No memories for company


Feelings of loneliness can be an early sign of Alzheimer’s disease, according to a US study published in JAMA Psychiatry.

Healthy elderly people with elevated levels of amyloid proteins in the brain, a marker of preclinical Alzheimer's disease, are more likely to report feelings of loneliness than people with lower levels of amyloid. Amyloid proteins clump together to form plaques, which are considered a hallmark of Alzheimer's.

To study the link, the researchers used imaging scans to detect the amount of amyloid protein in the brains of 43 women and 36 men, average age 76, who did not have any signs of dementia or Alzheimer’s. Loneliness was assessed using a loneliness scale.

People with high levels of amyloid in the brain were 7.5 times more likely to be classified as lonely, even after accounting for age, sex, socioeconomic status, depression, anxiety and social connections.

“We report a novel association of loneliness and cortical amyloid burden in cognitively normal adults and present evidence for loneliness as a neuropsychiatric symptom relevant to pre-clinical Alzheimer’s disease.”

“This work will inform new research into the neurobiology of loneliness and other socio-emotional changes in late life and may enhance early detection and intervention research in Alzheimer’s disease,” the study concluded.


Drinks that drain

A report published in BMJ Case Reports links excessive consumption of energy drinks to severe liver damage.

A 50-year-old man, who drank four to five energy drinks per day for three weeks, had acute hepatitis and was hospitalised. The man was otherwise healthy and did not report any changes in his diet or alcohol consumption. He was not taking any medications and did not have a family history of liver disease.

He started with flulike symptoms such as malaise, acute abdominal pain, nausea and vomiting, which later progressed to dark urine and jaundice. Blood tests showed liver enzymes indicating liver damage was elevated and a liver biopsy confirmed acute hepatitis.

The doctors think that high levels of vitamin B3, or niacin, found in energy drinks that the man consumed must have been the cause. The patient was consuming about 160-200 milligrams of niacin per day, which is twice the recommended daily dose.

There has been one other case of hepatitis induced by energy drink consumption where the woman had consumed 300 milligrams of niacin daily.

"As the energy drink market continues to rapidly expand, consumers should be aware of the potential risks of their various ingredients. Vitamins and nutrients, such as niacin, are present in quantities that greatly exceed the recommended daily intake, lending to their high risk for harmful accumulation and toxicity," the authors caution.

Did You Know

Music interventions added to medications can considerably reduce acute or chronic pain and emotional distress in cancer patients and in patients suffering from such pain.

Journal of Music Therapy


Cancer watch

About 5.5 million women are expected to die of cancer per year by 2030, mostly from breast cancer.

Women in poor and middle-income countries are going to bear a disproportionate burden of cancer deaths, which are largely preventable.

About two-thirds of breast cancer deaths and 90 per cent of cervical cancer deaths occur in the developing countries. At the same time, cancer incidence and mortality are steadily declining in rich countries partly due to better screening, early detection and medical treatment, prevention and tobacco control.

Five-year survival from breast cancer was more than 80 per cent in high-income countries, but was about 50 per cent in low- and middle-income countries such as South Africa, Mongolia, Algeria and India.

While mammography and radiation therapy can be too expensive in low-income countries, clinical breast examination and breast awareness campaigns are cost-effective and can help in diagnosing early stage breast cancer and getting early treatment. Cervical cancer can be almost entirely prevented with routine HPV vaccination and cervical screening, and treatment of pre-cancers when they are detected.

"There is a widespread misconception that breast and cervical cancers are too difficult and expensive to prevent and treat, particularly in resource-poor countries where the burden of these diseases is highest. But nothing could be further from the truth. High-impact, cost-effective interventions exist for countries at all stages of development. Recent estimates suggest that a basic cancer control package could be introduced in low- and middle-income countries for as little as $1.72 per person—equivalent to just 3 per cent of current health spending in these countries," said the lead researcher.

The analysis was conducted by the American Cancer Society and released at the World Cancer Congress in Paris.


Schedule right

Working long hours and not getting enough sleep can lead to adverse health outcomes in old age, according to a Finnish study published in the journal Age and Ageing.

