Older women are the group in society most at risk of osteoporosis and fractures. The fact that we have been able to show that treatment with probiotics can affect bone loss represents a paradigm shift. Treatment with probiotics can be an effective and safe way to prevent the onset of osteoporosis in many older people in the future," says Mattias Lorentzon.
Lactobacillus reuteri 6475 is a bacterium believed to have multiple health-promoting properties, and similar bacteria are already used in a variety of supplements on the market. The bacterium is naturally found in the human gastrointestinal tract. Bacteria in the stomach and intestine have received considerable attention in recent years because there is evidence that the composition of our bacterial flora is associated with diseases such as diabetes and obesity. The mechanisms, that is, the ways that the bacteria produce different effects in the body, are not yet clearly understood.

Mindful movement may help lower stress, anxiety

Taking a walk may be a good opportunity to mentally review your to-do list, but using the time to instead be more mindful of your breathing and surroundings may help boost your wellbeing, according to researchers.

The researchers found that while students reported being less stressed while they were on their feet and moving, they received an even greater benefit when they reported also being more mindful.
Chih-Hsiang "Jason" Yang, a postdoctoral scholar at the University of Southern California who led the study while earning his doctorate at Penn State, said the results suggest a simple way for people to boost their wellbeing throughout the day.

"It can be difficult to ask people to spend a lot of time doing moderate or vigorous activity by going to the gym or out for a run, especially if they feel stressed," Yang said. "But if they don't need to change their everyday behavior, and can instead try to change their state of mind by becoming more mindful, they can probably see this beneficial effect. You don't need to exert a lot of extra effort in order to improve your wellbeing by being more mindful while you're moving around."

David Conroy, professor of kinesiology at Penn State, also said the findings -- recently published in the journal Psychology of Sports and Exercise -- could help people who are not able to engage in strenuous exercise.

"If someone is looking for a way to manage these kinds of feelings, it may be worth trying some sort of mindful movement," Conroy said. "This option may be especially beneficial for people who don't enjoy exercise and would prefer a less intense form of physical activity."

According to the American College Health Association, more than half of college students experience anxiety, sadness or mental exhaustion at least once a year, suggesting a need for a simple way to reduce these negative states. Because students are often moving throughout their days, as they walk to class and go about other activities, the researchers wanted to see if there was a connection between mindfulness, movement and a reduction in negative states.

The researchers recruited 158 Penn State students for the study. For two weeks, a special mobile phone app, called Paco, randomly prompted the participants eight times a day to answer questions about their current activity and states of mind. The prompts included questions about where the participant was, if they were moving, and if they were stressed or anxious, as well as questions designed to assess mindfulness.

After analyzing the data, the researchers found that in the moments when participants were more mindful or active than usual, they showed reduced negative affect. They also found a possible synergistic effect when people were both mindful and active.

"When people were both more mindful and more active than usual, they seem to have this extra decrease in negative affect," Yang said. "Being more active in a given moment is already going to reduce negative affect, but by also being more mindful than usual at the same time, you can see this amplified affect."

Conroy said it was interesting to see patterns emerge within the individual participants, instead of just comparing people who are generally more mindful to people who are generally less mindful.

"Most studies in this area have focused on the differences between people who are more versus people who are less mindful, but we saw that college students often slipped in and out of mindful states during the day," Conroy said. "Developing the ability to shift into these states of mindfulness as needed may be valuable for improving self-regulation and well-being."

To better explore the causal role of mindfulness on lower negative states of being, Yang completed a second study, in which older adults who participated in an outdoor mindfulness activity then reported on their feelings of stress, anxiety and depression. Yang found that the mindful walking was associated with lower levels of these feelings.

The researchers said that in the future, studies that collect more objective data -- like gathering information about physical activity by using accelerometers -- and include more varied populations could be useful.

Army study quantifies changes in stress after meditation

For a thousand years, people have reported feeling better by meditating but there has never been a systematic study that quantified stress and how much stress changes as a direct result of meditation until now.

U.S. Army Research Laboratory researchers spent a year collaborating with a team of scientists from the University of North Texas to develop a new data processing technique that uses heart rate variability as a sensor to monitor the state of the brain. Their findings are reported in a paper published in the June edition of Frontiers in Physiology.

