25 Mar

Medical News Today: Diet tips to improve insulin resistance

Insulin is a hormone that helps the body absorb glucose, keeping blood sugar levels in balance. Insulin resistance makes it harder for glucose to be absorbed.

This causes problems for muscles, fat, and the liver, as they need glucose (sugar). Over time, insulin resistance can cause high blood sugar levels and damage cells.

Insulin resistance can lead to type 2 diabetes. People with insulin resistance are often diagnosed with prediabetes. They may need extra checks to make sure they don’t develop diabetes.

Diet and other lifestyle choices can increase the risks related to insulin resistance. Making diet changes can reduce insulin insensitivity. This reduces the risk of type 2 diabetes and the health problems that go with it.


Understanding insulin resistance

[nurse holds a plastic model of a pancreas]
The pancreas releases insulin to help the body absorb glucose and maintain healthy blood sugar levels.

Glucose is a vital source of energy for the body. However, many of the body’s cells can’t absorb glucose on their own.

The pancreas secretes insulin into the bloodstream. It joins up with glucose, and travels to the body’s cells, where it attaches to insulin receptors. Insulin allows the cells to absorb glucose, making sure that:

  • blood sugar levels remain at a safe level
  • muscle, fat, liver, and other cells are able to get energy

Insulin resistance makes cells less sensitive to insulin. This means the body has to produce more insulin to keep blood sugar levels healthy.

If the pancreas is unable to keep up with the increased demand for insulin, blood sugar levels go up. When this happens, cells can’t use all of the excess glucose in the blood. This leads to type 2 diabetes.


Diet tips

Following a healthful diet plan, such as the Mediterranean Diet, can improve insulin sensitivity.

This diet recommends eating lots of seasonal plant-based foods, having fruit as a dessert, and olive oil as the main source of fat. Fish, poultry, and dairy products should be eaten in moderation. It also advises people to have a very small amount of red meat and a little wine during meals.

How many calories you have each day should be based on weight loss goals and body size. Larger people need more calories, while smaller people need fewer calories. Generally, 2,000 calories per day is a healthy average to maintain weight.

The Mediterranean Diet is just one option for healthful eating. Other diet plans offer more specific ways to improve symptoms of insulin resistance.

Glycemic index

One of the simplest ways to tackle insulin resistance is to eat foods with a low glycemic index (GI).

Low GI foods are digested slowly and don’t produce as many blood sugar spikes. The difference between low GI and other foods is particularly noticeable when it comes to carbohydrates. Carbohydrates that have a high GI can cause blood sugar spikes and put more demand on the pancreas to make insulin.

As such, eating low GI foods is a good way to maintain balanced blood sugar levels.


Foods to eat

Western diets typically lack certain nutrients, such as magnesium, calcium, fiber, and potassium.

These nutrients are especially important to maintain blood sugar levels. So, people with insulin resistance should seek out foods rich in these ingredients.

It’s possible to enjoy foods from every food group even with insulin resistance. Understanding which foods increase blood sugar and which support insulin sensitivity is key.

[salmon brussel sprouts broccoli with olive oil]
Eating a Mediterranean diet with lean proteins and plenty of non-starchy vegetables can help reduce insulin insensitivity.

The following foods help to support insulin sensitivity:

  • non-starchy vegetables, such as broccoli and peppers
  • high-fiber foods, such as beans and whole grains
  • protein-rich foods, including lean meats, fish, and nuts
  • foods rich in omega-3 fatty acids, such as salmon
  • antioxidant foods, such as berries
  • sweet potatoes, which are lower GI than other potatoes
  • water, especially as a substitute for sweetened drinks
  • unsweetened teas


Foods to avoid

Certain foods are more likely to raise blood sugar. These foods should be limited or avoided to help maintain a steady blood sugar level:

  • sweetened beverages, including fruit juices, soda, and fountain drinks
  • alcohol, particularly beer and grain alcohol, especially in large quantities
  • grains, whether refined or whole, may worsen insulin sensitivity in some people
  • starchy vegetables, such as potatoes, pumpkin, corn, and yams
  • processed snacks and boxed foods
  • excessive sugary sweets, such as cupcakes, ice cream, or chocolate bars
  • white bread, rice, pasta, and flour, which is lower in fiber than whole grain
  • dairy from cows, especially milk
  • fried foods, even if the food is otherwise healthful
  • foods high in saturated fats, including chocolate, butter, and salt pork

Finding a healthful balance

It’s possible to sometimes eat foods on this list and still improve insulin sensitivity. The key is to limit these foods, and to replace them with more healthful options as often as possible.

By sticking to a diet rich in fiber and plants while being low in added sugars, it’s possible to steadily improve insulin sensitivity. Daily exercise is also an important factor. These lifestyle changes can reduce the risk of type 2 diabetes, cardiovascular disease, and other health conditions.


Causes of insulin resistance

Research shows ethnic and genetic factors may increase the risk of insulin resistance. However, lifestyle factors also make a big difference.

Making positive changes to lifestyle can greatly decrease the risk of insulin resistance.

Diet

Diet affects insulin resistance in at least two ways. Firstly, consuming too many calories whether from too much fat, sugar, or alcohol can make people gain weight. This increases the risk of insulin resistance.

Secondly, different food types affect insulin resistance. Some foods increase the risk and some foods reduce it.

Weight

[woman running up a set of stairs outside]
Physical activity lowers blood sugar levels by causing muscles to use the glucose consumed at mealtimes.

Being overweight makes insulin resistance much more likely. People with lots of fat around their middle, in particular, are at an even greater risk. This is because fat secretes hormones and other substances that may interfere with insulin.

Excess fat around the waist is also linked to chronic inflammation. This can trigger a wide range of health problems, including insulin resistance.

Not enough exercise

Not getting enough exercise can affect the way insulin regulates glucose. Physical activity plays an important role in keeping blood sugar levels steady. It is a great idea to do light exercise after meals because exercise causes the muscles to use up glucose and they don’t need insulin. This lowers blood sugar levels.


