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Decreased stomach tumor with lifestyle change

Metro Vancouver cancer patient’s diagnosis may have doctors ‘scratching their heads’

Brice Royer was told four years ago that the tumour in his stomach would likely kill him.

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Brice Royer was told four years ago that the tumour in his stomach would likely kill him.

He arrived at the doctor’s office for an update this week in a wheelchair and star-shaped sunglasses, accompanied by an entourage of four beloved friends.

He felt weak and had a migraine, he explained, as he rose shakily to greet a Vancouver Sun team, but had made the effort to come from Coquitlam to the south Granville office for an important purpose: to check on the size of his tumour.

Royer reacted to his 2012 diagnosis first with denial and then depression. He became bed-ridden, weak and contemplated suicide.

Then he read love and kindness could help people heal. Giving and receiving freely, he learned, helps people build community and recover from depression.

In 2013, Royer started a campaign of random acts of kindness.

He gave a chronically ill single mother in Pennsylvania whom he had never met $4,800 from his own savings to pay rent for the year. Late last year, he spearheaded a campaign to build a home for another single mother in Vancouver who lived in a shelter with her daughter and had offered to cook for him. That campaign raised $25,000.

He received global media recognition last year when a Craigslist ad he wrote on the site’s Vancouver real estate page offering unconditional love for $0 went viral.

Brice Royer with friend and caregiver Ruso Llanera after receiving a promising update from his doctor.
Brice Royer with friend and caregiver Ruso Llanera after receiving the good news from the doctor this week. ARLEN REDEKOP / PNG

Royer said his biggest lifestyle change included inviting strangers to his home for meals, to build a connection with the community. Some of those people became close friends.

One, Ruso Llanera, who was pushing his wheelchair, is now his full-time caregiver and has become “like a brother,” Royer said.

“The tumour actually gave me a gift, because if I didn’t have that, I would not have changed my lifestyle and I would not have appreciated the importance of community and belonging and being surrounded by loving kindness. I probably wouldn’t have changed much,” Royer said in the lobby of his doctor’s office.

“I think the reason I am alive today is because of the love and kindness I have received from so many people.”

Brice Royer with his doctor, Eric Cattoni, in Vancouver, BC. April 12, 2016. Royer hears from the doctor his cancer is benign after having an MRI in February. ARLEN REDEKOP / PNG

Dr. Eric Cattoni, Royer’s GP, took his entourage in stride, moving the appointment to a larger office.“Brice, how are you?” he asked.

“Up and down,” answered Royer, who also suffers from two neurological disorders that make him chronically weak and highly sensitive to most foods. He has been feeling extremely tired these past few days and suffers digestive problems. This was likely related to something he ate, he said.

Then the conversation turned to the question on everyone’s mind.

“What happened to the tumour?” Royer asked.

Cattoni turned to his computer, pulling Royer’s MRI results on to the screen.

“So basically it’s saying that … the mass has not increased, but has in fact decreased in size, which favours either an unexplained improvement or possibly more of a benign or indolent type of disease,” Cattoni said.

“So it’s gotten better?” Royer asked.

“It’s gotten better,” Cattoni confirmed. “And the fact that it has, they say here, (means) that it might be more of a benign type of lesion.”

“That’s good news,” Royer said quietly, with a nervous laugh.

“That is very good news,” Cattoni said. “And to start out, they weren’t saying that. They were saying, ‘No, this is scary looking, this is bad.’ And I think the fact that that’s changed, the fact that things have gotten better, I think you’re just probably going to have a lot of doctors trained like me scratching their heads.”

“Oh my god,” Royer said, cradling his head in his hands and bursting into tears. He was quickly hugged by both Llanera and his fiancée. Royer’s sobs were audible and his shoulders shook as the three embraced and absorbed the results.

Brice Royer with friend and caregiver Ruso Llanera after receiving the good news.
Brice Royer with friend and caregiver Ruso Llanera after receiving the good news. ARLEN REDEKOP / PNG

“That’s the best news I’ve heard since 2012,” Royer said, wiping away his tears. Cattoni handed him a tissue.

Asked by Royer to what extent his lifestyle changes could have affected his health, Cattoni said: “I think you’ve surrounded yourself with people that care for you and that you care for and I think that’s been very good for you. I think your mental health is very closely tied to physical health, which is no mystery to Western medicine.

