Tag Archives: iab-healthy living

Health

Complications during pregnancy linked to a higher risk of heart disease, study finds

Leave a comment



CNN
 — 

Five major pregnancy complications are strong lifelong risk factors for ischemic heart disease, a new study finds, with the greatest risk coming in the decade after delivery.

Ischemic heart disease refers to heart problems, including heart attack, caused by narrowed or dysfunctional blood vessels that reduce blood and oxygen flow to the heart.

Gestational diabetes and preeclampsia increased the risk of ischemic heart disease in the study by 54% and 30%, respectively, while other high blood pressure disorders during pregnancy doubled the risk. Delivering a baby early – before 37 weeks – or delivering a baby with a low birth weight were associated with a 72% and 10% increased risk, respectively.

The study, published in Wednesday in the BMJ, followed a cohort of more than 2 million women in Sweden with no history of heart disease who gave birth to single live infants between 1973 and 2015.

Roughly 30% of the women had at least one adverse pregnancy outcome. Those who had multiple adverse outcomes – whether in the same or different pregnancies – showed further increased risk of ischemic heart disease.

“These pregnancy outcomes are early signals for future risk of heart disease and can help identify high-risk women earlier and enable earlier interventions to improve their long-term outcomes and help prevent the development of heart disease in these women,” said Dr. Casey Crump, an author of the study and professor of family medicine at the Icahn School of Medicine at Mount Sinai.

Heart disease is the leading cause of death among women in the United States and accounts for 1 in 5 female deaths, according to the US Centers for Disease Control and Prevention. This research adds to mounting evidence that pregnancy provides important information about a woman’s cardiovascular health.

“What happens to a woman during pregnancy is almost like a stress test or a marker for her future cardiovascular risk after pregnancy. And unfortunately, a lot of women don’t get told this by anybody,” said CNN Medical Correspondent Dr. Tara Narula, an associate professor of cardiology and the associate director of the Women’s Heart Program at Lenox Hill Hospital. She was not involved in the new study.

Although it’s not completely clear why, experts say the normal changes that occur during pregnancy may unmask underlying health issues in some women with certain risk factors.

Experiencing an adverse pregnancy outcome – even temporarily – could result in changes to blood vessels and the heart that may persist or progress after delivery, increasing a woman’s risk for cardiovascular disease.

This heightened risk is a particular concern for women in the US, experts say, where the maternal mortality rate is several times higher than in other high-income countries.

“There’s been a change in the birthing population. US women are getting pregnant at a later age, and they have already accrued maybe one or two cardiovascular risk factors. Perhaps there are other stressors in life – depression, stress, isolation, obesity – lots of different things that are impacting women in the US,” said Dr. Garima Sharma, associate professor of cardiology and director of the Cardio-Obstetrics Program at Johns Hopkins University School of Medicine, who also was not involved in the new study.

Pregnancy complications are carefully monitored during pregnancy, but there is little evaluation of and education about the effects on cardiovascular health after delivery for women, experts say.

“And so they have their delivery, they’ve had maybe preeclampsia or gestational diabetes, and nobody really follows up with them. They are not told that, in fact, they are at increased risk,” Narula said.

Gestational diabetes is a marker not only for increased risk of diabetes but also for general cardiovascular disease. Preeclampsia and eclampsia are markers for hypertension risk as well as general cardiovascular risks.

Narula, a cardiologist who specializes in caring for women, regularly considers adverse pregnancy outcomes when evaluating patients and emphasizes the continued need for this.

“The classic risk calculator that we use doesn’t have anything in there for pregnancy complications, but you know, it should for women, and hopefully someday, they will start to take that into account,” she said.

The American Heart Association recommends that all health care professionals take a detailed history of pregnancy complications when assessing a woman’s heart disease risk, but this is not consistently done in clinical practice, especially in primary care, where most women are seen, Crump says.

“Raising awareness of these findings among physicians as well as women hopefully will enable more of these women to be screened early and hopefully improve their long-term outcomes,” he said.

Roughly 1 in 3 women will have an adverse pregnancy outcome. Experts say that improving your health before getting pregnant can help avoid these issues.

“Reducing your risk should start preconception, and so getting your body and yourself into the healthiest state possible before you ever even get pregnant is really the first step,” Narula said.

This includes achieving and maintaining a healthy body weight with a good diet and regular exercise, controlling high blood pressure and diabetes, quitting smoking and managing stress.

Taking action after pregnancy is equally important, as research has estimated that only 30% to 80% of women have a postpartum checkup 6 to 8 weeks after delivery.

“Making sure that these women actually are appropriately followed after their delivery and that there is a warm handoff between [obstetrics] and [maternal-fetal medicine] to their primary care doctors or preventive cardiologists who can then talk about optimizing cardiovascular risks and reduction of these risk factors post-pregnancy in the postpartum time frame is crucial,” Sharma said.

Experts hope that increased patient and provider awareness of the connection between pregnancy and heart health will keep birth from being a cause of death.

“Cardiovascular disease is preventable. It’s a leading cause of maternal mortality, but it doesn’t have to be. If we do a better job at screening patients before they get pregnant, if we do a better job of treating them during pregnancy and postpartum, we can improve women’s outcomes,” Narula said. “It’s a tragedy to bring a new life into the world, and then the mother suffers some horrible complication and/or death that could have been prevented.”

Read original article here

Health

Ultraprocessed foods linked to ovarian and other cancer deaths, study finds

Leave a comment

Editor’s Note: Sign up for CNN’s Eat, But Better: Mediterranean Style. Our eight-part guide shows you a delicious expert-backed eating lifestyle that will boost your health for life.



CNN
 — 

Eating more ultraprocessed foods raises the risk of developing and dying from cancer, especially ovarian cancer, according to a new study of over 197,000 people in the United Kingdom, over half of whom were women.

Overly processed foods include prepackaged soups, sauces, frozen pizza and ready-to-eat meals, as well as hot dogs, sausages, french fries, sodas, store-bought cookies, cakes, candies, doughnuts, ice cream and many more.

“Ultra-processed foods are produced with industrially derived ingredients and often use food additives to adjust colour, flavour, consistency, texture, or extend shelf life,” said first author Dr. Kiara Chang, a National Institute for Health and Care Research fellow at Imperial College London’s School of Public Health, in a statement.