Other lifestyle factors

A number of other lifestyle factors affect insulin resistance, including:

  • smoking
  • sleep issues
  • older age
  • use of steroids

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25 Mar

Medical News Today: How do alcohol and caffeine affect A-fib?

Some people with atrial fibrillation say it feels like their heart could flop out of their chests. Others feel like they’re about to pass out. And still others feel nothing at all.

Atrial fibrillation (A-fib) is the most common form of heart arrhythmia, or irregular heartbeat, affecting 2.7-6.1 million people in the United States, according to the Centers for Disease Control and Prevention (CDC).

Although A-fib disorders may appear with a variety of symptoms, they all have the same cause – irregular and rapid beating of the upper chambers of the heart.

Episodes of A-fib can be unsettling and uncomfortable, but are not generally life-threatening. However, if untreated, A-fib can lead to dangerous health conditions.

People with A-fib are around five times more likely to have a stroke than people without the condition, and strokes can lead to permanent disability or death.

A-fib can weaken the heart muscle over time, which triples the risk of heart failure. Risk of dementia doubles also.


How do caffeine and alcohol affect A-fib and the heart?

different bottles of alcohol
Alcohol may have both positive and negative effects on the heart according to studies.

The overall impact of alcohol on the heart is the subject of ongoing discussion in the medical community. Researchers have found it can have both positive and negative impacts on the heart.

The positive effects of alcohol, associated with moderate drinking only, include:

  • raising levels of the “good” cholesterol, HDL
  • preventing platelets from forming blood clots
  • reducing the buildup of plaque in the circulatory system

The following negative effects of alcohol on the heart are usually associated with heavy drinking:

According to the American Heart Association, although caffeine has many effects on the human body, at present no links have been confirmed between caffeine intake and heart disease.

In addition, studies have not found a link between caffeine and arrhythmia. However, reports indicate that drinking more than 5 cups of coffee each day can raise blood pressure.

Are alcohol and caffeine triggers that can cause A-fib?

Many health experts believe there is a connection between caffeine, alcohol, and A-fib, and that either substance can trigger an attack. However, researchers are still investigating the specific causes.

Many factors identified as possible triggers for A-fib may work alone or together to cause the condition. This makes it difficult to establish what is or is not a trigger.

As a result, it is also hard to work out how much coffee or alcohol could trigger an episode of A-fib.

Alcohol is a known trigger for a specific form of A-fib known as holiday heart syndrome (HHS). HHS is the sudden appearance of A-fib in individuals who are otherwise healthy, but who recently took part in binge drinking. The Centers for Disease Control and Prevention (CDC) define binge drinking as more than five drinks for men and four drinks for women in a 2-hour period.

Researchers have noticed these cases are more frequent after weekends and holidays linked with increased alcohol use, which is how HHS got its name.

In addition, some studies have found a connection between the risk of A-fib and chronic, alcohol use. A connection was not found for moderate drinkers.

A 2005 study exploring caffeine use in Scandinavia did not find any connection between A-fib and caffeine use.


Is it safe to consume alcohol or caffeine with A-fib?


The scientific community is divided on whether or not people with A-fib can consume alcohol or caffeine safely.

The American Heart Association advise individuals with A-fib to avoid excessive amounts of alcohol and caffeine.

However, a report published in the Journal of the American College of Cardiology found that even moderate use of alcohol increased the risk of A-fib. The risk rose by around 8 percent with each additional drink taken per day.

A third study found that two drinks each day for women did not increase the risk of A-fib, but three or more did. Another study found that the risk did not increase for men until they had more than five drinks per day.

There is some concern among experts regarding energy drinks. This is due to the high level of caffeine they contain and observed increases in the heart’s contraction rate. Healthy young adults could tolerate this increase, but it could be a problem for children and those with pre-existing heart conditions.


Tips and guidelines for consumption

couple enjoying coffee and alcohol
It is recommended that consumption of both caffeine and alcohol is moderate.

Even with the potential heart health benefits of moderate drinking, medical authorities generally do not advise anyone to start drinking alcohol solely to protect their hearts.

For those who do drink alcohol, the link between A-fib and alcohol use seems most apparent with chronic heavy drinking and binge drinking, and not with moderate drinking.
The problem lies in defining “moderate” drinking.

StopAfib.org recommend following the general heart health guidelines, which set limits of one drink per day for women and two drinks per day for men.

According to the American Heart Association, a drink is 12 ounces of beer, 4 ounces of wine, or 1.5 ounces of hard liquor.

The upper limit of safe, daily caffeine use, recommended by the Food and Drug Administration (FDA), is between four and five cups of coffee, or 400 milligrams (mg) of caffeine. Drinking between one and two cups of coffee per day seems to be safe, according to the American Heart Association.

Other risk factors for A-fib

Interestingly, people with A-fib report that the same activities, such as going for a walk, might prompt an attack one day and not the next.

Additionally, heart disease is a known risk factor for A-fib, as are age, obesity, and genetics, hyperthyroidism, diabetes, chronic kidney disease, and European ancestry.

However, there is a closer connection between obstructive sleep apnea and A-fib than any other risk factor.

A list of further potential A-fib causes includes:

  • certain medical procedures
  • emotional stress
  • physical stress
  • dehydration
  • sleep
  • hormones
  • exercise

Some more dietary factors to consider

Following a heart-healthy diet can help people with A-fib. Alcohol can be a part of that, if used in moderation, as can caffeine.

healthful foods
A heart-healthy diet may include a variety of fruits, vegetables, and whole grains.

The basic elements of a heart-healthy diet include:

  • eating a variety of fruits, vegetables, and whole grains
  • varying protein sources by eating legumes and simply prepared fish and poultry
  • increasing intake of omega-3 fatty acids by eating fish like salmon, herring, or trout
  • reducing sodium use to 2,400 mg per day, or less
  • avoiding saturated fats and the foods that contain them
  • limiting oil in general, selecting healthier oils like olive oil when using them, and avoiding tropical oils
  • avoiding beverages with added sugars
  • not smoking and avoiding secondhand smoke

Exercising regularly is essential for supporting a healthy heart function. A very basic level of activity for heart health, as recommended by the American Heart Association, is:

  • 30 minutes of moderate aerobic exercise 5 days a week
  • muscle-strengthening activities at least twice a week

People are encouraged to work with their healthcare providers to develop an appropriate exercise plan.

