Walking more than five flights of stairs a day can cut risk of heart disease by 20%

Forget walking 10,000 steps a day. Taking at least 50 steps climbing stairs each day could significantly slash your risk of heart disease, according to a new study from Tulane University.

The study, published in Atherosclerosis, found that climbing more than five flights of stairs daily could reduce risk of cardiovascular disease by 20%.

Atherosclerotic cardiovascular disease (ASCVD) along with coronary artery disease and stroke are the leading causes of morbidity and mortality worldwide.

“Short bursts of high-intensity stair climbing are a time-efficient way to improve cardiorespiratory fitness and lipid profile, especially among those unable to achieve the current physical activity recommendations,” said co-corresponding author Dr. Lu Qi, HCA Regents Distinguished Chair and professor at the Tulane University School of Public Health and Tropical Medicine. “These findings highlight the potential advantages of stair climbing as a primary preventive measure for ASCVD in the general population.”

Using UK Biobank data collected from 450,000 adults, the study calculated participants’ susceptibility to cardiovascular disease based on family history, established risk factors and genetic risk factors and surveyed participants about their lifestyle habits and frequency of stair climbing. Median follow-up time was 12.5 years.

The study found that climbing more stairs daily especially reduced risk of cardiovascular disease in those who were less susceptible. However, Qi said the increased risk of heart disease in more susceptible people could be “effectively offset” by daily stair climbing.

Qi touted the public availability of stairs as a low-cost, accessible way to incorporate exercise into daily routines.

“This study provides novel evidence for the protective effects of stair climbing on the risk of ASCVD, particularly for individuals with multiple ASCVD risk factors,” Qi said.

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JOURNAL

Atherosclerosis

DOI

10.1016/j.atherosclerosis.2023.117300 

Study pinpoints the length of incidental activity linked to health benefits

 

Peer-Reviewed Publication

UNIVERSITY OF SYDNEY

A new wearables study tracking over 25,000 people provides the best evidence yet that short bouts of incidental activity, the kind we do as part of daily living, could reduce risk of heart attack, stroke and even premature death – but the length of activity and intensity matters.

“From walking up the stairs to speedily mopping the floors; in recent years we’ve come to understand that it is not just structured exercise that is good for our health, but we know very little about how these short bouts of incidental activity translate to health benefits,” said the study’s senior author Professor Emmanuel Stamatakis from the University of Sydney’s Charles Perkins Centre.

In a study published in The Lancet Public Health today, a University of Sydney led team of international researchers with collaborators from University College London, University of Glasgow, University of Edinburgh, Loughborough University and University of Oxford set out to answer that question.

They used wrist-worn wearables data from the UK Biobank and machine learning to analyse the seven-day incidental physical activity patterns of 25, 241 UK adults aged 42 to 78, down to a 10-second time window. They then linked these physical activity micropatterns with participants' health records, following them for close to eight years to identify how length and intensity of physical activity bouts were linked to health status.

In this cohort of people who self-reported no participation in exercise or sport they found;

• 97% of incidental physical activity was accrued in bouts lasting <10 minutes
• Short bouts of <10 minutes at a moderate to vigorous intensity were associated with a steep decrease in major cardiac events (heart attack/stroke) and death by any cause.
• Moving consistently for at least 1 to 3 minutes was associated with significantly more benefit (29% lower) than very short bouts <1 minute.
• The longer the bouts the better (e.g., accrued in 2 minutes vs 30 seconds), regardless of total activity levels.
• The higher the % of vigorous activity in each bout the better – those who huffed and puffed for at least 15% of the bout (roughly 10 seconds per minute) saw the greatest benefit.
• Bouts <1 minute were also associated with benefits if the above 15% vigorous activity rule was applied.

 

“This study suggests people could potentially reduce their risk of major cardiac events by engaging in daily living activities of at least moderate intensity where they are ideally moving continuously for at least one to three minutes at a time. In fact, it appears that this can have comparable health benefits to longer bouts lasting 5 to 10 minutes,” said lead author Dr Matthew Ahmadi, Postdoctoral Research Fellow at the University of Sydney’s Charles Perkins Centre.

“The take-home message here is any type of activity is good for your health, but the more effort you put into those daily tasks and the longer you keep up that energy, the more benefits you are likely to reap,” said Professor Stamatakis.

“If you are huffing and puffing and unable to hold a conversation for some of that time you have hit the sweet spot.”

The observational nature of the study means researchers cannot prove a cause-and-effect relationship with certainty. However, the researchers made extensive use of the UK Biobank’s baseline health information allowing them to account for a number of factors such as diet, smoking, alcohol consumption, sleep and sedentary time. They also took precautionary measures against the potential effects of reverse causation, whereby poor health may influence activity patterns, by excluding those who had a cardiac event within five years of the wearables measurement, high frailty, and poor self-rated health.

Why do we need to know more about incidental activity?

Fewer than one in five middle-aged adults engage in regular exercise. There are a number of reasons for this including cost, time commitment, health status and access to facilities or infrastructure, but the fact remains that most people are not meeting recommended physical activity guidelines.

“The idea of accruing short bouts of moderate to vigorous activity through daily living activities makes physical activity much more accessible to people who are unwilling or unable to take part in structured exercise,” said Dr Ahmadi. “But as we see in this data, the length and the vigour people put into these incidental activities matters.”

The researchers say the study also provides some of the first direct evidence to support the idea that movement doesn’t have to be completed in continuous 10 minute bouts to be beneficial – a widely held belief until the World Health Organization removed this from their physical activity guidelines in 2020, instead focusing on the idea that ‘every move counts towards better health’. 

The researchers write: “If verified in future research, our findings could inform future public health messaging targeting the general population raising awareness of potential health benefits from short physical activity bouts in everyday life, especially for adults who do not or cannot exercise.”

Increasing steps by 3,000 per day can lower blood pressure in older adults

 

This study sought to determine if older adults with hypertension could receive these benefits by moderately increasing their daily walking, which is one of the easiest and most popular forms of physical activity for this population.

Peer-Reviewed Publication

UNIVERSITY OF CONNECTICUT

An estimated 80% of older adults in the U.S. have high blood pressure. Maintaining healthy blood pressure can protect against serious conditions like heart failure, heart attacks, and strokes.

A new study including Linda Pescatello, distinguished professor of kinesiology in UConn's College of Agriculture, Health and Natural Resources, found that adding a relatively minimal amount of movement, about 3,000 steps per day, can significantly reduce high blood pressure in older adults.

