As temperatures break records, many are unaware of symptoms of heat-related illnesses

Increasing numbers link extreme heat to climate change

Reports and Proceedings

Annenberg Public Policy Center of the University of Pennsylvania

With NASA data showing that July 22, 2024, was the hottest day on record and indications that July may have been the hottest month, an Annenberg Public Policy Center survey conducted in mid-July found that most people know three of the symptoms of a heat-related illness but do not know the location of their nearest cooling center. At the same time, increasing numbers of people think that heat waves are becoming more frequent and intense and affecting their daily activities.

Knowledge of cooling centers in the case of extreme heat

Although the locations of cooling centers, or indoor air-conditioned facilities such as libraries, community and senior centers, schools are publicized by city governments on hot days, many of those surveyed report being unaware of where to find one. Two-thirds of respondents (67%) say they do not know the location of a cooling center to which they could go to in case of extreme heat, a number statistically unchanged from last November. “Communities must do a better job of making the public, especially the most vulnerable, aware of these centers,” said Ken Winneg, managing director of survey research at APPC.

More today see link between extreme heat and climate change.

When compared with an APPC survey in November 2023, significantly more people now say that climate change is increasing the risk of heat-related illnesses, respiratory diseases, and insect-borne diseases. Two-thirds (67%) hold this view vs. just under 6 in 10 (58%) in November 2023.

More people indicate that heat waves in the United States are becoming more frequent and intense than in the past. About two-thirds (65%) believe heat waves are becoming more frequent and intense. Fifty-eight percent (58%) felt this way in November 2023, when we last asked the question. About a quarter (24%) believe heat waves are about as frequent and intense as they have always been, statistically unchanged from our earlier survey.

At the same time, the proportion of people who say extreme heat has often or frequently affected their typical daily activities in the past year has increased significantly. Forty-three percent (43%) say extreme outdoor heat has often (22%) or frequently (21%) affected their daily activities, an 8-point increase compared with November 2023 (35% in total said either “often” or “frequently”).

Signs of heat-related illnesses

Notably, most people also know three of the telltale signs of heat-related illnesses:

• Dizziness (89% compared to 86% in August 2022)
• Nausea (83% compared to 79% in August 2022)
• Hot, red, dry, or damp skin (72%, statistically unchanged from August 2022)
• Cold, pale, and clammy skin (42%, statistically unchanged from August 2022).

Public understands some extreme heat risks better than others

Thinking about the next 10 years, just under 6 in 10 (58%) think that people in their community will be more likely to experience heat stroke caused by extreme heat waves. This is significantly higher than in November 2023 when just over half (52%) said they thought people in their community would be more likely to experience heat stroke caused by extreme heat waves in the next 10 years.

However, only 3 in 10 (30%) know that a pregnant person in the U.S. who is exposed to extreme heat is more likely to deliver their baby early than a pregnant person who is not exposed to extreme heat. About a quarter (23%) incorrectly say that a pregnant person in the U.S. is either less or just as likely to deliver a baby early. Forty-seven percent (47%) are unsure which is correct.

Broad awareness that heat-related deaths are most common among seniors

Two-thirds (67%) know that heat-related deaths are most common among older adults, aged 65 or older, slightly but significantly higher than in August 2022 (62%).

Preventing heat-related illnesses

Nearly all (92%) know that drinking water is better to prevent heat-related illnesses than drinking sugary drinks.

APPC’s ASAPH survey

The survey data come from the 20th wave of a nationally representative panel of 1,496 U.S. adults, first empaneled in April 2021, conducted for the Annenberg Public Policy Center by SSRS, an independent market research company. This wave of the Annenberg Science and Public Health Knowledge (ASAPH) survey was fielded July 11-18, 2024, and has a margin of sampling error (MOE) of ± 3.6 percentage points at the 95% confidence level. All figures are rounded to the nearest whole number and may not add to 100%. Combined subcategories may not add to totals in the topline and text due to rounding.

Want to feel less stressed? Try the Mediterranean diet

Following the Mediterranean diet versus the traditional Western diet might make you feel like you’re under less stress, according to new research conducted by a team from Binghamton University, State University of New YorkThe findings suggest that people can lower their perception of how much stress they can tolerate by following a Mediterranean diet, said Lina Begdache, associate professor of health and wellness studies.

“Stress is recognized to be a precursor to mental distress, and research, including our own, has demonstrated that the Mediterranean diet lowers mental distress,” she said. “Thus, one element of the puzzle may be explained by the fact that the Mediterranean diet may be associated with a decrease in the negative components of perceived stress and an improvement in its positive attributes.”  

