A high-salt diet is not only bad for one's blood pressure, but also for the immune system. This is the conclusion of a current study under the leadership of the University Hospital Bonn. Mice fed a high-salt diet were found to suffer from much more severe bacterial infections. Human volunteers who consumed an additional six grams of salt per day also showed pronounced immune deficiencies. This amount corresponds to the salt content of two fast food meals. The results are published in the journal Science Translational Medicine.
Five grams a day, no more: This is the maximum amount of salt that adults should consume according to the recommendations of the World Health Organization (WHO). It corresponds approximately to one level teaspoon. In reality, however, many Germans exceed this limit considerably: Figures from the Robert Koch Institute suggest that on average men consume ten, women more than eight grams a day.
This means that we reach for the salt shaker much more than is good for us. After all, sodium chloride, which is its chemical name, raises blood pressure and thereby increases the risk of heart attack or stroke. But not only that: "We have now been able to prove for the first time that excessive salt intake also significantly weakens an important arm of the immune system," explains Prof. Dr. Christian Kurts from the Institute of Experimental Immunology at the University of Bonn.
This finding is unexpected, as some studies point in the opposite direction. For example, infections with certain skin parasites in laboratory animals heal significantly faster if these consume a high-salt diet: The macrophages, which are immune cells that attack, eat and digest parasites, are particularly active in the presence of salt. Several physicians concluded from this observation that sodium chloride has a generally immune-enhancing effect.
The skin serves as a salt reservoir
"Our results show that this generalization is not accurate," emphasizes Katarzyna Jobin, lead author of the study, who has since transferred to the University of Würzburg. There are two reasons for this: Firstly, the body keeps the salt concentration in the blood and in the various organs largely constant. Otherwise important biological processes would be impaired. The only major exception is the skin: It functions as a salt reservoir of the body. This is why the additional intake of sodium chloride works so well for some skin diseases.
However, other parts of the body are not exposed to the additional salt consumed with food. Instead, it is filtered out by the kidneys and excreted in the urine. And this is where the second mechanism comes into play: The kidneys have a sodium chloride sensor that activates the salt excretion function. As an undesirable side effect, however, this sensor also causes so-called glucocorticoids to accumulate in the body. And these in turn inhibit the function of granulocytes, the most common type of immune cell in the blood.
Granulocytes, like macrophages, are scavenger cells. However, they do not attack parasites, but mainly bacteria. If they do not do this to a sufficient degree, infections proceed much more severely. "We were able to show this in mice with a listeria infection," explains Dr. Jobin. "We had previously put some of them on a high-salt diet. In the spleen and liver of these animals we counted 100 to 1,000 times the number of disease-causing pathogens." Listeria are bacteria that are found for instance in contaminated food and can cause fever, vomiting and sepsis. Urinary tract infections also healed much more slowly in laboratory mice fed a high-salt diet.
Sodium chloride also appears to have a negative effect on the human immune system. "We examined volunteers who consumed six grams of salt in addition to their daily intake," says Prof. Kurts. "This is roughly the amount contained in two fast food meals, i.e. two burgers and two portions of French fries." After one week, the scientists took blood from their subjects and examined the granulocytes. The immune cells coped much worse with bacteria after the test subjects had started to eat a high-salt diet.
In human volunteers, the excessive salt intake also resulted in increased glucocorticoid levels. That this inhibits the immune system is not surprising: The best-known glucocorticoid cortisone is traditionally used to suppress inflammation. "Only through investigations in an entire organism were we able to uncover the complex control circuits that lead from salt intake to this immunodeficiency," stresses Kurts. "Our work therefore also illustrates the limitations of experiments purely with cell cultures."
High blood pressure, diabetes, and cardiovascular disease are so commonplace that everyone reading these words likely knows somebody with at least one of these maladies.
They are also the “underlying conditions” most associated with severe cases of COVID-19, based on early clinical profiles on the disease. Even though 80 percent of COVID-19 cases are mild, these reports reveal that the novel coronavirus can endanger people other than the elderly and infirm.
The idea that the virus only poses a threat to older people comes from focusing too heavily on COVID-19’s death rate, which the World Health Organisation updated last Wednesday to 3.4 percent. This rate is an average across ages, and the chances of dying do rise among older people.
But evidence also shows that COVID-19 is more fatal across all age groups than seasonal influenza, with death rates six to 10 times higher for those under 50. Moreover, death isn’t the only danger, and severe cases of COVID-19 are more common among young adults than you might think.
A study published February 28 in the New England Journal of Medicine, for example, examined the age breakdown for 1,099 coronavirus patients. The majority of non-severe cases—60 percent—are teens and adults between 15 to 49 years old, which might suggest this group is spared the worst of the virus.
In truth, severe cases were slightly more abundant among this younger demographic. Of the 163 severe cases reported in the study, 41 percent were young adults, 31 percent were aged 50 to 64, and 27 percent were above 65. The only age group spared by severe COVID-19 appeared to be kids under 14.
Millennials and Gen Z are also just as likely to catch the coronavirus as older groups, according to the largest profile to date on COVID-19, a clinical report of more than 72,000 patients published February 21 by the Chinese Centre for Disease Control and Prevention. So rather than rely on age to gauge who is most threatened by COVID-19, doctors say you may want to look at common underlying conditions and how they correspond with the death rates reported by the Chinese CDC. Doing so can offer clues on how to protect you and your loved ones.
“The death rate from this outbreak is high. We shouldn’t categorise it by young or senior,” Tedros Adhanom Ghebreyesus, director-general of the World Health Organisation, said during a Monday briefing. “We cannot say that we care about millions when we don’t care about an individual who may be senior or junior … Every individual life matters.”
The novel coronavirus tears apart the lungs, but the underlying condition most connected with COVID-19’s worst outcomes are afflictions of the heart.
Nearly half the adults living in the United States have high blood pressure. Likewise, diabetes is a household name. Both can factor into cardiovascular disease, a wide spectrum of disorders that kill one person roughly every 37 seconds in the United States alone.
