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Artificial sweeteners linked to diabetes and obesity

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People switch to zero-calorie artificial sweeteners such as aspartame and acesulfame potassium to limit their sugar intake. These are among the most common food additives worldwide, and is found in diet and zero-calorie sodas and other products. But, a US study presented at the Experimental Biology 2018 meeting have linked artificial sweeteners to obesity and an increased risk of diabetes.

The researchers looked at biochemical changes in the body after consumption of sugar or sugar substitutes, as well as their impact on vascular health by examining how they affected the lining of blood vessels.

The studies, which were done in rats and cell cultures, showed that artificial sweeteners change how the body processes fat and gets its energy. Also, acesulfame potassium seemed to accrue in the blood, and higher concentrations had a more harmful effect on the cells that line blood vessels.

"In our studies, both sugar and artificial sweeteners seem to exhibit negative effects linked to obesity and diabetes, albeit through very different mechanisms from each other. We also observed that replacing these sugars with non-caloric artificial sweeteners leads to negative changes in fat and energy metabolism," cautioned the lead researcher.

Certain Types ofanticholinergic drugs linked to dementia Long-term use of certain anticholinergic medications can increase the risk of dementia, according to a UK study published in the BMJ.

Anticholinergics work by blocking the action of acetylcholine, a chemical messenger, which carries signals across the nervous system. They are used to treat a variety of conditions, including depression, Parkinson's disease, urinary incontinence, chronic obstructive pulmonary disease and asthma.

The researchers looked at the medical records of 40,770 dementia patients aged 65 to 99, and compared them with those of 2,83,933 people without dementia. More than 27 million prescriptions were also analysed, making it the biggest study to look at the long-term impact of anticholinergic drugs in relation to dementia.

There was a greater incidence of dementia among patients prescribed anticholinergic antidepressants such as Amitriptyline, Dosulepin and Paroxetine; medications such as Tolterodine, Oxybutynin and Solifenacin prescribed for bladder conditions, and Procyclidine for Parkinson’s. The risk increased with greater exposure, and the associations persisted up to 20 years after exposure.

“We found that people who had been diagnosed with dementia were up to 30 per cent more likely to have been prescribed specific classes of anticholinergic medications,” said the lead researcher. “This research is really important because there are an estimated 350 million people affected globally by depression. Many of the treatment options for these conditions involve medication with anticholinergic effects.”

However, several other anticholinergic medications, including anti-histamines and those used for abdominal cramps, were not found to be linked to dementia.

“More than 50 million people worldwide are affected by dementia and this number is estimated to be 132 million by 2050. Developing strategies to prevent dementia is therefore a global priority,” said the researcher.

Certain Types of anticholinergic drugs linked to dementia

Long-term use of certain anticholinergic medications can increase the risk of dementia, according to a UK study published in the BMJ.

Anticholinergics work by blocking the action of acetylcholine, a chemical messenger, which carries signals across the nervous system. They are used to treat a variety of conditions, including depression, Parkinson's disease, urinary incontinence, chronic obstructive pulmonary disease and asthma.

The researchers looked at the medical records of 40,770 dementia patients aged 65 to 99, and compared them with those of 2,83,933 people without dementia. More than 27 million prescriptions were also analysed, making it the biggest study to look at the long-term impact of anticholinergic drugs in relation to dementia.

There was a greater incidence of dementia among patients prescribed anticholinergic antidepressants such as Amitriptyline, Dosulepin and Paroxetine; medications such as Tolterodine, Oxybutynin and Solifenacin prescribed for bladder conditions, and Procyclidine for Parkinson’s. The risk increased with greater exposure, and the associations persisted up to 20 years after exposure.

“We found that people who had been diagnosed with dementia were up to 30 per cent more likely to have been prescribed specific classes of anticholinergic medications,” said the lead researcher. “This research is really important because there are an estimated 350 million people affected globally by depression. Many of the treatment options for these conditions involve medication with anticholinergic effects.”

However, several other anticholinergic medications, including anti-histamines and those used for abdominal cramps, were not found to be linked to dementia.

“More than 50 million people worldwide are affected by dementia and this number is estimated to be 132 million by 2050. Developing strategies to prevent dementia is therefore a global priority,” said the researcher.

Do age and gender of surgeons matter?

Do surgeons' skills improve with experience, or do loss of dexterity or less familiarity with new technologies contribute to poorer surgical outcomes for older doctors?

According to a US study published in the BMJ, surgeries performed by older surgeons have lower patient mortality rates than those performed by younger surgeons. Both male and female surgeons are equally good—patient mortality rates do not differ significantly, whether the surgeon is male or female.

The conclusion was based on an analysis of 8,92,187 patients aged 65 to 99 who had one of 20 major emergency surgeries, performed by 45,826 surgeons.