“But I think a lot of the improvement you’re experiencing, you’re not going to find answers from me or most Western-trained physicians. That doesn’t make the success you’re having by surrounding yourself with love less real, right? I think you kind of have your answer there. I think what you’re doing and the way you’re approaching things is good for you and I think it is going to help you and possibly save your life. But I also think that it’s not going to be the only answer. I think there are medical interventions that, if suggested by specialists, you need to consider seriously.”

In the lobby of Cattoni’s office, Royer was still wiping away tears.

“It gives me courage to keep doing what I’m doing. It encourages me to keep giving and I’m probably going to give even more.”

The next day, Royer celebrated by helping a friend pay for a car-related expense.

 

How sleepless nights compromise the health of your gut

How sleepless nights compromise the health of your gut

Summary: Study reveals the function of specific immune cells, well documented as playing a significant role in gut health, is directly controlled by our circadian clock.

Source: Champalimaud Center for the Unknown

It is well known that individuals who work night-shifts, or travel often across different time zones, have a higher tendency to become overweight and suffer from gut inflammation. The underlying cause for this robust phenomenon has been the subject of many studies that tried to relate physiological processes with the activity of the brain’s circadian clock, which is generated in response to the daylight cycle.

Now, the group of Henrique Veiga-Fernandes, at the Champalimaud Centre for the Unknown in Lisbon, Portugal, discovered that the function of a group of immune cells, which are known to be strong contributors to gut health, is directly controlled by the brain’s circadian clock. Their findings were published today in the scientific journal Nature.

“Sleep deprivation, or altered sleep habits, can have dramatic health consequences, resulting in a range of diseases that frequently have an immune component, such as bowel inflammatory conditions”, says Veiga-Fernandes, the principal investigator who led the study. “To understand why this happens, we started by asking whether immune cells in the gut are influenced by the circadian clock.”

The big clock and the little clock

Almost all cells in the body have an internal genetic machinery that follows the circadian rhythm through the expression of what are commonly known as “clock genes”. The clock genes work like little clocks that inform cells of the time of day and thereby help the organs and systems that the cells make up together, anticipate what is going to happen, for instance if it’s time to eat or sleep.

Even though these cell clocks are autonomous, they still need to be synchronised in order to make sure that “everyone is on the same page”. “The cells inside the body don’t have direct information about external light, which means that individual cell clocks can be off”, Veiga-Fernandes explains. “The job of the brain’s clock, which receives direct information about daylight, is to synchronise all of these little clocks inside the body so that all systems are in synch, which is absolutely crucial for our wellbeing”.

Among the variety of immune cells that are present in the intestine, the team discovered that Type 3 Innate Lymphoid Cells (ILC3s) were particularly susceptible to perturbations of their clock genes. “These cells fulfill important functions in the gut: they fight infection, control the integrity of the gut epithelium and instruct lipid absorption”, explains Veiga-Fernandes. “When we disrupted their clocks, we found that the number of ILC3s in the gut was significantly reduced. This resulted in severe inflammation, breaching of the gut barrier, and increased fat accumulation.”

These robust results drove the team to investigate why is the number of ILC3s in the gut affected so strongly by the brain’s circadian clock. The answer to this question ended up being the missing link they were searching for.

It’s all about being in the right place at the right time

When the team analysed how disrupting the brain’s circadian clock influenced the expression of different genes in ILC3s, they found that it resulted in a very specific problem: the molecular zip-code was missing! It so happens that in order to localise to the intestine, ILC3s need to express a protein on their membrane that works as a molecular zip-code. This ‘tag’ instructs ILC3s, which are transient residents in the gut, where to migrate. In the absence of the brain’s circadian inputs, ILC3s failed to express this tag, which meant they were unable to reach their destination.

This shows an alarm clock

According to Veiga-Fernandes, these results are very exciting, because they clarify why gut health becomes compromised in individuals who are routinely active during the night. “This mechanism is a beautiful example of evolutionary adaptation”, says Veiga-Fernandes. “During the day’s active period, which is when you feed, the brain’s circadian clock reduces the activity of ILC3s in order to promote healthy lipid metabolism. But then, the gut could be damaged during feeding. So after the feeding period is over, the brain’s circadian clock instructs ILC3s to come back into the gut, where they are now needed to fight against invaders and promote regeneration of the epithelium.”

“It comes as no surprise then”, he continues, “that people who work at night can suffer from inflammatory intestinal disorders. It has all to do with the fact that this specific neuro-immune axis is so well-regulated by the brain’s clock that any changes in our habits have an immediate impact on these important, ancient immune cells.”