Though the specific influence of COVID-19 on the cardiovascular system remains unclear, the American College of Cardiology states, “there have been reports of acute cardiac injury, arrhythmias, hypotension, tachycardia, and a high proportion of concomitant cardiovascular disease in infected individuals, particularly those who require more intensive care.” One study of 150 patients from Wuhan, China—the epicentre of the coronavirus outbreak—found that patients with cardiovascular diseases had a significantly increased risk of death when they are infected.
That’s because the heart and lungs are incredibly interconnected. Breathe in and out rapidly, and your pulse automatically increases its pace. But if your heart is already weak or you have blocked arteries, then you are working harder than a normal person to circulate blood and oxygen throughout your body.
“If this new virus enters our communities as it has been, I really worry for my cardiac patients,” says Erin Michos, a cardiologist and director of Women's Cardiovascular Health at Johns Hopkins Medicine in Baltimore. “During their day-to-day existence, their heart is having trouble pumping efficiently, and then you add a serious respiratory infection on top of that. That's the tipping point.”
Cardiac distress is yet another arena where the coronavirus mirrors what happens with the flu. Influenza has long been established as a propellant for heart attacks and cardiovascular disease, so much so that some doctors have wondered if the seasonal virus is a direct cause. A 2018 study published in the New England Journal of Medicine found that within seven days of a flu diagnosis, people were six times more likely to have a heart attack.
“I don't think the community fully appreciates it,” Michos says. “We know that viruses can trigger a heart attack or stroke.”
Moreover, people can be infected by more than one disease at the same time, further exacerbating any existing heart conditions. In a preliminary study of coronavirus patients from Wuhan, four percent of confirmed cases were infected with a second virus, mostly influenza.
“If your immune system is weakened already ‘cause you're fighting off one major pathogen, you're much more susceptible to get a secondary infection,” Michos says.
That’s why she, the U.S. Centres for Disease Control and Prevention, and the American Heart Association recommend that cardiac patients take extra precautions as the coronavirus outbreak grows, which includes getting vaccinated for the flu and bacterial pneumonia.
When it comes to matters of the heart, many people may also be at risk from underlying conditions they don’t even know they have. For example, high blood pressure—or hypertension—contributes to atherosclerosis, a process whereby the walls of a person’s blood vessels grow dense plaques made of fat and tissue fibres. If one of these plaques erodes or ruptures, it can block the blood vessel, leading to a heart attack or stroke.
Michos says a lot of people are walking around unaware with plaques and hypertension. The CDC estimates that 108 million Americans have hypertension, but at least 11 million have no idea.
That’s where the threat of respiratory infections such as influenza and coronavirus comes in. These infections can create a “blood storm” of inflammation that courses throughout a person’s body. (Once your body's infected, this is what coronavirus does.) An early study of Wuhan patients spotted “fulminant myocarditis,” an unusual syndrome that erodes the muscles in the heart.
“We know, especially for people who have no history of cardiovascular disease, that inflammation can be a trigger for a plaque rupture,” Michos says. Diabetes can also spur atherosclerosis and accelerate these plaque ruptures, and those with the disease also have relatively suppressed immune systems, making them more vulnerable for infections.
Given we are in the midst of flu season and the coronavirus crisis, Michos recommends that cardiac patients and diabetics make sure that they have enough of their regular medications, and that everyone checks that their blood pressure is under control.
Asthma action plan
Beyond cardiac health, the coronavirus outbreak has serious implications for people with chronic respiratory illnesses such as cystic fibrosis, chronic obstructive pulmonary disease, asthma, or allergies, as well as for people with lung damage linked to smoking. Even mild cases of a cold or the flu can aggravate these conditions, increasing one’s chances of landing in the hospital.
One alarming distinction with COVID-19 is the long incubation period before symptoms appear, which ranges from two to 14 days. This contributes to a situation in which members of the general public can be infected and contagious, yet have no awareness of their illness. And a new study published Monday in Lancet found that coronavirus patients shed the virus, an indicator of being contagious, for between eight to 37 days.
“I would advise anyone with a chronic respiratory illness before they travel, especially using public transportation, that they sit down and come up with a plan of protection,” says Enid Neptune, a pulmonologist at Johns Hopkins Medicine. Such a plan could be as simple as upping dosages of routine medications, or as thorough as pinpointing which nearby hospitals employ respiratory specialists.
“That may also mean not going to certain parties or gatherings where you don't really know where people have been or what their health status is,” Neptune says. Most of all, patients should not shy away from seeking professional advice.
“Sometimes patients feel that they're being alarmist and are inappropriately notifying their physicians,” Neptune says. “When there's a great deal of misinformation in the public arena and when there's much that we don't know yet about the virus, this is the time to use your medical contacts.”
Cancer patients are also in the group that needs to be concerned about respiratory conditions. People being treated with intensive therapy for leukemia or lymphoma, and those receiving bone marrow transplants, are among those more prone to catching pneumonias, including the viral versions. That’s because their immune systems are often compromised as a result of their tumors or due to the treatments they receive.
“Patients who have had cancer treatment in the past may also remain immunologically compromised even though they appear to have recovered,” says J. Leonard Lichtenfeld, deputy chief medical officer for the American Cancer Society in Atlanta.
These cancer patients are sometimes so jeopardised that they cannot take vaccinations and must rely on the protection afforded by community-wide immunisation. For now, the sole intervention for vulnerable cancer patients is social distancing and enhanced hygiene practices for their family and health care workers.
“That's difficult, because obviously cancer patients are at different stages of their illness, and people want to be with their loved ones,” Lichtenfeld says. “But we're all in this together, and we need to all take appropriate steps to protect ourselves and protect those we love.”
The kids are alright?
At the same time, all the data collected so far suggest that COVID-19 is rare and less severe in children. Through February 11, the Chinese CDC recorded 44,600 confirmed cases, but only 400 involved kids under 9 years old, and none died. So does this mean children are less likely to be infected, or that they just don't get very sick?