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25 Mar

Medical News Today: Metastatic breast cancer: Symptoms, treatment, and outlook

Metastatic breast cancer is when the cancer has spread to other parts of the body. Also referred to as stage 4 or advanced cancer, it can occur if initial treatment for breast cancer has not been successful.

Breast cancer can spread when cancer cells do one of the following:

  • invade nearby healthy cells and replicate
  • travel throughout the body in the bloodstream
  • lodge in capillaries and move into nearby tissue
  • form new tumors in other places around the body


Symptoms

Symptoms of metastatic breast cancer depend upon where the cancer has spread to. The areas it often spreads to are the brain, bone, lungs, or liver.

Brain

[breast cancer cells]
Metastatic breast cancer, also known as stage 4 breast cancer, is when the cancer cells spread to other areas in the body.

Depending on where in the brain the cancer spreads to, it can cause:

  • headaches
  • seizures
  • changes in behavior
  • disturbed vision
  • vomiting
  • nausea

Bones

If cancer spreads to the bones, it can cause:

  • severe pain
  • increased chance of fractures
  • swelling
  • decreased mobility
  • spinal cord compression

Lungs

If cancer spreads to the lungs, it often shows no symptoms but can cause:

  • shortness of breath
  • coughing up blood
  • chest pain

Liver

If cancer spreads to the liver, it can cause:

  • pain
  • loss of appetite
  • yellowing of the skin
  • itchy skin or rash
  • vomiting and nausea
  • bleeding

Other symptoms

Other general symptoms of metastatic breast cancer can include:

However, these symptoms can also be caused by medication and depression associated with the condition.
It’s important to identify these symptoms early and contact a doctor so the right treatment can be arranged.


Treatment

There are several ways to treat metastatic breast cancer. Treatment depends on the hormone receptor status or type of breast cancer.

Around two in three cases of breast cancer test positive for hormone receptors. These cancers are named as either:

  • Estrogen receptor positive (ER+): where the cancer cells have receptors for the hormone estrogen.
  • Progesterone receptor positive (PR+): where the cancer cells have receptors for the hormone progesterone.

A third type of breast cancer is known as HER2 positive (HER+). This is where there is a higher level of a particular protein, called human epidermal growth factor receptor 2 (HER2). It makes up around 15 to 20 percent of breast cancer cases where the cancer is likely to spread.

Another type of breast cancer is triple negative breast cancer (TNBC). This is where the cancer cells do not have receptors for estrogen, progesterone or HER2.

About 10 to 20 percent of breast cancers are TNBC. These cancers can’t be treated with hormone therapy, but other treatments can be used.

A decision on treatment will be made after the hormone receptor status has been determined.

Hormone therapy treatment

[white pills on a table]
Hormone therapy may be taken as a tablet or injected into a muscle.

Hormone therapy either lowers the level of estrogen or progesterone in the body, or blocks their effects on the body.

It is generally used when the breast cancer cells have ER+. In the case of metastatic breast cancer, it is used to control the cancer.

There are four main types of hormone treatment:

Tamoxifen

This treatment is usually taken as a tablet and is used when a person has:

  • ER+ cancer cells
  • not reached menopause
  • not previously had tamoxifen treatment

Aromatase inhibitors (AIs)

This treatment is also taken in tablet form and is used when someone has:

  • ER+ cancer cells
  • reached menopause
  • already had tamoxifen treatment

Fulvestrant


This treatment is injected into the muscle and is used when a person has:

  • ER+ cancer cells
  • reached menopause
  • already had tamoxifen or AI treatment

Progesterone

This can be taken as a tablet or by injection. It is used if the cancer has stopped responding to tamoxifen or AIs.

Side effects

Side effects are common in hormone therapies and vary depending on which drug is being taken.

They will generally be worse at the start of treatment and lessen as it goes on. The doctor may be able to help limit them.

The main side effects are:

  • hot flushes and sweating
  • changes to periods for pre-menopausal patients
  • less interest in sex
  • vaginal dryness or discharge
  • feeling sick
  • painful joints
  • mood changes
  • tiredness

Chemotherapy

Chemotherapy aims to destroy cancer cells in the body. It targets both where the cancer started and where it has spread to.

Known as a systemic therapy, it affects the whole body because it is sent around via the bloodstream.

As the American Cancer Society explain, chemotherapy can stop the spread of cancer and prolong survival. However, there can also be side effects such as nerve damage and heart problems. Also, cancer cells can become resistant to chemotherapy.

Targeted drug therapy

Unlike chemotherapy, which attacks all growing cells cancerous or not, targeted drugs just work on cancerous cells. They are designed to block the growth of these cells and stop them spreading.

As such, they can work when chemotherapy does not. They can also help improve the effects of other types of treatment.

In the case of HER2+ breast cancers, there are a number of drugs that target this protein:

[woman with cancer being comforted]
Targeted drugs only attack cancerous cells, unlike chemotherapy, which attacks all growing cells.

Trastuzumab

  • often used alongside chemotherapy
  • given into a vein

Pertuzumab

  • can be used with trastuzumab
  • given into a vein

Ado-trastuzumab emtansine

  • used if already treated by trastuzumab and chemotherapy
  • given into a vein

Lapatinib

  • typically used when trastuzumab is no longer working
  • used alongside certain chemotherapy and hormone therapy
  • taken as a tablet

Side effects

Trastuzumab, pertuzumab, and ado-trastuzumab emtansine can all cause heart damage. As such, patients should let their doctor know if they are experiencing:

  • shortness of breath
  • leg swelling
  • severe fatigue

Lapatinib can cause severe diarrhea, so patients should tell their doctor if this occurs. It can also cause hand-foot syndrome, where hands and feet become red and sore and can blister and peel.