Pescatello worked with Elizabeth Lefferts, the lead author of the paper, Duck-chun Lee, and others in Lee’s lab at Iowa State University. They published their findings in a recent issue of the Journal of Cardiovascular Development and Disease.

“We’ll all get high blood pressure if we live long enough, at least in this country,” Pescatello says. “That’s how prevalent it is.”

Pescatello is an expert on hypertension (the clinical term for high blood pressure) and exercise. Her previous research has demonstrated that exercise can have a significant immediate and long-lasting impact on lowering blood pressure in hypertensive adults.

This study sought to determine if older adults with hypertension could receive these benefits by moderately increasing their daily walking, which is one of the easiest and most popular forms of physical activity for this population.

“It’s easy to do, they don’t need any equipment, they can do it anywhere at almost any time,” Lee says.

The study focused on a group of sedentary older adults between ages 68 and 78 who walked an average of about 4,000 steps per day before the study.

After consulting existing studies, Lee determined that 3,000 steps would be a reasonable goal. This would also put most participants at 7,000 daily steps, in line with the American College of Sports Medicine’s recommendation.

“3,000 steps is large enough but not too challenging to achieve for health benefits,” Lee says.

The team conducted the study during the height of the COVID-19 pandemic, which meant they had to do everything remotely.

The researchers sent participants a kit with pedometers, blood pressure monitors, and step diaries for participants to log how much they were walking each day.

On average, participants’ systolic and diastolic blood pressure decreased by an average of seven and four points, respectively, after the intervention.

Other studies suggest decreases of these magnitudes correspond to a relative risk reduction of all-cause mortality by 11%, and 16% for cardiovascular mortality, an 18% reduction in the risk of heart disease, and a 36% risk reduction of stroke.

“It’s exciting that a simple lifestyle intervention can be just as effective as structured exercise and some medications,” Lefferts says.

The findings suggest that the 7,000-step regimen the participants in the study achieved is on-par with reductions seen with anti-hypertensive medications.Eight of the 21 participants were already on anti-hypertensive medications. Those participants still saw improvements in systolic blood pressure from increasing their daily activity.

“In a previous study, we found that when exercise is combined with medication, exercise bolsters the effects of blood pressure medication alone,” Pescatello says. “It just speaks to the value of exercise as anti-hypertensive therapy. It’s not to negate the effects of medication at all, but it’s part of the treatment arsenal.”

The researchers found that walking speed and walking in continuous bouts did not matter as much as simply increasing total steps.

“We saw that the volume of physical activity is what’s really important here, not the intensity,” Pescatello says. “Using the volume as a target, whatever fits in and whatever works conveys health benefits.”

This work was a pilot study, and the researchers hope to use these data to launch a larger clinical trial.

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JOURNAL

Journal of Cardiovascular Development and Disease

Latest version of the Healthy Eating Index covers toddler diet quality

Leading nutrition experts critically review the Healthy Eating Index-2020 and introduce the tandem index for toddlers aged 12 through 23 months in the Journal of the Academy of Nutrition and Dietetics– In four articles in the Journal of Nutrition and Dietetics, published by Elsevier, leading nutrition experts describe and evaluate the latest versions of the Healthy Eating Index (HEI), issued to correspond to the 2020-2025 Dietary Guidelines for Americans (DGA). For the first time, there are two new HEIs, one for children and adults 2 years and older, and one for young children aged 12 through 23 months.

The Call to Action of the ninth edition of the Dietary Guidelines for Americans is “Make Every Bite Count.” These guidelines form the basis of nutrition policy for the US Government and the foundation of all federal nutrition guidance. Developed to measure alignment with the evidence-based DGA, the HEI is a tool designed to measure diet quality—that is, how closely an eating pattern or mix of foods matches the recommendations in the DGA.

Four articles were written by the Healthy Eating Index Team, through a collaboration between the HHS, National Cancer Institute, and the USDA Food and Nutrition Service.

Jill Reedy, PhD, MPH, RDN, Chief, Risk Factor Assessment Branch, National Cancer Institute, explained: “For the first time, the current DGA (2020-2025) includes a USDA Dietary Pattern for toddlers aged 12 through 23 months. The HEI has a long and robust history of evolving to align with the state of the science. The development of the HEI-Toddlers-2020 is a clear example of this and answers the call by the 2020 Dietary Guidelines Advisory Committee to ‘develop a dietary pattern scoring system, such as the Healthy Eating Index (HEI), for infants and children from birth to 24 months, considering findings from this report and future dietary guidance.’”

Reflecting the current DGA, the HEI articles cover the two separate indices: the HEI-2020 and the new HEI-Toddlers-2020. In addition to an introductory editorial, they include one article that highlights the HEI-2020 that was updated for children and adults (i.e., two years and older); two articles on the new HEI-Toddlers-2020 that was developed and evaluated for toddlers 12 through 23 months; and an overarching article that discusses the continuity, considerations, and future directions for diet quality throughout the lifespan. They contribute to the growing literature on dietary patterns, toddler nutrition, and the healthy eating trajectory.

Both the HEI-Toddlers-2020 and the HEI-2020 have 13 components, each of which reflects an important aspect of diet quality. Nine components focus on adequacy (foods we should eat enough of to get the nutrients we need and for overall good health), and four components focus on moderation (dietary components that should be limited or consumed in small amounts). Calculations using the HEI-Toddlers-2020, like the HEI-2020, result in a total score and a set of individual component scores that reveal a dietary pattern.

HEI-Toddlers-2020 and HEI-2020 radar plots including total scores for each age group are shown in the figure below. Total HEI scores across the lifespan are suboptimal with the highest scores being for young children ages 12 through 23 months (HEI-Toddlers-2020 Total Score 63.4) and adults 60 years and older (HEI-2020 Total Score 59.5).

The HEI-Toddlers-2020, like HEI-2020, has 13 components reflecting all constituents of dietary intake, except for human milk or infant formula. Healthy dietary patterns for toddlers have unique considerations reflected in the scoring standards for Added Sugars and Saturated Fats, notably:

• A recommendation to avoid added sugars (the guidance for ages 2 and older recommends limiting added sugars to less than 10% of calories per day)
• No recommendation to limit saturated fats to less than 10% of energy intake (the guidance for ages 2 and older recommends limiting saturated fats to less than 10% of energy intake)

Consumption of ultraprocessed food = higher risk of depression

The findings of this study suggest that greater ultraprocessed food (UPF; i.e., energy-dense, palatable, and ready-to-eat items) intake, particularly artificial sweeteners and artificially sweetened beverages, is associated with increased risk of depression. Although the mechanism associating UPF to depression is unknown, recent experimental data suggests that artificial sweeteners elicit purinergic transmission in the brain, which may be involved in the etiopathogenesis of depression.  