“Our bodies may not react the same way to these ultra-processed ingredients and additives as they do to fresh and nutritious minimally processed foods,” Chang said.

However, people who eat more ultra-processed foods also tend to “drink more fizzy drinks and less tea and coffee, as well as less vegetables and other foods associated with a healthy dietary pattern,” said Duane Mellor, a registered dietitian and senior teaching fellow at Aston Medical School in Birmingham, UK, in an email.

“This could mean that it may not be an effect specifically of the ultra-processed foods themselves, but instead reflect the impact of a lower intake of healthier food,” said Mellor, who was not involved in the study.

The study, published Tuesday in the journal eClinicalMedicine, looked at the association between eating ultraprocessed foods and 34 different types of cancer over a 10-year period.

Researchers examined information on the eating habits of 197,426 people who were part of the UK Biobank, a large biomedical database and research resource that followed residents from 2006 to 2010.

The amount of ultraprocessed foods consumed by people in the study ranged from a low of 9.1% to a high of 41.4% of their diet, the study found.

Eating patterns were then compared with medical records that listed both diagnoses and deaths from cancer.

Each 10% increase in ultraprocessed food consumption was associated with a 2% increase in developing any cancer, and a 19% increased risk for being diagnosed with ovarian cancer, according to a statement issued by Imperial College London.

Deaths from cancers also increased, the study found. For each additional 10% increase in ultraprocessed food consumption, the risk of dying from any cancer increased by 6%, while the risk of dying from ovarian cancer rose by 30%, according to the statement.

“These associations persisted after adjustment for a range of socio-demographic, smoking status, physical activity, and key dietary factors,” the authors wrote.

When it comes to death from cancer among women, ovarian cancer is ranked fifth, “accounting for more deaths than any other cancer of the female reproductive system,” noted the American Cancer Society.

“The findings add to previous studies showing an association between a greater proportion of ultra-processed foods (UPFs) in the diet and a higher risk of obesity, heart attacks, stroke, and type 2 diabetes,” said Simon Steenson, a nutrition scientist at the British Nutrition Foundation, a charity partially supported by food producers and manufacturers. Steenson was not involved in the new study.

“However, an important limitation of these previous studies and the new analysis published today is that the findings are observational and so do not provide evidence of a clear causal link between UPFs and cancer, or the risk of other diseases,” Steenson said in an email.

People who ate the most ultraprocessed foods “were younger and less likely to have a family history of cancer,” Chang and her colleagues wrote.

High consumers of ultraprocessed foods were less likely to do physical activity and more likely to be classified as obese. These people were also likely to have lower household incomes and education and live in the most underprivileged communities, the study found.

“This study adds to the growing evidence that ultra-processed foods are likely to negatively impact our health including our risk for cancer,” said Dr. Eszter Vamos, the study’s lead author and a clinical senior lecturer at Imperial College London’s School of Public Health in a statement.

This latest research is not the first to show an association between a high intake of ultraprocessed foods and cancer.

A 2022 study examined the diets of over 200,000 men and women in the United States for up to 28 years and found a link between ultraprocessed foods and colorectal cancer — the third most diagnosed cancer in the United States — in men, but not women.

And there are “literally hundreds of studies (that) link ultraprocessed foods to obesity, cancer, cardiovascular disease, and overall mortality,” Marion Nestle, the Paulette Goddard professor emerita of nutrition, food studies and public health at New York University told CNN previously.

While the new UK-based study cannot prove causation, only an association, “other available evidence shows that reducing ultra-processed foods in our diet could provide important health benefits,” Vamos said.

“Further research is needed to confirm these findings and understand the best public health strategies to reduce the widespread presence and harms of ultra-processed foods in our diet,” she added.

Read original article here

Health

Infant screen time could impact academic success, study says

Leave a comment



CNN
 — 

Letting infants watch tablets and TV may be impairing their academic achievement and emotional well-being later on, according to a new study.

Researchers found that increased use of screen time during infancy was associated with poorer executive functioning once the child was 9 years old, according to the study published Monday in the journal JAMA Pediatrics.

Executive functioning skills are mental processes that “enable us to plan, focus attention, remember instructions, and juggle multiple tasks successfully,” according to the Harvard University Center on the Developing Child.

Those executive functioning skills are important for higher-level cognition, such as emotional regulation, learning, academic achievement and mental health, according to the study. They influence our success socially, academically, professionally and in how we care for ourselves, said Dr. Erika Chiappini, assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine in Baltimore.

“Though these cognitive processes naturally develop from infancy through adulthood, they are also impacted by the experiences that we have and when we have them in our development,” said Chiappini, who was not involved in the study, in an email.

The results support recommendations from the American Academy of Pediatrics, which discourages all screen time before 18 months old, with the exception of video chatting, said Dr. Joyce Harrison, associate professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. Harrison was not involved in the research.

The study looked at data from Growing Up in Singapore Towards healthy Outcomes, or GUSTO, which surveyed women from all socioeconomic backgrounds during their first trimester of pregnancy. The sample was made up of 437 children who underwent electroencephalography (EEG) scans, which are used to look at the neural pathways of cognitive functions in the brain, at age 1, 18 months and 9 years old.

The parents reported each child’s screen time, and researchers found there was an association between screen time in infancy and attention and executive function at 9 years old, according to the study.

Further research needs to be done, however, to determine if the screen time caused the impairments in executive function or if there are other factors in the child’s environment that predispose them to both more screen time and poorer executive functioning, the study noted.

In a learning-packed time like infancy, one of the big problems with screen use is that young children aren’t learning much from them, according to AAP.

“There is no substitute for adult interaction, modeling and teaching,” Harrison said.

Babies have a hard time interpreting information presented in two dimensions, such as on screens, and have trouble distinguishing fantasy from reality, Chiappini said.

“Babies and kids are also social learners and very much benefit from the back-and-forth interaction with others (adults and kids) which is hard to achieve with screens,” Chiappini said via email.

When it comes to emotional regulation, infants and toddlers can learn from their caregivers when they model self-control or help to label emotions and appropriate expressions, she added.