In cases of ER+ and PR+, targeted drug therapy can be helpful alongside hormone therapy:

Palbociclib


For patients who have reached menopause, this drug slows cancer growth. Taken as a pill, it can cause:

  • anemia
  • tiredness
  • nausea
  • mouth sores
  • hair loss
  • diarrhea
  • increased chance of infection

Everolimus

For patients who have reached menopause, this can limit the growth of tumors. It also often helps hormone therapy work better. Taken as a pill, it can cause:

  • mouth sores
  • diarrhea
  • nausea
  • fatigue
  • low blood counts
  • shortness of breath
  • a cough
  • increased chance of infection

Surgery

There is some debate about whether surgery in cases of metastatic breast cancer improves survival rates. However, due to the negative effects of surgery it is not often offered as a treatment.


How is it monitored?

Monitoring, or follow-up care, is extremely important. This will check to see if the cancer has spread further, help to manage side effects, and monitor overall health.

The doctor will often examine the neck, chest, underarm, and breast area at check-ups. They will also check the general health of the patient.

If there are any new health problems, or changes to the treated area or other breast, then the doctor should be informed straight away.


Outlook

Outlook depends on the type of breast cancer, where it has spread to, and how much the tumor is affecting these areas.

The average survival time is 18 to 24 months, but it can vary widely. The American Cancer Society found that 22 percent of people who have metastatic breast cancer survive for 5 years or more.

Many people can live long and productive lives with metastatic breast cancer, and treatment can control the cancer.

Survival rates will vary depending on the individual, and the best thing to do is speak to the doctor to get a better understanding of specific circumstances.

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25 Mar

Medical News Today: Erectile dysfunction: Stem cell therapy restores sexual function in phase I trial

Early results of a clinical trial suggest that stem cell therapy may be a promising treatment for erectile dysfunction, after the procedure was found to restore sexual function in men with the condition.
[Blue stem cells]
Researchers suggest that stem cell therapy may be an effective treatment strategy for ED.

The stem cell therapy involves injecting the patients’ own stem cells – derived from abdominal fat cells – into the erectile tissue of the penis.

Lead researcher Dr. Martha Haahr, of Odense University Hospital in Denmark, and colleagues found that within 6 months of the procedure, 8 of the 21 men treated were able to engage in spontaneous sexual intercourse.

The researchers recently presented their findings at EAU17 – the European Association of Urology’s annual conference – held in London in the United Kingdom.

Erectile dysfunction (ED) is a condition whereby a man has difficulties getting or maintaining an erection in order to engage in sexual intercourse.

According to the National Institute of Diabetes and Digestive Kidney Diseases, around 12 percent of men under the age of 60, and 22 percent of men aged between 60 and 69, have ED.

High blood pressure, diabetes, heart disease, chronic kidney disease, and prostate surgery are some of the physical conditions that can cause ED. Psychological issues – such as anxiety, stress, depression, and low self-esteem – can also contribute to ED.

Current treatments for ED include PDE5 inhibitors (such as Viagra), penile implants, and injections. However, Dr. Haahr and team note that all of these therapies can have significant side effects.

As a result, researchers are on the hunt for alternative treatments for ED, and stem cell therapy has emerged as a promising candidate in animal trials.

Sexual function improvements evident a year after treatment

In their phase I trial, Dr. Haahr and colleagues tested stem cell therapy on 21 men who had ED as a result of undergoing radical prostatectomy for prostate cancer. None of the men had responded to standard medical treatment for ED.

For the stem cell procedure, abdominal fat cells were extracted from each man through liposuction. Stem cells were then isolated from the fat cells and injected into the corpus cavernosum of the penis – the spongy tissue that normally becomes filled with blood during an erection.

Before the stem cell procedure and 6 and 12 months after, the participants’ erectile function was assessed using the International Index of Erectile Function (IIEF) questionnaire. An IIEF score of 5-7 represents severe erectile dysfunction, 12-16 is mild to moderate erectile dysfunction, and 22-25 is no erectile dysfunction.

All 21 men saw their erectile function improve with stem cell therapy: their IIEF score increased from 6 prior to treatment to 12 at 6 months after treatment.

Eight of the men reported that they had been able to engage in spontaneous sexual activity 6 months after stem cell therapy, and this outcome remained evident at 12 months after treatment. These men saw their IIEF score rise from 7 to 14 with stem cell therapy.

“What we have done establishes that this technique can lead to men recovering a spontaneous erection – in other words, without the use of other medicines, injections, or implants,” says Dr. Haahr.

Stem cell therapy ‘could be a long-term solution’ for ED

Although the study findings are preliminary, the team says that they show promise for stem cell therapy as an effective treatment strategy for ED.

“We are the first to use a man’s own fat stem cells as a treatment for erectile dysfunction in a clinical trial. The technique has been trialed in animal work, but this is the first time stem cell therapy has allowed patients to recover sufficient erectile function to enable intercourse,” says Dr. Haahr.

“We are pleased with the preliminary outcomes, especially as these men had previously seen no effect from traditional medical treatment and continue to have good erectile function after 12 months follow-up, indicating that this might be a long-term solution.

This suggests the possibility of therapeutic options for patients suffering from erectile dysfunction from other causes. But we need to remember that this is a small trial, with no control group. We’re still some time away from a clinically available solution.”

Dr. Martha Haahr

The researchers are now in the process of initiating a phase II trial to further investigate the safety and efficacy of stem cell therapy for ED.

Learn how eating more fruits could help to lower the risk of ED.

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25 Mar

Medical News Today: Hangover memories more likely with a family history of drinking problems

Headache, nausea, vomiting, dehydration – these are just some of the symptoms of a hangover that many of us would rather forget. But for people with a family history of alcoholism, this might be easier said than done.
[A very tired woman]
People with a family history of alcoholism may have more lucid memories of hangovers, research suggests.

Researchers found that people who have a family history of alcohol use disorders are more likely to remember hangovers after a night of heavy drinking than those without alcoholism in their families.

Study leader Dr. Richard Stephens, a psychologist at Keele University in the United Kingdom, and his team recently reported their findings in the journal Psychopharmacology.

According to the National Institute on Alcohol Abuse and Alcoholism, studies have shown that alcohol use disorders can run in families, with genetics accounting for around 50 percent of the risk of alcoholism.