Healthy heartbeats have irregularities built into them with a slight random variation occurring in the time interval between successive beats. The sinus node, or the heart's natural pacemaker, receives signals from the autonomic or involuntary portion of the nervous system, which has two major branches: the parasympathetic, whose stimulation decreases the firing rate of the sinus node, and the sympathetic, whose stimulation increases the firing rate. These two branches produce a continual tug-of-war that generates fluctuations in the heart rate of healthy individuals.

Heart rate variability provides a window through which we can observe the heart's ability to respond to external disturbances, such as stress, said Dr. Bruce West, the Army's senior research scientist for mathematics.

He said it turns out that the HRV time series is very sensitive to changes in the physiological state of the brain and the new data processing system, called dynamic subordination technique, can quantify the changes in HRV and relate these directly to brain activity, such as produced by meditation. Thus, the DST has quantified the level of stress reduction produced by meditation and offers the potential to quantify such things as the inability to concentrate and sustain focus, impatience, impulsiveness and other dysfunctional properties that severely limit a soldier's ability to do his job.

Stress modulates the autonomic nervous system signals, which in turn disrupts normal HRV and therefore the stress level can be detected by processing HRV time series.

Through a new method of processing HRV time series data, the researchers developed a way to measure the change in the level of stress provided by meditation. This measure assigns a number to the level of variability of heartbeat interval time series before and during meditation. This number indicates precisely how much stress is alleviated by control of the heart-brain coupling through meditation.

In the article, Rohisha Tuladhar, Gyanendra Bohara, and Paolo Grigolini, all from the University of North Texas and Bruce J. West, Army Research Office, propose and successfully test a new model for the coupling between the heart and brain, along with a measure of the influence of meditation on this network. Traditional models of biofeedback focus on the coherent behavior, assuming a kind of resonance, however the new approach includes both periodicity and complexity.

The research team compared two schools of meditation and determined that Yoga, over Chi meditation, is more effective in reducing stress and can show by how much. They also found that the long-term practice of meditation has the effect of making permanent the meditation-induced physiologic changes. Moreover that meditators show a stronger executive control, that is, the ability to carry out goal-oriented behavior, using complex mental processes and cognitive abilities.

Many military historians believe battles, even wars, have been won or lost in the warrior's mind, long before any physical conflict is initiated. Learning how to circumvent the debilitating psychological influence of stress requires that we have in hand a way to quantify its influence, in order to gauge the effectiveness of any given procedure to counteract its effects, explained West, who's a Fellow with the American Physical Society, American Association for the Advancement of Science and ARL.

Historically, one purpose of meditation has been to reduce stress, however, the Army's long-term goal is to use it to mitigate the effects of post-traumatic stress disorder, or PTSD. West said the potential for this to succeed has been dramatically increased with the new ability to quantify the degree of effectiveness in stress reduction using different meditation techniques.
From a physiological perspective, meditation constitutes a coupling of the functionalities of the heart and brain. We are only now beginning to understand how to take advantage of the coupling of the two to measure stress reduction by applying the methods of science and data analysis to HRV time series.
Our research focus is on changes in physiologic processes, such as stress level. It is the most direct measure of the effectiveness of meditation in reducing stress to date and compliments an existing ARL program on determining the efficacy of mindfulness meditation stress reduction, which quantifies the influence on different task performance measures, such as changes in PTSD symptoms, West said.
This early research could guide the design and testing of new interventions for improving warrior readiness and resilience, as well as reducing symptoms of PTSD.