Suppressing negative thoughts may be good for mental health after all

The commonly-held belief that attempting to suppress negative thoughts is bad for our mental health could be wrong, a new study from scientists at the University of Cambridge suggests.

Researchers at the Medical Research Council (MRC) Cognition and Brain Sciences Unit trained 120 volunteers worldwide to suppress thoughts about negative events that worried them, and found that not only did these become less vivid, but that the participants’ mental health also improved.

“We’re all familiar with the Freudian idea that if we suppress our feelings or thoughts, then these thoughts remain in our unconscious, influencing our behaviour and wellbeing perniciously,” said Professor Michael Anderson.

“The whole point of psychotherapy is to dredge up these thoughts so one can deal with them and rob them of their power. In more recent years, we’ve been told that suppressing thoughts is intrinsically ineffective and that it actually causes people to think the thought more – it’s the classic idea of ‘Don’t think about a pink elephant’.

These ideas have become dogma in the clinical treatment realm, said Anderson, with national guidelines talking about thought avoidance as a major maladaptive coping behaviour to be eliminated and overcome in depression, anxiety, PTSD, for example.

When COVID-19 appeared in 2020, like many researchers, Professor Anderson wanted to see how his own research could be used to help people through the pandemic. His interest lay in a brain mechanism known as inhibitory control – the ability to override our reflexive responses – and how it might be applied to memory retrieval, and in particular to stopping the retrieval of negative thoughts when confronted with potent reminders to them.

Dr Zulkayda Mamat – at the time a PhD student in Professor Anderson’s lab and at Trinity College, Cambridge – believed that inhibitory control was critical in overcoming trauma in experiences occurring to herself and many others she has encountered in life. She had wanted to investigate whether this was an innate ability or something that was learnt – and hence could be taught.

Dr Mamat said: “Because of the pandemic, we were seeing a need in the community to help people cope with surging anxiety. There was already a mental health crisis, a hidden epidemic of mental health problems, and this was getting worse. So with that backdrop, we decided to see if we could help people cope better.”

Professor Anderson and Dr Mamat recruited 120 people across 16 countries to test whether it might in fact be possible – and beneficial – for people to practice suppressing their fearful thoughts. Their findings are published today in Science Advances.

In the study, each participant was asked to think of a number of scenarios that might plausibly occur in their lives over the next two years – 20 negative ‘fears and worries’ that they were afraid might happen, 20 positive ‘hopes and dreams’, and 36 routine and mundane neutral events. The fears had to be worries of current concern to them, that have repeatedly intruded in their thoughts.

Each event had to be specific to them and something they had vividly imagined occurring. For each scenario, they were to provide a cue word (an obvious reminder that could be used to evoke the event during training) and a key detail (a single word expressing a central event detail). For example:

• Negative – visiting one’s parents at the hospital as a result of COVID-19, with the cue ‘Hospital’ and the detail ‘Breathing’.
• Neutral – a visit to the opticians, with the cue ‘Optician’ and the detail ‘Cambridge’.
• Positive – seeing one’s sister get married, with the cue ‘Wedding’ and the detail ‘Dress’.

Participants were asked to rate each event on a number of points: vividness, likelihood of occurrence, distance in the future, level of anxiety about the event (or level of joy for positive events), frequency of thought, degree of current concern, long-term impact, and emotional intensity.

Participants also completed questionnaires to assess their mental health, though no one was excluded, allowing the researchers to look at a broad range of participants, including many with serious depression, anxiety, and pandemic-related post-traumatic stress.

Then, over Zoom, Dr Mamat took each participant through the 20-minute training, which involved 12 ‘No-imagine’ and 12 ‘Imagine’ repetitions for events, each day for three days.

For No-imagine trials, participants were given one of their cue words, asked to first acknowledge the event in their mind.  Then, while continuing to stare directly at the reminder cue, they were asked to stop thinking about the event – they should not try to imagine the event itself or use diversionary thoughts to distract themselves, but rather should try to block any images or thoughts that the reminder might evoke.  For this part of the trial, one group of participants was given their negative events to suppress and the other given their neutral ones.

For Imagine trials, participants were given a cue word and asked to imagine the event as vividly as possible, thinking what it would be like and imagining how they would feel at the event. For ethical reasons, no participant was given a negative event to imagine, but only positive or neutral ones.

At the end of the third day and again three months later, participants were once again asked to rate each event on vividness, level of anxiety, emotional intensity, etc., and completed questionnaires to assess changes in depression, anxiety, worry, affect, and wellbeing, key facets of mental health.

Dr Mamat said: “It was very clear that those events that participants practiced suppressing were less vivid, less emotionally anxiety-inducing, than the other events and that overall, participants improved in terms of their mental health. But we saw the biggest effect among those participants who were given practice at suppressing fearful, rather than neutral, thoughts.” 

Following training – both immediately and after three months – participants reported that suppressed events were less vivid and less fearful. They also found themselves thinking about these events less.

Suppressing thoughts even improved mental health amongst participants with likely post-traumatic stress disorder. Among participants with post-traumatic stress who suppressed negative thoughts, their negative mental health indices scores fell on average by 16% (compared to a 5% fall for similar participants suppressing neutral events), whereas positive mental health indices scores increased by almost 10% (compared to a 1% fall in the second group).

In general, people with worse mental health symptoms at the outset of the study improved more after suppression training, but only if they suppressed their fears. This finding directly contradicts the notion that suppression is a maladaptive coping process.

Suppressing negative thoughts did not lead to a ‘rebound’, where a participant recalled these events more vividly. Only one person out of 120 showed higher detail recall for suppressed items post-training, and just six of the 61 participants that suppressed fears reported increased vividness for No-Imagine items post-training, but this was in line with the baseline rate of vividness increases that occurred for events that were not suppressed at all.  

“What we found runs counter to the accepted narrative,” said Professor Anderson. “Although more work will be needed to confirm the findings, it seems like it is possible and could even be potentially beneficial to actively suppress our fearful thoughts.”

Although participants were not asked to continue practising the technique, many of them chose to do so spontaneously. When Dr Mamat contacted the participants after three months, she found that the benefits in terms of reduced levels of depression and negative emotions, continued for all participants, but were most pronounced among those participants who continued to use the technique in their daily lives.

“The follow up was my favourite time of my entire PhD, because every day was just joyful,” she said. “I didn’t have a single participant who told me ‘Oh, I feel bad’ or ‘This was useless’. I didn't prompt them or ask ‘Did you find this helpful?’ They were just automatically telling me how helpful they found it.”