With this in mind, Dr. Stephens and colleagues set out to investigate whether a family history of drinking problems might also influence a person’s risk of hangovers.

Exploiting hangover memories could reduce heavy drinking

The researchers conducted two studies. The first study involved 142 adults aged between 18 and 29 years, of whom 24 had a family history of alcoholism.

Participants were asked to complete an online survey that assessed their alcohol intake and hangover frequency over the past 12 months.

Compared with subjects without a family history of alcoholism, adults with a family history of drinking problems reported remembering more frequent hangover symptoms.

“This occurred despite more relevant measures of alcohol consumption – estimated blood alcohol following the largest amount consumed over the past month and drinking frequency – being taken into account,” note the authors.

The second study involved 49 adults aged between 18 and 23 years. Of these, 17 had a family history of drinking problems.

For this study, subjects were interviewed the night after engaging in heavy drinking. Their blood alcohol concentrations were measured, and any hangover symptoms were reported.

The team identified no difference in reported hangover symptoms between adults with and without a family history of drinking problems.

“Taken together with findings from prior research it appears that people who are predisposed to develop problem drinking are no more susceptible to developing a hangover after a night of alcohol than people who are not predisposed. However, we found that such people appear to remember their hangovers more lucidly.”

Dr. Richard Stephens

Dr. Stephens says that exploiting this lucid memory could be one way to reduce heavy drinking among individuals with a family history of alcoholism.

“Reminding problem drinkers of the negative consequences of incapacitating hangover, for example, letting down family members due to abandoned plans, may help them to manage their alcohol consumption,” he adds.

Learn how a hormone link between the liver and the brain could control alcohol intake.

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24 Mar

Medical News Today: Spiritual retreats alter brain's reward, emotion centers

A new study sheds light on why people who attend spiritual retreats report greater psychological well-being, after finding that such retreats may increase levels of “feel-good” hormones in the brain.
[A woman meditating by the beach]
New research offers insight into how spiritual retreats affect the brain.

Researchers from Thomas Jefferson University in Philadelphia, PA, found that individuals who attended a spiritual retreat for 7 days experienced changes in the dopamine and serotonin systems of the brain, which boosts the availability of these neurotransmitters.

Dopamine helps to regulate movement and emotional responses, while serotonin helps to control emotion and mood.

Co-author Dr. Andrew Newberg, director of research in the Marcus Institute of Integrative Health at Thomas Jefferson University, and colleagues say their study provides insight into the emotional impact of spiritual practices.

“Since serotonin and dopamine are part of the reward and emotional systems of the brain, it helps us understand why these practices result in powerful, positive emotional experiences,” says Dr. Newberg.

Spiritual retreats can be defined as a place for people of varying spiritual beliefs to engage in practices aimed at reinforcing their faith and improving their health and well-being.

According to the researchers, an increasing number of people are visiting such retreats, and studies have shown that these individuals often report a reduction in anxiety, stress, and other psychological benefits.

“However,” note Dr. Newberg and colleagues, “no studies have explored the neurophysiological effects of these retreat programs.” The team set out to address this gap in research.

Reductions in serotonin, dopamine transporter binding

For their study, the researchers enrolled 14 Christian adults aged 24-76 years. Subjects were required to visit an Ignatian retreat for 7 days. Here, the participants engaged in spiritual exercises created by St. Ignatius Loyola, who founded the Jesuits.

Each day, the participants attended a morning mass. For the rest of the day, subjects engaged in silent contemplation, prayer, and reflection. They also met with a spiritual director, who provided spiritual guidance and information on the aims of the retreat.

Before and after visiting the retreat, participants underwent DaTscan single photon emission computed tomography (SPECT), which enabled the researchers to assess their brain activity.

Subjects also completed a series of questionnaires that assessed their physical and psychological well-being.

After the 7-day retreat, participants demonstrated a 5-8 percent reduction in dopamine transporter binding, as well as a 6.5 percent reduction in serotonin transporter binding. The researchers say these decreases can lead to greater availability of dopamine and serotonin in the brain, which can have positive psychological effects.

The participants also reported an increase in self-transcendence following the 7-day retreat, which the team says correlated with reductions in dopamine binding. Subjects also reported improvements in physical health, tension, and fatigue.

“Our study showed significant changes in dopamine and serotonin transporters after the 7-day retreat, which could help prime participants for the spiritual experiences that they reported.”

Dr. Andrew Newberg

In future studies, the researchers wish to pinpoint the specific practices at spiritual retreats that are responsible for changes to serotonin and dopamine transporter binding. They would also like to determine whether results vary dependent on the type of retreat.

Read about how the “love hormone” oxytocin might intensify spiritual beliefs.

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24 Mar

Medical News Today: Parkinson's: 2.5 hours of weekly exercise benefits mobility, quality of life

Exercising for at least 2.5 hours every week may help maintain physical health and quality of life for patients with Parkinson’s disease, a new study suggests.
[An older woman exercising with an instructor]
Researchers suggest that exercising for at least 2.5 hours weekly may benefit patients with Parkinson’s.

From an analysis of more than 3,400 patients with Parkinson’s disease, researchers found that those who engaged in a minimum of 150 minutes of physical activity a week experienced much slower declines in health-related quality of life (HRQL) and mobility over 2 years, compared with patients who exercised less than 150 minutes weekly.

What is more, the team found that patients in the advanced stages of Parkinson’s may benefit most from increasing their physical activity by 30 minutes each week.

Study leader Miriam R. Rafferty, Ph.D., of the Center for Education in Health Sciences at Northwestern University in Chicago, IL, and colleagues recently reported their findings in the Journal of Parkinson’s Disease.

Parkinson’s disease is a progressive condition characterized by tremors, stiffness of the limbs and trunk, poor balance and coordination, and mobility impairment.

According to the Parkinson’s Disease Foundation, up to 1 million people in the United States are living with Parkinson’s, and around 60,000 new cases are diagnosed in the U.S. every year.

Previous research has indicated that exercise may yield benefits for patients with Parkinson’s. One study reported by Medical News Today in 2015, for example, found that patients with early Parkinson’s who engaged in a 40-60-minute exercise program three times weekly experienced improved mobility and balance over 6 months, resulting in a reduction in falls.