The Mediterranean diet is plant-based with healthy fats and mostly includes wholesome food and a spectrum of natural colors. The diet stands in sharp contrast to the Western diet, which is known for its high concentration of high-glycemic and low-quality processed foods.

While the Mediterranean diet is known for its benefits to both mental health and physical health, little is known about its effect on perceived stress, which is the idea of how much stress you are under at any particular time.

To assess this, Begdache and her students conducted a survey of over 1,500 people, asking them what types of foods they ate and assessing their levels of perceived stress. Using a machine learning model, the results show that consuming components of the Mediterranean diet is associated with lower levels of perceived stress and mental distress, while consuming Western dietary components is correlated with perceived stress and mental distress.

Begdache said that these results close a gap in the literature because the majority of studies on diet and stress focused on how stress affects dietary choices and quality. She and her team are looking at different aspects of brain function and behaviors in relation to dietary patterns.

The study, “Effects of Mediterranean and Western dietary patterns on perceived stress and mental distress,” was published in Nutrition and Health.

Type 2 diabetes can be prevented by diet and exercise even in individuals with a high genetic risk

A new study from the University of Eastern Finland is the first in the world to show that a healthy diet and regular exercise reduce the risk of type 2 diabetes even in individuals with a high genetic risk. In other words, everyone benefits from lifestyle changes, regardless of genetic risk.

Type 2 diabetes is a global problem. According to the International Diabetes Federation, IDF, one in eleven adults worldwide has diabetes, with type 2 diabetes accounting for 90 per cent of the cases. To date, researchers have identified more than 500 genetic variants that predispose individuals to type 2 diabetes, but lifestyle factors, too, affect the risk of developing the disease. Significant lifestyle-related risk factors include overweight, low intake of dietary fibre, high intake of saturated fats, and lack of exercise. Previous studies have shown that type 2 diabetes can be effectively prevented by lifestyle changes, but it has not been explored whether the disease can be prevented even in individuals carrying numerous genetic variants that predispose them to type 2 diabetes.

The T2D-GENE Trial was a three-year lifestyle intervention that involved nearly 1,000 men aged 50 to 75 in eastern Finland. All those invited to the study had elevated fasting glucose at baseline. The lifestyle intervention group included more than 600 men, and the rest served as a control group. Men in the intervention group received guidance on health-promoting lifestyles in group meetings, and they were supported by a web portal designed for the study. Those invited to the study belonged either to the lowest or the highest tertile in terms of genetic risk, i.e., they had either a high or a low risk of developing type 2 diabetes. Genetic risk was determined based on 76 gene variants known to predispose to type 2 diabetes. During the intervention, neither the study participants nor the researchers knew to which genetic risk group the participants belonged. All those who participated in the intervention received the same lifestyle guidance.

Men participating in the lifestyle intervention were able to significantly improve the quality of their diet. They increased their intake of dietary fibre, improved the quality of fats in their diet and increased their consumption of vegetables, fruits and berries. Weight loss was also observed, although this was not an actual weight loss study. The participants were physically very active already at baseline, and they managed to maintain their good exercise habits throughout the study. With these changes, it was possible to reduce the deterioration of glucose metabolism. The prevalence of type 2 diabetes was significantly lower in the lifestyle intervention group than in the control group. The effects of lifestyle changes were equally significant for individuals regardless of whether they had a low or a high genetic risk.

“These findings encourage everyone to make lifestyle changes that promote health. Furthermore, they demonstrate the effectiveness of group- and internet-based lifestyle guidance, which saves healthcare resources,” says University Lecturer, Docent Maria Lankinen of the University of Eastern Finland, the first author of the study.

Eating more fruits & vegetables: lowers blood pressure, improves kidney and heart health

 

Doctors recommend making fruits and vegetables a foundational part of the treatment of patients with hypertension. Diets high in fruits and vegetables are found to lower blood pressure, reduce cardiovascular risk, and improve kidney health due to their base-producing effects. A new study in The American Journal of Medicine, published by Elsevier, details the findings from a five-year interventional randomized control trial.

Despite ongoing efforts to improve hypertension treatment and reduce its adverse outcomes with pharmacological strategies, hypertension-related chronic kidney disease and its cardiovascular mortality are increasing. Heart disease is the number one reason that patients with chronic kidney disease die.

