Family dinners improve teens' eating habits no matter how well family functions, study finds Uni

A new University of Guelph study has revealed teenagers and young adults who sit down for family dinners - regardless of how well the family unit manages daily routines, communicates and connects emotionally - are more likely to have healthier eating habits than if they graze or fend for themselves at suppertime.

"Gathering around the dinner table is sort of a magical thing," said lead researcher Kathryn Walton, dietitian and U of G PhD student who worked on the study with family relations and applied nutrition professor Jess Haines.

"It's a time when families can slow down from their busy days to talk, spend time together and problem-solve. It's also a time that parents can model healthful eating behaviours."

The researchers found that when families sit down together, adolescents and young adults eat more fruits and veggies and consume fewer fast-food and takeout items.

The study to be published Nov. 21 in JAMA Network Open looked at more than 2,700 participants 14 to 24 years of age who were living with their parents in 2011. They were asked how often they sat down for dinner with their families, how well their family functions, and about their consumption of fruit and vegetables, sugar-sweetened beverages, fast food and takeout food.

The study found that family dinners are associated with better dietary intake for adolescents from both high and low functioning families.
"To reap the many benefits of family dinners, the meal doesn't have to be a big drawn-out affair," said Haines. "Even if it's something you pull out of the freezer, add a bagged salad on the side and you'll have a decent nutritional meal."
Walton said many teens and young adults living at home are busy with evening extracurricular activities or part-time jobs, making it hard to find time for dinner with family members. But finding that time once a day - even if it's breakfast together - can be just as effective.
She also said when family members participate in helping to prepare food, they are more likely to eat it. Getting the whole family involved helps cut down on prep-time and teaches adolescents important food skills. Every meal together counts, start with one and sit down together more frequently as the family schedule allows.

Keep slapping on that sunscreen and ignore toxic claims

It's safe to slap on the sunscreen this summer - in repeated doses - despite what you have read about the potential toxicity of sunscreens.

A new study led by the University of Queensland (UQ) and University of South Australia (UniSA) provides the first direct evidence that zinc oxide nanoparticles used in sunscreen neither penetrate the skin nor cause cellular toxicity after repeated applications.

The research, published this week in the Journal of Investigative Dermatology, refutes widespread claims among some public advocacy groups - and a growing belief among consumers - about the safety of nanoparticulate-based sunscreens.

UQ and UniSA lead investigator, Professor Michael Roberts, says the myth about sunscreen toxicity took hold after previous animal studies found much higher skin absorption of zinc-containing sunscreens than in human studies.

"There were concerns that these zinc oxide nanoparticles could be absorbed into the epidermis, with toxic consequences, including DNA damage," Professor Roberts says.

The toxicity link was picked up by consumers, sparking fears that Australians could reduce their sunscreen use, echoed by a Cancer Council 2017 National Sun Protection Survey showing a drop in the number of people who believed it was safe to use sunscreens every day.

Professor Roberts and his co-researchers in Brisbane, Adelaide, Perth and Germany studied the safety of repeated applications of zinc oxide nanoparticles applied to five volunteers aged 20-30 years.
Volunteers applied the ZnO nanoparticles every hour for six hours on five consecutive days.
"Using superior imaging methods, we established that the nanoparticles remained within the superficial layers of the skin and did not cause any cellular damage," Professor Roberts says.
"We hope that these findings help improve consumer confidence in these products and in turn lead to better sun protection. The terrible consequences of skin cancer and skin damage caused by prolonged sun exposure are much greater than any toxicity posed by approved sunscreens."

Hypnotherapy could help relieve irritable bowel syndrome symptoms

Gut-directed hypnotherapy delivered by psychologists appears as effective in group or individual sessions, potentially offering a new treatment option for irritable bowel syndrome in primary and secondary care.

Hypnotherapy might help relieve irritable bowel syndrome (IBS) complaints for some patients for as long as 9 months after the end of treatment, according to a randomised controlled trial of 354 adults with IBS in primary and secondary care published in The Lancet Gastroenterology & Hepatology journal.

After 3 months of treatment, adequate relief of IBS symptoms was reported by more patients who received individual (40%; 41/102 for whom data were available) and group hypnotherapy (33%; 31/91) than those given education and supportive care (17%; 6/35), and these benefits persisted at 9 months follow-up (42% [38/91], 50% [40/80], and 22% [7/31]).

Importantly, the findings suggest that group hypnotherapy is as effective as individual sessions, which could enable many more patients with IBS to be treated at reduced cost.

The study is the largest randomised trial of hypnotherapy for IBS to date, and one of the first conducted in primary care, where the vast majority of IBS patients are treated.