This study joins a series of groundbreaking discoveries produced by Veiga-Fernandes and his team, all drawing new links between the immune and nervous systems. “The concept that the nervous system can coordinate the function of the immune system is entirely novel. It has been a very inspiring journey; the more we learn about this link, the more we understand how important it is for our wellbeing and we are looking forward to seeing what we will find next”, he concludes.

ABOUT THIS NEUROSCIENCE RESEARCH ARTICLE

Source:
Champalimaud Center for the Unknown
Media Contacts:
Maria João Soares – Champalimaud Center for the Unknown
Image Source:
The image is in the public domain.

Original Research: Closed access
“Light-entrained and brain-tuned circadian circuits regulate ILC3 and gut homeostasis”. Cristina Godinho-Silva, Rita G. Domingues, Miguel Rendas, Bruno Raposo, Helder Ribeiro, Joaquim Alves da Silva, Ana Vieira, Rui M. Costa, Nuno L. Barbosa-Morais, Tania Carvalho, Henrique Veiga-Fernandes.
Nature doi:10.1038/s41586-019-1579-3.

Abstract

Light-entrained and brain-tuned circadian circuits regulate ILC3 and gut homeostasis

Group 3 innate lymphoid cells (ILC3s) are major regulators of inflammation, infection, microbiota composition and metabolism1. ILC3s and neuronal cells have been shown to interact at discrete mucosal locations to steer mucosal defence2,3. Nevertheless, it is unclear whether neuroimmune circuits operate at an organismal level, integrating extrinsic environmental signals to orchestrate ILC3 responses. Here we show that light-entrained and brain-tuned circadian circuits regulate enteric ILC3s, intestinal homeostasis, gut defence and host lipid metabolism in mice. We found that enteric ILC3s display circadian expression of clock genes and ILC3-related transcription factors. ILC3-autonomous ablation of the circadian regulator Arntl led to disrupted gut ILC3 homeostasis, impaired epithelial reactivity, a deregulated microbiome, increased susceptibility to bowel infection and disrupted lipid metabolism. Loss of ILC3-intrinsic Arntl shaped the gut ‘postcode receptors’ of ILC3s. Strikingly, light–dark cycles, feeding rhythms and microbial cues differentially regulated ILC3 clocks, with light signals being the major entraining cues of ILC3s. Accordingly, surgically or genetically induced deregulation of brain rhythmicity led to disrupted circadian ILC3 oscillations, a deregulated microbiome and altered lipid metabolism. Our work reveals a circadian circuitry that translates environmental light cues into enteric ILC3s, shaping intestinal health, metabolism and organismal homeostasis.

Supportive relationships in childhood leads to longer lives

Supportive relationships in childhood leads to longer lives

Summary: Closer social relationships in childhood and being raised by a family with higher socioeconomic status was linked to people being more optimistic during midlife and increased chances of living to an older age. Those who were more disadvantaged growing up and experienced psychosocial stressors tended to experience more stressful events during midlife and had an increased risk of early death.

Source: Boston University School of Medicine

After years of generalized theories and hypothesis, research has finally pinpointed certain aspects of childhood experience linked to people living longer.

Individuals raised in families with higher socioeconomic status were more optimistic in midlife, and in turn, lived longer. Those who experienced more psychosocial stressors, such as parental death, frequent moves and harsh discipline, tended to encounter more stressful life events in midlife, and had greater risk of dying.

Prior research has shown that adverse childhood experiences are associated with higher mortality risk. However, the effects appear to be driven by a small proportion of individuals who experienced multiple “hits” of severe stressors, such as physical abuse and domestic violence. Little is known about the potential effects of milder but more common stressors and the potential benefits of favorable childhood experiences on longevity. How different aspects of childhood experiences come to influence life span has rarely been studied. These questions are addressed in a new study in the journal Psychology and Aging.

The study involved 1,042 men who had been followed since 1961 in the Normative Aging Study. Three aspects of childhood experiences, including socioeconomic status, psychosocial stressors and presence of close relationships were assessed at study entry and in 1995. Optimism, life satisfaction, stressful life events and negative affect in midlife were assessed from 1985-91. Mortality status was tracked through 2016.