“All of us in the field think the latter is true,” says John Williams, chief of the division of pediatric infectious diseases at the University of Pittsburgh Medical Center. Early tracing among close contacts and in households has found that children are just as likely to catch the novel coronavirus as adults. The low number of childhood cases reported so far could be due to testing being concentrated at hospitals, Williams notes. “Once testing involves more mild patients, outpatients in clinics, and doctor’s offices, you will find more adults and probably a lot more kids.”
Seeing fewer kids with severe COVID-19 has some precedence among other coronaviruses and infectious diseases. Pediatric cases occurred during the SARS coronavirus epidemic 20 years ago, but most were mild. And while chickenpox is occasionally fatal for kids, unvaccinated adults who catch the disease are much more likely to suffer severe pneumonia and end up in the hospital.
“For any infectious disease, part of the symptoms and damage are caused by the germ itself, while part is caused by our immune system responding to the infection,” Williams says. “So the thought is that perhaps children, because their immune systems are less mature, just don't mount as much of a response to the infection as adults do.”
Despite this youth benefit, the school closures seen worldwide are justified, because children are the major spreaders of every respiratory illness known to exist. In the U.S., about 20 percent of American children get infected with the flu every year, versus 5 percent of adults.
“We also have a lot of vulnerable children in this country with chronic conditions,” Williams says, such as transplant recipients, cancer chemotherapy patients, or children with chronic heart and lung diseases. “We don't know yet if those kids are going to be at higher risk for more severe COVID-19 disease, but based on other viruses, my guess would be yes.”
Passengers who are stuck sitting next to, in front of, or behind a sick person on a plane: beware. There's a pretty good chance you'll catch their cough, cold, or flu.
That's the finding of a new study, which was funded by Boeing and conducted by in-flight data scientists from Emory University and Georgia Tech.
For their research, a troupe of 10 data scientists embarked on five round-trip cross-country flights, most of which were fully booked and flew during the height of flu season. In the air, the scientists worked like a band of germ-sniffing spies: they documented how passengers moved around the cabin, took hundreds of environmental samples, and tested the planes for the presence of 18 common respiratory illnesses.
The researchers used the data they collected about passengers' in-flight movement to simulate how transmission might work when a person is sick. They found that passengers sitting in a sick flier's row, or the row directly in front of or behind that germ-bag, will almost certainly come within a 1-meter (3.28-foot) radius of the sick person.
The people sitting near you on a plane are the greatest threat to your health
Since the most common way to spread viruses like the flu is by sneezing, coughing or breathing on healthy people, spending hours in close proximity to a person who's spewing virus particles is a near sure-fire way to get sick.
The study takes as an example a sick person sitting in the aisle seat of a plane that has three seats per side.
That person has a roughly 80% chance of infecting everyone in their row on that side of the aisle, as well as those in the rows directly in front and behind them on that side, the study found.
On the other side of the aisle, the person in the aisle seat directly across from this hypothetical sick person also has an 80% chance of catching the bug. So do the people in the aisle seats one row ahead of and behind the sick individual. But the people sitting across the aisle from a germy person in a middle or a window seat are significantly more shielded from exposure, with just a 10-30% chance of infection.
The researchers did not compare this scenario to one in which people are sitting near each other for long periods of time without the help of airplane air filters (like on a train, for example).
Nonetheless, they concluded that the people who are farther than one row away from a sick person on a flight probably wouldn't catch the illness, since most people on planes don’t interact with anyone besides their immediate seatmates, even when they get up.
Even in-flight movements like getting up to open an overhead bin or go to the restroom had little effect on illness transmission beyond those three rows in the danger zone.
Germs are "unlikely to be directly transmitted beyond 1 meter from the infectious passenger," the study authors wrote.
By their calculations, the best way to avoid catching germs is to get a window seat and stay there for the duration of the flight. Middle seats were rated second-safest, while the aisles were most dangerous for passing around and catching germs.
Even if your seatmates look healthy, that doesn’t mean you’re safe
As luck would have it, the flights the scientists took were full of pretty healthy travelers: all 229 of the germ samples they took on the planes came back negative, and the observers only saw one passenger who was coughing "moderately."
That surprised lead study author Vicki Hertzberg, a professor of data science at Emory University.
"Eight out of the 10 flights were taken during 'influenza season,'" she told Business Insider in an email. "I thought we might have seen something."
But it's probably a good thing they didn't, for the passengers' sake.
Some research suggests that illness droplets can travel as far as six feet away from a sick person, and flu particles can last for up to 24 hours on hard surfaces. So if you don't wash your hands frequently, you're going to be at risk while traveling, no matter where you sit on a plane.
Some planes that were in the air in Asia during the 2003 SARS outbreak found that as much as 40% of the cabin was at risk of becoming infected with the deadly virus.
For those reasons, the scientists behind this limited, US-based study were cautious about drawing any major conclusions. After all, a long international flight is bound to have more people getting up and milling around in the aisles.
So there’s just no sure way to know what kinds of germs might await on your next flight.
Young people with diabetes are at greater risk than peers without the disease of developing mental health problems or attempting suicide as they transition into adulthood, a Canadian study suggests.
Based on data for more than 1 million young people born in Quebec, researchers found that being diagnosed with diabetes is associated with increased odds of being diagnosed in an emergency room or hospital with a mood disorder like depression. It’s also linked to higher odds of being admitted to a hospital for a suicide attempt, according to the report in Diabetes Care.
Between the ages of 15 and 25, adolescents and young adults with diabetes are 325% as likely to attempt suicide as their same-age peers, and 133% as likely to suffer from a mood disorder, said Dr. Marie-Eve Robinson, a pediatric endocrinologist at the Children’s Hospital of Eastern Ontario, in Ottawa, Canada, who led the study.
Past research has explored risks for psychiatric disorders in individuals with and without type-1 diabetes, Robinson and her colleagues write in Diabetes Care, but the risks during the transition from adolescence to adulthood have not been assessed.