One participant was so impressed by the technique that she taught her daughter and her own mother how to do it. Another reported how she had moved home just prior to COVID-19 and so felt very isolated during the pandemic.

“She said this study had come exactly at the time she needed it because she was having all these negative thoughts, all these worries and anxiety about the future, and this really, really helped her,” said Dr Mamat. “My heart literally just melted, I could feel goosebumps all over me. I said to her ‘If everyone else hated this experiment, I would not care because of how much this benefited you!’.”

Moderate to vigorous physical activity early in the day influences weight management, health outcomes

 

Even though epidemiological evidence has been controversial regarding the optimal timing of physical activity for weight management, the hours of 7 a.m. to 9 a.m. appear to be the most favorable time of day to enhance the association between daily moderate to vigorous physical activity and obesity, according to a new analysis published in Obesity, The Obesity Society’s (TOS) flagship journal.

“Our study provided a novel tool to explore the diurnal pattern of physical activity and to investigate its impact on health outcomes,” said Tongyu Ma, PhD, assistant professor, Health Sciences Department, Franklin Pierce University, Rindge, N.H.; and the Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China. Ma is the corresponding author of the study.

Experts note that previous research has focused on the frequency, intensity and duration of physical activity. So far, few studies have investigated the diurnal pattern of accelerometer-measured physical activity to classify the time of day of human movement. It is unclear whether accumulating physical activity at different times of day is equally associated with obesity. Additionally, it is unclear whether meeting the physical activity guidelines (150 minutes/week of moderate to vigorous physical activity) with different patterns is equally beneficial for reducing obesity. In the current research, researchers explored whether the diurnal pattern of accelerometer-measured moderate to vigorous physical activity influences the association between such human movement and obesity.

Researchers used data from the 2003–2004 and 2005–2006 cycles of the National Health and Nutrition Examination Survey by the Centers for Disease Control and Prevention because accelerometry was implemented during that time. A total of 5,285 participants were cross-sectionally analyzed. The diurnal pattern of objectively measured moderate to vigorous physical activity was classified into three categories by K-means clustering analysis: morning, mid-day and evening. K-means is an established algorithm that is commonly used to identify hidden patterns in unlabeled data sets.

Results revealed a strong linear association between moderate to vigorous physical activity and obesity in the morning group, whereas a weaker curvilinear connection was found in the midday and evening groups. Participants who met the physical activity guidelines in the morning cluster had a lower body mass index and waist circumference than those in the other clusters. Self-reported dietary recall indicated that participants in the morning cluster had a healthier diet and less daily energy intake per unit of body weight compared with other clusters. The study’s authors also found that participants in the morning cluster spent a significantly higher amount of time on sedentary behavior than the participants in the other clusters. Despite the longer duration of sedentary time, the lower body mass index and waist circumference outcomes in the morning group persisted.

Overall, participants in the morning cluster were 10-to-13 years older than the two other groups. The morning cluster also had the highest percentage of female participants among the three groups. The majority of participants in the morning group were primarily non-Hispanic White, had a college or higher education, and had never used tobacco or alcohol.

“Our findings propose that the diurnal pattern of moderate to vigorous physical activity could be another important dimension to describe the complexity of human movement,” Ma and his colleagues stated in the study.

Rebecca Krukowski, PhD, a clinical psychologist with expertise in behavioral weight management, commented, “This is exciting new research that is consistent with a common tip for meeting exercise goals—that is, schedule exercise in the morning before emails, phone calls or meetings that might distract you.”

However, Krukowski said, since this is a cross-sectional study, “it is not known whether people who exercise consistently in the morning may be systematically different from those who exercise at other times, in ways that were not measured in this study. For example, people who exercise regularly in the morning could have more predictable schedules, such as being less likely to be shift workers or less likely to have caregiving responsibilities that impede morning exercise. Predictable schedules could have other advantageous effects on weight that were not measured in this study, such as with sleep length/quality and stress levels. In addition, the ‘morning larks’ who consistently rise early enough for morning exercise may be biologically different from their ‘night owl’ counterparts.”  

Krukowski, professor, and co-director of the Community-Based Health Equity center, University of Virginia, School of Medicine, Department of Public Health Sciences, was not associated with the research.

The study’s authors noted that prospective studies and randomized clinical trials are needed to confirm their findings.

Healthy lifestyle can help prevent depression – and new research may explain why

A healthy lifestyle that involves moderate alcohol consumption, a healthy diet, regular physical activity, healthy sleep and frequent social connection, while avoiding smoking and too much sedentary behaviour, reduces the risk of depression, new research has found.

In research published today in Nature Mental Health, an international team of researchers, including from the University of Cambridge and Fudan University, looked at a combination of factors including lifestyle factors, genetics, brain structure and our immune and metabolic systems to identify the underlying mechanisms that might explain this link.

According to the World Health Organization, around one in 20 adults experiences depression, and the condition poses a significant burden on public health worldwide. The factors that influence the onset of depression are complicated and include a mixture of biological and lifestyle factors.

To better understand the relationship between these factors and depression, the researchers turned to the UK Biobank, a biomedical database and research resource containing anonymised genetic, lifestyle and health information about its participants.

By examining data from almost 290,000 people – of whom 13,000 had depression – followed over a nine-year period, the team was able to identify seven healthy lifestyle factors linked with a lower risk of depression. These were:

• moderate alcohol consumption
• healthy diet
• regular physical activity
• healthy sleep
• never smoking
• low-to-moderate sedentary behaviour
• frequent social connection

Of all of these factors, having a good night’s sleep – between seven and nine hours a night – made the biggest difference, reducing the risk of depression, including single depressive episodes and treatment-resistant depression, by 22%.

Frequent social connection, which in general reduced the risk of depression by 18%, was the most protective against recurrent depressive disorder.

Moderate alcohol consumption decreased the risk of depression by 11%, healthy diet by 6%, regular physical activity by 14%, never smoking by 20%, and low-to-moderate sedentary behaviour by 13%.

Based on the number of healthy lifestyle factors an individual adhered to, they were assigned to one of three groups: unfavourable, intermediate, and favourable lifestyle. Individuals in the intermediate group were around 41% less likely to develop depression compared to those in the unfavourable lifestyle, while those in the favourable lifestyle group were 57% less likely.

The team then examined the DNA of the participants, assigning each a genetic risk score. This score was based on the number of genetic variants an individual carried that have a known link to risk of depression. Those with the lowest genetic risk score were 25% less likely to develop depression when compared to those with the highest score – a much smaller impact than lifestyle.