A key finding was that men who recalled having more childhood stressors also tended to experience more stressors as adults, and in turn, had greater risk of dying. For example, when comparing men who had five versus one childhood psychosocial stressors, those with more childhood stressors had a three percent greater risk of dying that was due to having more adulthood stressors. These findings suggest that a continuous pattern of stressor exposure from childhood to midlife may act as a precursor to reduced lifespan.

This shows two little girls playing

The researchers also looked at whether and how favorable aspects of childhood experiences may contribute to longevity. In particular, men raised in families with higher socioeconomic status tended to report higher levels of optimism and life satisfaction in midlife, and in turn, had greater likelihood of having longer lives. These findings suggest that optimism and life satisfaction are resilience pathways which convey the benefits of childhood socioeconomic resources onto longer lives.

“Our findings offer novel evidence on unique and shared pathways linking specific dimensions of early life experiences to longevity,” said corresponding author Lewina Lee, PhD, clinical research psychologist at the National Center for PTSD at VA Boston and assistant professor of psychiatry at Boston University School of Medicine. “We hope that our research will stimulate further work to identify and intervene on factors which lie on the pathways linking childhood experiences to later-life health.”

ABOUT THIS NEUROSCIENCE RESEARCH ARTICLE

Source:
Boston University School of Medicine
Media Contacts:
Press Office – Boston University School of Medicine
Image Source:
The image is in the public domain.

Original Research: Closed access
“The long arm of childhood experiences on longevity: Testing midlife vulnerability and resilience pathways”. Lewina Lee et al.
Psychology and Aging doi:10.1037/pag0000394.

Abstract

The long arm of childhood experiences on longevity: Testing midlife vulnerability and resilience pathways

Adverse early experiences have been associated with higher mortality risk, but evidence varies by type of experiences, and relatively little is known about the role of favorable early experiences on health in later life. This study evaluated the independent contributions to longevity of favorable and unfavorable early experiences, including psychosocial stressors, childhood socioeconomic status (SES), and close relationships. We also examined 4 midlife psychosocial factors as vulnerability and resilience pathways potentially mediating these associations. The sample included 1,042 men from the VA Normative Aging Study. Early experiences were assessed retrospectively in 1961–1970 and 1995. Midlife psychosocial factors were measured in 1985–1991 and included stressful life events (SLEs), negative affect, life satisfaction, and optimism. Mortality was assessed through 2016. In multiple mediator structural equation models, which account for the overlap among pathways, higher number of SLEs in midlife mediated the association of having more childhood psychosocial stressors to reduced longevity, supporting stress continuity as a vulnerability pathway. Higher optimism in midlife also mediated the association of higher childhood SES to greater longevity. In single mediator models, higher life satisfaction in midlife transmitted the benefits of higher childhood SES and presence of close relationships onto longevity. Higher optimism also mediated the association of fewer childhood psychosocial stressors to longevity. However, these indirect effects were attenuated when accounting for shared variance among mediators, suggesting overlapping pathways. Findings offer novel evidence on unique and shared pathways linking specific dimensions of early experiences to longevity.

Obesity associated with abnormal bowel habits, not diet

Obesity associated with abnormal bowel habits, not diet

Summary: Study reveals a link between obesity and chronic diarrhea, independent of lifestyle, diet, and other medical conditions. Those who are obese are 60% more likely to experience bouts of chronic diarrhea. A possible explanation could be the link between obesity and low-grade inflammation, which may trigger diarrhea more frequently.

Source: BIDMC

Obesity affects approximately 40 percent of Americans, according to the Centers for Disease Control and Prevention (CDC). While obesity is known to be associated with increased risk of other health conditions – such as heart disease, diabetes, and gastrointestinal diseases – less is known about the relationship between obesity and abnormal bowel habits. In the most comprehensive analysis of the relationship between Body Mass Index (BMI) and bowel habits to date, published today in Alimentary Pharmacology & Therapeutics, a team of physician-researchers at Beth Israel Deaconess Medical Center (BIDMC) found a strong association between obesity and chronic diarrhea independent of an individual’s dietary, lifestyle, psychological factors or medical conditions. The findings could have important implications for how physicians might approach and treat symptoms of diarrhea in patients with obesity.

“While several previous studies have pointed to an association between obesity and bowel habits, all lacked data on whether dietary or other factors drive the connection,” said corresponding author Sarah Ballou, PhD, a health psychologist in the Division of Gastroenterology, Hepatology, and Nutrition at BIDMC. “Our research confirms a positive association between obesity and chronic diarrhea and reveals for the first time that this relationship is not driven by confounding factors such as diet or physical activity level.”