Use of alternative medicines has doubled among kids, especially teens

A new study published in JAMA Pediatrics shows that since 2003, the use of alternative medicines, such as herbal products and nutraceuticals, among children has doubled. The University of Illinois at Chicago researchers who conducted the study cite an increased use of Omega-3 fatty acids and melatonin among adolescents ages 13 to 18 as the primary driver of the change, despite clinical recommendations against use of such supplements in children.
Use of dietary supplements, of which herbal, non-vitamin alternative medicines are one type, remained high but otherwise stable, with approximately one-third of children using a dietary supplement.
Study author Dima Qato says the widespread use of supplements among children and the increased use of alternative medicines among teens is worrisome.
"Dietary supplements are not required to go through the same FDA regulations and approval process as prescription drugs. As a result, we know very little about their safety and effectiveness, especially in children," said Qato, assistant professor of pharmacy systems, outcomes and policy at the UIC College of Pharmacy. "Many dietary supplements have also been implicated in adverse drug events, especially cardiovascular, which is a safety concern."
"We simply do not know if there are any benefits to children that outweigh the potential harms, and this study suggests supplement use is widespread and therefore an important, yet often ignored, public health issue," she said.
To study supplement use in children, Qato and her colleagues retrospectively analyzed six recent cycles -- 2003 to 2004 through 2013 to 2014 -- of data from the National Health and Nutrition Examination Survey. During the in-person survey, participants responded to a dietary supplement questionnaire.
If participants indicated supplement use within the last 30 days, they were asked to show the interviewers the containers for all supplements. Each supplement was classified as a nutritional product - those that primarily contain vitamins or minerals - or an alternative medicine and further classified by primary use.
In addition to the high prevalence of supplement use, the researchers observed that, when it comes to adolescents, supplement use varied by gender and use patterns may relate to other health issues.
"Adolescents are using supplements to treat common health conditions or adverse effects of prescription medications," said Qato. "For example, we've seen an increase in use of melatonin, which is promoted as having sleep benefits. At the same time, other studies have shown an increase in the use of ADHD medications, which we know are associated with a risk for insomnia."
The researchers also found use of Vitamin B products and folic acid were most popular among teenage girls. These supplements are promoted as having benefits against depression. For boys, use of Omega-3 fatty acids -- which are marketed as having cognitive benefits -- and body building supplements were popular.
"This suggests that supplement use among children may be targeting specific ailments, but the fact remains that common use of these products in otherwise healthy kids is potentially dangerous," Qato said. "Parents should be aware of the dangers, especially as many may be purchasing the supplements for their children. Health care providers working with children, especially pediatricians and pharmacists, should also take note of the prevalence of supplement use in this age group and ask patients and parents about such use regularly."

Daily fasting works for weight loss

Daily fasting is an effective tool to reduce weight and lower blood pressure, according to a new study published by University of Illinois at Chicago researchers in the journal Nutrition and Healthy Aging.
The study is the first to examine the effect of time-restricted eating -- a form of fasting that limits food consumption to select hours each day -- on weight loss in obese individuals.

To study the effect of this type of diet, researchers worked with 23 obese volunteers who had an average age of 45 and average body mass index, or BMI, of 35.

Between the hours of 10 a.m. and 6 p.m. the dieters could eat any type and quantity of food they desired, but for the remaining 16 hours they could only drink water or calorie-free beverages. The study followed the participants for 12 weeks.

When compared to a matched historical control group from a previous weight loss trial on a different type of fasting, the researchers found that those who followed the time-restricted eating diet consumed fewer calories, lost weight and had improvements in blood pressure.

On average, participants consumed about 350 fewer calories, lost about 3 percent of their body weight and saw their systolic blood pressure decreased by about 7 millimeters of mercury (mm Hg), the standard measure of blood pressure. All other measures, including fat mass, insulin resistance and cholesterol, were similar to the control group.

"The take-home message from this study is that there are options for weight loss that do not include calorie counting or eliminating certain foods," said Krista Varady, associate professor of kinesiology and nutrition in the UIC College of Applied Health Sciences and corresponding author on the study.
While this is the first study to look at the 16:8 diet, named for its 16 hours of fasting and its 8 hours of "feasting," Varady says that the results align with previous research on other types of intermittent fasting diets.

"The results we saw in this study are similar to the results we've seen in other studies on alternate day fasting, another type of diet," Varady said, "but one of the benefits of the 16:8 diet may be that it is easier for people to maintain. We observed that fewer participants dropped out of this study when compared to studies on other fasting diets."

Varady says that while the research indicates daily fasting works for weight loss, there have not yet been studies to determine if it works better than other diets, although the researchers observed the weight loss to be slightly less than what has been observed in other intermittent fasting diet studies.

"These preliminary data offer promise for the use of time-restricted feeding as a weight loss technique in obese adults, but longer-term, large-scale randomized controlled trials [are required]," Varady and her colleagues write.

"The 16:8 diet is another tool for weight loss that we now have preliminary scientific evidence to support," Varady said. "When it comes to weight loss, people need to find what works for them because even small amounts of success can lead to improvements in metabolic health."

The Centers for Disease Control and Prevention estimates that more than one-third of adults in the U.S. have obesity, which greatly increases the risk of metabolic diseases such as coronary heart disease and Type 2 diabetes, and that obesity is most prevalent among non-Hispanic black individuals and middle-age adults.