In people at high, medium, and low genetic risk for depression, the team further found that a healthy lifestyle can cut the risk of depression. This research underlines the importance of living a healthy lifestyle for preventing depression, regardless of a person's genetic risk.

Professor Barbara Sahakian, from the Department of Psychiatry at the University of Cambridge, said: “Although our DNA – the genetic hand we’ve been dealt – can increase our risk of depression, we’ve shown that a healthy lifestyle is potentially more important.

“Some of these lifestyle factors are things we have a degree control over, so trying to find ways to improve them – making sure we have a good night’s sleep and getting out to see friends, for example – could make a real difference to people’s lives.”

To understand why a healthy lifestyle might reduce the risk of depression, the team studied a number of other factors.

First off, they examined MRI brain scans from just under 33,000 participants and found a number of regions of the brain where a larger volume – more neurons and connections – was linked to a healthy lifestyle. These included the pallidum, thalamus, amygdala and hippocampus.

Next, the team looked for markers in the blood that indicated problems with the immune system or metabolism (how we process food and produce energy). Among those markers found to be linked to lifestyle were the C-reactive protein, a molecule produced in the body in response to stress, and triglycerides, one of the primary forms of fat that the body uses to store energy for later.

These links are supported by a number of previous studies. For example, exposure to stress in life can affect how well we are able to regulate blood sugar, which may lead to a deterioration of immune function and accelerate age-related damage to cells and molecules in the body. Poor physical activity and lack of sleep can damage the body’s ability to respond to stress. Loneliness and lack of social support have been found to increase the risk of infection and increase markers of immune deficiency.

The team found that the pathway from lifestyle to immune and metabolic functions was the most significant. In other words, a poorer lifestyle impacts on our immune system and metabolism, which in turn increases our risk of depression.

Dr Christelle Langley, also from the Department of Psychiatry at the University of Cambridge, said: “We’re used to thinking of a healthy lifestyle as being important to our physical health, but it’s just as important for our mental health. It’s good for our brain health and cognition, but also indirectly by promoting a healthier immune system and better metabolism.”

Professor Jianfeng Feng, from Fudan University and Warwick University, added: “We know that depression can start as early as in adolescence or young adulthood, so educating young people on the importance of a healthy lifestyle and its impact on mental health should begin in schools.”

Reference
Zhao, Y & Yang, L et al. The brain structure, immunometabolic and genetic mechanisms underlying the association between lifestyle and depression. Nature Mental Health; 11 Sept 2023; DOI: 10.1038/s44220-023-00120-1

FOR OLDER MEN, TREATING URINARY SYMPTOMS MAY LEAD TO LOWER MORTALITY RISK

Effective treatment for lower urinary tract symptoms (LUTS) in men aged 50 or older is associated with a lower risk of death over the next few years reports a study in the October issue of The Journal of Urology®, an Official Journal of the American Urological Association (AUA). The journal is published in the Lippincott portfolio by Wolters Kluwer. 

"We found a small but significant decrease in mortality risk for older men who received medications for treatment of LUTS," comments lead author Blayne Welk, MD, MSc, of Western University and Lawson Health Research Institute, London, Ont., Canada. "The findings suggest that we may need to view urinary symptoms differently, possibly with an emphasis on earlier treatment." Dr. Welk's coauthor was Andrew McClure, MSc.  

One-point reduction in urinary symptoms linked to 4% reduction in mortality 

The researchers analyzed data on 3,046 men aged 50 years or with moderate to severe LUTS from a previous clinical trial (the Medical Treatment of Prostate Symptoms trial). Participants were randomly assigned to active treatment with medications for LUTS – the alpha-1 blocker doxazosin, the 5-alpha reductase inhibitor finasteride, or a combination of the two – or inactive placebo treatment. 

Follow-up data were used to assess the relationship between reduction in urinary symptoms and the risk of death after an average of six years. Severity was assessed using a standard score (the AUA Symptom Score), which rates the impact of LUTS symptoms on a scale from 0 to 35. The patients' median age was 62 years; 117 men died during the two-year follow-up period. 

"Improvement in male LUTS was associated with a reduced risk of death," the researchers write. For each one-point reduction in symptom score, the relative likelihood (hazard ratio) for death decreased by 4%. Greater symptom reductions were linked to greater reductions risk of death: hazard ratio decreased by 12% with a three-point reduction in symptom score and by 35% with a 10-point reduction in LUTS. 

Men assigned to all three active treatment groups had significant reductions in mortality risk, but the placebo group did not. The findings were consistent on further analyses including adjustment for potential confounding factors or for surgical treatment (transurethral prostate resection). Reductions in specific types of symptoms (storage or voiding symptoms) were associated with similar reductions in mortality. 

Could earlier treatment for LUTS lower risk of death? 

Lower urinary tract symptoms such as weak stream and frequent nighttime urination (nocturia) are very common in older men. Previous studies have linked moderate to severe LUTS to an increased risk of death. The new study is the first to focus on whether improvement in male LUTS may reduce this excess risk of death. 

The reduction in mortality in men receiving effective medications may have implications for the approach to treatment for LUTS in older men. Such urinary symptoms are generally viewed as a "benign condition," treated only if they become a bothersome problem for the patient. 

The researchers emphasize that their study cannot determine whether there is a causal relationship between improvement in LUTS symptoms and subsequent mortality risk. If so, then earlier treatment based on symptom scores would be an appropriate strategy – analogous to the long-term reductions in mortality resulting from early treatment for mild increases in blood pressure.  

The authors also note that the study did not evaluate the effect of other treatment options, including newer types of selective alpha blockers. Dr. Welk and Mr. McClure conclude: "Further study is necessary to see if early LUTS treatment independently decreases the risk of mortality." 

Link to Paper [The Reduction of Male Lower Urinary Tract Symptoms Is Associated With a Decreased Risk of Death]  

Turmeric may be as good for treating indigestion as drug to curb excess stomach acid

 

A natural compound found in the culinary spice turmeric may be as effective as omeprazole—a drug used to curb excess stomach acid—for treating indigestion symptoms, suggests the first study of its kind, published online in the journal BMJ Evidence-Based Medicine.

Turmeric is derived from the root of the Curcuma longa plant. It contains a naturally active compound called curcumin thought to have anti-inflammatory and antimicrobial properties, and has long been used as a medicinal remedy, including for the treatment of indigestion, in South East Asia. 

But it’s not clear how well it compares with conventional drugs for this indication, largely because there have been no head to head studies.