“In addition to challenges inherent to adolescence, young adults with diabetes who transition to adult care need to adapt to a new adult-care provider and a treatment facility,” Robinson told Reuters Health.
Young adults tend to perceive pediatricians as more family-centered and less formal compared to adult-care providers and this can sometimes make the transition difficult, she explained.
Type-1 diabetes, formerly known as juvenile diabetes, occurs when the pancreas makes little or no insulin; the disease typically emerges in childhood or adolescence. Type-2 diabetes, the more common form of the illness, is associated with aging and overweight and occurs when the body becomes less responsive to insulin.
Young people with type-1 diabetes must also take full responsibility for managing their diabetes, Robinson said, which includes injecting insulin multiple times a day, monitoring their glucose and paying close attention to diet and physical activity.
“This can be overwhelming, especially when their previous caregivers were providing significant support during childhood and adolescence.”
To assess the mental health toll of these burdens, the researchers used Quebec registries to identify people born between April 1982 and December 1998 without any mental illness diagnosed before age 15. The final analysis included 3,544 adolescents diagnosed with diabetes between ages 1 and 15, and nearly 1.4 million young people without diabetes.
The study team followed the youths from age 15 to 25 and found that in addition to increased risks for a mood disorder diagnosis or a suicide attempt, youth with diabetes were almost twice as likely to visit a psychiatrist, compared to peers without diabetes.
With diabetes, young people also had a 29% higher risk of being diagnosed with any psychiatric disorder. However, there were no differences between the groups in schizophrenia diagnoses.
Even without a diagnosis of diabetes, there is a lot of anxiety and depression nowadays in the adolescent population, said Dr. Anastassios G. Pittas, co-director of the Diabetes and Lipid Center, at Tufts Medical Center in Boston.
“To be diagnosed, on top of that, with a chronic, incurable medical condition that affects essentially every minute of one’s life has a huge impact,” Pittas, who was not involved in the current study, told Reuters Health in a phone interview.
However, depending on the age of the child, a major medical diagnosis need not always have a negative impact, he added.
For Pittas, one major limitation of the study was the large range in ages at which diabetes was diagnosed, and he would have liked to see if there were differences in mental health risk on that basis.
“Children diagnosed with diabetes at age 1 or 2 do not know life without diabetes,” said Pittas, adding that kids diagnosed before ages 7 or 8 tend to do better than those diagnosed in the middle of adolescence.
Even so, the study authors note in their report, endocrinologists who treat young adults rarely receive a patient’s psychosocial summary as part of their referral documents from their pediatric colleagues.
“As children with diabetes will inevitably transfer to adult care, pediatric and adult healthcare providers should be aware of the increased risk of developing mental health problems,” Robinson said.
Every star athlete has a team of pros that help them stay at the top of their game. Take Russell Wilson. At home in Seattle, the guy has a personal chef, mental coach, personal trainer—the list goes on. But a wellness squad isn’t only reserved for the rich and famous. That’s right: There are certain experts that we should all have in our back pocket to help stay in tip-top shape, regardless of what’s going on the squat rack, office, or wherever else you’re striving for those big gains.Now, if you’re anything like me, you typically only go seek out this sort of help when something feels off. That weird pain is traveling down your leg again, or your shoulders feel extra tight, or you’re waking up feeling bummed more often than you would like.
Don’t wait. Instead, check in with your wellness roster on the regular. From acupuncturists to therapists to general practitioners, we got experts to weigh in on the specialists you should be seeing.
According to the Cleveland Clinic, men have a habit of avoiding annual doctor visits. Of 1,174 men surveyed, only 50 percent of men go to the doctor for preventative care, and 41 percent of men were told as children that men don’t complain about health issues. Considering annual wellness visits are included gratis with any regular insurance plan, it’s time to stop making excuses and get yourself into a paper gown, stat.
What to look for: There are several different types of physicians that can be identified as a primary care doctor, including family practice, internal medicine, and general practice. Regardless of which one you go with, the right doctor will talk to you about an overall picture of wellness, instead of just what you can do to avoid illness, according to Steven Lamm, MD, medical director of the NYU Preston Robert Tisch Center for Men’s Health.
“The foundations for wellness require you to understand the importance of things like sleep, stress management, nutrition, and exercise,” he says. “You should be comfortable being open with them.”
Injuries happen to all of us. Research shows that between 19 and 74 percent of CrossFitters and 40 to 50 percent of runners struggle with injury each year. Connecting with a good physical therapist can help you stay off the injured list. And should you land there, the right DPT (that stands for doctor of physical therapy) can get you back toward better movement patterns in no time.
What to look for: When looking for a physio, examining their credentials is a great place to start, says Dan Giordano, DPT, CSCS, and co-founder of Bespoke Treatments. According to Giordano, your therapist should have “DPT” next to their name, which means that they’ve completed a postgraduate degree that takes about three more years and passed the National Physical Therapy Examination (NPTE) administered by the Federation of State Boards of Physical Therapy (FSBPT).
“Look at the work they have done outside the four walls of a clinic,” he adds. “Look for experience and see where it has been applied. Do not go to a PT that has 15-minute appointment slots that consist of heat packs and massage. Your time (and money) is worth more than that.”
Like a chocolate-dipped ice cream cone or a trip to that good Italian spot you usually only save for fourth dates, a stellar massage can be a treat. It can also do way more than just help you relax. “Massages can help loosen your muscles and tendons, allowing for increased blood flow and circulation,” says Brittany Driscoll, CEO and founder of Squeeze, a new massage concept from the team behind DryBar. “This can eliminate toxins, manage pain, and reduce fatigue.”
While Driscoll says weekly massages are great, it’s understandable that funds might not allow that. Aim to get one monthly for best results, she suggests.