The researchers studied the health outcomes of 3,490 white men born between 1919 and 1934 and followed them for 26 years; 1,527 men provided information about clinical variables, self-rated health, working hours and sleep duration in 1974 when they were in their 40s and 50s and again in 2000, when they were in their 70s and 80s.

Those who worked more than 50 hours a week and slept less than 47 hours weekly in middle age had worse physical health in old age compared to those who kept a healthy work and sleep schedule. They did poorly on scores that measured physical functioning, vitality and general health.

Did You Know

Young adults who had abused alcohol for at least five years tend to suffer from more health problems—both physical and mental—once they reach their 60s, even if they had quit drinking decades ago.

Journal of Studies on Alcohol & Drugs


And sleep well, too

People who do not get a good night’s sleep tend to consume more calories the following day.

For the study in the European Journal of Clinical Nutrition, researchers analysed 11 studies that included 172 participants. Those who were sleep-deprived consumed an average of 385 extra calories a day compared to those who got enough sleep.

Sleep deprivation did not have a considerable effect on energy expenditure, meaning they had a net gain of 385 calories a day. For people who are chronically sleep deprived, extra 385 calories a day can add up, leading to weight gain.

Sleep deprived people were also more likely to consume more fat and less protein.

"The main cause of obesity is an imbalance between calorie intake and expenditure and this study adds to accumulating evidence that sleep deprivation could contribute to this imbalance. So there may be some truth in the saying 'early to bed, early to rise, makes a man healthy and wise'," said the senior study author.

Dine early

Eating dinner very early, or skipping it altogether, may help obese people lose weight, according to a study presented at the annual meeting of The Obesity Society.

The strategy called early time-restricted feeding (eTRF) was tried in humans for the first time. The approach was previously tried in animals, and had shown to reduce fat mass and the risk of chronic diseases.

Eleven obese men and women tried two different eating patterns: for four days they ate between 8am and 2pm (eTRF), and the next four days between 8am and 8pm (typical eating pattern). All the participants ate the same number of calories during each approach, and ate only the food provided by the researchers.

The researchers studied the impact of eTRF on calories burned, fat burned and appetite. eTRF did not affect how many calories participants burned. However, it reduced daily hunger swings and improved metabolic flexibility—the body’s ability to switch between burning carbs and fats—which may improve metabolism and help with weight loss.

"Eating only during a much smaller window of time than people are typically used to may help with weight loss. We found that eating between 8am and 2pm followed by an 18-hour daily fast kept appetite levels more even throughout the day, in comparison to eating between 8am and 8pm,” the lead researcher noted.


First step

Teens who vape are more likely to transition to regular cigarettes within six months, according to a US study published in the Journal of the American Medical Association.

They also have greater odds of becoming more frequent and heavy cigarette smokers.

To determine whether vaping influences subsequent cigarette smoking, researchers surveyed 3,084 tenth graders, 54 per cent girls, once at the start of the school year and then six months later about their use of e-cigarettes and cigarettes, smoking frequency and heaviness.

The prevalence of vaping and smoking was overall low. But teens who vaped frequently were about 10 times more likely to become regular smokers compared to teens who never vaped.

While 20 per cent of regular vapers had become frequent smokers, only less than 1 per cent of kids who had never vaped took up cigarette smoking at follow-up.

More frequent vapers were also more likely to smoke more cigarettes.

"The more you vape, the more likely in the future you're going to be smoking (cigarettes). You're going to be smoking more frequently and you're going to smoke more cigarettes per day on your smoking days," the study author added.

Signs of big c

A lump may not always be the first sign of breast cancer, though it is the most widely reported symptom.

Around one in six women (17 per cent) diagnosed with breast cancer go to their doctor with a symptom other than a lump, according to a British study presented at the National Cancer Research Institute (NCRI) Cancer conference.

The study is advising women to be aware of other symptoms (non-lump) that can indicate breast cancer, such as nipple abnormalities, breast pain, skin abnormalities, ulceration, shape abnormalities and an infected or inflamed breast.

The researchers looked at data from 2,316 women diagnosed with breast cancer.

Although most women with breast cancer sought help quickly, those with 'non-lump' symptoms were more likely to delay going to their doctor. Women who had a breast lump, but also had a 'non-lump' symptom, were also more likely to delay seeking help.