For example, you can give a young child options for what they can do when they are mad, like taking a break or breathing deeply instead of inappropriate behaviors like hitting, Harrison said.

Talking about emotions can be too abstract for preschool-age kids, and in those cases using color zones to talk about emotions can be helpful, said Dr. Jenny Radesky, a developmental behavioral pediatrician and associate professor of pediatrics at Michigan Medicine C.S. Mott Children’s Hospital. Radesky was not involved in the research.

Calm and content can be green; worried or agitated can be yellow; and upset or angry can be red, using graphics or images of faces to help kids match what they’re feeling with their color zone. To reinforce it, adults can talk about their own emotions in terms of colors in front of their kids, Radesky said in a CNN previous article.

Parents and children can go through the colors together and come up with calming tools for the different zones, she added.

To strengthen those executive function skills, Harrison says it’s important to provide structured engagement where a child can work through solving problems to the extent that they can at their developmental level — instead of having problems solved for them.

And yet, sometimes parents just need to get the laundry done or attend a work meeting, and screens can feel like an effective distraction.

For very young children, it’s probably still best to avoid screen time, Harrison emphasized.

Instead, try to involve the child in house chores, she said.

“Give your toddler some clothes to fold alongside you while you are trying to get laundry done or keep your infant safely in a position where you can make frequent eye contact while you are engaged your chore,” Harrison said via email.

For older preschoolers, save up your screen time to use strategically, she said.

“For example, their one hour of screen time can be reserved for a time when you have an important video meeting to attend,” Harrison said.

And there is some content that can help teach emotional regulation when your tank is empty. Finding media that is aimed at speaking to children directly about emotions — like Daniel Tiger or Elmo Belly Breathing — can be like a meditation instead of distraction, Radesky previously told CNN.

And you can make screen time works better by engaging your child while they watch, Chiappini said. Ask questions like “what is that character feeling?” and “what could they do to help their friend?” she added.

Raising children is a complex and sometimes overwhelming task, and no caregiver can give their child everything they want to all the time, Radesky said.

Read original article here

Health

Weight loss surgery extends lives, study finds

Leave a comment



CNN
 — 

Weight loss surgery reduces the risk of premature death, especially from such obesity-related conditions as cancer, diabetes and heart disease, according to a new 40-year study of nearly 22,000 people who had bariatric surgery in Utah.

Compared with those of similar weight, people who underwent one of four types of weight loss surgery were 16% less likely to die from any cause, the study found. The drop in deaths from diseases triggered by obesity, such as heart disease, cancer and diabetes, was even more dramatic.

“Deaths from cardiovascular disease decreased by 29%, while deaths from various cancers decreased by 43%, which is pretty impressive,” said lead author Ted Adams, an adjunct associate professor in nutrition and integrative physiology at the University of Utah’s School of Medicine.

“There was also a huge percentage drop — a 72% decline — in deaths related to diabetes in people who had surgery compared to those who did not,” he said. One significant downside: The study also found younger people who had the surgery were at higher risk for suicide.

The study, published Wednesday in the journal Obesity, reinforces similar findings from earlier research, including a 10-year study in Sweden that found significant reductions in premature deaths, said Dr. Eduardo Grunvald, a professor of medicine and medical director of the weight management program at the University of California San Diego Health.

The Swedish study also found a significant number of people were in remission from diabetes at both two years and 10 years after surgery.

“This new research from Utah is more evidence that people who undergo these procedures have positive, beneficial long-term outcomes,” said Grunvald, who coauthored the American Gastroenterological Association’s new guidelines on obesity treatment.

The association strongly recommends patients with obesity use recently approved weight loss medications or surgery paired with lifestyle changes.

“And the key for patients is to know that changing your diet becomes more natural, more easy to do after you have bariatric surgery or take the new weight loss medications,” said Grunvald, who was not involved in the Utah study.

“While we don’t yet fully understand why, these interventions actually change the chemistry in your brain, making it much easier to change your diet afterwards.”

Despite the benefits though, only 2% of patients who are eligible for bariatric surgery ever get it, often due to the stigma about obesity, said Dr. Caroline Apovian, a professor of medicine at Harvard Medical School and codirector of the Center for Weight Management and Wellness at Brigham and Women’s Hospital in Boston. Apovian was the lead author for the Endocrine Society’s clinical practice guidelines for the pharmacological management of obesity.

Insurance carriers typically cover the cost of surgery for people over 18 with a body mass index of 40 or higher, or a BMI of 35 if the patient also has a related condition such as diabetes or high blood pressure, she said.

“I see patients with a BMI of 50, and invariably I will say, ‘You’re a candidate for everything — medication, diet, exercise and surgery.’ And many tell me, ‘Don’t talk to me about surgery. I don’t want it.’ They don’t want a surgical solution to what society has told them is a failure of willpower,” she said.

“We don’t torture people who have heart disease: ‘Oh, it’s because you ate all that fast food.’ We don’t torture people with diabetes: ‘Oh, it’s because you ate all that cake.’ We tell them they have a disease, and we treat it. Obesity is a disease, too, yet we torture people with obesity by telling them it’s their fault.”

Most of the people who choose bariatric surgery — around 80% — are women, Adams said. One of the strengths of the new study, he said, was the inclusion of men who had undergone the procedure.

“For all-causes of death, the mortality was reduced by 14% for females and by 21% for males,” Adams said. In addition, deaths from related causes, such as heart attack, cancer and diabetes, was 24% lower for females and 22% lower for males who underwent surgery compared with those who did not, he said.

Four types of surgery performed between 1982 and 2018 were examined in the study: gastric bypass, gastric banding, gastric sleeve and duodenal switch.

Gastric bypass, developed in the late 1960s, creates a small pouch near the top of the stomach. A part of the small intestine is brought up and attached to that point, bypassing most of the stomach and the duodenum, the first part of the small intestine.

In gastric banding, an elastic band that can be tightened or loosened is placed around the top portion of the stomach, thus restricting the volume of food entering the stomach cavity. Because gastric banding is not as successful in creating long-term weight loss, the procedure “is not as popular today,” Adams said.

“The gastric sleeve is a procedure where essentially about two-thirds of the stomach is removed laparoscopically,” he said. “It takes less time to perform, and food still passes through the much-smaller stomach. It’s become a very popular option.”