The study found that IBS patients undergoing hypnotherapy reported a greater overall improvement in their condition and were more able to cope with, and were less troubled by, their symptoms compared with those who received educational supportive therapy. However, hypnotherapy did not appear to reduce the severity of symptoms.
While the findings are promising, the authors conclude that more research will be needed to test the optimum number of hypnotherapy sessions, the effect that patient expectations may have on treatment outcome, and the extent to which hypnotherapy outcomes are influenced by the magnitude of the psychological complaints of the patient.
"Our study indicates that hypnotherapy could be considered as a treatment option for patients with IBS, irrespective of symptom severity and IBS subtype," says Dr Carla Flik from the University Medical Center Utrecht, Netherlands, who led the research. "It is also promising to see that group hypnotherapy is as effective as individual sessions, which may mean that more people could be treated with it at lower cost, should it be confirmed in further studies." [1]
"What's striking about these findings is the extent to which patient's perception of their illness has an effect on their suffering, and that their perception of symptoms appears to be as important as actual symptom severity." [1]
IBS affects around 1 in 5 people worldwide and is a persistent and difficult-to-treat condition, with symptoms that can seriously affect quality of life including abdominal pain, bloating, diarrhoea, and constipation. For many sufferers, drug and dietary treatments are not successful.
Psychological interventions have proven effective, but their use is limited by a shortage of trained therapists. Hypnotherapy has previously shown promising results for IBS, but the majority of studies have been done in highly specialised centres, and more research is needed into whether hypnotherapy is beneficial in primary and secondary care where most patients are treated.
The IMAGINE study recruited 354 adults (aged 18-65 years) with IBS who were referred by primary care physicians and hospital specialists to 11 hospitals across the Netherlands between May 2011 and April 2016. Participants were randomly assigned to receive either 45-minute individual sessions (150 patients) or group sessions (150) of hypnotherapy twice weekly for 6 weeks, or education and supportive care (54).
Hypnotherapy treatment was provided by psychologists who were trained as hypnotherapists and involved a technique of positive visualisation during which patients were given suggestions about how they could gain control over their digestive system to reduce feelings of pain and discomfort. Patients were also given a CD so they could practice self-hypnosis exercises at home for 15-20 minutes every day.
Participants completed assessments on their level of symptom severity, quality of life, psychological symptoms, health-care costs, and work absence at the start of the trial and immediately after treatment (3 months) and again 9 months later, as well as symptom relief immediately after treatment and 9 months later.
Results showed that immediately after treatment, participants in the two hypnotherapy groups reported satisfactory relief at substantially higher rates than those who received educational supportive care, and these benefits persisted for 9 months after the treatment ended (table 2).
Nevertheless, satisfactory relief of symptoms was not accompanied by a significant improvement in symptom severity.
As Dr Flik explains: "We do not know exactly how gut-directed hypnotherapy works, but it may change patients' mindset and internal coping mechanisms, enabling them to increase their control over autonomic body processes, such as how they process pain and modulate gut activity." [1]
Improvements in quality of life, psychological complaints, cognitions and reductions in medical costs and IBS-related work absence were similar between groups.
Overall, hypnotherapy was well tolerated. Eight serious unexpected adverse reactions (six in the individual hypnotherapy group and two in the group hypnotherapy group) were reported, mostly cancer and inflammatory bowel disease, but were not related to hypnotherapy.
The authors note some limitations--for instance, that 22 (15%) patients in the individual hypnotherapy group, 22 (15%) in the group hypnotherapy group, and 11 (20%) in the control group dropped out before or during therapy, and a substantial number of participants did not complete questionnaires at 3 months and 9 months after treatment, which might have biased the results (figure 1). They also point out that the inexperience of therapists in dealing with IBS, and the low number (six) of hypnotherapy sessions provided (half the usual number), might have led to underestimations of the effects of hypnotherapy.
Writing in a linked Comment, Professor Olafur Palsson, University of North Carolina at Chapel Hill, USA discusses factors that may have contributed to the "modest" therapeutic impact of hypnosis in the study.
He writes: "The hypnotherapy tested in this study might have been suboptimal in amount or implementation. However, as the authors note, the smaller therapeutic effect in this trial compared with most hypnotherapy trials in tertiary care might have been because IBS in primary and secondary care is different to that in tertiary care--perhaps simpler in nature and with less involvement of psychological factors. Therefore, despite this impressive investigative effort by Flik and colleagues, it remains unclear whether gut-directed hypnotherapy is well suited for the treatment of patients with IBS in primary and secondary care, and future trials are needed to provide definitive answers."