What to look for: We don’t want to downplay the goodness of a no-name massage parlor where you can sneak in a full hour’s worth of bodywork for $45 or less. However, most states require massage therapists to be licensed before they can legally practice—and you may not find that there. “Find a spot you’re interested in, then inquire about a masseuse’s style or speciality,” says Driscoll. “Make sure to be detailed about what you’re hoping to achieve, where you want more focus or areas to avoid, and definitely don’t be shy about asking for more or less pressure throughout your session.”
A few facts on acupuncture: More than 14 million people in the U.S. have tried the millennia-old Chinese practice, and a lot of doctors hope it can be an effective alternative to opioids for pain management. Part of the rapidly growing “alternative” medicine industry, estimated to be worth $197 billion by 2025, acupuncture can help the body “with pretty much anything you can think of (and some things you may not),” according to Molly Forsyth, DACM, L.Ac., founder of 8 Point Wellness in New York City. “Acupuncture is an incredibly effective tool to manage and minimize the ailments caused by physical and emotional pressures of day to day life.”
Specialists use super-small needles on areas around the body called acupuncture points. According to Forsyth, the goal is helping patients achieve results like better digestion, increased energy, better mood, deeper sleep, and even an increase in concentration and work performance.
What to look for: Forsyth suggests finding a good referral and to seek treatment from a licensed acupuncturist (L.Ac). You can find or check credentials on the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). “Finding an acupuncturist can be like finding a therapist,” she says. "If the first acupuncturist you meet and work with doesn’t feel like a good fit, don’t hesitate to try another.”
There’s a growing awareness that mental health is just as important as physical health. But it’s still something that a large crop of men really struggle with. Dozens of studies have shown that men are less likely than women to seek out mental help for things like substance abuse, depression, and stress. Men also make up over 75 percent of suicide victims in the United States, which translates into one death every 20 minutes or so.
"Therapy can be incredibly beneficial for men, who may feel pressured to excel without addressing their emotional wellbeing and mental health due to social stigma or lack of awareness,” says Salina Grilli, LCSW and owner of SMG Psychotherapy in New York. “In therapy, men can take a step back to gain insight into their behaviors and thoughts, which can help develop ways to productively manage their stress.”
What to look for: When seeking out a therapist, look for someone who is licensed to practice therapy and has a postgraduate degree, says Grilli, including LCSW, LMHC, LMHC, PsyD, or PhD. A lot of experts, including Grilli, suggest people speak with a therapist weekly, especially at the beginning, to develop a good, comfortable relationship and explore the practice. From there, there may be room to progress to biweekly visits or check-ins as needed.
Developing the right mindset for weight loss is how you will ultimately find success in your journey. If you set out to lose those few extra pounds surrounded with negativity for yourself and your body, you’re setting yourself up for failure. Most people try to lose the weight with the worst possible opinion of themselves rolling around in their brain and with the notion that they need to ‘fix’ themselves. They dive into these fad diets and exercise regimens out of a sense of self-deprecation, calling themselves “fat”, referring to their “wiggly” parts, and being overwhelmed with how they see themselves in the mirror and how they feel on the regular. This inevitably leads to an unhealthy obsession with fast results, a concentration on a ‘fast fix’ and losing sight of what will be something you can sustain, caring for yourself, and overall health.
This warped ideology is destructive as the focus is only on weight and deprivation and being dissatisfied as opposed to what the actual benefits of the weight loss will bring to you. This is only negativity-focused; what you don’t or can’t have. That doesn’t mean that you merely think positively and it’s fixed; a thought isn’t going to fix it for you. Changing to a healthy mindset is more than that. It’s about shifting the thoughts as well as the decisions that you make for yourself and the behavior that you allow for yourself, in turn, producing different results.
Why Mind Over Matter May Be The Right Approach
Having the right mindset for weight loss is going to affect what it is you’re focused on. What you’re focused on affects the things that you in turn think about yourself. The things that you feel about yourself affect your decisions. Your decisions will then affect the way in which you are going to behave and those variant behaviors are going to bring about differing results. With the right mindset, you will start out knowing there is no problem to fix and this whole process will be a positive one with a successful outcome.
Why You May Be Too Stressed To Lose Weight
There is a protein, betatrophin, that is being deemed the culprit in our inability to lose weight due to stress. If you’re wondering, can stress stop weight loss, it indeed can particularly high amounts of stress. There is a link between your stress and fat metabolism due to the betatrophin. Our chronic stress will stimulate our body’s production of this protein which in turn inhibits a needed enzyme for fat metabolism. Basically, betatrophin decreases our ability to break down the fat. So, your stress levels are actually causing you to accumulate fat. Another reason why mindfulness is very important in creating a balance and decreasing the stress that you have in your life.
Increasing Energy And Motivation
A good way to instill motivation and energy into your weight-loss program is to add daily self-care and self-kindness to your regimen. This is showing your mind, body, and soul that you are accepting and loving of yourself and focused on taking the best care of yourself. This makes you feel good in the moment and leads your energy into weight loss motivation. Allowing ourselves pleasure oftentimes takes a back seat especially when we’re busy or stressed and, over time, this leads to those negative thoughts and a bad attitude.
Self-care is an essential component in order for you to be successful with your weight management whether it be to lose or to maintain. When you are providing yourself with the proper amount of care, you will learn how to increase focus and energy and in turn how to be motivated to lose weight. It’s about doing things that will promote overall good health, acts of kindness towards yourself, not expecting far too much from yourself all at one time, being patient with the process, and not coming down on yourself if it doesn’t go as you had hoped right away. Speaking harshly of or to ourselves leads to shame and guilt to the point where we have no inspiration or motivation to continue to work towards any of our goals. Always try to uplift yourself with self-care and self-kindness every day, be accepting, be loving, and you will be successful.
Healthy Mind, Healthy Body
In order to have a healthy mind and a healthy body it is important that we be both mentally and physically fit and strong. A good healthy mental faculty is essential for good physical well being. A large problem in today’s society is everyone is living a very fast-paced lifestyle, many are extremely stressed, and generally rushing against the clock in order to do all that the day holds for us. There is no time for us to eat the way that we need to, sleep as we owe our bodies to, or exercise in the way that we are required to. There is always a search for the mental peace in order to deflate the stress levels, but we are not paying attention to the fact that if we neglect our body, how is our brain going to get the proper nourishment.