The duodenal switch is typically reserved for patients who have a high BMI, Adams added. It’s a complicated procedure that combines a sleeve gastrectomy with an intestinal bypass, and is effective for type 2 diabetes, according to the Cleveland Clinic.

One alarming finding of the new study was a 2.4% increase in deaths by suicide, primarily among people who had bariatric surgery between the ages of 18 and 34.

“That’s because they are told that life is going to be great after surgery or medication,” said Joann Hendelman, clinical director of the National Alliance for Eating Disorders, a nonprofit advocacy group.

“All you have to do is lose weight, and people are going to want to hang out with you, people will want to be your friend, and your anxiety and depression are going to be gone,” she said. “But that’s not reality.”

In addition, there are postoperative risks and side effects associated with bariatric surgery, such as nausea, vomiting, alcoholism, a potential failure to lose weight or even weight gain, said Susan Vibbert, an advocate at Project HEAL, which provides help for people struggling with eating disorders.

“How are we defining health in these scenarios? And is there another intervention — a weight neutral intervention?” Vibbert asked.

Past research has also shown an association between suicide risk and bariatric surgery, Grunvald said, but studies on the topic are not always able to determine a patient’s mental history.

“Did the person opt for surgery because they had some unrealistic expectations or underlying psychological disorders that were not resolved after the surgery? Or is this a direct effect somehow of bariatric surgery? We can’t answer that for sure,” he said.

Intensive presurgery counseling is typically required for all who undergo the procedure, but it may not be enough, Apovian said. She lost her first bariatric surgery patient to suicide.

“She was older, in her 40s. She had surgery and lost 150 pounds. And then she put herself in front of a bus and died because she had underlying bipolar disorder she had been self-medicating with food,” Apovian said. “We as a society use a lot of food to hide trauma. What we need in this country is more psychological counseling for everybody, not just for people who undergo bariatric surgery.”

Managing weight is a unique process for each person, a mixture of genetics, culture, environment, social stigma and personal health, experts say. There is no one solution for all.

“First, we as a society must consider obesity as a disease, as a biological problem, not as a moral failing,” Grunvald said. “That’s my first piece of advice.

“And if you believe your life is going to benefit from treatment, then consider evidence-based treatment, which studies show are surgery or medications, if you haven’t been able to successfully do it with lifestyle changes alone.”

Read original article here

Business

FDA vaccine advisers vote to harmonize Covid-19 vaccines in the United States

Leave a comment



CNN
 — 

A panel of independent experts that advises the US Food and Drug Administration on its vaccine decisions voted unanimously Thursday to update all Covid-19 vaccines so they contain the same ingredients as the two-strain shots that are now used as booster doses.

The vote means young children and others who haven’t been vaccinated may soon be eligible to receive two-strain vaccines that more closely match the circulating viruses as their primary series.

The FDA must sign off on the committee’s recommendation, which it is likely to do, before it goes into effect.

Currently, the US offers two types of Covid-19 vaccines. The first shots people get – also called the primary series – contain a single set of instructions that teach the immune system to fight off the original version of the virus, which emerged in 2019.

This index strain is no longer circulating. It was overrun months ago by an ever-evolving parade of new variants.

Last year, in consultation with its advisers, the FDA decided that it was time to update the vaccines. These two-strain, or bivalent, shots contain two sets of instructions; one set reminds the immune system about the original version of the coronavirus, and the second set teaches the immune system to recognize and fight off Omicron’s BA.4 and BA.5 subvariants, which emerged in the US last year.

People who have had their primary series – nearly 70% of all Americans – were advised to get the new two-strain booster late last year in an effort to upgrade their protection against the latest variants.

The advisory committee heard testimony and data suggesting that the complexity of having two types of Covid-19 vaccines and schedules for different age groups may be one of the reasons for low vaccine uptake in the US.

Currently, only about two-thirds of Americans have had the full primary series of shots. Only 15% of the population has gotten an updated bivalent booster.

Data presented to the committee shows that Covid-19 hospitalizations have been rising for children under the age of 2 over the past year, as Omicron and its many subvariants have circulated. Only 5% of this age group, which is eligible for Covid-19 vaccination at 6 months of age, has been fully vaccinated. Ninety percent of children under the age of 4 are still unvaccinated.

“The most concerning data point that I saw this whole day was that extremely low vaccination coverage in 6 months to 2 years of age and also 2 years to 4 years of age,” said Dr. Amanda Cohn, director of the US Centers for Disease Control and Prevention’s Division of Birth Defects and Infant Disorders. “We have to do much, much better.”

Cohn says that having a single vaccine against Covid-19 in the US for both primary and booster doses would go a long way toward making the process less complicated and would help get more children vaccinated.

Others feel that convenience is important but also stressed that data supported the switch.

“This isn’t only a convenience thing, to increase the number of people who are vaccinated, which I agree with my colleagues is extremely important for all the evidence that was related, but I also think moving towards the strains that are circulating is very important, so I would also say the science supports this move,” said Dr. Hayley Gans, a pediatric infectious disease specialist at Stanford University.

Many others on the committee were similarly satisfied after seeing new data on the vaccine effectiveness of the bivalent boosters, which are cutting the risk of getting sick, being hospitalized or dying from a Covid-19 infection.

“I’m totally convinced that the bivalent vaccine is beneficial as a primary series and as a booster series. Furthermore, the updated vaccine safety data are really encouraging so far,” said Dr. David Kim, director of the the US Department of Health and Human Services’ National Vaccine Program, in public discussion after the vote.

Thursday’s vote is part of a larger plan by the FDA to simplify and improve the way Covid-19 vaccines are given in the US.

The agency has proposed a plan to convene its vaccine advisers – called the Vaccines and Related Biological Products Advisory Committee, or VRBPAC – each year in May or June to assess whether the instructions in the Covid-19 vaccines should be changed to more closely match circulating strains of the virus.

The time frame was chosen to give manufacturers about three months to redesign their shots and get new doses to pharmacies in time for fall.

“The object, of course – before anyone says anything – is not to chase variants. None of us think that’s realistic,” said Jerry Weir, director of the Division of Viral Products in the FDA’s Office of Vaccines Research and Review.