Study estimates how much time adults sit, how many are physically inactive

Sitting too long and being physically inactive can be bad for your health, and it's important to understand how common these behaviors are among U.S. adults. This study used data from a nationally representative survey of about 5,900 adults to examine sitting time and leisure-time physical activity. Researchers report 1 in 4 adults sit for more than 8 hours a day, 4 in 10 are physically inactive with no moderate or vigorous activity during the week, and 1 in 10 reported both sitting more than 8 hours a day and being physically inactive. Limitations of the study include self-reported data. Practitioners can help support programs and policies that help adults sit less and move more.

Sugar-sweetened beverages are harmful to health and may be addictive

Just as we might have guessed, those tasty, sugar-sweetened beverages that increase risk of diabetes and other chronic diseases may actually be addictive. Youth between 13 and 18 years of age who were deprived of sugary drinks for just three days reported headaches, cravings and other withdrawal symptoms, according to a University of California study with researchers from both the Davis and Berkeley campuses.

All 25 participants in this exploratory study reported normally consuming at least three sugar-sweetened beverages a day before the study and were told they were participating in a study exploring "how soda affects teenagers' health."

The youths reported the following specific symptoms during the three-day period of cessation from sugary drinks: increased headaches, decreased motivation to do work, lack of contentment and ability to concentrate, cravings for sugary drinks, and lower ratings of overall wellbeing.

The findings were published in an article, "Potentially addictive properties of sugar-sweetened beverages among adolescents," appearing in the journal Appetite.

"An abundance of research points to sugary drinks as contributing to a number of chronic diseases. Our findings -- that these drinks may have addictive properties -- make their ubiquitous availability and advertising to youth even more concerning for public health," said Jennifer Falbe, assistant professor in the Department of Human Ecology in the College of Agricultural and Environmental Sciences at UC Davis and the lead author of the article.

The teens, all overweight, were instructed to consume their normal beverages for five days, then, for three days afterward, to consume only water or plain milk. They were reimbursed for travel and received up to $160 for participation.
Participants, a diverse population living in and around the San Francisco Bay Area, kept beverage journals and reported in to researchers several times during the study. Three quarters of the participants were female. They also submitted saliva samples to test for caffeine intake, which could affect results. Most of the participants were not high caffeine consumers before the study, reducing the likelihood that participants were just suffering from caffeine withdrawal, an established disorder, rather than also reduced sugar intake.
Among nine participants, there were some lapses in compliance, usually due to drinking flavored milk instead of plain milk.
The study noted that results were consistent with previous research that has reported the addictive potential for sugar, a relatively new but burgeoning area with parallels to substance abuse. Additionally, researchers said, the study was needed because sugar-sweetened beverage consumption by teens had increased five-fold since the 1950s, and adolescence is a time for increased susceptibility to addiction. Young people, the report said, consume the largest amounts of sugary beverages and have experienced the greatest relative gains in obesity in the past several decades.
The study may have important implications for public health and should be repeated with a larger sample, the researchers said.
"These results, combined with present and future corroborating evidence, could inform clinical practice around helping adolescents reduce sugar-sweetened beverage intake, have important implications for messaging in public health campaigns, and inform the need for efforts to reduce sugar-sweetened-beverage advertising to youth and those drinks' availability in and around schools," the report concluded.

A program of personalized physical exercise reverses functional decline in the over-75s