"It's crucial that women are aware that a lump is not the only symptom of breast cancer. If they are worried about any breast symptoms, the best thing to do is to get it checked by a doctor as soon as possible. Diagnosing cancer earlier really is key in order to increase the chances of survival. Symptom awareness campaigns such as the Be Clear on Cancer campaign should continue to emphasise breast symptoms other than breast lump," the lead researcher suggested.


Heart disease after cancer

The age at which cancer survivors are diagnosed with cancer may have a bearing on their risk of death from heart disease. The risk is greatest for cancer survivors diagnosed at a younger age, according to a British study published in the journal Circulation.

Cancer treatment can increase the risk of death from heart disease particularly among survivors of childhood cancer, breast cancer and Hodgkin's lymphoma.

To assess cardiac mortality risk among teens and young adult cancer survivors, the researchers looked at more than two lakh cancer survivors who were diagnosed with the disease between ages 15 to 39 and who survived at least five years after being diagnosed.

Overall, 6 per cent of the deaths were attributed to heart disease. Those diagnosed at ages 15 to 19 had 4.2 times higher risk of death from heart disease compared to their peers. But those who had the diagnosis at ages 35 to 39 had only a 1.2 times higher risk of death from heart disease.

The significance of age at diagnosis was most important for survivors of Hodgkin's lymphoma: 6.9 per cent of those diagnosed at ages 15-19 died of heart disease by age 55 compared to 2 per cent of those diagnosed at ages 35-39. In comparison, less than 1 per cent of people in the general population would die from heart disease by age 55.

Overall, survivors of Hodgkin's lymphoma had a 3.8 times greater risk of death from heart disease. Survivors of other types of cancer including leukaemia, genitourinary cancer, lung cancer and breast cancer also had a higher risk of death from heart disease.


Smoke alarm

Smoking a pack of cigarettes a day for a year causes 150 mutations in lung cells.

Smoking is linked to at least 17 types of cancer, but the process that leads to it is largely unknown. For the study in the journal Science, researchers assessed the genetic damage caused by smoking and identified several different mechanisms by which tobacco smoking causes mutations in DNA that lead to cancer.

For this, they compared over 5,000 cancer tumours of smokers and nonsmokers.

Smokers’ DNA had particular molecular fingerprints of damage called mutational signatures. They counted how many of these particular mutations were present in the different tumours.

"With this study, we have found that people who smoke a pack a day develop an average of 150 extra mutations in their lungs every year, which explains why smokers have such a higher risk of developing lung cancer,” the lead researcher added.

Mutations also happened in other organs. Smoking a pack a day led to a yearly average of 97 mutations in each cell in the larynx, 39 mutations for the pharynx, 23 mutations for the mouth, 18 mutations for the bladder, and six mutations in every cell of the liver.

Tobacco smoking is one of the most avoidable risk factors for cancer. It kills at least six million people every year. If this trend continues, more than 1 billion will die from tobacco-related causes in this century, according to the World Health Organization.

Did You Know

Palliative care should be offered to patients with advanced cancer early in the disease course, and not in the last weeks and months of life.

American Society for Clinical Oncology


WHO's word for moms-to-be

According to new guidelines from the WHO on antenatal care, pregnant women should see their health providers at least eight times to reduce the risk of stillbirths and pregnancy complications.

“More and better quality contacts between all women and their health providers throughout pregnancy will facilitate the uptake of preventive measures, timely detection of risks, reduces complications and addresses health inequalities,” noted WHO's director of Maternal, Newborn, Child and Adolescent Health.

Pregnant women should have their first doctor’s visit in the first 12 weeks’ gestation, followed by visits at 20, 26, 30, 34, 36, 38 and 40 weeks’ gestation.

Other recommendations include eating healthy and staying physically active during pregnancy; taking 30-60mg of iron supplements and 0.4mg folic acid daily during pregnancy; tetanus toxoid vaccination is recommended for all pregnant women; one ultrasound scan before 24 weeks’ gestation; and pregnant women should be asked about their current and past use of alcohol and other substances at every antenatal visit.

“Counselling about healthy eating, optimal nutrition and what vitamins or minerals women should take during pregnancy can go a long way in helping them and their developing babies stay healthy throughout pregnancy and beyond."


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The Week

Topics : #health

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