“But I think our experience so far, with the bivalent vaccines that we have, does indicate that we can continue to make improvements to the vaccine, and that would be the goal of these meetings,” Weir said.

In discussions after the vote, committee members were supportive of this plan but pointed out many of the things we still don’t understand about Covid-19 and vaccination that are likely to complicate the task of updating the vaccines.

For example, we now seem to have Covid-19 surges in the summer as well as the winter, noted Dr. Michael Nelson, an allergist and immunologist at the University of Virginia. Are the surges related? And if so, is fall the best time to being a vaccination campaign?

The CDC’s Dr. Jefferson Jones said that with only three years of experience with the virus, it’s really too early to understand its seasonality.

Other important questions related to the durability of the mRNA vaccines and whether other platforms might offer longer protection.

“We can’t keep doing what we’re doing,” said Dr. Bruce Gellin, chief of global public health strategy at the Rockefeller Foundation. “It’s been articulated in every one of these meetings despite how good these vaccines are. We need better vaccines.”

The committee also encouraged both government and industry scientists to provide a fuller picture of how vaccination and infection affect immunity.

One of the main ways researchers measure the effectiveness of the vaccines is by looking at how much they increase front-line defenders called neutralizing antibodies.

Neutralizing antibodies are like firefighters that rush to the scene of an infection to contain it and put it out. They’re great in a crisis, but they tend to diminish in numbers over time if they’re not needed. Other components of the immune system like B-cells and T-cells hang on to the memory of a virus and stand ready to respond if the body encounters it again.

Scientists don’t understand much about how well Covid-19 vaccination boosts these responses and how long that protection lasts.

Another puzzle will be how to pick the strains that are in the vaccines.

The process of selecting strains for influenza vaccines is a global effort that relies on surveillance data from other countries. This works because influenza strains tend to become dominant and sweep around the world. But Covid-19 strains haven’t worked in quite the same way. Some that have driven large waves in other countries have barely made it into the US variant mix.

“Going forward, it is still challenging. Variants don’t sweep across the world quite as uniform, like they seem to with influenza,” the FDA’s Weir said. “But our primary responsibility is what’s best for the US market, and that’s where our focus will be.”

Eventually, the FDA hopes that Americans would be able to get an updated Covid-19 shot once a year, the same way they do for the flu. People who are unlikely to have an adequate response to a single dose of the vaccine – such as the elderly or those with a weakened immune system – may need more doses, as would people who are getting Covid-19 vaccines for the first time.

At Thursday’s meeting, the advisory committee also heard more about a safety signal flagged by a government surveillance system called the Vaccine Safety Datalink.

The CDC and the FDA reported January 13 that this system, which relies on health records from a network of large hospital systems in the US, had detected a potential safety issue with Pfizer’s bivalent boosters.

In this database, people 65 and older who got a Pfizer bivalent booster were slightly more likely to have a stroke caused by a blood clot within three weeks of their vaccination than people who had gotten a bivalent booster but were 22 to 42 days after their shot.

After a thorough review of other vaccine safety data in the US and in other countries that use Pfizer bivalent boosters, the agencies concluded that the stroke risk was probably a statistical fluke and said no changes to vaccination schedules were recommended.

At Thursday’s meeting, Dr. Nicola Klein, a senior research scientist with Kaiser Permanente of Northern California, explained how they found the signal.

The researchers compared people who’d gotten a vaccine within the past three weeks against people who were 22 to 42 days away from their shots because this helps eliminate bias in the data.

When they looked to see how many people had strokes around the time of their vaccination, they found an imbalance in the data.

Of 550,000 people over 65 who’d received a Pfizer bivalent booster, 130 had a stroke caused by a blood clot within three weeks of vaccination, compared with 92 people in the group farther out from their shots.

The researchers spotted the signal the week of November 27, and it continued for about seven weeks. The signal has diminished over time, falling from an almost two-fold risk in November to a 47% risk in early January, Klein said. In the past few days, it hasn’t been showing up at all.

Klein said they didn’t see the signal in any of the other age groups or with the group that got Moderna boosters. They also didn’t see a difference when they compared Pfizer-boosted seniors with those who were eligible for a bivalent booster but hadn’t gotten one.

Further analyses have suggested that the signal might be happening not because people who are within three weeks of a Pfizer booster are having more strokes, but because people who are within 22 to 42 days of their Pfizer boosters are actually having fewer strokes.

Overall, Klein said, they were seeing fewer strokes than expected in this population over that period of time, suggesting a statistical fluke.

Another interesting thing that popped out of this data, however, was a possible association between strokes and high-dose flu vaccination. Seniors who got both shots on the same day and were within three weeks of those shots had twice the rate of stroke compared with those who were 22 to 42 days away from their shots.

What’s more, Klein said, the researchers didn’t see the same association between stroke and time since vaccination in people who didn’t get their flu vaccine on the same day.

The total number of strokes in the population of people who got flu shots and Covid-19 boosters on the same day is small, however, which makes the association a shaky one.

“I don’t think that the evidence are sufficient to conclude that there’s an association there,” said Dr. Tom Shimabukuro, director of the CDC’s Immunization Safety Office.

Nonetheless, Richard Forshee, deputy director of the FDA’s Office of Biostatistics and Pharmacovigilance, said the FDA is planning to look at these safety questions further using data collected by Medicare.

The FDA confirmed that the agency is taking a closer look.

“The purpose of the study is 1) to evaluate the preliminary ischemic stroke signal reported by CDC using an independent data set and more robust epidemiological methods; and 2) to evaluate whether there is an elevated risk of ischemic stroke with the COVID-19 bivalent vaccine if it is given on the same day as a high-dose or adjuvanted seasonal influenza vaccine,” a spokesperson said in a statement.

The FDA did not give a time frame for when these studies might have results.

Read original article here

Health

Midriff bulge linked to later physical decline, study says

Leave a comment

Editor’s Note: Seek advice from a health care provider prior to starting a workout program.



CNN
 — 

If you are a man or woman approaching 50, look down at your middle. If you’re like many people, you might have to lean over a bit to see your feet. Yes, it’s the dreadful midriff bulge — that expanding waistline that can often creep up on you as you age, much like a receding hairline or extra wrinkles.