What is the answer? We need to take the time to do what is needed, what is owed, and what is required. That means eat on time, slowly, and in a healthy way; sleep for eight full hours in a night without any interruptions; exercise even if it's for short spurts each day; take breaks away from the chaos to decompress; pursue interests outside of work and everyday life that you have a passion for. All of this is going to lead you to a much healthier life and in turn a much healthier version of yourself. This is going to show you how to increase energy and motivation within your life and before you know it your body will slowly turn into what you want it to be. Healthy mind results in a healthy body.
With growing concerns about mental health, and how we care for ourselves, it’s important to address stress – it’s something we all struggle with during certain periods of our lives, and it can not only become overwhelming, but act as a contributor to other serious physical conditions, such as osteoporosis.
In recent years, stress has been considered a primary catalyst for mental health issues, and while the mechanisms underlying the physiological impact of stress on osteoporosis are not well-understood, several studies have shown that stress hormone signalling via the brain- immune connection is a significant contributor to the disease.
Osteoporosis, as the most common form of metabolic bone disease, is also known as the ‘silent disease’. In most cases, osteoporosis gradually develops and rarely has any symptoms until the bones are brittle and start to break more easily – typically a diagnosis of osteoporosis is not established until multiple breaks have occurred. The fact is that as many as 3 million people in the UK suffer from osteoporosis, and with an ageing population, and instances of osteoporosis set to rise, chances to slow down or prevent the disease ought to be considered across all generations.
A recent study* shows that chronic stress has been associated with increased systemic inflammation. In addition, the inflammatory factors have been shown to have a detrimental effect on osteoporosis through the promotion of osteoclasts, or the elements that break down the bone matter, and an increase in the cell death of osteoblast populations, the elements responsible for rebuilding healthy bone matter. The result being, factors that contribute to the breakdown of bones are increased by chronic stress, whilst bone rebuilding is decreased, and this contribution can advance symptoms of osteoporosis.
It is also worth considering the impact that osteoporosis carries psychologically, particularly if a fracture has been experienced. There are likely to be long-lasting effects on overall quality of life; physical, social, financial and psychological well-being all being potential casualties. It’s possible that osteoporosis can lead to feelings of anxiety, driven by a fear of falling, or even depression, as a result of reduced self-esteem and feelings of helplessness and loss of independence.
Preventative treatment is crucial when it comes to maintaining bone health throughout life. Exercise, a healthy diet, and getting enough vitamin D are always recommended as well as limited alcohol consumption, no smoking and reducing unnecessary stress. In addition, it is recommended that we maintain healthy levels of calcium, through our diets – but also through effective supplements, such as LithoLexal® OSTEOPOROTIC Bone Health.
Until recently, the majority of calcium supplements available were all rock-based, containing inorganic matter that is hard for the body to absorb. LithoLexal® contains a natural, marine plant-based extract that contains a highly bio-available source of calcium and magnesium, and a unique bioactivity not exhibited in comparative products - making LithoLexal® uniquely positioned to demonstrate its excellence and clinical efficacy in users by improving the health of the bones.
Source: Sustain Health
Good or bad news first…?
Since good news soothes the bad, let’s go with the bad news first: According to a recent article in the British Journal of Medicine, the U.S. currently faces twin pain-and-opioid crises (Mackey & Kao, 2019). Chronic pain (CP), pain lasting three or more months or beyond expected healing time, is an epidemic currently affecting over 100 million American adults—more than diabetes, heart disease, and cancer combined—at an estimated cost of $635 billion (IOM, 2011).
CP can interrupt life, impeding the ability to work, exercise, have sex, engage in hobbies, or even go outside. It’s the number-one cause of long-term disability in the U.S. (NIH, 2011). As if this wasn’t bad enough, we now find ourselves in the midst of an opioid crisis—what the U.S. Department of Health calls “the most daunting and complex public health challenge of our time.”
One reason we find ourselves in this pickle is that pain has historically been framed as a “biomedical” problem, due exclusively to biological issues like tissue damage and anatomical dysfunction. It has, therefore, primarily been treated with biomedical solutions, like pills and procedures. However, CP is neither being cured nor solved, addiction rates are skyrocketing, and the prevalence of chronic pain is still on the rise (Nahin et al., 2019). While this does not mean we should rip pills from the hands of long-term pain sufferers—which is unethical at best and cruel at worst—something clearly needs to change.
Now for the good news (and not soon enough!): Thanks to recent advances in science and medicine, we now understand pain better than ever before. Research on pain management and treatment advances daily, and previous wrongs are being made right. There is hope.
To better understand pain, let’s first define it: the International Association for the Study of Pain (IASP) defines pain as an “unpleasant sensory and emotional experience.” Said another way, pain is both physical and emotional 100 percent of the time. It’s never just one or the other. This is confirmed by neuroscience research indicating that pain is processed by multiple parts of the brain, including the limbic system—your brain’s emotion center (Martucci & Mackey, 2018).
“Physical” pain is also, and always, impacted by your emotions.
So why do we have pain? Answer: pain serves as the body’s danger response system, keeping us safe and alive by warning us of possible harm. Pain teaches us to avoid dangerous situations in the future and motivates us to take action in the present. Step on a nail? Pain galvanizes you to pull it out! Break your ankle on a run? Pain motivates you to stop, get help, and heal. And once you burn your hand on that hot stove, chances are high you’ll learn never to do it again.
You may reasonably believe that pain is located exclusively in your body, in the part that hurts. But while sensory information from the body is critical to pain processing, pain is actually constructed by the brain. Evidence of this is a condition called phantom limb pain, in which an accident victim loses a limb and continues to feel terrible pain in that missing body part. If pain were located exclusively in the body, no limb should mean no pain!