For this latest study, Rafferty and colleagues set out to determine how regular exercise might benefit HRQL and mobility for patients with Parkinson’s over a 2-year period.

Mobility, quality of life improved with regular exercise

The research included 3,408 patients with Parkinson’s disease who were a part of the National Parkinson Foundation Quality Improvement Initiative (NPF-QII), which collects data on clinical care and outcomes for Parkinson’s patients at 21 sites across North America, Israel, and the Netherlands.

Patients engaged in at least three clinic visits over 2 years. During these visits, data were collected on the number of hours patients exercised each week, as well as information on functional mobility and HRQL.

Functional mobility was assessed using the Timed Up and Go (TUG) test, which times patients as they rise from a seated position, walk 3 meters, turn around, and sit back down. HRQL was self-reported through The Parkinson Disease Questionnaire (PDQ-39).

Compared with patients who engaged in less than 2.5 hours of physical activity each week, those who did at least 2.5 hours of exercise weekly demonstrated a significantly slower decline in HRQL and mobility over the 2-year period.

This finding was true for patients who exercised regularly from study baseline, as well as those who began exercising for at least 2.5 hours a week during follow-up.

“The most important part of the study is that it suggests that people who are not currently achieving recommended levels of exercise could start to exercise today to lessen the declines in quality of life and mobility that can occur with this progressive disease,” says Rafferty.

Boosting exercise by 30 minutes a week beneficial in advanced stages

The researchers also looked at the effects of 30-minute increases in weekly exercise among patients with Parkinson’s.

The team found that increasing physical activity by 30 minutes each week led to improvements in both HRQL and mobility. Interestingly, the greatest improvements in HRQL were seen among patients in the advanced stages of Parkinson’s.

The researchers say this finding has important implications for making physical activity more accessible to patients with advanced Parkinson’s disease. They note that such patients may have more severe mobility impairments, making participation in current exercise programs challenging.

The study was not designed to pinpoint what types of exercise are best for patients with Parkinson’s, but the authors say that engaging in any form of physical activity is better than being sedentary.

“People with [Parkinson’s disease] should feel empowered to find the type of exercise they enjoy, even those with more advanced symptoms.”

Miriam R. Rafferty, Ph.D.

Learn how blocking a brain enzyme could improve the motor symptoms of Parkinson’s.

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24 Mar

Medical News Today: Diabetes: Heart attack risk due to loss of small blood vessels around the heart

People with diabetes have a significantly higher risk for heart attack. Now, new research suggests that diabetes damages the small blood vessels around the heart, and this might explain the link to heart attack. In a study reported in the Journal of the American College of Cardiology, the researchers also propose a solution may lie in gene therapy.
black and red image of heart
The researchers suggest that the high blood sugar that occurs in untreated diabetes damages the small blood vessels of the heart and this explains the link between diabetes and higher risk of heart attack.

Diabetes is a chronic disease that arises either because the body does not produce enough insulin (typical of type 1 diabetes) or because it cannot effectively use the insulin it produces (typical of type 2 diabetes). Around 90 percent of people with diabetes have type 2.

Insulin is a hormone that helps keep blood sugar (glucose) under control. Uncontrolled diabetes results in high blood sugar, or hyperglycemia, which, over time, damages many parts of the body, including nerves and blood vessels.

The number of people with diabetes worldwide was estimated to be 422 million in 2014, up from 108 million in 1980. The disease is a major cause of blindness, heart attack, stroke, kidney failure, and lower limb amputation

In the United States, there are now more than 29 million people with diabetes, up from 26 million in 2010.

Another 86 million people have prediabetes, a condition in which blood sugar is higher than normal but not yet in the range for type 2 diabetes.

Diabetes affects small cardiac blood vessels

Fast facts about diabetes

  • The global prevalence of diabetes among adults rose from 4.7 percent in 1980 to 8.5 percent in 2014.
  • Once a disease seen only in adults, the number of children with type 2 diabetes is increasing.
  • The total medical costs and lost productivity and wages associated with diabetes in the U.S. came to $245 billion in 2012.

Learn more about diabetes

The new study – led by researchers at Technical University of Munich (TUM) in Germany – investigates the effect of diabetes on the small blood vessels, or capillaries, that surround the heart. Damage to these can affect the whole of the heart muscle.

The heart’s network of veins and arteries and small offshoots into capillaries can be compared to a road traffic network. If one small minor road is blocked, it has little effect on the whole network.

However, if more and more small side roads come to a halt, the traffic on the main roads and highways becomes denser and denser, and eventually the whole system seizes up and a heart attack ensues.

The researchers suggest their findings show how diabetes can have this effect.

They compared samples of heart tissue taken from patients with and without diabetes who underwent heart transplants. The samples from patients with diabetes showed that their hearts had significantly fewer small blood vessels around them.

After running tests in the laboratory, the team also found high levels of blood sugar are linked to loss of pericytes – a type of cell that forms a protective layer around small blood vessels.

The team believes this layer stabilizes the blood vessel and causes the blood vessels to break up when damaged.

Gene therapy may reverse damage to cardiac capillaries

The researchers also studied the effect of blood vessel loss in pigs genetically engineered to develop type 1 diabetes that is like the human form. They found the same damage occurred in their hearts.

However, with the help of gene therapy, the team was able to increase production of a protein that stimulates growth of pericytes. This led to new growth of lasting and functioning small blood vessels.

It will be some time before such a treatment is available for use in humans, note the researchers, who also point out how the findings reinforce the importance of diagnosing diabetes early.

One in four people with diabetes do not know they have the disease. First author Dr. Rabea Hinkel, a cardiologist at TUM’s university hospital, concludes:

“Diabetes often remains undetected in patients for years or even decades. Over that long period, massive damage can occur.”

Learn how taking statins is linked to higher risk of diabetes in older women.

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24 Mar

Medical News Today: Catheter ablation for A-fib: What to expect

Catheter ablation for atrial fibrillation is a procedure that involves using radiofrequency energy to destroy areas of heart tissue that are causing the heart to beat with an irregular rhythm.