Plant-based diets improve cardiometabolic risk factors in diabetes patients

Plant-based diets improve glycemic control, lead to weight loss, and improve cholesterol in people with type 2 diabetes, according to a new review published in the journal Clinical Nutrition.

Researchers reviewed nine randomized controlled trials that assessed the effectiveness of vegan and vegetarian diets for diabetes patients. The results show that those who ate a plant-based diet lowered their cholesterol, lost weight, lowered HbA1c levels, and improved other cardiometabolic risk factors when compared to those who ate a nonvegetarian diet.

More than 100 million Americans currently have diabetes or prediabetes. Those with diabetes are two to four times more likely to die from cardiovascular disease than those who do not have diabetes.

"The link between diabetes and cardiovascular disease is strong. Sixty to seventy percent of people who have type 2 diabetes die of heart disease," says study co-author Hana Kahleova, M.D., Ph.D., director of clinical research at the Physicians Committee for Responsible Medicine. "The good news is that this study shows that the same simple prescription--eating a plant-based diet--can reduce our risk for heart problems and improve type 2 diabetes at the same time."

The study authors suggest that plant-based diets, which center on fruits, vegetables, grains, and legumes, benefit both glycemic control and cardiovascular health, because they are low in saturated fat, rich in phytochemicals, high in fiber, and often rich in low-glycemic fruits and vegetables.

Previous controlled trials and prospective cohort studies have shown that a plant-based dietary pattern is associated with a lower risk of coronary heart disease, type 2 diabetes, obesity, hypertension, cardiovascular mortality, and all-cause mortality.

Why being left-handed matters for mental health treatment

Treatment for the most common mental health problems could be ineffective or even detrimental to about 50 percent of the population, according to a radical new model of emotion in the brain.
Since the 1970s, hundreds of studies have suggested that each hemisphere of the brain is home to a specific type of emotion. Emotions linked to approaching and engaging with the world - like happiness, pride and anger - lives in the left side of the brain, while emotions associated with avoidance - like disgust and fear - are housed in the right.

But those studies were done almost exclusively on right-handed people. That simple fact has given us a skewed understanding of how emotion works in the brain, according to Daniel Casasanto, associate professor of human development and psychology at Cornell University.

That longstanding model is, in fact, reversed in left-handed people, whose emotions like alertness and determination are housed in the right side of their brains, Casasanto suggests in a new study. Even more radical: The location of a person's neural systems for emotion depends on whether they are left-handed, right-handed or somewhere in between, the research shows.

The study, "Approach motivation in human cerebral cortex," is published in Philosophical Transactions of the Royal Society B: Biological Sciences.

According to the new theory, called the "sword and shield hypothesis," the way we perform actions with our hands determines how emotions are organized in our brains. Sword fighters of old would wield their swords in their dominant hand to attack the enemy -- an approach action -- and raise their shields with their non-dominant hand to fend off attack -- an avoidance action. Consistent with these action habits, results show that approach emotions depend on the hemisphere of the brain that controls the dominant "sword" hand, and avoidance emotions on the hemisphere that controls the non-dominant "shield" hand.

The work has implications for a current treatment for recalcitrant anxiety and depression called neural therapy. Similar to the technique used in the study and approved by the Food and Drug Administration, it involves a mild electrical stimulation or a magnetic stimulation to the left side of the brain, to encourage approach-related emotions.

But Casasanto's work suggests the treatment could be damaging for left-handed patients. Stimulation on the left would decrease life-affirming approach emotions. "If you give left-handers the standard treatment, you're probably going to make them worse," Casasanto said.

"And because many people are neither strongly right- nor left-handed, the stimulation won't make any difference for them, because their approach emotions are distributed across both hemispheres," he said.

"This suggests strong righties should get the normal treatment, but they make up only 50 percent of the population. Strong lefties should get the opposite treatment, and people in the middle shouldn't get the treatment at all."

However, Casasanto cautions that this research studied only healthy participants and more work is needed to extend these findings to a clinical setting.

Lifetime light alcohol drinkers had the lowest combined risk of mortality or developing cancer

The risk of mortality, and of developing a number of cancers, is lowest in light drinkers consuming an average of less than one drink per day across their lifetime, and the risk of some cancers increases with each additional drink per week, according to a new study, published this week in PLOS Medicine by Andrew Kunzmann of Queen's University Belfast, and colleagues.

In comparison, current U.S. guidelines recommend no more than 2 drinks per day for men and no more than 1 drink per day for women.