It’s also reasonable to believe that pain is due exclusively to body-based biological issues, as suggested by the biomedical model (e.g., “the issue is in the tissues”). However, what we now know—and have actually known for decades—is that pain is not biomedical, but rather biopsychosocial (Gatchel, 2004).
This means there are three overlapping, equally-important domains to target if we want to effectively treat CP: biology, psychology, and social functioning. The biological domain includes genetics, hormones, tissue damage, inflammation, anatomical issues, system dysfunction, even sleep and nutrition. This domain typically receives the most attention. But two-thirds of the model remain, and psychosocial factors, critical to address for effective treatment, are frequently ignored.
The psychological domain of pain includes thoughts and beliefs (e.g., “I’m broken; I’ll never get better”); prior experiences and expectations; emotions (e.g., anxiety, anger, depression), and coping behaviors (e.g., withdrawing, avoiding movement and activity). Social factors include socioeconomic status, access to care, family, friends, culture, community, context, and other socioenvironmental factors. Neuroscience research reveals that negative emotions, catastrophic thoughts, and unhealthy coping behaviors actually amplify pain, exacerbate symptoms, and keep you stuck in a cycle of fear, inactivity, misery, and pain. Said another way: stress, anxiety, depression, catastrophic thinking, negative predictions, focusing on pain, social withdrawal, lack of exercise, and activity avoidance all make pain worse.
On the flip side, however, this revelation offers some optimism: Research confirms that we can exert some control over pain by taking charge of emotions, thoughts, beliefs, attentional processes and coping behaviors using treatments like Cognitive Behavioral Therapy (CBT), biofeedback, and Mindfulness-Based Stress Reduction (MBSR) (Cherkin et al, 2016; Kerns et al, 2011; Nahin et al, 2016; Sturgeon, 2014). These interventions have a robust evidence-base that grows every day. Additionally, providing patients with pain education may reduce pain and disability, increasing understanding of pain while reducing fear of movement and activity-avoidance (Louw et al., 2013; Louw et al., 2016).
Biobehavioral interventions like these have been shown to change both brain and body, neuroscience and biology, showing potential to calm the pain system and increase functioning (Davidson et al., 2003; Flor, 2014; Petersen et al., 2014; Martucci & Mackey 2018). Indeed, psychosocial approaches to pain management are so promising that some pain programs, such as those at UCSF and Stanford, now incorporate them into their integrative pain management clinics. As a pain psychologist, I see the effectiveness of these therapies every day in my practice, as patients get out of bed and resume their important lives.
So if you’re coping with chronic pain, remember this: Changing your brain can change your pain. Addressing your emotional health directly impacts your physical health because brain and body are always connected. Consider hiring a therapist to be your “pain coach”—it doesn’t mean you’re crazy, and it’s not all in your head. Try biobehavioral interventions like CBT, biofeedback, and mindfulness, and request that your insurance company reimburse these approaches to pain management in addition to pills and procedures.
Source: Psychology Today
People don’t generally connect diet with mental health, and it’s certainly not on the radar of most health professionals when treating depression. But as global rates of depression and other non-communicable diseases have risen, the average diet quality has changed drastically.
Recent studies have shown that not only are diet and depression related, but people with unhealthy diets are more likely to become depressed. (That’s even after controlling for factors like smoking, alcohol, physical activity, marital status, education, and income.) Conversely, healthy diets are protective.
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After years of exploring the effects of nutritional supplements on mental health as a researcher at the University of South Australia, I became frustrated. After all, people eat food, not nutrients. Food delivers a virtual orchestra of vitamins, minerals, proteins, fats, carbohydrates, fiber, and phytonutrients, all of which contribute to the symphony that is our living body and brain.
It’s no accident I say body and brain — they are intimately connected. Confirming Hippocrates’ observation circa 400 BC, scientists have identified multiple connections between the brain and the rest of your body. Most revealing are pathways between the brain and gut. This “gut-brain axis,” or the biochemical signaling between your gastrointestinal tract and nervous system, can affect everything from mood to libido. (And vice versa. Think of the queasy, fluttering feeling in your stomach before a speech or job interview.)
So what does the gut-brain axis tell us about depression? This debilitating condition afflicts over 300 million people and carries the largest burden of disease worldwide. Not the least of that burden is a higher rate of heart disease and other protracted ailments. Biological factors, like inflammation, poor nutrition, and dysbiosis (imbalanced gut bacteria), are related to both physical illness and depression, so they might help explain this connection. But the best way to show cause and effect – to answer the question of whether diet improves mood, or if depression causes poor diet – is with a randomized controlled trial.
So in 2014 and 2015, my team recruited people with depression. We eventually signed up 152 people, ages of 18 to 65, with self-reported or diagnosed depression. These volunteers visited our clinic for blood tests and completed questionnaires about their diet and mental health. Then we randomly allocated them to a diet intervention or control group. To keep everything else constant, participants were instructed not to change any existing treatments or start any new ones.
Running this kind of study is no easy task, and our group was one of the first to do it in people with depression. In some clinical trials, it’s easy to design a controlled experiment: participants take an active supplement or placebo and everyone finds out afterward which one they took. But changing people’s diets is a different matter. First, we researched strategies that nudge people towards healthier eating. Then we tested the program. Our multi-pronged approach included interactive nutrition education, individual goal setting, food hampers, recipes and – yes – cooking workshops. Eat your heart out, MasterChef. My post-doc, Dorota Zarnowiecki, and I even made some cooking videos, bloopers and all. (Turns out, you can’t put an onion back together if you messed up while chopping it.)
Depressed people often feel better just by engaging in research or activities that generate peer support. So volunteers allocated to the control group not only continued their normal diets, they attended social groups instead of cooking workshops. In these they shared holiday tales, played games, amused themselves with personality tests, and enjoyed tea and snacks. Cooking workshops and social groups were held once a fortnight for three months. Our team was so wonderful that everyone enjoyed themselves – I even started worrying the social group was having too much fun.