By destroying the tissue, the electrical signals that made the heart beat irregularly should now travel through tissue that generates only a regular heartbeat.

Catheter ablation is also used to treat other irregular or harmful heart rhythms, including atrial flutter. A cardiologist specializing in the electrical activity of the heart performs the procedure.


What happens?

The procedure takes place in a lab similar to an operating room but with special equipment. This includes screens and imaging technology that allow the doctor to view the heart in real time.

[doctor and patient in a cath lab]
A catheter ablation takes place in a lab with special equipment used to display the heart in real time.

A person will receive medications through a line into a vein. Some will be asleep with a breathing tube, and others will be breathing on their own. The approach depends on the person’s overall health.

The doctor will make small cuts in the groin and thread special wires (catheter wires) to the heart to sense its electrical activity and create a “map.” This map directs the doctor to areas of the heart that are overactive and potentially causing A-fib.

Once the map has identified the areas for treatment, the doctor will guide the catheter wires to where ablation is needed. Next, the catheter delivers high levels of energy to scar the area. A person’s heart rhythm should then return to normal.

The procedure usually takes anywhere from 2-4 hours. After it is done, the catheters and breathing tube are removed, and pressure is held on the wound sites.

The patient may have to lie flat for a few hours and limit movement of the legs to reduce the risk of bleeding from the wound sites.

Most people will be discharged the same day, but they should not attempt to drive because of the medication they have been given.

Types of ablation

An estimated 90 percent of patients with paroxysmal A-fib, which is A-fib that is not constant, have symptoms that start as a result of defects in the pulmonary vein region.

The pulmonary vein carries oxygen-rich blood to the upper left chamber of the heart before the blood is pumped out to the rest of the body. Most commonly, a doctor will scar this upper area of the heart to keep the signals that are causing A-fib from being sent out.

Sometimes, the problem areas can spread to other sections of the upper heart chambers. Then A-fib ablation is more difficult and less likely to be successful.

Another ablation type is AV node ablation with pacemaker. Pacemakers are devices that help the heart maintain a regular rhythm.

This procedure is used when a person’s A-fib is not controllable with medications or ablations on other parts of their heart.

By destroying the AV node and inserting a pacemaker, the heart can return to normal rhythm without any irregular signals to disrupt the normal heartbeat.


Who is catheter ablation for?

[hands holding water and pills]
A catheter ablation may be recommended if anti-arrhythmic medications are ineffective, or if their side effects are intolerable.

As catheter ablation is an invasive procedure, doctors don’t usually recommend it as a first treatment for A-fib.

Most of the time, a person must meet certain criteria before an ablation is recommended. Examples include when:

  • they have taken anti-arrhythmic medications, yet their A-fib continues
  • they can’t tolerate the side effects of anti-arrhythmic medication
  • their condition is declining, and they have symptoms of heart failure, or a reduction in how much blood the heart pumps out

Athletes sometimes experience A-fib due to the extra demands on their hearts. When this is the case, a doctor may recommend an ablation as a first treatment.

A doctor will not recommend ablation because a patient no longer wishes to take anticoagulants to reduce their risk of blood clots. As an ablation is an invasive procedure, the risks can sometimes outweigh the benefits. This is why the case is made for taking anticoagulants instead of having an ablation procedure most of the time.


Benefits and risks

A-fib increases risk of stroke or other blood clot-related conditions. It can also affect a person’s quality of life and overall activity levels. A-fib will worsen if left untreated, and can lead to heart failure. Treating it as early as possible can slow or possibly stop it getting worse.

By correcting the underlying cause with A-fib ablation, a person can live life without worrying about the heart palpitations or shortness of breath that occur.

With any procedure, however, there are some risks. The most significant is that a doctor might damage a blood vessel while inserting, removing, or moving the catheters. Other organs or structures that are close by, such as the food pipe may also be affected.

Infection at the entry site is another possibility or a person may have an adverse reaction to the medications that puts them to sleep. Even so, A-fib ablation is a “low-risk” procedure, according to the American Heart Association.


How to prepare for a catheter ablation

Before a catheter ablation, a doctor may conduct many types of cardiac testing to measure overall heart health. These tests can help work out the likelihood of an ablation being successful, and can show the doctor where to perform the procedure.

[doctor taking blood from a patient's arm]
Several tests may be done before the procedure, including Holter monitor testing and blood testing.

Examples of these tests include:

  • Blood testing, to determine if a person’s blood is at a therapeutic level.
  • Computed tomography (CT), where a scan shows a doctor the heart and its structures and identifies abnormalities.
  • Electrocardiogram, which measures the heart’s electrical activity and rhythm.
  • Holter monitor testing, where a person wears a monitor that detects and records the heart’s rhythms.
  • Transthoracic echocardiogram, involving a non-invasive test that estimates the functioning of the heart valves and the amount of blood being pumped to the body.
  • Transesophageal echocardiogram, which involves putting a probe down the throat to more closely view the chambers of the heart.

Doctors will give patients a list of things to do the day before the procedure, such as not eating or drinking after midnight. They may ask them to use a special soap that helps kill germs and reduces the risk of infection.

A doctor will also tell a person what medications they should take, or in some cases not take, before the ablation.


Recovery and outlook

After an A-fib ablation, many people return home the same day. A doctor will usually advise against heavy lifting and strenuous exercise for about 3 days. Patients can usually resume their regular activities, such as going back to work, the day after an A-fib ablation.

A patient should seek emergency medical attention if they experience the following symptoms:

  • swelling at the entry site that is quickly enlarging
  • pain in the chest that radiates to the arm, neck, or jaw
  • a foot turns numb, cold, or blue-tinged
  • the heart begins to beat very fast or irregularly
  • breathing is difficult and a person becomes short of breath

A-fib ablations are not always successful. In one study, the success rate was 73.6 percent and some people remained on anti-arrhythmic or other drugs to prevent A-fib from returning.

Furthermore, an A-fib ablation may only work for a short time. A repeat procedure may be carried out to allow the doctor to find any remaining areas that are transmitting faulty electric signals.