Even light-to-moderate levels of alcohol intake have previously been linked to increased cancer risk.

At the same time, research has demonstrated a "J-shaped" risk curve relating alcohol intake to all-cause mortality, suggesting some protective effect of light-to-moderate drinking, particularly for death from cardiovascular disease. Those results have led to mixed public health messages.

The new study analyzed whether combined risk of cancer or death from any cause differed in individuals with different alcohol intakes across their entire lifetime, using data from 99,654 individuals around the US who were followed for an average of 8.9 years as participants in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Alcohol use was measured using a diet history questionnaire administered between 1998 and 2000.

During the study, 9,559 deaths and 12,763 primary cancers occurred among the participants. The expected J-shaped relationship between overall mortality and alcohol consumption was seen: in comparison to lifetime light alcohol drinkers (1-3 drinks per week), lifetime never or infrequent drinkers (<1 1.01-1.13="" 1.02-1.18="" 1.03-1.13="" 1.07="" 1.08="" 1.10="" 1.13-1.30="" 1.21="" 95="" alcohol="" and="" as="" cancer-related="" cancer.="" cancer="" ci="" combined="" comparison="" confidence="" consumption.="" contrast="" day="" developing="" drink="" drinkers="" drinks="" further="" had="" hazard="" heavy="" in="" increased="" infrequent="" interval="" lifetime="" light="" linearly="" lowest="" mortality.="" mortality="" nbsp="" never="" of="" or="" overall="" p="" ratio="" risk="" the="" very="" week="" well="" with="">
The analysis is limited to older adults and may be confounded by socioeconomic factors, and the findings should not be taken to support a protective effect of light drinking, the authors caution.
"This study provides further insight into the complex relationship between alcohol consumption, cancer incidence, and disease mortality and may help inform public health guidelines," the authors say.

Bad habits that lead to cancer, chronic disease corrected by simple lifestyle intervention

Does this sound like someone you know? He or she spends too much time in front of screens, gets little exercise and eats a diet high in fat and low in fruits and vegetables.

It likely sounds familiar because it describes a significant portion of the U.S. population.
A new Northwestern Medicine study found that a lifestyle intervention could fully normalize these four unhealthy behaviors, which put people at risk of developing heart disease and common cancers, including breast, colon and prostate.

The study will be published in the Journal of Medical Internet Research Tuesday, June 19.
"Our findings suggest that prevention of chronic disease through behavior change is feasible. They contradict the pessimistic assumption that it's not possible to motivate relatively healthy people to make large, long-lasting healthy lifestyle changes," said lead author Bonnie Spring, director of the Center for Behavior and Health in the Institute for Public Health and Medicine and professor of preventive medicine at Northwestern University Feinberg School of Medicine.

With the help of a smartphone app, a wearable activity tracker, some social support from a coach and a small financial incentive, study participants made large improvements in their eating and activity habits. From a starting point of less than two servings of fruits and vegetables per day, they increased their intake by 6.5 servings per day. They decreased saturated fat intake by 3.6 percent to consume less than 8 percent of their calories from saturated fat. From a baseline of 4.5 hours per day of leisure screen time, they decreased screen time by almost three hours and increased their moderate to vigorous exercise by 25 minutes per day over a nine-month trial.

Even better, participants were able to achieve the same gains whether they implemented all four diet and exercise changes simultaneously or sequentially (changing two or three first and then changing other behaviors later).
"When most people start a diet and exercise plan, they're excited to hit the ground running, but they can feel quickly defeated when they can't keep up with everything," Spring said. "The tech tools, support and incentives our intervention offered made the changes simple and motivating enough that our participants were able to start making them all at once without becoming overwhelmed."
Previous research has found that healthy behavior change usually reverts once financial incentives cease. But this study stopped offering the financial incentive after only 12 weeks, and participants still achieved positive results throughout the nine-month trial.
Additionally, the changes observed in this study and in a prior trial by the same group were larger and more sustained than what has been previously observed in studies of technology-supported interventions. Spring said she attributes this to two features of the intervention: modest early financial incentives that motivate participants to make changes larger than what they thought they could achieve; and giving digital feedback not only to participants but also to coaches.
How they conducted the study
Between 2012 and 2014, the study, Make Better Choices 2, enrolled 212 Chicago-area adults, primarily female (76 percent), minority (59 percent), college educated (69 percent) and with a mean age of 41 years old. All participants had low fruit and vegetable and high saturated fat intakes, low moderate to vigorous physical activity and high sedentary leisure screen time.
Participants used smartphones and accelerometers to track their activity and behavior, which they also sent to a coach who monitored whether they were tracking and how they were eating and being active. Perfect behavioral adherence was rewarded with an incentive of $5 per week for 12 weeks.
Based on the incoming data, the coach counseled people by telephone in 10- to 15-minute personalized sessions, weekly for three months, then biweekly for the next three months. Then, until nine months, they retained the intervention app but received no further coaching.
"We suggest that giving accelerometer feedback to both the participant and their coach is the way to improve diet and activity habits, because the coach can support, hold the person accountable and personalize coaching when they know what's going on," Spring said.