Using the 2009-2010 National Health and Nutrition Examination Survey (NHANES) – a program of studies administered by the CDC designed to assess the health and nutritional status of adults and children in the United States – Ballou and colleagues analyzed the bowel health questionnaire responses of 5,126 patients over the age of 20 years who did not report a history of irritable bowel syndrome, celiac disease or colon cancer. The team compared the reported bowel habits of patients who had a BMI associated with being underweight, normal weight, overweight, obese and severely obese.

After controlling for dietary, physical activity, diabetes, laxative use, and demographic factors, the team found that respondents who were obese or severely obese were 60 percent more likely to have experienced chronic diarrhea compared to those with normal bowel habits or constipation.

This shows a male and female toilet sign

While the study reveals the association is not driven by compounding factors the team controlled for, questions still remain about what underlying causes may explain why obese individuals would be more likely than non-obese individuals to have diarrhea. One possible explanation may be related to the link between obesity and chronic low-grade inflammation, which may contribute to diarrhea. Future research clarifying this relationship and determining how obesity triggers inflammation could serve as a base for how physicians approach treating abnormal bowel habits with this patient population.

“The treatment of obesity and obesity-related medical conditions requires multidisciplinary management,” said senior author Anthony Lembo, MD, a gastroenterologist in the Division of Gastroenterology, Hepatology, and Nutrition at BIDMC. “Clinicians should be aware of the relationship between obesity and diarrhea, especially considering the potential negative impacts altered bowel habits can have on quality of life.”

In addition to Ballou and Lembo, co-authors include Prashant Singh, Vikram Rangan, Johanna Iturrino and Judy Nee, all of the Department of Medicine at BIDMC.

Funding: This work was supported by the National Institutes of Health (T32DK007760).

ABOUT THIS NEUROSCIENCE RESEARCH ARTICLE

Source:
BIDMC
Media Contacts:
Chloe Meck – BIDMC
Image Source:
The image is in the public domain.

Original Research: Open access
“Obesity is associated with significantly increased risk for diarrhoea after controlling for demographic, dietary and medical factors: a cross‐sectional analysis of the 2009‐2010 National Health and Nutrition Examination Survey”. Sarah Ballou, Prashant Singh, Vikram Rangan, Johanna Iturrino, Judy Nee, Anthony Lembo.
Alimentary Pharmacology & Therapeutics doi:10.1111/apt.15500.

Abstract

Obesity is associated with significantly increased risk for diarrhoea after controlling for demographic, dietary and medical factors: a cross‐sectional analysis of the 2009‐2010 National Health and Nutrition Examination Survey

Background
Obesity is associated with increased risk for various gastrointestinal and liver diseases. However, the relationship between obesity and abnormal bowel habits is poorly understood.

Aim
To investigate the relationship between body mass index (BMI) and bowel habit, controlling for clinical, demographic and dietary factors, in a representative sample of the United States adult population

Methods
Data were extracted from the 2009‐2010 National Health and Nutrition Examination Survey. Survey responses were included in this study if respondents completed the bowel health questionnaire (BHQ), were ≥20 years of age, and did not report history of IBD, celiac disease or colon cancer. BMI was divided into the following categories: underweight, normal weight, overweight, obese and severely obese. Stepwise logistic regression provided risk ratios of constipation and diarrhoea controlling for confounding factors (dietary, life‐style, psychological and medical).

Results
A total of 5126 respondents completed the BHQ, had BMI data available, and met eligibility criteria. Of these, 70 (1.40%) were underweight, 1350 (26.34%) were normal weight, 1731 (33.77%) were overweight, 1097 (21.40%) were obese and 878 (17.13%) were severely obese. Up to 8.5% of obese and 11.5% of severely obese individuals had chronic diarrhoea, compared to 4.5% of normal weight individuals. Stepwise regression revealed that severe obesity was independently associated with increased risk of diarrhoea.

Conclusion
Obesity is positively associated with chronic diarrhoea in a nationally representative US adult population after adjusting for several known confounding factors.

Microbiome may be involved in mechanisms related to muscle strength in older adults

Microbiome may be involved in mechanisms related to muscle strength in older adults

Summary: Study adds to the growing body of evidence that the microbiome may impact muscle mass and physical function. In high-functioning older adults and mouse models, researchers identified higher levels of good bacteria in the microbiome than in their lower-functioning peers.

