Here’s the thing about coffee: there’s never been much scientific debate about whether it’s healthy. Yes, people have been concerned about it since the 16th century, but as long as we’ve been analyzing its effects we’ve observed that drinking coffee tends to improve your health, not harm it. In moderation, of course.
The fear that coffee harms us is pervasive, though, and as a result it feels like there's been a lot of back-and-forth. One day it's good for you. The next it's bad. In reality, the large-scale analyses of the harms or benefits of a cup o' joe have pretty much all shown definitive upsides, or at the very least no effect at all. It's not going to cure all that ails you or make you live forever, but most evidence suggests coffee is part of a healthy diet.
On Monday, another of these giant studies came out, this time looking at residents of the United Kingdom. Researchers there wanted to examine how coffee habits affected overall health, as measured by a statistic called all-cause mortality. That basically means they grouped people by how many cups of coffee they drank per day, then looked to see whether those groups that consumed more cups had more deaths during the course of the study. If the cohort that drank eight cups per day had fewer deaths than the group that drank just two, that would imply that somehow the high-volume coffee drinkers were more healthy. And that's exactly what they found. Across 502,641 participants ranging from 38 to 73 years old, both male and female, the more coffee a person drank the less likely they were to die. The researchers published their results in JAMA Internal Medicine on Monday.
The differences weren’t giant, but they were statistically significant. This is getting a little into the weeds here (skip down a paragraph if you hate statistics), so bear with for a moment. When doing a large observational study like this, researchers use a hazard ratio to measure how much of an effect a variable like coffee consumption has. For example, in this case a hazard ratio of 1 means there’s no difference in how often people die, whereas a hazard ratio of 0.5 would mean the group that drank coffee died only half as often as the non-coffee drinkers. This study grouped participants into six cohorts: those who drank less than one, one, two to three, four to five, six to seven, and more than eight cups of coffee per day. The researchers found that the hazard ratios generally declined as the number of cups consumed increased, indicating that the more coffee people drank, the less likely they were to die during a set period. In order, the hazard ratios were 0.94, 0.92, 0.88, 0.88, 0.84, and 0.86. All but the first ratio are considered statistically significant—meaning that the difference between the groups was profound enough to (probably) be more than random chance.
Studies like this can only ever tell us what health outcomes tend to look like for people who drink coffee. They're observational—no one is assigning groups of participants to drink five or two or zero cups per day and then making sure their lives are otherwise identical, so they can't provide any real causation. But because we're never going to run a clinical trial in which coffee gets prescribed, observational studies are the closest we'll get. That's why it's important to gather a lot of people—hundreds of thousands or even millions are ideal—so that you can be assured that your finding isn't just a statistical fluke. Drinking coffee may be associated with lots of other habits that influence health, or perhaps not drinking coffee is associated with something. For instance, people who have serious illnesses like cancer may not drink coffee, but these people are also more likely to die—that would artificially increase mortality for the non-coffee-drinking group.
The researchers in this study looked to see which other traits were associated with drinking lots or no coffee—things like smoking, body weight, socioeconomic status, and so on—and tried to control for those factors to prevent them from interfering with the results. Coffee drinkers tended to be male and white, for example, and also drank more alcohol and were former smokers. Particularly high coffee consumption was correlated with being a current smoker. Drinking between one and three cups correlated with having a university degree and being older, and well as reporting “excellent” health.
All of these findings generally line up with what other large-scale studies have found: drinking more coffee tends to correlate with good health and fewer deaths. Here is a 2017 European study showing that, with 521,330 people. Here's one from 2012 involving 5,148,760 Americans finding the same inverse correlation. And here's another from 2017 focusing on nonwhite populations in the U.S., still finding that drinking coffee is generally associated with lower risk of death.
This study is, for the most part, the same as the rest, except for one thing: it looked at genetic variations in caffeine metabolism. Relatively recent work has established certain mutations that make a person respond to caffeine in different ways. Researchers think this may partly explain why some people can down a cappuccino after dinner and sleep fine, whereas others have to stop drinking joe after 4 p.m.