Possible link found between diabetes and common white pigment

In a pilot study by a team of researchers at The University of Texas at Austin, crystalline particles of titanium dioxide -- the most common white pigment in everyday products ranging from paint to candies -- were found in pancreas specimens with Type 2 diabetes, suggesting that exposure to the white pigment is associated with the disease.
Titanium dioxide (TiO₂) is not a known constituent of any normal human tissue. Our body normally has plenty of salts and compounds of metallic elements such as sodium, potassium, calcium, iron and magnesium, as well as lesser amounts of other metallic elements like cobalt or molybdenum but not of titanium.
The team examined 11 pancreas specimens, eight of which were from donors who had Type 2 diabetes (T2D) and three from donors who did not. Whereas the three non-diabetic pancreatic tissue specimens contained no detectable TiO2 crystals, the crystals were detected in all of the eight T2D pancreatic tissue specimens. The UT Austin researchers found more than 200 million TiO2 crystallites per gram of TiO₂ particles in the specimens from T2D donors but not in the three specimens from non-diabetic donors. They published their findings last month in the journal Chemical Research in Toxicology.
The UT study was led by Adam Heller, professor in the McKetta Department of Chemical Engineering in the Cockrell School of Engineering, a 2007 recipient of the National Medal of Technology and Innovation and a lifelong champion for diabetes research. Heller was a leading member of the teams that designed FreeStyle, the first painless blood-glucose-monitoring system used by millions of people with diabetes worldwide; and the glucose-sensing technology of the FreeStyle Libre system, developed by Abbott Diabetes Care.
"Our initial findings raise the possibility that Type 2 diabetes could be a chronic crystal-associated inflammatory disease of the pancreas, similar to chronic crystal-caused inflammatory diseases of the lung such as silicosis and asbestosis," Heller said.
In the mid-20th century, titanium dioxide pigment replaced highly toxic lead-based pigments. It became the most commonly used white pigment in paints and in foods, medications, toothpaste, cosmetics, plastics and paper. As a result, annual production of titanium dioxide has increased by 4 million tons since the 1960s.
According to the World Health Organization, the number of people with diabetes has quadrupled during the past four decades, affecting approximately 425 million people, with T2D comprising the majority of recorded cases. Although obesity and an aging population are still considered major factors leading to a rise in T2D cases worldwide, Heller's study suggests that increased use of titanium dioxide may also be linked to the rapid rise in the number of people suffering from the disease.
"The increased use of titanium dioxide over the last five decades could be a factor in the Type 2 diabetes epidemic," Heller said. "The dominant T2D-associated pancreatic particles consist of TiO₂ crystals, which are used as a colorant in foods, medications and indoor wall paint, and they are transported to the pancreas in the bloodstream. The study raises the possibility that humanity's increasing use of TiO2 pigment accounts for part of the global increase in the incidence of T2D."
Given the wide-reaching implications of his findings, Heller is keen to repeat the study, but this time using a larger sample. "We have already begun a broader study," he said. "Our work isn't over yet."

The iPad neck plagues women more

Is your iPad being a literal pain in the neck?

The answer is likely yes -- especially if you're a young adult or a woman. "iPad neck" -- persistent pain in the neck and upper shoulders caused by slouching or bending into extreme positions while using tablet computers -- is a growing problem among Americans, according to a new UNLV study.
Findings, released last week in the Journal of Physical Therapy Science, show:

"iPad neck," sometimes called "tablet neck," is usually associated with sitting without back support, such as on a bench or on the ground, or slumping over the tablet while it rests in the user's lap. Other postures significantly associated with pain included using tablets while lying on the side or back.