The Dietary Approaches to Stop Hypertension (DASH) diet that is rich in fruits and vegetables reduces blood pressure and is the recommended first-line treatment for primary hypertension. Nevertheless, this diet is under-prescribed, and when prescribed is under-implemented despite supportive epidemiological data. The DASH diet and others generally high in fruits and vegetables are associated with lower blood pressure, lower risk for and progression of chronic kidney disease, lower cardiovascular disease risk indicators, and lower cardiovascular disease mortality.

Lead investigator of the study Donald E. Wesson, MD, MBA, Department of Internal Medicine, Dell Medical School – The University of Texas at Austin, says, "As a nephrologist (kidney doctor), my acid-base laboratory studies ways by which the kidney removes acid from the blood and puts it into the urine. Our animal studies showed years ago that mechanisms used by kidneys to remove acid from the blood can cause kidney injury if the animals were chronically (long term) exposed to an acid-producing diet. Our patient studies showed similar findings: that is, an acid-producing diet (one high in animal products) was kidney-harmful, and one that is base-producing (one high in fruits and vegetables) is kidney-healthy. Other investigators showed that a diet high in fruits and vegetables is heart-healthy. We hypothesized that one way that fruits and vegetables are both kidney- and heart-healthy is that they reduce the amount of acid in the diet and therefore the amount of acid that kidneys have to remove from the body."

To test this hypothesis, a study was designed in which participants with hypertension, but not diabetes, and very high levels of urine albumin excretion (macroalbuminuria) were selected. Patients with macroalbuminuria have chronic kidney disease, a high risk for the worsening of their kidney disease with time, and a high risk to subsequently develop cardiovascular diseases. In a randomized control trial over a five-year period, investigators divided the cohort of 153 patients with hypertension into three groups:

1. Study participants adding 2-4 cups of base-producing fruits and vegetables in addition to their usual daily food intake
2. Study participants prescribed NaHCO3 (acid-reducing sodium bicarbonate, which is common baking soda) tablets in two daily doses of 4-5 650 mg tablets
3. Study participants receiving standard medical care from primary care clinicians

The results of the study show that both fruits and vegetables and NaHCO3 improved kidney health, but only fruits and vegetables, and not NaHCO3, reduced blood pressure and improved indices of cardiovascular disease risk.

Co-investigator Maninder Kahlon, PhD, Department of Population Health, Dell Medical School – The University of Texas at Austin, explains, "Importantly, fruits and vegetables achieved the latter two benefits with lower doses of medication used to lower blood pressure and reduce cardiovascular disease risk. This means that one can get the kidney health benefits with either fruits and vegetables or NaHCO3, but we get the blood pressure reduction and reduced cardiovascular disease risk with fruits and vegetables, but not with NaHCO3. This supports our recommendation that fruits and vegetables should be ‘foundational’ treatment for patients with hypertension, because we accomplish all three goals (kidney health, lower blood pressure, and reduced cardiovascular disease risk) with fruits and vegetables, and we can do so with lower medication doses.

The research team emphasizes "foundational" because many clinicians begin hypertension treatment with drugs and then add diet strategies if blood pressure is not properly controlled. The findings from its studies support the opposite: treatment should begin with fruits and vegetables and then add drugs as needed.

Dr. Wesson concludes, "Dietary interventions for chronic disease management are often not recommended and even less often executed because of the many challenges to get patients to implement them. Nevertheless, they are effective, and in this instance, kidney and cardiovascular protective. We must increase our efforts to incorporate them into patient management and more broadly, make healthy diets more accessible to populations at increased risk for kidney and cardiovascular disease.”

The researchers also advise patients with hypertension to ask their clinician to measure a urine albumin-to-creatinine ratio (UACR) to determine if they have underlying kidney disease and an increased risk for subsequent cardiovascular disease.

Ketogenic Diet reduces friendly gut bacteria and raises cholesterol levels

Published in Cell Reports Medicine, the research from the Centre for Nutrition, Exercise, and Metabolism involved 53 healthy adults for up to 12 weeks. Participants followed either a moderate sugar diet (control), a low-sugar diet (less than 5% of calories from sugar), or a ketogenic (keto) low-carbohydrate diet (less than 8% of calories from carbohydrates).

Key findings include:

• Increased Cholesterol: The keto diet raised cholesterol levels, particularly in small and medium sized LDL particles.  The diet increased apolipoprotein B (apoB), which causes plaque buildup in arteries. In contrast, the low-sugar diet significantly reduced cholesterol in LDL particles.

 

• Reduced Favourable Gut Bacteria: The keto diet altered gut microbiome composition, notably decreasing Bifidobacteria, beneficial bacteria often found in probiotics. This bacteria has wide ranging benefits: producing b vitamins, inhibiting pathogens and harmful bacteria and lowering cholesterol. Sugar restriction did not significantly impact the gut microbiome composition.