The U.K. researchers used a large database containing genetic information about participants to test whether certain variants correlated with better or worse health outcomes. Perhaps those that respond quickly and easily to caffeine would fare worse—they just weren’t sure. But even looking across 400,000 people for whom genetic data was available, the researchers found no difference in outcomes between those whose genes predisposed them to caffeine sensitivity and those who didn’t. That is, across genetic variants, those who drank more coffee tended to have lower risk of death.
They did find, somewhat unsurprisingly, that those with a higher "caffeine metabolism score"—those who metabolize caffeine faster—tended to drink more coffee.
If you're one of those people who can't have more than a cup without getting jittery, but still want to drink joe, don't worry—you can drink decaf and still get the health benefits. This study, like others, found that the caffeine content made no difference to the risk of death. Even instant coffee seems to work, though the researchers note that the associations for ground, caffeinated coffee were "generally stronger." Researchers aren't sure what's in coffee that seems to boost our health, but the scientists on this study noted it provides further evidence that the secret ingredient isn't caffeine. Christopher Gardner, a professor studying food and health associations at the Stanford Prevention Research Center, told NPR that it may be the many antioxidant-rich compounds in our morning brew. One 2005 study in JAMA suggested that it could be compounds that reduce inflammation and insulin resistance, like lignans, quinides, and magnesium.
Of course, none of this means that coffee isn't an addictive substance or that pregnant people should be chugging it (the American College of Obstetricians and Gynecologists recommends no more than 200 milligrams per day, or about two cups of coffee). Caffeine is a stimulant, and though "too much" depends on your personal metabolism, an overload can give you headaches, irritability, restlessness, a fast heartbeat, and muscle tremors. Plus it can deprive you of sleep. The Mayo Clinic recommends limiting yourself to about 400 milligrams a day for that reason. It also doesn't mean that you can put oodles of sugar and cream in without having other negative health effects, like obesity or heart disease. But it does mean that the average person can drink their moderately-sugared, lightly-creamed joe in peace—even though we already knew that.
Mental stress and anger may have clinical implications for patients with heart failure according to a new report published in the Journal of Cardiac Failure.
Heart failure is a life-threatening cardiovascular disease in which the heart is damaged or weakened. This can lead to a reduced ejection fraction, in which the heart muscle pumps out a lower amount of blood than is typical with each contraction.
In this study of patients who had heart failure with reduced ejection fraction, the authors — including researchers at Yale — evaluated the effects of stress and anger on diastolic function. Diastolic function describes the ability of the heart to relax and refill between muscle contractions and is predictive of mortality risk.
For one week, participants completed daily questionnaires about their experiences of stress, anger, and negative emotions during the previous 24 hours. Participants then completed a standardized “mental stress” protocol in which they solved challenging arithmetic problems and described a recent stressful experience. Echocardiograms were performed to assess diastolic function at rest and during the stress task.
Patients who reported experiencing anger in the week prior to the laboratory mental stress protocol exhibited worse baseline resting diastolic pressure, the researchers said. Furthermore, most patients demonstrated stress-provoked changes in diastolic function, including decreased early relaxation and increased diastolic pressure.
“Mental stress is common in patients with heart failure due in part to the complexities of disease self-management, progressively worsening functional limitations, and frequent symptom exacerbations and hospitalizations,” said the lead author Kristie Harris, a postdoctoral associate in cardiovascular medicine at Yale.
“We have evidence that patients who experience chronically elevated levels of stress experience a more burdensome disease course with diminished quality of life and increased risk for adverse events. Clarifying the relevant behavioral and physiological pathways is especially important in the era of COVID-19 when the typical stressors of heart failure may be further compounded by pandemic-related stressors,” Harris said.
“Factors such as mental stress and anger often go unrecognized and are under-addressed,” said Matthew Burg, a Yale clinical psychologist and senior author of the study. “This study contributes to the extensive literature showing that stress and anger affect clinical outcomes for patients with heart disease, adding chronic heart failure to the list that includes ischemic heart disease (narrowed arteries) and arrhythmic disease.”
Burg said that while stress management and related techniques have been shown to reduce risk for adverse events among patients with ischemic heart disease (narrowed arteries), further work is needed to identify factors that increase vulnerability to the effects of stress in heart failure, and to determine whether stress management can improve outcomes for these patients.