The researchers therefore randomly assigned 206 patients aged 18-70 with recurrent upset stomach (functional dyspepsia) of unknown cause, recruited from hospitals in Thailand between 2019 and 2021, to one of three treatment groups for a period of 28 days.

These were: turmeric (two large 250 mg capsules of curcumin 4 times a day) and one small dummy capsule (69 patients); omeprazole (one small 20 mg capsule daily and two large dummy capsules 4 times a day (68 patients); and turmeric plus omeprazole (69 patients).

Omeprazole is a proton pump inhibitor, or PPI for short. PPIs are used to treat functional dyspepsia, the symptoms of which include feeling excessively full after food (postprandial fullness), feeling full up after only a little food (early satiety), and pain and/or burning sensation in the stomach and/or food pipe (epigastric pain).

But long term use of PPIs has been linked to increased fracture risk, micronutrient deficiencies, and a heightened risk of infections, note the researchers.

Of the 206 patients enrolled, 151 completed the study, with 20 in the curcumin group;19 in the omeprazole group; and 16 in the combined treatment group, dropping out. 

Patients in all three groups had similar clinical characteristics and indigestion scores, as assessed by the Severity of Dyspepsia Assessment score or SODA, at the start of the trial. Patients were reassessed after 28 days and then again after 56 days.

SODA scores indicated significant reductions in symptom severity by day 28 for pain (−4.83, –5.46 and −6.22) and other symptoms (−2.22, –2.32, and −2.31) for those in the combined, curcumin alone, and omeprazole alone groups, respectively. 

These improvements were even stronger after 56 days for pain (−7.19, –8.07 and −8.85, respectively) and other symptoms (−4.09, –4.12 and −3.71, respectively). 

SODA also captures satisfaction scores: these scarcely changed over time among the curcumin users, which might possibly be related to its taste and/or smell, suggest the researchers.

No serious side effects were reported, although liver function tests indicated some level of deterioration among curcumin users carrying excess weight, note the researchers.

They acknowledge the small size of the study, as well as several other limitations, including the short intervention period and lack of long-term monitoring data. Further larger, long term studies are needed, they say.

Nevertheless, they conclude: “This multicentre randomised controlled trial provides highly reliable evidence for the treatment of functional dyspepsia,” adding that “the new findings from our study may justify considering curcumin in clinical practice.”

Older people may have glaucoma without realizing it

 

IMAGE: LENA HAVSTAM JOHANSSON, SAHLGRENSKA ACADEMY AT THE UNIVERSITY OF GOTHENBURG. view more 

CREDIT: PHOTO BY MALIN ARNESSON

It can be hard to know that you have glaucoma. In a study carried out at the University of Gothenburg, almost five percent of 70-year-olds were found to have glaucoma, and half of those diagnosed were unaware that they had the disease.

Glaucoma is a common eye disease that damages the optic nerve and thereby the field of vision. In the most serious cases, glaucoma can lead to blindness.

The research was carried out by Lena Havstam Johansson, a PhD student at the University of Gothenburg and a specialist nurse at Sahlgrenska University Hospital. The study shows that 4.8% of the 560 study participants examined by eye specialists had glaucoma.

“Of those who were diagnosed with glaucoma via the study, 15 people – or 2.7% of all participants – were unaware that they had the disease before being examined,” says Lena Havstam Johansson. “So half of those who turned out to have glaucoma were diagnosed because they took part in the study.”

For those who were newly diagnosed, the discovery of the disease meant they could start treatment with daily eye drops that lower the pressure in the eye and slowing down the damage to the optic nerve.

Reduced vision affects daily life

Compared to people without the disease those with glaucoma had similar levels of physical activity and did not smoke more, or drink more alcohol. They rated their overall quality of life as being just as good as others, they were not more tired or more depressed.

“This was a positive surprise, and was a finding that I hope can bring comfort to many people who have been diagnosed with glaucoma. It’s hard to live with a disease that gradually impairs vision, but life can still be good in many ways.”

By contrast, people with glaucoma reported that their vision-related quality of life was poorer.

“It’s harder to climb stairs, see curbs in the evening, and notice things in your peripheral vision. This means that people with glaucoma may avoid visiting others, or going to restaurants or parties, and instead stay at home. They lose their independence, and may feel frustrated about it.”

Around a thousand 70-year-olds

The research was carried out as part of the H70 study, examining the health of older people, which has been conducted at the University of Gothenburg for fifty years. The H70 study continuously invites all 70-year-olds born in a certain year in Gothenburg to attend several comprehensive physical and cognitive examinations. The 1,203 70-year-olds included in the glaucoma study were born in 1944. For these studies, almost everyone (1,182 people) answered written questions about their eye health and the presence of glaucoma in their family. Eye specialists at Sahlgrenska University Hospital also examined 560 of the participants.

The research confirms that there are hereditary factors behind the disease, as those diagnosed with glaucoma were more likely to have a close relative with the same diagnosis. The results also confirm that glaucoma involves higher eye pressure, although they also show that the majority of those who were newly diagnosed (67%) still had normal eye pressure.

During the early stages of the disease, the healthy eye can compensate for the loss of vision, meaning that many people believe their vision is as good as before. These studies confirm that glaucoma often does not initially involve a loss of visual acuity, which may make it harder to detect the disease.

The results have been published in two articles in the journal Acta Ophthalmologica.

The prevalence of glaucoma in a 70-year-old Swedish population in the city area of Gothenburg, https://doi.org/10.1111/aos.15734 

Vision-related quality of life among 70-year-olds diagnosed with glaucoma, https://doi.org/10.1111/aos.1573

High blood pressure while lying down linked to higher risk of heart health complications

• An analysis of data from a long-running study of more than 11,000 adults from four diverse communities in the United States has found that adults who had high blood pressure while both seated upright and lying supine (flat on their backs) had a higher risk of heart disease, stroke, heart failure or premature death compared to adults without high blood pressure while upright and supine. 
• Adults who had high blood pressure while lying supine but not while seated upright had similar elevated risks of heart attack, stroke, heart failure or premature death as adults who had high blood pressure in both supine and upright positions.
• The increased risk of heart disease, stroke, heart failure or premature death did not differ by the type of blood pressure medication used among participants.

Embargoed until 6:30a.m. CT/7:30 a.m. ET Thursday, Sept. 7, 2023

BOSTON, Sept. 7, 2023 — People who had high blood pressure while lying flat on their backs had a higher risk of heart attack, stroke, heart failure or premature death, according to new research to be presented at the American Heart Association’s Hypertension Scientific Sessions 2023, to be held Sept. 7-10, 2023, in Boston. The meeting is the premier scientific exchange focused on recent advances in basic and clinical research on high blood pressure and its relationship to cardiac and kidney disease, stroke, obesity and genetics.