If A-fib ablation is unsuccessful, there are other invasive procedures available. However, these often carry added risks. As A-fib ablation techniques improve, the procedure is likely to be more effective in helping people return their heart rhythms to normal.

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24 Mar

Medical News Today: Atrial fibrillation: Natural treatments, remedies, and tips

The heart’s upper chambers normally beat in a regular, coordinated rhythm with the heart’s lower chambers. In atrial fibrillation, the heart’s upper chambers can quiver out of rhythm.

The result is an irregular heart rhythm that can cause symptoms, such as shortness of breath, weakness, and heart palpitations. The condition can also lead to blood clots developing in the upper chambers, which can cause a stroke.

Atrial fibrillation (A-fib) treatments can vary based on the symptoms that people experience. While it’s important for people to follow a doctor’s advice related to A-fib treatments, they might also choose to supplement medical treatments with natural ones.


Natural treatments

Acupuncture
Acupuncture may help control the heart rate of people with A-fib.

Although natural treatments are often not widely studied, there are several treatments and activities that may help to reduce the symptoms and effects of A-fib. Some of these treatments may include the following:

Acupuncture

Acupuncture, a traditional Chinese medicine approach, may help those with A-fib control their heart rates, according to a study published in the journal Evidence-Based Complementary and Alternative Medicine.

Acupuncture involves applying small needles to specific points on the body to promote energy flow. The acupuncture point is linked with controlling heart rhythm problems, but more research is still needed.

Yoga

Yoga is the practice of deep breathing, meditation, and body postures. Regular yoga practice for 1 hour, 3 days a week has been shown to reduce the amount of A-fib episodes, according to one study.

While the exact way that yoga reduces the incidence of A-fib isn’t known, researchers suggest that yoga could reduce stress and inflammation that damages the heart as well as reduce a person’s resting heart rate.


Herbs and supplements

One of the natural herbs reported to reduce A-fib and its symptoms is the Chinese herb extract Wenxin Keli (WXKL).

In a review of current studies regarding WXKL and its proposed effects, the authors found that taking the herb could have the following effects:

  • reduce changes to the heart that can occur as a result of A-fib
  • improve the maintenance of regular rhythm
  • have similar benefits as the beta-blocker sotalol in maintaining regular heart rhythms
  • reduce symptoms associated with A-fib, such as chest tightness, palpitations, and difficulty sleeping

However, the researchers noted that there are not a significant amount of studies or recommendations regarding a dosage for WXKL.

Another study studied the effects of traditional Chinese medicine (TCM) herbs compared with prescription medications in treating A-fib.

traditional chinese medicine herbs
Traditional Chinese medicine herbs may help to treat females that are younger than 65 who have A-fib. However, research on the use of TCM herbs is inconclusive.

At the conclusion of the study, researchers made the following conclusions:

  • The TCM users had a reduced risk for stroke (1.93 percent) compared with non-TCM users (12.59 percent).
  • TCM users who were female or younger than 65 experienced the greatest stroke reduction benefits.
  • Those older than age 65 did not experience a significant reduced stroke risk.

However, it’s important to note that one Chinese herb called Dan Shen can interact harmfully with warfarin, a blood thinner that doctors often prescribe to people with A-fib.

The researchers noted that there were several limitations to the study. For example, they did not track any of the participants’ lifestyle factors that could have affected their risk. The participants could also have been using other herbal medicines that the researchers weren’t aware of.

Other herbs and supplements that may help treat AFib, according to the Journal of Thoracic Diseases, include:

  • barberry (berberis)
  • cinchona
  • hawthorn
  • motherwort
  • omega-3 fatty acids
  • shensongyangxin


Substances to avoid

Lifestyle habits and eating certain foods and drinks can potentially trigger episodes of A-fib. One such habit is smoking. Other examples include:

  • Drinking alcohol excessively: no more than 1 to 2 alcoholic drinks for a man each day and no more than 1 drink per day for women. People older than age 65 should have no more than 1 alcoholic drink per day. Moderate to heavy alcohol drinkers were 1.35 times more likely to have A-fib than non-drinkers.
  • Consuming excess amounts of caffeine. About 400 milligrams of caffeine is a safe upper limit for adults on a daily basis. This is roughly the same as four brewed cups of coffee.
  • Taking cough and cold medicines that contain stimulants, such as dextromorphan or promethazine-codeine cough syrup.
  • Eating more than four servings of “dark” fish per week. According to one study, eating more than 4 servings of dark fish, such as salmon, swordfish, bluefish, mackerel, and sardines can actually increase the risk for A-fib.

Some people are more sensitive to medications and additives than others. If a person notices that eating a certain food or drink increases the incidence of irregular heart rhythms, they should talk to their doctor.


Lifestyle tips for living with A-fib

Many people with A-fib have a condition called sleep apnea. The most common form is obstructive sleep apnea, which causes a person to stop breathing for brief periods while they are asleep.

Sleep apnea can weaken the heart because the heart has to start working harder to make up for the lost oxygen when a person stops breathing.

Symptoms that suggest a person could be experiencing sleep apnea include:

  • being told they snore
  • waking themselves up at night with snoring or irregular breathing
  • having excessive daytime sleepiness

Anyone with these symptoms should see their doctor or a sleep medicine specialist.

A healthful lifestyle overall tends to promote heart health. As a result, a person may experience a reduced incidence of A-fib or lessen the risk of their symptoms getting worse.

Alcohol and coffee
Healthful habits to follow for people with A-fib include avoiding excess caffeine and alcohol.

Examples of healthful habits to follow include:

  • eating a healthy diet filled with fruits, vegetables, and whole grains
  • exercising regularly
  • managing high blood pressure through both medications and natural treatments, if desired
  • avoiding excess intakes of alcohol and caffeine
  • managing long-term conditions that could contribute to or worsen A-fib

Long-term conditions that could contribute to A-fib include high blood pressure, sleep apnea, thyroid disease, diabetes, and chronic lung disease.

According to the American Heart Association, a person with A-fib is five times more likely to have a stroke than someone who does not have a history of heart disease. By working to prevent cardiac complications, a person can live a healthier life with A-fib.

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Source: medicalnewstoday