• The condition is more prevalent among young adults than older adults.
• Women were 2.059 times more likely to experience musculoskeletal symptoms during iPad use than men.
• Those with a history of neck and shoulder pain reported experiencing more neck and shoulder symptoms during tablet computer use.

UNLV physical therapy professor Szu-Ping Lee, lead author of the study, said the results concern him, especially given the growing popularity of tablet computers, e-book readers, and other connected devices for personal, school, and business purposes.

"Such high prevalence of neck and shoulder symptoms, especially among the younger populations, presents a substantial burden to society," he said.

"We were able to quantify exactly how frequent those problems are and what common factors contribute to them," Lee said. The top risk factor was surprising. "Theoretically, the more hours you spend bent over an iPad, the more neck and shoulder pain you experience -- but what we found is that time is not the most important risk factor. Rather, it's gender and specific postures."

UNLV -- in conjunction with researchers from hospitals and physical therapy centers across Southern Nevada -- conducted a survey of 412 public university students, staff, faculty, and alumni (135 men and 275 women) who are touchscreen tablet computer users about their device usage habits and neck/shoulder complaints. (No word on how many of those surveyed completed the questionnaire on an iPad.)

The most frequently reported symptoms were stiffness, soreness, or aching pain in the neck, upper back/shoulder, arms/hands, or head. Most (55 percent) reported moderate discomfort, but 10 percent said their symptoms were severe and 15 percent said it affected their sleep.

Postures that led to pain included those that cause the tablet user to "slump" over and gaze downward:

• Sitting without back support (This increased odds of pain by over two times)
• Sitting with the device in the lap
• Sitting in a chair with the tablet placed on a flat desk surface

Flexing the neck forward for long periods of time can put pressure on the spine, causing neck and shoulder muscle strain and pain.

Researchers found that the group of university students, staff, and alumni they studied reported a higher prevalence of neck and shoulder pain than the general population -- likely attributed to posture and sedentary behavior commonly observed among people in a university setting. Researchers noted that students especially are less likely to have a dedicated work space while on the go so might sit in uncomfortable postures such as slouched cross-legged on the floor when studying on their tablet computers.

Still, only 46 percent of respondents said they'd stop using the device when experiencing discomfort.
Regarding gender differences, 70 percent of female respondents reported experiencing symptoms compared to just under 30 percent of men. Interestingly, women were also more likely (77 percent) to use their tablets while sitting on the floor than men (23 percent).

The pain disparity among genders might be explained by size and movement differences. According to the researchers, women's tendency to have lower muscle strength and smaller stature (for example: shorter arms and narrow shoulders) might lead them to assume extreme neck and shoulder postures while typing.

Preventing iPad Neck

Lee offered these tips:

• Sit with in a chair with back support. "And perhaps that's something for building planners to think about: Installing benches or other chairs without back support invites people to crunch down with iPads in their laps, contributing to posture-related pain problems," Lee said.
• Use a posture reminder device. Also known as "posture trainers" or "posture coaches," these small, wearable devices adhere directly to the skin or clip on to clothing and beep to let you know when you're slouching.
• Take a stand. Place your iPad on a stand (rather than a flat surface) and attach a keyboard in order to achieve a more upright posture when using your tablet.
• Exercise to strengthen neck and shoulder muscles. This is particularly important for women who experience neck and shoulder pain. "Using these electronic devices is becoming a part of our modern lives," Lee said. "In order to reduce the risk of developing long-term neck and shoulder problems, we need to think about how technology like tablet computer affects human ergonomics and posture."

Kitchen towels could cause food poisoning

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Researchers from the University of Mauritius have shown that factors such as family size, type of diet, multi-usage of towels, among other factors, impact the growth of pathogens on kitchen towels, potentially causing food poisoning. The research is presented at ASM Microbe, the annual meeting of the American Society for Microbiology, held from June 7th to June 11th in Atlanta, Georgia.

"Our study demonstrates that the family composition and hygienic practices in the kitchen affected the microbial load of kitchen towels," said Dr. Biranjia-Hurdoyal."We also found that diet, type of use and moist kitchen towels could be very important in promoting the growth of potential pathogens responsible for food poisoning," she said.

49% of the kitchen towels collected in the study had bacterial growth which increased in number with extended family, presence on children and increasing family size. The towels for multipurpose usage (wiping utensils, drying hands, holding hot utensils, wiping/cleaning surfaces) had a higher bacterial count than single-use towels and humid towels showed higher bacterial count than the dry ones. Out of the 49 samples which were positive for bacterial growth, 36.7% grew coliforms, 36.7% Enterococcus spp and 14.3% S. aureus.