The autonomic nervous system regulates blood pressure in different body positions; however, gravity may cause blood to pool when seated or upright, and the body is sometimes unable to properly regulate blood pressure during lying, seated and standing positions, the authors noted.

“If blood pressure is only measured while people are seated upright, cardiovascular disease risk may be missed if not measured also while they are lying supine on their backs,” said lead study author Duc M. Giao, a researcher and a 4th-year M.D. student at Harvard Medical School in Boston.

To examine body position, blood pressure and heart health risk, the researchers examined health data for 11,369 adults from the longitudinal Atherosclerosis Risk in Communities (ARIC) study. The data on supine and seated blood pressure was gathered during the enrollment period, ARIC visit 1, which took place between 1987–1989. Participants had their blood pressure taken while briefly lying down at a clinic. The average age of participants at that time was 54 years old; 56% of the group self-identified as female; and 25% of participants self-identified as Black race. Participants in this analysis were followed for an average of 25 to 28 years, up through ARIC visit 5, which includes health data collected from 2011-2013.

The researcher’s findings included:

• 16% percent of participants who did not have high blood pressure — defined in this study as having top and bottom blood pressure measures greater than or equal to 130/80 mm Hg — while seated had high blood pressure while lying supine (flat on their backs), compared to 74% of those with seated high blood pressure who also had supine high blood pressure.
• In comparison to participants who did not have high blood pressure while seated and supine, participants who had high blood pressure while seated and supine had a 1.6 times higher risk of developing coronary heart disease; a 1.83 times higher risk of developing heart failure; a 1.86 times higher risk of stroke; a 1.43 times higher risk of overall premature death; and a 2.18 times higher risk of dying from coronary heart disease
• Participants who had high blood pressure while supine but not while seated had similar elevated risks as participants who had high blood pressure while both seated and supine.
• Differences in blood pressure medication use did not affect these elevated risks in either group.

“Our findings suggest people with known risk factors for heart disease and stroke may benefit from having their blood pressure checked while lying flat on their backs,” Giao said.

“Efforts to manage blood pressure during daily life may help lower blood pressure while sleeping. Future research should compare supine blood pressure measurements in the clinic with overnight measurements.”

The study’s limitations included that it focused on adults who were middle-aged at the time of enrollment, meaning the results might not be as generalizable to older populations, Giao said.

Use of common painkillers alongside hormonal contraception linked to heightened risk of blood clots

 

Women who use non-steroidal anti-inflammatory painkillers alongside hormonal contraception appear to be at a small increased risk of blood clots known as venous thromboembolism (VTE), finds a large Danish study published by The BMJ today.

The risk was greater in women using combined oral contraceptives containing third or fourth generation progestins, but smaller in women using progestin-only tablets, implants and coils, alongside the non-steroidal anti-inflammatory drugs (NSAIDs) ibuprofen, diclofenac, and naproxen.

The researchers stress that the absolute risk of developing a serious blood clot is low, even in women using high risk hormonal contraception. But given the widespread use of both hormonal contraception and NSAIDs, they say women should be advised of this potential drug interaction accordingly. 

NSAIDs have previously been linked to blood clots, but little is known about whether using NSAIDs influences the risk of venous thromboembolism in otherwise healthy women using hormonal contraception.

To address this, researchers used national medical records to track first time diagnoses of venous thromboembolism among 2 million women aged 15 to 49 years living in Denmark between 1996 and 2017 with no history of blood clots, cancer, hysterectomy or fertility treatment.

Hormonal contraception was divided into high, medium and low risk, according to their association with VTE based on previous studies.

High risk hormonal contraception included combined oestrogen and progestin patches, vaginal rings, and pills containing either 50 mcg oestrogen or third or fourth generation progestins. Medium risk contraception included all other combined oral contraceptives and the medroxyprogesterone injection, while progestin-only tablets, implants, and hormone intrauterine devices (coils) were classed as low or no risk.

A range of potentially influential factors such as age, education level, pregnancy history, prior surgery, high blood pressure and diabetes, were also taken into account.

In the study, NSAIDs were used by 529,704 women while using hormonal contraception. Ibuprofen was the most frequently used NSAID (60%), followed by diclofenac (20%) and naproxen (6%).

Over an average 10-year monitoring period, 8,710 venous thromboembolic events occurred (2,715 pulmonary embolisms and 5,995 deep venous thromboses), and 228 (2.6%) women died within 30 days of their diagnosis.

In absolute terms, NSAID use was associated with four extra venous thromboembolic events per week per 100,000 women not using hormonal contraception, 11 extra events in women using medium risk hormonal contraception, and 23 extra events in women using high risk hormonal contraception.

Among individual NSAIDs, the association was strongest for diclofenac compared with ibuprofen and naproxen.

This is an observational study, so can’t establish cause, and the researchers highlight several limitations, such as missing information about smoking and obesity, which they say may have affected their results.

Nevertheless, this was a large study based on high quality registry data and the researchers were able to adjust for a wide range of potentially influential factors. What’s more, the associations persisted after further analysis, suggesting that they are robust.

As such, the researchers conclude: “Using high quality, linkable, national registries, this nationwide study adds new knowledge on the risk of a potentially fatal event during concomitant use of two drug classes often prescribed to otherwise healthy women.”  

They add: “Women needing both hormonal contraception and regular use of NSAIDs should be advised accordingly.”

These data raise important concerns about using NSAIDs, particularly diclofenac, and high risk hormonal contraception concomitantly, writes Morten Schmidt at Aarhus University Hospital, in a linked editorial.

He suggests that healthcare authorities and regulators should include these findings in their safety assessment of available over-the-counter diclofenac, and women using hormonal contraception and their clinicians should consider alternatives to NSAIDs for analgesia. 

“If treatment with NSAIDs is needed, agents other than diclofenac seem preferable, along with lower risk hormonal contraceptives such as progestin only tablets, implants, or intrauterine devices,” he concludes.

High intake of several emulsifier E numbers linked to increased cardiovascular disease risk

High intake of several emulsifiers (part of the ‘E numbers’ group of food additives), widely used in industrially processed foods to improve texture and extend shelf-life, is associated with increased risk of cardiovascular disease (CVD), suggests a study published by The BMJ today.

Given that these food additives are used ubiquitously in thousands of widely  consumed ultra-processed food products, these findings have important public health implications, say the researchers.