The risk of dying in the month after a surgery steadily decreased as the surgeon’s age increased: mortality rates were 6.6 per cent for surgeons under age of 40; 6.5 per cent for surgeons aged 40 to 49 ; 6.4 per cent for surgeons aged 50 to 59; and, 6.3 per cent for surgeons aged 60 and older.

Female surgeons in their 50s had the lowest patient mortality when comparing men and women surgeons across all age groups.

“Our finding that younger surgeons have higher mortality suggests that more oversight and supervision early in surgeons’ post-residency career may be useful and warrants further empiric investigation. Equivalent outcomes between male and female surgeons suggest that patients undergoing surgery receive high quality care irrespective of the sex of the surgeon,” the study concluded.

Did You Know

A woman’s diet can influence the timing of menopause. Menopause tend to start earlier for women whose diets are high in refined carbohydrates such as pasta and rice, whereas it starts later for those who consume a lot of fish and fresh legumes such as peas and green beans.

Journal of Epidemiology & Community Health

Is vaginal birth safe after C-section?

The risk of adverse effects or death for mothers and infants are higher if the mother opts for a vaginal birth after a previous caesarean delivery, according to a study published in the Canadian Medical Association Journal.

For women who have had a single previous caesarean section, deciding on the best delivery option in a subsequent pregnancy is challenging: there are risks and benefits to both methods. Vaginal birth after caesarean is associated with a higher risk of uterine rupture, haemorrhage, and other maternal and infant complications. And, repeated caesarean sections are associated with an increased risk of surgical and placental complications.

The researchers analysed data from nearly 200,000 Canadian women who had a previous caesarean delivery, and then gave birth between 2003 and 2014.

Infant outcomes after vaginal delivery following a caesarean have actually worsened over the study period.

Though the absolute risk of adverse maternal and neonatal outcomes are low with both vaginal birth and C-section after a caesarean delivery, vaginal birth after caesarean “continues to be associated with higher relative rates of severe adverse maternal and neonatal outcomes compared with an elective repeat caesarean delivery," the lead researcher noted.

“If patients are properly selected and managed, both options for delivery are reasonable and of low risk,” he said.

Seat belts may reduce risk of severe liver injury in car crashes

Wearing seat belts may reduce the risk of suffering severe liver damage in car crashes. One of the most commonly injured organs in a car crash is the liver.

“Trauma can result in a number of serious complications, including bile leakage or obstruction of bile flow, abscess formation, bleeding without the ability to appropriately clot blood and an inability to filter metabolites resulting in jaundice,” said the study author.

The study was based on 55,543 people who were taken to a hospital after a motor-vehicle crash.

Those who wore seat belts were 21 per cent less likely to suffer a severe liver injury, such as ruptured clots with uncontrolled bleeding, deep lacerations and other kinds of wounds requiring immediate treatment.

Those protected by both a seatbelt and an airbag were 26 per cent less likely to suffer serious liver damage. Airbags without seatbelt use, however, were not protective against severe liver injury.

Those with severe liver injuries were twice as likely to die compared to those with mild or moderate liver injuries.

“Seat belts are associated with lower liver injury severity and are more protective with airbags present,” the study published in the Journal of Epidemiology and Community Health concluded.

Resistance training exercises can reduce depression

Resistance training exercises such as weightlifting and strength training are not just beneficial to help you bulk up; they are also good for your mental well-being.

According to an Irish study published in the JAMA Psychiatry, resistance training exercises can significantly reduce the symptoms of depression.

An analysis of 33 clinical trials that included 1,877 participants found that resistance training was associated with significant improvements in depressive symptoms such as low mood, a loss of interest in activities and feelings of worthlessness, irrespective of age, sex, health status or the kind of exercise regimen followed.

“Interestingly, larger improvements were found among adults with depressive symptoms indicative of mild-to-moderate depression compared to adults without such scores, suggesting RET may be particularly effective for those with greater depressive symptoms,” the lead researcher noted.

Exercise can increase blood flow to the brain and release mood-enhancing chemicals like endorphins.

“The available empirical evidence supports resistance exercise training as an alternative and/or adjuvant therapy for depressive symptoms,” the study concluded.

Eggs are not bad for heart

A new Australian study published in the American Journal of Clinical Nutrition has concluded that eating up to 12 eggs a week does not increase cardiovascular risk factors like cholesterol in people with pre-diabetes or type 2 diabetes.

For the study, 140 people with pre-diabetes or type 2 diabetes (which put them at risk for cardiovascular diseases) were randomised to a high egg diet (12 eggs per week) or a low egg diet (less than 2 eggs per week), along with a healthy diet that included whole grains, low glycemic index carbohydrate foods, and replacing saturated fats with monounsaturated and polyunsaturated fats like olive oil. They followed this diet for 12 months.

There were no significant differences between the two groups in a wide range of cardiovascular risk factors including cholesterol, blood sugar and blood pressure. People on both diets lost an equivalent amount of weight, too.