 

• Glucose Tolerance: The keto diet reduced glucose tolerance, meaning the adults’ bodies became less efficient at handling carbohydrates.

 

• Both Diets Resulted In Fat Loss:  Keto Diet resulted in an average of 2.9 kg fat mass loss per person, whilst the sugar restricted diet followed with an average 2.1 kg fat mass loss per person at 12 weeks.

 

• Metabolism: Researchers also noticed that the keto diet caused significant changes in lipid metabolism and muscle energy use, shifting the body’s fuel preference from glucose to fats.

 

• Physical Activity Levels: Both sugar restriction and keto diets achieved fat loss without changing physical activity levels. Previous studies from the Centre for Nutrition, Exercise and Metabolism have shown that skipping breakfast or intermittent fasting cause reductions in physical activity.

 

Lead researcher Dr. Aaron Hengist highlighted the concerning cholesterol findings:

 

“Despite reducing fat mass, the ketogenic diet increased the levels of unfavourable fats in the blood of our participants, which, if sustained over years, could have long-term health implications such as increased risk of heart disease and stroke.”

 

Dr. Russell Davies, who led the microbiome research, explained the impact on gut health:

 

“Dietary fibre is essential for the survival of beneficial gut bacteria like Bifidobacteria. The ketogenic diet reduced fibre intake to around 15 grams per day, half the NHS recommended intake. This reduction in Bifidobacteria might contribute to significant long-term health consequences such as an increased risk of digestive disorders like irritable bowel disease, increased risk of intestinal infection and a weakened immune function.”

 

Professor Javier Gonzalez, who oversaw the research, commented on the glucose findings:

 

“The ketogenic diet reduced fasting glucose levels but also reduced the body’s ability to handle carbs from a meal. By measuring proteins in muscle samples taken from participants’ legs, we think this is probably an adaptive response to eating less carbohydrates day-to-day and reflects insulin resistance to storing carbs in muscle. This insulin resistance is not necessarily a bad thing if people are following a ketogenic diet, but if these changes persist when people switch back to a higher carbohydrate diet it could increase the risk of developing type 2 diabetes in the long-term”

 

In light of this new research, the academics conclude that if you’re considering a diet, a low sugar one will be better for most people. More work is needed to understand how individuals may benefit from each type of diet. The government recommends that free sugars (those added to food or drink or found naturally in honey, syrups, fruit juices and smoothies) should be restricted to less than 5% of total energy intake. Professor Dylan Thompson, who also oversaw the work, said:

 

“The ketogenic diet is effective for fat loss, but it comes with varied metabolic and microbiome effects that may not suit everyone. In contrast, sugar restriction supports government guidelines for reducing free sugar intake, promoting fat loss without apparen­­t negative health impacts.”

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This work was supported by an initial grant from The Rank Prize Funds, with subsequent funding from Cosun Nutrition Center, The University of Bath, and Ian Tarr. Exploratory analyses included fellowship support for some investigators from the British Heart Foundation and Medical Research Council.

Fish oil supplements:lower levels of cholesterol and triglycerides. higher “good” cholesterol

 But see: https://healthnewsreport.blogspot.com/2024/05/regular-use-of-fish-oil-supplements.html

Fish oil supplements are a multi-billion dollar industry in the U.S. and abroad, with about two out of every 25 people popping the popular omega-3 pills.

And a new study from the University of Georgia might encourage a new population to start looking into the supplements as well: people with a genetic predisposition to high cholesterol.

Using genetic data from more than 441,000 participants, the researchers calculated a score to predict the genetic likelihood of high levels of total cholesterol, high LDL cholesterol (which is often referred to as “bad” cholesterol), triglycerides and HDL cholesterol (or “good” cholesterol).

“Recent advances in genetic studies have allowed us to predict someone’s genetic risk of high cholesterol,” said Yitang Sun, a recent doctoral graduate from UGA’s Department of Genetics. “But the current prediction has room for improvement because it does not consider individual differences in lifestyles, such as taking fish oil supplements.” 

The researchers found that participants who reported taking fish oil supplements have lower blood lipid levels than predicted, especially for total cholesterol, LDL cholesterol and triglycerides.

“Our study shows that considering lifestyles will improve genetic prediction,” said Kaixiong Ye, corresponding author of the study and an assistant professor of genetics in UGA’s Franklin College of Arts and Sciences. “Our findings also support that fish oil supplements may counteract the genetic predisposition to high cholesterol.”