Raise your hand if you’re one of the many that found themselves walking a lot more during lockdown? Us too.
With the gyms shut, pubs closed and social gatherings cancelled, walking has been our go-to distraction. A way to separate the mundane work day and step away from our not-so-comfortable makeshift desks. Or a means of socialising (when restrictions lifted).
Depending where you’re at, at your fitness level, you may not be able to run, but the vast majority can walk – even if it’s only a very short distance. But if you’ve become a recent convert who plans to pack away the pedometer once the spin studios and weight rooms reopen, consider this: Walking is the most accessible, easiest way to stay fit. That might seem unlikely if you’re into more intense forms of exercise. After all, if you’ve spent half your life at Barry’s Bootcamp (in person or online), walking isn’t going to make much of a difference… Or is it?
Since the 1970s, ‘no pain, no gain’ has been the ever-present motto of trainers and running clubs. If you’re not working at 80% of your overall max, you’re not working hard enough. While that sort of high-intensity training is great for significantly boosting fitness and preparing for races and competitions, it’s not always sustainable. With training hard on a daily basis, you run the risk of injury, fatigue and even a drop off in interest.
Low impact steady state cardio (LISS), on the other hand, is still great for heart health and you can do it every day. In fact, a 2013 study claimed that walking briskly can help your heart health as much as running. Published in the American Heart Association journal Arteriosclerosis, Thrombosis and Vascular Biology, researchers compared data from two studies of 33,060 runners and 15,045 walkers. Walkers experienced greater health benefits than runners: seeing the risk of first-time high blood pressure drop by 7.2%, compared to runners’ 4.2% – while cholesterol risk was cut by 7 % for walkers compared to 4.3% for runners. Both had the same 12 percent cut in risk for first-time diabetes.
“Walking and running provide an ideal test of the health benefits of moderate-intensity walking and vigorous-intensity running because they involve the same muscle groups and the same activities performed at different intensities,” says study leader Dr Paul Williams, from the Lawrence Berkeley National Laboratory in California. “People are always looking for an excuse not to exercise, but now they have a straightforward choice to run or to walk and invest in their future health.”
In a report that included findings from multiple studies, researchers found that walking reduced the risk of cardiovascular events by 31% and cut the risk of dying by 32%. These benefits were equally prevalent in men and women and were apparent by covering just 5.5 miles a week at a speed of two miles per hour. If you walk 10,000 steps a day, you’re covering almost five miles a day so you really don’t have to go far at all to reap the cardio protections. People who walked longer distances or walked at a faster pace (or both) resulted in the largest reduction of risk for cardiovascular disease.
While any form of walking is good, Dr Georgina Stebbings, Senior Lecturer in Sport & Exercise Physiology from the Manchester Metropolitan University, explains that intensity does make a difference: “Ideally, it’ll be intense enough to get you out of breath (i.e. moderate intensity), which could be a short power-walk or a longer, slower paced walk over more difficult terrain”.
“In a society when sedentary/sitting time averages approximately eight hours per day for adults, it’s not only important to be active, but to also reduce the sitting time. So, even if you’re not able to complete moderate intensity walking/activity, simply breaking up prolonged periods of sitting every 30 minutes with light intensity movements/walking is sufficient at keeping blood sugar levels lower throughout the day (which is helpful in staving off diabetes).”
She points to a 2016 Health Survey for England which estimated that less than 35% of adults manage to complete the recommended 150 minutes of moderate intensity exercise a week. In order to walk your way to that target, you could go for a 10-minute power walk three times a day – easily achievable when many of us are still working from home and are more able to take a quick break from our desks.
Her point confirms the findings of a 2017 study by the University of Leicester which found that slow walkers were around twice as likely to die of a cardiovascular issue than people who considered themselves to be ‘brisk’ walkers. The study tracked 420,727 healthy adults over a six year period and – after factoring in things like smoking and hours spent watching TV – researchers found that the link between walking pace and heart health was still strong. Professor Tom Yates, lead author of the study and reader in Physical Activity, Sedentary Behaviour and Health at the University of Leicester said that this “suggests habitual walking pace is an independent predictor of heart-related death”.