Emulsifiers are often added to processed and packaged foods such as pastries, cakes, ice cream, desserts, chocolate, bread, margarine and ready meals, to enhance their appearance, taste, texture and shelf life. They include celluloses, mono- and diglycerides of fatty acids, modified starches, lecithins, carrageenans  (derived from red seaweed; used to thicken foods), phosphates, gums and pectins.

As with all food additives, the safety of emulsifiers is regularly assessed based on the available scientific evidence, yet some recent research suggests that emulsifiers can disrupt gut bacteria and increase inflammation, leading to potentially increased susceptibility to cardiovascular problems.

To explore this further, researchers in France set out to assess the associations between exposure to emulsifiers and risk of cardiovascular disease, including coronary heart disease and cerebrovascular disease - conditions affecting blood flow and blood vessels in the heart and brain.

Their findings are based on 95,442 French adults (average age 43 years; 79% women) with no history of heart disease who were taking part in the NutriNet-Santé cohort study between 2009 and 2021.

During the first two years of follow-up, participants completed at least three (and up to 21) 24-hour online dietary records. Each food and beverage item consumed was then matched at the brand level against three databases to identify the presence and the dose of any food additive. Laboratory tests were also performed to provide quantitative data.

Participants were also asked to report any major CVD event, such as a heart attack or stroke, which were validated by an expert committee after reviewing the participants’ medical records. 

Deaths linked to CVD were also recorded using the French national death register, and several well known risk factors for heart disease including age, sex, weight (BMI), educational level, family history, smoking status, physical activity levels, and diet quality (e.g. sugar, salt, energy, alcohol intakes) were taken into account.

After an average follow-up of 7 years, higher intake of total celluloses (E460-E468), cellulose (E460) and carboxymethylcellulose (E466) were found to be positively associated with higher risks of CVD and specifically coronary heart disease. 

Higher intakes of monoglycerides and diglycerides of fatty acids (E471 and E472) were associated with higher risks of all studied outcomes. Among these emulsifiers, lactic ester of monoglycerides and diglycerides of fatty acids (E472b) was associated with higher risks of CVD and cerebrovascular diseases, and citric acid ester of monoglycerides and diglycerides of fatty acids (E472c) was associated with higher risks of CVD and coronary heart disease. 

High intake of trisodium phosphate (E339) was also associated with an increased risk of coronary heart disease.

There was no evidence of an association between the other studied emulsifiers and any of the cardiovascular outcomes.

This is a single observational study, so can’t establish cause, and the researchers acknowledge some study limitations. For example, the high proportion of women, higher educational background, and overall more health conscious behaviours among the NutriNet-Santé study participants compared with the general French population, may limit the generalisability of the results. 

Nevertheless, the study sample was large and they were able to adjust for a wide range of potentially influential factors, while using unique detailed brand-specific data on food additives. What’s more, the results were unchanged after further testing, suggesting that they are robust.

The authors stress that these results need replication in other large scale studies, but say they could “contribute to the re-evaluation of regulations around food additive usage in the food industry to protect consumers.” 

“Meanwhile, several public health authorities recommend limiting the consumption of ultra-processed foods as a way of limiting exposure to non-essential controversial food additives,” they add.

Burning candles and fumes from cooking is harmful for people with mild asthma

A new study from Aarhus University shows that young individuals with even mild asthma should remember to turn ventilation all the way up when cooking or burning candles. The fumes can cause irritation and inflammation in the body.

Peer-Reviewed Publication

AARHUS UNIVERSITY

 

IMAGE: A SIZZLING STEAK IN THE PAN AND THE LIT CANDLES DOES NOT ONLY CREATE A COSY ATMOSPHERE. A NEW STUDY FROM AARHUS UNIVERSITY SHOWS THAT THE FUMES ARE HARMFUL TO INDIVIDUALS WITH EVEN MILD ASTHMA. POSTDOC KARIN ROSENKILDE LAURSEN FROM THE DEPARTMENT OF PUBLIC HEALTH IS BEHIND THE STUDY. view more 

CREDIT: TORBEN SIGSGAARD

A cosy set table, a nice steak in the pan, and romantic candlelight may sound like the start of a lovely evening. However, a new study from the Department of Public Health at Aarhus University suggests that you should be cautious about inhaling too much of the cosy atmosphere. Karin Rosenkilde Laursen, a postdoc at the department and co-author of the study, says:

"Our study shows that indoor air pollution caused by fumes from cooking and burning candles can lead to adverse health effects such as irritation and inflammation in young individuals with mild asthma. Among other things, we’ve found indications of DNA damage and signs of inflammation in the blood."

When we turn on the oven, place a pan on the hob, or light candles, ultrafine particles and gases are produced, which we then inhale. Previous studies have shown that these particles and gases can be detrimental to health. What sets this study apart is that the researchers have focused on the effects on young individuals with mild asthma, aged between 18 and 25, says Karin Rosenkilde Laursen:

"In the study, we observed that even very young individuals with mild asthma can experience discomfort and adverse effects if the room is not adequately ventilated during cooking or when burning candles. Young people are generally fitter and more resilient than older and middle-aged individuals. Therefore, it is concerning that we observed a significant impact from the particles on this particularly young age group."

But not only people diagnosed with asthma need to keep an eye on the indoor climate, she says.

"Even though the study focused on young asthmatics, its findings are interesting and relevant for all of us. Winter is approaching, a time when we tend to light many candles and perhaps are less likely to open doors and windows while cooking. By prioritising a healthier indoor climate, even when we're cosying up indoors, we may be able to help reduce the incidence of serious lung and cardiovascular diseases, as well as cancer."

Karin Rosenkilde Laursen plans to follow up this study with another examining how emissions from cooking and candles affect healthy adults.

The research results - more information 

• Studytype: The study is a randomised controlled double-blind exposure study in which 36 young asthmatics were exposed to three different exposures in the climate chambers at Aarhus University. They were exposed to emissions from cooking, emissions from burning candles and finally clean air. Each time, the participants were exposed for five hours under highly controlled conditions. During the exposures, we measured particles and gases, and participants reported symptoms related to irritation and general well-being. Biomarkers in relation to airway and systemic inflammatory changes were assessed before exposure, immediately after exposure and again the next morning.
• Partners: The Department of Chemistry, Aarhus University. The Department of Public Health, University of Copenhagen, The Department of Public Health and Community Medicine, University of Gothenburg, Aarhus University Hospital.
• Funding: The study is financed by Realdania Research grant of DKK 2.8 million. 
• Read more in the scientific article