Fish oil counters effect of family history of high cholesterol

It’s no secret that high cholesterol is bad for the body. Arteries start to harden, and the risk of heart attack or stroke increases.

While a healthy diet and exercise can help prevent it, the Centers for Disease Control and Prevention estimates that more than 86 million American adults — or about one in four — have high cholesterol.

Millions more are at risk of developing high cholesterol due to a variety of factors including one they can’t control: genetics.

For people whose families have a history of high cholesterol, the study’s findings offer another possibility to help safeguard their health.

“Taking fish oil is associated with a shift toward a healthy lipid profile,” Ye said.

The researchers also analyzed the effects of fish oil on HDL cholesterol and found the supplements are beneficial in raising the so-called “good” cholesterol.

Published in the American Journal of Clinical Nutrition, the study was led by Yitang Sun, a doctoral student in UGA’s Department of Genetics. Additional co-authors include Tryggvi McDonald, Abigail Baur, Huifang Xu and Naveen Brahman Bateman, of UGA’s Franklin College; Ye Shen of UGA’s College of Public Health; and Changwei Li, of Tulane University.

Honey added to yogurt supports probiotic cultures for digestive health

 

 If you enjoy a bowl of plain yogurt in the morning, adding a spoonful of honey is a delicious way to sweeten your favorite breakfast food. It also supports the probiotic cultures in the popular fermented dairy product, according to two new studies from the University of Illinois Urbana-Champaign.

“We were interested in the culinary pairing of yogurt and honey, which is common in the Mediterranean diet, and how it impacts the gastrointestinal microbiome,” said Hannah Holscher, associate professor in the Department of Food Science and Human Nutrition, part of the College of Agricultural, Consumer and Environmental Sciences at Illinois. She is a co-author of the two studies, which are both published in The Journal of Nutrition.

Greek yogurt and other yogurts contain probiotic strains such as Bifidobacterium animalis in addition to conventional yogurt starter cultures. Consumption of certain probiotics can promote digestive health and regular bowel movements, and it can have a positive effect on mood and cognition.

“The enzymes in our mouth, stomach, and intestines help with digestion and facilitate nutrient absorption, but they also reduce the viability of microbes. That’s great when it’s pathogens but not necessarily when it comes to beneficial bacteria,” Holscher said. “We wanted to see if honey could help probiotic bacteria survive in the gut.”

In the first study, the researchers conducted a laboratory experiment where they tested the effect of four different kinds of honey (alfalfa, buckwheat, clover, and orange blossom) on the viability of B. animalis in yogurt through simulated digestion processes. They grew microbes in petri dishes with solutions that mimicked the composition of saliva, stomach acid, intestinal bile, and enzymes.

For the saliva and stomach fluids, there were no differences in B. animalis survival between any of the honey varietals and control treatments of yogurt mixed with sugar or water. However, yogurt with honey – particularly the clover varietal – helped support the survival of probiotics in the intestinal phase of digestion. 

Next, the researchers wanted to test their findings in a clinical study. They recruited 66 healthy adults and asked them to consume two different items for two weeks each – yogurt with clover honey and pasteurized, heat-treated yogurt. The participants provided stool samples and information about their bowel movements. They also filled out questionnaires and completed tasks evaluating their mood, cognition, and overall well-being.

“Our findings showed that pairing honey with yogurt supported the survival of the yogurt’s probiotic bacteria in the gut, so the lab study results did translate to real-world application in humans,” Holscher stated. 

However, there were no changes in intestinal transit time, bowel movement frequency, or any of the mood and cognition measures. Holscher said this is likely because the participants already were healthy adults with regular bowel movements, so there wasn’t a lot of room for improvement.

The researchers also conducted a smaller follow-up study with 36 participants who consumed a third food item, yogurt with sugar. When the researchers compared the results of all three conditions, the combination of yogurt with honey preserved the most probiotics, but there were no effects on the health measures.

“We found that one tablespoon of honey in a serving of yogurt helps support probiotic survival. However, we have to keep in mind that honey is an added sugar, and most Americans need to be cognizant of the amount of sugar in their diet to maintain a healthy body weight,” she stated. “But adding a little bit of honey to unsweetened yogurt is a nice culinary pairing to incorporate into your menu rotation.”

You can also add toppings to make a yogurt parfait and support gut health and the microbiome by getting more fiber in your diet. For example, you can add berries and seeds, or nuts, and drizzle a bit of honey on top, Holscher suggested.