"In this study, we investigated the potential role of kitchen towels in cross-contamination in the kitchen and various factors affecting the microbial profile and load of kitchen towels," said Dr. Susheela D. Biranjia-Hurdoyal, Senior Lecturer, Department of Health Sciences, University of Mauritius, lead author on the study.

A total of 100 kitchen towels were collected after one month of use. The researchers cultured the bacteria and identified them by standard biochemical tests. They also determined the bacterial load on the towels.

S. aureus was isolated at a higher rate from families of lower socio-economic status and those with children. The risk of having coliforms (Escherichia coli) was higher from humid towels than the dried ones, from multipurpose towels than single-use ones and from families on non-vegetarian diets.
Coliform and S. aureus were detected at significantly higher prevalence from families with non-vegetarian diets. Escherichia coli is a normal flora of human intestine and it is released in large numbers in human feces. The presence of Escherichia coli indicates possible fecal contamination and lack of hygiene practices.

"The data indicated that unhygienic practices while handling non-vegetarian food could be common in the kitchen," said Dr. Biranjia-Hurdoyal. The presence of potential pathogens from the kitchen towels indicates that they could be responsible for cross-contamination in the kitchen and could lead to food poisoning. "Humid towels and multipurpose usage of kitchen towels should be discouraged. Bigger families with children and elderly members should be especially vigilant to hygiene in the kitchen," she said.

This study was done by Moodelly V as part of an undergraduate project under the supervision of Susheela D Biranjia-Hurdoyal, Senior Lecturer from the Department of Health Sciences, University of Mauritius, Mauritius. The practical component of the work was funded by the University of Mauritius.

Loneliness is bad for the heart

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Loneliness is bad for the heart and a strong predictor of premature death, according to a study presented today at EuroHeartCare 2018, the European Society of Cardiology's annual nursing congress. The study found that feeling lonely was a stronger predictor of poor outcomes than living alone, in both men and women.

"Loneliness is more common today than ever before, and more people live alone," said Anne Vinggaard Christensen, study author and PhD student, The Heart Centre, Copenhagen University Hospital, Denmark. "Previous research has shown that loneliness and social isolation are linked with coronary heart disease and stroke, but this has not been investigated in patients with different types of cardiovascular disease."

The study investigated whether poor social network was associated with worse outcomes in 13,463 patients with ischaemic heart disease, arrhythmia (abnormal heart rhythm), heart failure, or heart valve disease. Data from national registers was linked with the DenHeart survey, which asked all patients discharged from April 2013 to April 2014 from five heart centres in Denmark to answer a questionnaire about their physical and mental health, lifestyle factors such as smoking, and social support.

Social support was measured using registry data on living alone or not, and survey questions about feeling lonely -- Do you have someone to talk to when you need it? Do you feel alone sometimes even though you want to be with someone? "It was important to collect information on both, since people may live alone but not feel lonely while others cohabit but do feel lonely," explained Ms Vinggaard Christensen.

Feeling lonely was associated with poor outcomes in all patients regardless of their type of heart disease, and even after adjusting for age, level of education, other diseases, body mass index, smoking, and alcohol intake. Loneliness was associated with a doubled mortality risk in women and nearly doubled risk in men. Both men and women who felt lonely were three times more likely to report symptoms of anxiety and depression, and had a significantly lower quality of life than those who did not feel lonely.

"Loneliness is a strong predictor of premature death, worse mental health, and lower quality of life in patients with cardiovascular disease, and a much stronger predictor than living alone, in both men and women," said Ms Vinggaard Christensen.

Ms Vinggaard Christensen noted that people with poor social support may have worse health outcomes because they have unhealthier lifestyles, are less compliant with treatment, and are more affected by stressful events. But she said: "We adjusted for lifestyle behaviours and many other factors in our analysis, and still found that loneliness is bad for health."

She concluded: "We live in a time when loneliness is more present and health providers should take this into account when assessing risk. Our study shows that asking two questions about social support provides a lot of information about the likelihood of having poor health outcomes."

European guidelines on cardiovascular prevention state that people who are isolated or disconnected from others are at increased risk of developing and dying prematurely from coronary artery disease. The guidelines recommend assessment of psychosocial risk factors in patients with established cardiovascular disease and those at high risk of developing cardiovascular disease.