Tough to combat, it almost seems like a rite of passage, just part of the cycle of life, right? But a new study has found that allowing your middle to expand will do more than send you shopping for the next size up in britches -— it can also harm your physical abilities later in life.

The study, which followed 4,509 people who were 45 years old or older in Norway for over two decades, found participants who had a high or moderately high waist circumference at the start of the study were 57% more likely to be “frail” than those with a normal waistline.

But frailty is not that “tottering” elderly person bent over a cane that comes to mind. Instead, frailty includes a poor grip strength, a slower walking speed, overall exhaustion, unintentional weight loss and low physical activity.

People who were obese at the start of the study, defined as having a body mass index (BMI) of 30 and higher, were also 2.5 more likely to be frail than those with normal BMI (18.5 to 24.9), according to the study published January 23, 2023, in the journal BMJ Open.

There could be several reasons, according to study authors. Obesity leads to an increase in inflammation in fat cells, which can damage muscle fibers “resulting in reduced muscle strength and function,” study coauthor Shreeshti Uchai, a doctoral research fellow in nutritional epidemiology at the University of Oslo in Tromsø, Norway, and her colleagues wrote.

The results highlight the need to stay on top of both overall weight gain and any rise in waist circumference, and to broaden the definition of frailty, the authors concluded.

“In the context where the population is rapidly ageing and the obesity epidemic is rising, growing evidence recognises the subgroup of ‘fat and frail’ older individuals in contrast to viewing frailty only as a wasting disorder,” they wrote.

Exercise can help counter the growing frailty that aging may bring. Adults should perform muscle-strengthening exercises involving all major muscle groups on at least two or more days each week, in addition to exercising at least two hours and 30 minutes per week at a moderate intensity, according to the US Department of Health and Human Services’ physical activity guidelines for Americans.

Reducing body fat and building lean muscle can help improve balance and posture, Dr. Nieca Goldberg, the medical director of Atria New York City and clinical associate professor of medicine at New York University’s Grossman School of Medicine, told CNN previously.

To stay strong and healthy, try to do both aerobics and strength exercises.

They “appear to work together and help each other move toward better outcomes,” said Dr. William Roberts, a professor in the department of family medicine and community health at the University of Minnesota Medical School. “A balanced program of strength and aerobic activity is probably best and probably more closely mimics the activities of our ancestors, which helped determine our current gene sets.”

To get started on strength exercises, CNN fitness contributor Dana Santas, a mind-body coach in professional sports, suggests mastering body-weight movements first before moving on to free weights.

– Source:
CNN
” data-fave-thumbnails=”{“big”:{“uri”:”https://media.cnn.com/api/v1/images/stellar/prod/210813103541-lbb-bodyweight-03.jpg?q=x_0,y_0,h_1080,w_1919,c_fill/h_540,w_960″},”small”:{“uri”:”https://media.cnn.com/api/v1/images/stellar/prod/210813103541-lbb-bodyweight-03.jpg?q=x_0,y_0,h_1080,w_1919,c_fill/h_540,w_960″}}” data-vr-video=”” data-show-name=”” data-show-url=”” data-check-event-based-preview=”” data-network-id=”” data-details=””>

Try this 10-minute body-weight workout

Get all the details of these exercises and more by signing up for CNN’s Fitness, But Better newsletter series, a seven-part expert-backed guide that can help you ease into a healthy routine.

Read original article here

Health

A few minutes of brisk activity can help your brain, study finds

Leave a comment

Editor’s Note: Seek advice from a health care provider before starting a workout program.



CNN
 — 

What if you could look at all the things you do daily — walking from room to room, preparing a presentation at your desk, running up and down stairs to deliver folded laundry or taking a jog around the block — and know which ones will best help or hurt your brain?

A new study attempted to answer that question by strapping activity monitors to the thighs of nearly 4,500 people in the United Kingdom and tracking their 24-hour movements for seven days. Researchers then examined how participants’ behavior affected their short-term memory, problem-solving and processing skills.

Here’s the good news: People who spent “even small amounts of time in more vigorous activities — as little as 6 to 9 minutes — compared to sitting, sleeping or gentle activities had higher cognition scores,” said study author John Mitchell, a Medical Research Council doctoral training student at the Institute of Sport, Exercise and Health at University College London, in an email.

Moderate physical activity is typically defined as brisk walking or bicycling or running up and down stairs. Vigorous movement, such as aerobic dancing, jogging, running, swimming and biking up a hill, will boost your heart rate and breathing.

The study, published Monday in the Journal of Epidemiology & Community Health, found doing just under 10 minutes of moderate to vigorous exertion each day improved study participants’ working memory but had its biggest impact on executive processes such as planning and organization.

The cognitive improvement was modest, but as additional time was spent doing the more energetic workout the benefits grew, Mitchell said.

“Given we don’t monitor participants’ cognition over many years, this may be simply that those individuals who move more tend to have higher cognition on average,” he said. “However, yes, it could also imply that even minimal changes to our daily lives can have downstream consequences for our cognition.”

Steven Malin, an associate professor in the department of kinesiology and health at Rutgers University in New Jersey, told CNN the study provides new insight in how activity interacts with sedentary behavior as well as sleep.

“Understanding the interaction of sleep and various physical activities is often not examined,” said Malin, who was not involved in the new study.

While the study had some limitations, including a lack of knowledge about the health of the participants, the findings illustrate how “the accumulation of movement patterns in a day to a week to a month is just as, if not more important, than just getting outside for a single session of exercise,” he said.

There was bad news as well: Spending more time sleeping, sitting or engaged only in mild movement was linked to a negative impact on the brain. The study found cognition declined 1% to 2% after replacing an equivalent portion of moderate to vigorous physical activity with eight minutes of sedentary behavior, six minutes of light intensity or seven minutes of sleep.

“In most cases we showed that as little as 7 to 10 minutes less MVPA (moderate to vigorous physical activity) was detrimental,” Mitchell said.

That change is only an association, not a cause and effect, due to the observational methods of the study, Mitchell stressed.

In addition, the study’s findings on sleep can’t be taken at face value, he said. Good quality sleep is critical for the brain to operate at peak performance.

“The evidence on the importance of sleep for cognitive performance is strong,” Mitchell said, “yet there are two major caveats. First, over-sleeping can be linked to poorer cognitive performance.