Source: Tufts University

A novel new study suggests that the gut microbiome has a role in mechanisms related to muscle strength in older adults. The work, led by researchers at the Jean Mayer USDA Human Nutrition Research Center on Aging (HNRCA) at Tufts, is available as a pre-proof in advance of print in Experimental Gerontology.

The gut-muscle axis, or the relationship between gut microbiota and muscle mass and physical function, has gained momentum as a research topic in the last few years as studies have established that gut microbiota influences many aspects of health. While researchers have begun exploring the connection between the gut microbiome, muscle, and physical function in mice and younger adults, few studies have been conducted with older adults.

To gain insight into this population, the researchers compared bacteria from the gut microbiomes of 18 older adults with high-physical function and a favorable body composition (higher percentage of lean mass, lower percentage of fat mass) with 11 older adults with low-physical function and a less favorable body composition. The small study identified differences in the bacterial profiles between the two groups.

Similar bacterial differences were present when mice were colonized with fecal samples from the two human groups, and grip strength was increased in mice colonized with samples from the high-functioning older adults, suggesting a role for the gut microbiome in mechanisms related to muscle strength in older adults.

Specifically, when compared to the low-functioning older adult group, the researchers found higher levels of Prevotellaceae, Prevotella, Barnesiella, and Barnesiella intestinihominis–all potentially good bacteria–in the high-functioning older adults and in the mice that were colonized with fecal samples from the high-functioning older adults.

No significant differences in body composition or endurance capacity were observed in the colonized mice; however, the researchers note that the length of the intervention period was short and these data may warrant further study.

“While we were surprised that we didn’t identify a role for the gut microbiome on the maintenance of body composition, with these results we now start to understand the role of gut bacteria in the maintenance of muscle strength in older adults,” said Michael Lustgarten, last and corresponding author on the study and a researcher in the Nutrition, Exercise Physiology & Sarcopenia (NEPS) Laboratory at the HNRCA. “For example, if we were to conduct an intervention to increase Prevotella levels in the gut microbiome, we would expect to see an increase in muscle strength if these bacteria are involved. Prevotella’s role in the maintenance of muscle strength in older adults is one area we expect to continue to explore.”

This shows an older man walking on a beach

“As we age, body composition, muscle strength, and lean mass all decrease,” said first author Roger Fielding, director of the NEPS Laboratory at the HNRCA. “Identifying differences in bacteria present in the high-functioning and low-functioning groups in this study moves us toward a fuller understanding of both the gut microbiome and healthy aging.”

For the study, the researchers measured lower extremity function, mobility, and strength in the sedentary older adult group (ages 70-85) at the first and one-month study visits. In the mice, they measured body composition with quantitative magnetic resonance imaging, and grip strength and treadmill endurance capacity to test physical function. Fecal samples from the older adults were transplanted into young, gender-matched germ-free mice. Four weeks after fecal transfer, the researchers measured body composition, physical function, and gut microbiome in the 18 mice colonized with fecal samples from the high-functioning human group and the 18 mice colonized with fecal samples from the low-functioning human group.

The authors note the small sample size and brief time period as potential study limitations.

Funding: This work was supported by awards from the National Institutes of Health’s National Institute on Aging (K01AG050700), the Boston Claude D. Pepper Older Americans Independence Center (5P30AG031679), and the U.S. Department of Agriculture’s Agricultural Research Service. The content of this announcement is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the U.S. Department of Agriculture.

Fielding is also a professor at the Friedman School of Nutrition Science and Policy at Tufts and Tufts University School of Medicine

Additional authors on this study are Andrew R. Reeves, Christine Liu, and Brittany B. Barrett, HNRCA; and Ravi Jasuja, Boston Claude D. Pepper Older Americans Independence Center, Brigham and Women’s Hospital, Harvard Medical School.

ABOUT THIS NEUROSCIENCE RESEARCH ARTICLE

Source:
Tufts University
Media Contacts:
Lisa LaPoint – Tufts University
Image Source:
The image is in the public domain.

Original Research: Closed access
“Muscle strength is increased in mice that are colonized with microbiota from high-functioning older adults”. Fielding, R.A., Reeves, A.R., Jasuja, R., Liu, C., Barrett, B.B., Lustgarten, M.S.
Experimental Gerontology doi:10.1016/j.exger.2019.110722.