"While eggs themselves are high in dietary cholesterol and people with type 2 diabetes tend to have higher levels of the 'bad' low density lipoprotein (LDL) cholesterol, this study supports existing research that shows consumption of eggs has little effect on the levels of cholesterol in the blood of the people eating them," said the study author.

“Eggs are a source of protein and micronutrients that could support a range of health and dietary factors including helping to regulate the intake of fat and carbohydrate, eye and heart health, healthy blood vessels and healthy pregnancies. People do not need to hold back from eating eggs if this is part of a healthy diet," the study concluded.

Did You Know

Reading aloud to kids can improve their attention span and behavioural and social skills, and reduce hyperactivity and aggression.

Pediatrics

HPV vaccine safe and effective

Human papillomavirus (HPV) vaccines are safe and effective, and protect against cervical lesions that can eventually turn into cervical cancer, in young women, especially those who are vaccinated between the ages of 15 and 26.

Most sexually active people are exposed to the human papillomavirus, but the HPV infection is usually cleared by the immune system. When the immune system fails to clear the virus, persistent HPV infection can cause abnormal cervical lesions known as cervical 'pre-cancer' and over time they can progress into cervical cancer if left untreated.

The conclusion was based on a review, doneww by Cochrane researchers, of 26 studies involving 73,428 women across all continents over the last eight years.

In young women who did not have the HPV, vaccination reduced the risk of developing pre-cancer. About 164 of every 10,000 women who got placebo developed cervical pre-cancerous lesions, compared to two of 10,000 women who got the vaccine.

None of the studies followed the participants long enough to analyse its effect on cervical cancer.

The vaccine, however, did not work well in older women vaccinated between 26 to 45 years, probably because they would have already been exposed.

The vaccines did not have serious side effects and also did not increase the risk of miscarriages in women who became pregnant after vaccination.

“There is high-certainty evidence that HPV vaccines protect against cervical pre-cancer in adolescent girls and women who are vaccinated between 15 and 26 years of age,” the study concluded.

Did You Know

Eating dark chocolate can reduce stress and inflammation, and improve memory, immunity and mood.

Experimental Biology 2018 meeting

Low-carb diet may help people with type 1 diabetes

Following a very low-carb diet can help both adults and children diagnosed with type 1 diabetes to better control their blood sugar levels, with low rates of complications.

A very low-carb diet is often not recommended for people, especially children, with type 1 diabetes, for fear of complications such as hypoglycaemia (dangerous drop in blood sugar levels) and potential to stunt growth.

The study in the journal Pediatrics involved 316 people, including 131 children. The participants followed a low-carb, high protein diet, with an average daily carbohydrate intake of 36 grams, or about 5 per cent of total daily calories. They took lower than normal doses of insulin.

Average haemoglobin A1C values—the primary measure of blood-sugar control—fell to the normal range, at 5.67 percent.

Only 2 per cent of the participants reported hospitalisations within the past year for hypoglycaemia, diabetic ketoacidosis or other diabetes complications, which was much lower than those generally reported in people with type 1 diabetes. There was also no sign of impaired growth in children.

The participants also had favourable measures of insulin sensitivity and cardio-metabolic health, such as low triglyceride levels and high HDL cholesterol levels.

According to the study authors, severe carbohydrate restriction helped extend the lives of children with type 1 diabetes before the discovery of insulin. But, after the introduction of insulin treatment, carb restriction loosened.

A low carb diet include non-starchy vegetables, nuts, seafood and meat.

Did You Know

Meditation can enhance attention, mental abilities and psychological well-being, and protect against stress and age-related cognitive decline.

Journal of Cognitive Enhancement

Positioning matters during cancer radiation

How patients with lung or throat cancer are positioned during radiation treatments may have a bearing on the outcome. Even tiny shifts during radiation can harm organs around tumours in the chest, especially the heart.

"We already know that using imaging can help us to target cancers much more precisely and make radiotherapy treatment more effective. This study examines how small differences in the way a patient is lying can affect survival, even when an imaging protocol is used. It tells us that even very small remaining errors can have a major impact on patients' survival chances, particularly when tumours are close to a vital organ like the heart," said the lead researcher.

The study was based on 780 patients undergoing radiation therapy for non-small cell lung cancer. Using images, the researchers assessed how precisely the radiation was delivered, and if it had shifted closer or farther away from the heart.

Patients whose radiation shifted slightly towards their heart were 30 per cent more likely to die than those who had a similar shift away from their heart.

When the researchers looked at 177 throat cancer patients, they found an even greater difference—about 50 per cent greater risk of death.

"By imaging patients more frequently and by reducing the threshold on the accuracy of their position, we can help lower the dose of radiation that reaches the heart and avoid unnecessary damage," noted the lead researcher.

The findings were presented at the European Society for Radiotherapy and Oncology annual meeting.

CONTRIBUTOR: SHYLA JOVITHA ABRAHAM

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