This is the conclusion of a research project coordinated by Nicolás Martínez-Velilla and Mikel Izquierdo-Redín, researchers at Navarrabiomed, the biomedical research centre of the Government of Navarre and the Public University of Navarre (NUP/UPNA); its results have just been published in the Journal of the American Medical Association (JAMA Internal Medicine).
These findings open up the possibility of medical hospitalisation units changing their traditional paradigm, which focusses mainly on disease, to another that recognises the person's functional status as a clinical sign that may be negatively affected by this traditional hospitalisation (classically based on bed rest).
Programme of physical exercise involving strength, balance and walking
The people participating in this research participated in a controlled, personalised programme of strength, balance and walking exercises adapted to their possibilities, even during the acute phase of their diseases. Depending on the status of each patient, training intensity ranging between 30% and 60% of their muscular capacity was specified, so they did leg and arm exercises. These sessions lasted twenty minutes twice a day (morning and afternoon), over between five and seven consecutive days (including weekends and public holidays) under the individual supervision of experts in the field of physical exercise for the elderly.
The programme of physical activity adapted from the VIVIfrail training programme (already successfully tried out on nearly a thousand people with problems of frailty and residing in seven European countries) was adapted at all times to the clinical circumstances of each patient; far from leading to complications in their initial state of health, it was found to be "a significant support in preventing frailty, a factor in eliminating complications linked to passive stay in hospital and a means of motivation for overcoming disease", as Nicolás Martínez-Velilla and Mikel Izquierdo pointed out.
"Our study shows that intervention involving, innovative, personalised multicomponent physical exercise that includes moderate intensity endurance training over a very short period of time, five days on average, has a significant benefit on routine care and may help to reverse the functional and cognitive deterioration associated with the hospitalisation of the elderly," said the NUP/UPNA professor.
The results of the study show that when discharged from hospital, the group that had participated in the prescribed programme of exercise achieved, in comparison with those who had not done it, a total of 2.2 points above the average on a maximum score of 12 in the SPPB (Short Physical Performance Battery) functional assessment tool, which measures balance, walking speed and leg strength, and 6.9 points above the average score in the Barthel Functional Index for Activities of Daily Living, which has a maximum score of 100 points. These results are particularly important, as there is scientific consensus that regards a one-point increase on the SPPB scale and five on the Barthel scale as clinically significant.
In comparison with the interventions carried out so far with patients that fit this profile, this is new and constitutes significant progress in dealing with functional aspects when abandoning hospitalisation models that encourage the bed rest and sendentarism of the patient. "Until now, no one had suggested that patients of this type (elderly people with a range of diseases) could benefit in just five days from a personalised exercise programme far removed from the usual message of 'get up and walk along the corridor a little' or 'rest in bed or in an armchair´," explained the head of the Geriatric Service at the CHN. Significant benefits of the intervention from the cognitive and life quality perspective were also found. The above-mentioned improvements were achieved without any side effects or increase in hospital stay, as the researchers point out in their article.
"Nevertheless, this intervention did not change the rate of re-admittance or mortality three months later. In such an elderly population as those in the study and with a theoretically short life expectancy following hospitalisation, the aim of our intervention was not to increase the quantity but the quality of life," said Nicolás Martínez-Velilla.
"Sometimes we believe that improvements in technologies or the latest innovative treatment can provide all the solutions for our problems, but we are not aware that disability generated by hospitalisation may exert a greater impact than the very disease that prompted admittance in the first place. In this respect the hugely positive effect that physical exercise can have on disease prevention and treatment is reiterated," added Mikel Izquierdo.

Having poor vision can raise risk for falls among older adults

Vision impairment and blindness affect one in 11 Americans age 65 and older. Because our population is aging, the number of older adults with vision problems is predicted to rise. Older adults who have impaired vision may be at risk for decreased independence, poorer well-being, and an increased risk of falls. For example, in any given year, approximately 30 percent of adults over age 65 will fall. Having impaired vision more than doubles this risk.

For older adults, falls are a major cause of illness and death. Even having a fear of falling is a challenge that can limit activity and worsen quality of life and independence as you age.
However, we don't have much information on how often visually impaired older adults experience a fall, and we have even less information about what happens to them after a fall. A team of researchers suggested that we need this information in order to understand the scope of the problem and create ways to prevent falls in visually impaired older adults.

To learn more, the research team examined information from the National Health and Aging Trends Study (NHATS). They published their study in the Journal of the American Geriatrics Society.
Their goal was to provide up-to-date information on the frequency of falls. The team also wanted to learn more about the fear of falling and how it might limit activity among older adults who have vision impairments.

Participants in the study were considered visually impaired if they had trouble recognizing someone across the street and/or reading newspaper print, even when using corrective lenses.
Falls were defined as "any fall, slip, or trip" that involved losing balance and landing on the floor or ground or at a lower level. Participants were asked if they had any fall in the past month and if they fell more than once in the past 12 months. Fear of falling was determined by asking participants if they had worried about falling down in the last month. An additional question asked whether worrying about falling ever caused participants to limit their activities.
The researchers also asked about the number of chronic conditions the participants had, including heart attack, heart disease, high blood pressure, arthritis, osteoporosis, diabetes, lung disease, stroke, and cancer.
The researchers concluded that falls, fear of falling, and limiting activity were considerably more common among older adults who were visually impaired.
About 50 percent of people who said they had trouble seeing were afraid of falling and as a result, limited their activity. More than one in four older adults with vision problems had recurrent falls in the year before they were surveyed.
The researchers said their study suggested that taking steps to prevent falls for older adults with vision problems was important and could limit the harmful consequences of falls for older adults. What's more, helping older adults prevent falls might also slow declines in well-being, quality of life, and independence associated with a fear of falling.
The researchers noted that vision impairment can be treated or even avoided in many cases, and they speculated that doing so might be a strategy to decrease falls and fall-related problems for some older adults with vision problems.
"We need more information about falls and the fear of falling in older adults with vision problems. This will help us design public health and clinical interventions to address some of the key consequences of vision loss for older adults," said study co-author Joshua R. Ehrlich, MD, MPH.