Abstract

Muscle strength is increased in mice that are colonized with microbiota from high-functioning older adults

Evidence in support of a gut-muscle axis has been reported in rodents, but studies in older adult humans are limited. Accordingly, the primary goals of the present study were to compare gut microbiome composition in older adults that differed in terms of the percentage of whole body lean mass and physical functioning (high-functioning, HF, n = 18; low-functioning, LF, n = 11), and to evaluate the causative role of the gut microbiome on these variables by transferring fecal samples from older adults into germ-free mice.

Family-level Prevotellaceae, genus-level Prevotella and Barnesiella, and the bacterial species Barnesiella intestinihominis were higher in HF older adults at the initial study visit, at a 1-month follow-up visit, in HF human fecal donors, and in HF-colonized mice, when compared with their LF counterparts. Grip strength was significantly increased by 6.4% in HF-, when compared with LF-colonized mice.

In contrast, despite significant differences for the percentage of whole body lean mass and physical functioning when comparing the human fecal donors, the percentage of whole body lean mass and treadmill endurance capacity were not different when comparing human microbiome-containing mice.

In sum, these data suggest a role for gut bacteria on the maintenance of muscle strength, but argue against a role for gut bacteria on the maintenance of the percentage of whole body lean mass or endurance capacity, findings that collectively add to elucidation of the gut-muscle axis in older adults.

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Mullein herb for lung and breast health – COPD signs, symptoms and diagnosis
Metabolic Syndrome and Parkinson
Gut microbes, depression and other health issues
Top 2000 posts in this site
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Brain disorders, stress , sleep and diseases
Zinc and lemongrass for skin health issues
The Common Good by Robert Reich
Chest pain, flu and fever
Let lovers be crazy, disgraceful and wild, for those who fret about such things aren’t in love. Rumi

AI in medicine to read EKG and still hands on continuity of care in home care

Is AI Better Than Your Cardiologist?

With 47 million datasets, the world’s largest cardiovascular company Lepu will debut their FDA-approved AI system that reads EKGs better than cardiologists. Lepu AI is built on Intel’s new AI chipset that makes AI on the EKG device possible.

 Two-time Academy Award Winner Richard Chuang will open with the myths of AI and how to separate the science from the fiction.

Home Care is hands on and continuity of home care service is a must

With Motherhealth caregivers, case manager must ensure continuity of care, training of caregivers and daily monitoring of client and caregivers skill set. Skill set can include knowledge similar to nurses , massage therapist, nutritionist and home care in lower level but same goals of providing home care to seniors matching their needs and treating them like family. 408-854-1883 for bay area caregivers from MOtherhealth LLC , http://www.clubalthea.com
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Ginger, cinnamon and fecal cyst

Ginger, by supporting the digestive system, can help to kill parasites in the stomach before they pass on to the intestine. Once parasites have invaded the intestine, anti-parasitic herbs are needed, along with a careful diet, to rid the body of parasites.

Ginger and cinnamon caused reduction of fecal cyst and trophozoites counts. Histopathology, scanning electron microscopy (SEM) and transmission electron microscopy (TEM) after exposure to each extract revealed evident improvement of intestinal mucosal damage produced by G. lamblia infection and direct structural injury to the trophozoites. However, these results were more obvious after exposure to cinnamon extracts.

Cinnamon extracts in this study especially in a dose of 20 mg/kg/day were more effective than ginger not only in decreasing fecal cyst count but also in improving the histopathological and electron microscopic changes of intestinal mucosa.

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Constipation, digestive issues and Parkinsons

Pathologists reported seeing the distinctive synuclein fibres in nerves of the gut during autopsies – both in people with Parkinson’s and in those without symptoms but who had the fibres in their brain. They suggested the trigger was some unknown microbe or toxin.

“Knowing the location of the first strike allows for early detection – and treatment”

The finding made sense because people with Parkinson’s often report digestive problems – mainly constipation – starting up to 10 years before they notice tremors. Interestingly, another early symptom of Parkinson’s is loss of smell. It may be no coincidence, says Burn, that the nose and gut are two organs where nerve cells are exposed to the outside world – and to potentially problematic toxins and microbes.

Now, the synuclein fibres have been shown travelling from the gut to deep within the brain. Collin Challis at the California Institute of Technology and his colleagues injected synuclein fibres into the stomach and intestine of mice. Three weeks later the fibres could be seen at the base of the brain, and by two months they had travelled to parts of the brain that control movement. The mice also became less agile – similar to people with Parkinson’s disease. The work was reported at the Society for Neuroscience meeting in San Diego last month.