“Secondly, sleep quality may be even more important than duration. Our accelerometer devices can estimate how long people slept for, but cannot tell us how well they slept.”

Additional studies need to be done to verify these findings and understand the role of each type of activity. However, Mitchell said, the study “highlights how even very modest differences in people’s daily movement — less than 10 minutes — is linked to quite real changes in our cognitive health.”

Read original article here

Health

A few minutes of brisk activity can help your brain, study finds

Leave a comment

Editor’s Note: Seek advice from a health care provider before starting a workout program.



CNN
 — 

What if you could look at all the things you do daily — walking from room to room, preparing a presentation at your desk, running up and down stairs to deliver folded laundry or taking a jog around the block — and know which ones will best help or hurt your brain?

A new study attempted to answer that question by strapping activity monitors to the thighs of nearly 4,500 people in the United Kingdom and tracking their 24-hour movements for seven days. Researchers then examined how participants’ behavior affected their short-term memory, problem-solving and processing skills.

Here’s the good news: People who spent “even small amounts of time in more vigorous activities — as little as 6 to 9 minutes — compared to sitting, sleeping or gentle activities had higher cognition scores,” said study author John Mitchell, a Medical Research Council doctoral training student at the Institute of Sport, Exercise and Health at University College London, in an email.

Moderate physical activity is typically defined as brisk walking or bicycling or running up and down stairs. Vigorous movement, such as aerobic dancing, jogging, running, swimming and biking up a hill, will boost your heart rate and breathing.

The study, published Monday in the Journal of Epidemiology & Community Health, found doing just under 10 minutes of moderate to vigorous exertion each day improved study participants’ working memory but had its biggest impact on executive processes such as planning and organization.

The cognitive improvement was modest, but as additional time was spent doing the more energetic workout the benefits grew, Mitchell said.

“Given we don’t monitor participants’ cognition over many years, this may be simply that those individuals who move more tend to have higher cognition on average,” he said. “However, yes, it could also imply that even minimal changes to our daily lives can have downstream consequences for our cognition.”

Steven Malin, an associate professor in the department of kinesiology and health at Rutgers University in New Jersey, told CNN the study provides new insight in how activity interacts with sedentary behavior as well as sleep.

“Understanding the interaction of sleep and various physical activities is often not examined,” said Malin, who was not involved in the new study.

While the study had some limitations, including a lack of knowledge about the health of the participants, the findings illustrate how “the accumulation of movement patterns in a day to a week to a month is just as, if not more important, than just getting outside for a single session of exercise,” he said.

There was bad news as well: Spending more time sleeping, sitting or engaged only in mild movement was linked to a negative impact on the brain. The study found cognition declined 1% to 2% after replacing an equivalent portion of moderate to vigorous physical activity with eight minutes of sedentary behavior, six minutes of light intensity or seven minutes of sleep.

“In most cases we showed that as little as 7 to 10 minutes less MVPA (moderate to vigorous physical activity) was detrimental,” Mitchell said.

That change is only an association, not a cause and effect, due to the observational methods of the study, Mitchell stressed.

In addition, the study’s findings on sleep can’t be taken at face value, he said. Good quality sleep is critical for the brain to operate at peak performance.

“The evidence on the importance of sleep for cognitive performance is strong,” Mitchell said, “yet there are two major caveats. First, over-sleeping can be linked to poorer cognitive performance.

“Secondly, sleep quality may be even more important than duration. Our accelerometer devices can estimate how long people slept for, but cannot tell us how well they slept.”

Additional studies need to be done to verify these findings and understand the role of each type of activity. However, Mitchell said, the study “highlights how even very modest differences in people’s daily movement — less than 10 minutes — is linked to quite real changes in our cognitive health.”

Read original article here

Health

Intermittent fasting may not be as helpful for losing weight as once thought, study finds

Leave a comment

Sign up for CNN’s Adulthood, But Better newsletter series. Our seven-part guide has tips to help you make more informed decisions around personal finance, career, wellness and personal connections.



CNN
 — 

Are snacks before bed your vice? Or do you prefer to wait a few hours after you wake up to eat?

The timing of meals may not have as big an impact on weight as once thought, according to a new study.

The study tracked the portion sizes and eating times of 547 people, in addition to data on their health and weight, over the course of six years. The data showed no association between an interval of the day in which people had their meals and their weight, according to the study published Wednesday in the Journal of the American Heart Association.

Restricting eating times, as seen in diet trends such as intermittent fasting, has been a popular method to try to lose weight in recent years.

But the researchers found no association between restricting eating times and weight loss, said principal investigator of the study Dr. Wendy Bennett, an associate professor of medicine in the division of general internal medicine at Johns Hopkins School of Medicine. That included how long people ate after waking up, how long their window of eating was throughout the day and how close to going to bed they ate, she noted.

Instead, smaller meals were associated with weight loss, she said.

“Based on other studies that have come out, including ours, we are starting to think that timing of meals through the day most likely doesn’t immediately result in weight loss,” Bennett said, adding the caveat that for some people, timing meals may be a useful tool in tracking nutrition.

The results of this study should be taken with a grain of salt, experts cautioned.

There were few racial and ethnic minorities among the participants, noted Dr. Fatima Cody, associate professor of medicine at Harvard Medical School. There are also many social determinants of health, such as stress and people’s environment, that could be added to the data, Cody added.

Those factors could be important for getting a better look at the effects of meal timing, added Alice Lichtenstein, professor of nutrition science and policy at Tufts University.

“I suspect that if they looked more closely at the data, that there would be subgroups (where timing of meals) may have had a significant effect,” Lichtenstein said.

This study was observational, Bennett noted, meaning that they looked at existing patterns for the study instead of making changes to a randomized group. Further work on this topic is underway, she added.

The big takeaways are that there is no one strategy that works for all people when it comes to nutrition, and that quality of the food counts, Lichtenstein said.

“If you make some effort to consume a healthy diet, you make some effort to be physically active, you’re less likely to have diabetes, chronic kidney disease, obstructive pulmonary disease and hypertension,” Lichtenstein said.

It’s the boring stuff no one wants to hear, she added, but there is no getting around eating fruits and vegetables and getting physical activity when it comes to weight management.