Back in 2018, Public Health England (PHE) and the Royal College of General Practitioners encouraged the nation to incorporate at least 10 minutes of brisk walking into their day, calling it the ‘Active 10’ in order to cut the risk of type II diabetes and other conditions related to inactivity.
“I’d advise anyone of any age and activity level to fit in at least one 10-minute brisk walk a day as a simple way to get more active, especially those who may be taking medication for a long-term health condition – you will receive even more benefits from walking briskly for 10 minutes or more a day,” Professor Sir Muir Gray, clinical advisor for the Active 10 app and PHE’s One You campaign said at the time.
The Active 10 wasn’t designed to be a leisurely stroll. Although low-impact, power walking is a full-body workout that sculpts arms, legs and core muscles. Benefits also include firing up the metabolism and improving blood circulation, blood pressure and cholesterol. Getting outdoors even for 10 minutes enables you to get a good dose of that hard-to-find vitamin D too.
During lockdown, Diren Kartal – head coach at Project X Training – has been taking to his Instagram Stories to encourage his followers to get up and start their day by hitting 10,000 before breakfast.
“People don’t necessarily have to hit 10,000 steps a day – I just advocate people to move more,” he explains.
Pregnant women with hypertensive disorders, particularly preeclampsia, a form of high blood pressure during pregnancy, are at greater risk of having children with mental health issues, according to a new study conducted by researchers from the University of Helsinki in Finland.
Women were recruited into the study in early pregnancy at Finnish maternity hospitals. The children in the study were born between 2006 and 2010 and were tracked until the end of 2016 when they were 6.4 to 10.8 years old. Mental disorders were identified from Care Register for Health Care.
Overall, the research team looked at 4,743 mother-child pairs and found a link between hypertensive pregnancy disorders, including chronic hypertension (high blood pressure), gestational hypertension, preeclampsia and eclampsia, and childhood mental disorders.
Preeclampsia is a common pregnancy complication often characterized by high blood pressure and protein in the urine, which can indicate damage to other organs including the liver and kidneys. Eclampsia is a severe complication of preeclampsia in which high blood pressure during pregnancy results in seizures.
The study findings show that maternal preeclampsia and its severity are linked to an increase in the risk of any childhood mental disorder and psychological development and behavioral and emotional disorders.
Specifically, the research team found a 66 percent higher risk of mental health disorders among children whose mothers had preeclampsia. They also found a two-fold higher risk of childhood mental health issues among children whose mothers had severe preeclampsia.
“While previous studies have shown significant effects of preeclampsia on ADHD, autism spectrum disorder and schizophrenia in the offspring, a novel aspect of our findings was that the predisposing effects of maternal preeclampsia extended to any childhood mental disorder in the offspring,” said Dr. Marius Lahti-Pulkkinen, one of the senior researchers of the study and a docent at the University of Helsinki.
The research team also noted that the combination of maternal hypertensive disorders, overweight/obesity and diabetes disorders in pregnancy increases the cumulative prevalence of childhood mental disorders from 6.6 percent among children of mothers with none of those conditions to 22.2 percent in offspring exposed to all three of these negative maternal conditions.
In addition, the link between the mother’s preeclampsia and mental disorders in her offspring could not be explained by her own mental health disorders, age, substance use, number of previous pregnancies, education, overweight/obesity or diabetes disorders or by the father’s mental or hypertensive disorders.
“The findings emphasize the need for preventive interventions and treatments for maternal hypertensive disorders, since such interventions have the potential to benefit both the well-being of the expectant mother and her offspring,” said Lahti-Pulkkinen.
“The findings also shed important new light on the etiology of childhood mental disorders. This information may help in targeting preventive interventions and support for families at risk, and aid clinicians in understanding issues and the underlying causes of childhood mental disorders.”
Hypertensive disorders in pregnancy are also key risk factors for maternal mortality, stillbirth, preterm birth and intrauterine growth restriction, and these disorders can predict cardiovascular morbidity in the mother and her offspring.
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.
SOOTHING EMOTIONS WILL GUIDE YOU WITH RESEARCH, ARTICLES, AND INTERACTIVE TOOLS TO HELP YOU ON THE JOURNEY OF NAVIGATING YOUR MENTAL HEALTH.
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