Cook like a nonna
Married to an Italian whose parents cultivated their own produce and pressed home-grown olives into oil, I am partial to a Mediterranean diet. It turns out abundant research strongly supports this traditional diet’s health benefits for chronic disease, and its bountiful nutrients sustain healthy brain function. So this is what we recommended.
Over years of cooking for a family while studying and working, I had developed a portfolio of simple, quick, tasty Mediterranean-style meals that could be reheated as leftovers or frozen. Popular recipes included chili beans with avocado, eggplant parmigiana, and Greek lentil soup. They sound simple – and they are. One participant summed it up nicely: “I like the fact that you turn up to a cooking class and you’ve got half a dozen ingredients sitting on a bench, and you sort of look at them and go, ‘Oh, that’s not gonna add up to much.’ But then you cook it up and go, ‘Wow, that small number of ingredients cooked up to make such delicious food.’”
The recipes embodied Mediterranean diet principles: abundant plant foods like vegetables, fruit, legumes, nuts, seeds, and olives, as well as generous dollops of extra virgin olive oil, fish, and moderate portions of dairy. Traditional Mediterraneans ate virtually no processed food like refined grains, sweets, or red meat. Because people with mental illness have particularly low omega-3 levels, we also supplemented the diet group with fish oil to boost their omega-3s.
One of the challenges we faced was that human studies are often plagued by drop-outs. Several people pulled out before they even got to baseline assessment — understandable if you suffer depression. Others left once they discovered their group allocation. (Many wanted to do the dietary intervention.) So we ended up testing 95 people after three months, and 85 after six months. Fortunately, clever statistical analyses enabled us to factor in all cases; in other words, to estimate the missing data for those who had left the program.
As suspected, the results showed all mental health parameters improved in both groups. But mood improved significantly more in the Mediterranean diet group: the severity of depressive symptoms was 45 percent lower in the diet group, compared to 26.8 percent in the social group. At the beginning of the study, 80 percent of all participants reported ‘extremely severe’ depression; this dropped by 60 percent overall. Some people made life changes and got new jobs. One participant went so far as to describe herself as “born again,” saying, “It’s really changed me – it’s changed my life.” She now uses her deep-fryer basket to blanch bulk vegetables.
Our budding chefs rejoiced in shunning low-fat diets and embracing extra virgin olive oil – and some even lost weight. Many reported a new-found love of legumes. But others found it hard; for instance, when going out, or if partners or children were reluctant to depart from old favorites. Our team reported that encouraging participants to plan ahead helped some of them mitigate these barriers.
How we can be confident these changes in diet played a role in the participants’ recovery? The diet group increased their Mediterranean diet score on a 14-item questionnaire, and reported eating more fruit, vegetables, nuts, legumes, and greater diversity of fruit and vegetables. They also ate less red meat and unhealthy snacks. Better yet, improved diet and the correlated mental health changes were still apparent at six-month follow up assessments. Blood omega-3 levels increased in the treatment group, and were associated with some mental health outcomes, but surprisingly not with reduced depression.
This study was limited, since it wasn’t a double blind trial for obvious reasons (people were clearly assigned to groups that either cooked or just socialized). This could influence participants’ perceptions or reports of their diet and mental health. Future research would also benefit from measuring blood indicators of improved diet, like carotenoid – the pigments responsible for bright red, yellow, and orange hues in plants – as a proxy for increased fruit and vegetable consumption. It would also be useful to measure inflammatory markers, like C-reactive protein, interleukins, or tumor necrosis factor, to investigate physiological changes that could help explain enhanced mood. Longer term follow-ups would show if improved diet and mental health can be sustained.
This research and another recent pioneering study with similar findings tell us the benefits of wholesome diets extend beyond better physical health. My dream is for children to grow up enjoying real food. Imagine the difference it would make if health professionals embraced diet as an essential tool in their clinical kits: doctors could prescribe food vouchers and cooking workshops, or subsidize healthy food for people with chronic health issues, including depression. It may seem strange now, but research is catching up to common sense: eating well makes you feel better.
An international research team has discovered that reduced levels of serotonin in the blood may be linked to heightened somatic awareness, a condition where people experience physical discomforts for which there is no physiological explanation.
Symptoms of heightened somatic awareness may include headaches, sore joints, nausea, constipation or itchy skin. Patients are also twice as likely to develop chronic pain, as the condition is associated with illnesses such as fibromyalgia, rheumatoid arthritis and temporomandibular disorders. The illness tends to cause great emotional distress, particularly since patients are often told it’s “all in their head.”
“Think of the fairy tale of the princess and the pea,” said Dr. Samar Khoury, a postdoctoral fellow at McGill University’s Alan Edwards Centre for Research on Pain.
“The princess in the story had extreme sensitivity where she could feel a small pea through a pile of 20 mattresses. This is a good analogy of how someone with heightened somatic awareness might feel; they have discomforts caused by a tiny pea that doctors can’t seem to find or see, but it’s very real.”
The study, recently published in the Annals of Neurology, found that patients who suffer from somatic symptoms share a common genetic variant. The mutation leads to the malfunctioning of an enzyme important for the production of serotonin, a neurotransmitter with numerous biological functions.
“I am very happy and proud that our work provides a molecular basis for heightened somatic symptoms,” said Dr. Luda Diatchenko, lead author of the new study and a professor in McGill’s Faculty of Dentistry.
“We believe that this work is very important to patients because we can now provide a biological explanation of their symptoms. It was often believed that there were psychological or psychiatric problems, that the problem was in that patient’s head, but our work shows that these patients have lower levels of serotonin in their blood.”
The findings have laid the groundwork for the development of animal models that could be used to better characterize the molecular pathways in heightened somatic awareness. But mostly, the researchers hope their work will pave the way for treatment options.
“The next step for us would be to see if we are able to target serotonin levels in order to alleviate these symptoms,” said Diatchenko, who holds the Canada Excellence Research Chair in Human Pain Genetics.
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