For some people, trying intermittent fasting or restricting eating intervals can be a helpful way to take note of personal tendencies, but many people can’t sustain it for enough time to see long-term change — or keep off any weight they lose, Lichtenstein added.

Cody, who is an obesity medicine physician at Boston’s Massachusetts General Hospital Weight Center, doesn’t like to focus too strongly on either calorie restriction or intermittent fasting, she said. Instead, she wants her clients to look at the nutritional value of the food they are eating.

To the body, 100 calories of gummy bears is not the same as 100 calories of oatmeal with fruit and nuts, she added.

But different approaches work better in different lifestyles, and everyone should work with their own doctor and their own body without stress and shame, Cody said.

If a nutrition strategy works for someone else, she said, “it just means someone’s body responded and the other one didn’t. It doesn’t mean you’re flawed. It just means that’s just not what your body needed.”

Read original article here

Health

Decreasing rates of childhood immunization are a major concern. Our medical analyst explains why

Leave a comment



CNN
 — 

Vaccine rates for measles, polio, diphtheria and other diseases are decreasing among US children, according to a new study from the US Centers for Disease Control and Prevention.

The rate of immunizations for required vaccines among kindergarten students declined from 95% to approximately 94% during the 2020-21 school year. It dropped further — to 93% — in the 2021-22 school year.

That’s still a high number, so why is this drop in immunization significant? What accounts for the decline? What might be the consequences if these numbers drop further? If parents are unsure about vaccinating their kids, what should they do? And what can be done on a policy level to increase immunization numbers?

To help us with these questions, I spoke with CNN Medical Analyst Dr. Leana Wen, an emergency physician, public health expert and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She is also author of “Lifelines: A Doctor’s Journey in the Fight for Public Health.”

CNN: Why is it a problem that childhood immunization rates are declining?

Dr. Leana Wen: The reduction of vaccine-preventable diseases is one of the greatest public health success stories in the last 100 years.

The polio vaccine was introduced in the United States in 1955, for example. In the four years prior, there were an average of over 16,000 cases of paralytic polio and nearly 2,000 deaths from polio each year across the US. Widespread use of the polio vaccine had led to the eradication of polio in the country by 1979, according to the CDC, sparing thousands of deaths and lifelong disability among children each year.

The measles vaccine was licensed in the US in 1963. In the four years before that, there were an average of over 500,000 cases and over 430 measles-associated deaths each year. By 1998, there were just 89 cases recorded — and no measles-associated deaths.

These vaccines are very safe and extremely effective. The polio vaccine, for example, is over 99% effective at preventing paralytic polio. The measles vaccine is 97% effective at preventing infection.

We can do this same analysis for other diseases for which there are routine childhood immunizations.

It’s very concerning that rates of immunization are declining for vaccines that have long been used to prevent disease and reduce death. That means more children are at risk for severe illness — illness that could be averted if they were immunized. Moreover, if the proportion of unvaccinated individuals increases in a community, this also puts others at risk. That includes babies too young to be vaccinated or people for whom the vaccines don’t protect as well — for example, patients on chemotherapy for cancer.

CNN: What accounts for the decline in vaccination numbers?

Wen: There are probably many factors. First, there has been substantial disruption to the US health care system during the Covid-19 pandemic. Many children missed routine visits to the pediatrician during which they would have received vaccines due to pandemic restrictions. In addition, some community health services offered also became disrupted as local health departments focused on Covid-19 services.

Second, disruption to schooling has also played a role. Vaccination requirements are often checked prior to the start of the school year. When schools stopped in-person instruction, that led to some families falling behind on their immunizations.

Third, misinformation and disinformation around Covid-19 vaccines may have seeded doubt in other vaccines. Vaccine hesitancy and misinformation were already major public health concerns before the coronavirus emerged, but the pandemic has exacerbated the issues.

According to a December survey published by the Kaiser Family Foundation, more than one in three American parents said vaccinating children against measles, mumps, and rubella shouldn’t be a requirement for them to attend public schools, even if that may create health risks for others. This was a substantial increase from 2019, when a similar poll from the Pew Research Center found only 23% of parents opposed school vaccine requirements.

CNN: What are some consequences if immunization rates drop further?

Wen: If immunization rates drop further, we could see more widespread outbreaks. Diseases that were virtually eliminated in the US could reemerge, and more people can become severely ill and suffer lasting consequences or even die.

We are already seeing some consequences: Last summer, there was a confirmed case of paralytic polio in an unvaccinated adult in New York. It’s devastating that a disease like polio has been identified again in the US, since we have an extremely effective vaccine to prevent it.

There is an active measles outbreak in Ohio. As of January 17, 85 cases have been reported. Most of the cases involved unvaccinated children, and at least 34 have been hospitalized.

CNN: If parents are unsure of vaccinating their kids, what should they do?

Wen: As parents, we generally trust pediatricians with our children’s health. We consult pediatricians if our kids are diagnosed with asthma and diabetes, or if they have new worrisome symptoms of another illness. We should also consult our pediatricians about childhood immunizations; parents and caregivers with specific questions or concerns should address them.

The national association of pediatricians, the American Academy of Pediatrics, “strongly recommends on-time routine immunization of all children and adolescents according to the Recommended Immunization Schedules for Children and Adolescents.”

CNN: What can be done to increase immunization numbers?

Wen: There needs to be a concerted educational campaign to address why vaccination against measles, mumps, rubella, chickenpox, polio and so forth is so crucial. One of the reasons for vaccine hesitancy, in my experience, is that these diseases have been rarely seen in recent years. Many people who are parents now didn’t experience the devastation of these diseases growing up, so may not realize how terrible it would be for them to return.

Specific interventions should be targeted at the community level. In some places, low immunization levels may be due to access. Vaccination drives at schools, parks, shopping centers, and other places where families gather can help increase numbers. In other places, the low uptake may be because of vaccine hesitancy and misinformation. There will need to be different strategies implemented in that situation.

Overall, increasing immunization rates for vaccine-preventable childhood diseases needs to be a national imperative. I can’t underscore how tragic it would be for kids to suffer the harms of diseases that could be entirely prevented with safe, effective and readily available vaccines that have been routinely given for decades.

Read original article here