This study builds on a growing body of work that the gut plays a role in Parkinson’s, says Burn. For example, people who have had the main nerve to their stomach cut – an old treatment for stomach ulcers – have a lower risk of the condition.

No single bacterium or virus has been pinpointed as the cause. But early evidence suggests that people with Parkinson’s have different gut bacteria to healthy people. Some doctors are already experimenting with treating patients with antibiotics or faecal transplants.

“It could be that having the wrong bacteria in your gut triggers inflammation,” says Sébastien Paillusson at King’s College London. “We know that inflammation makes synuclein more likely to aggregate.”

Other studies have shown that farmers exposed to certain pesticides, and people who get their drinking water from wells – which might be contaminated with pesticides – are more likely to get Parkinson’s. Perhaps these chemicals can also damage nerves in the gut.

Whatever the culprit, knowing the location of the first strike allows for early detection – and treatment. For instance, drugs that mop up synuclein fibres or block their formation are in the works. If these are given to people before the fibres reach the brain they should have a better chance of success. It might also be possible one day to screen for fibres in the nerves of the gut during colonoscopies for early-stage cancers, says Burn.

Read more: https://www.newscientist.com/article/mg23231024-100-parkinsons-disease-may-start-in-the-gut-and-travel-to-the-brain/#ixzz5zizvNkAc

Metabolic Syndrome and Parkinson

Metabolic Syndrome (MetS) is a group of conditions that occur together that result in insulin resistance and increase the risk of heart disease, stroke and diabetes. According to a new study, MetS may be associated with Parkinson’s disease (PD).

While MetS can be prevented, controlled, treated and even reversed. It is not always easy to treat, since it is a cluster of five interrelated risk factors:

  1. high blood pressure
  2. high blood sugar (fasting glucose)
  3. high levels of triglycerides (a type of fat in your blood)
  4. low levels of HDL (the “good” cholesterol)
  5. a large waist circumference (over 40 inches for men and over 35 inches for women)

MetS is associated with developing a number of diseases, including heart disease, stroke, and type-2 diabetes. It is also associated with an increased all-cause mortality risk (meaning, dying from any cause). Additionally, there’s mounting evidence suggesting that oxidative stress is a major component of MetS-associated diseases – and Parkinson’s disease also has been shown to have a strong oxidative stress component. Thus, there may be shared disease pathways that could be targeted for future treatments and interventions.

A recently published study in the journal, PLOS Medicine, titled, “Metabolic syndrome and risk of Parkinson disease: A nationwide cohort study” (Nam et al., 2018), approached this important investigation in a big way. Spanning a 5-year period (2009 through 2012), the research scientists analyzed the health check-up data of nearly the entire South Korean population who met the study criteria, e.g., study individuals had to be 40 years of age or older and have no prior diagnosis of PD.

Ultimately, 8,215,180 men and 8,948,380 women (for a total of 17,163,560 people) were part of the study analyses. Demographics and lifestyle data were gathered through self-reporting questionnaires, including comorbidities (hypertension, diabetes mellitus, dyslipidemia, ischemic heart disease and stroke), as well as smoking status, alcohol consumption, income, age, gender, and of course, their specific test results for all 5 MetS risk factors. Of note, study participants were diagnosed as having MetS if they had 3 or more of the 5 risk factors.

Results

  • At baseline, 5,848,508 of the individuals (34.1% of the total study population) were diagnosed as having MetS.
  • Upon follow-up, 44,205 individuals were diagnosed with PD.
  • The rate of PD incidence was 2.2 times higher in those with MetS compared to those who didn’t have MetS.
  • Overall, individuals who had MetS had a 24 percent higher risk of PD than those without MetS.
  • Having even just one of the 5 MetS risk factors increased an individual’s PD risk; and, that PD risk increased with each additional risk factor.
    • Individuals with 3 MetS risk factors were at 31% higher risk of PD, compared to those without any risk factors.
    • Individuals with all 5 MetS risk factors were at 66% higher risk, compared to those without any risk factors.
  • Individuals 65 years and older were all shown to be at increased risk for PD, with the greatest PD risk for those with MetS; this association was particularly prominent in women.
  • Even after adjusting for potential confounders (age, sex, smoking, alcohol consumption, physical activity, income, body mass index, kidney function, and history of stroke), individuals with MetS had an increased risk of PD compared to those without MetS.

What Does This Mean?

This study suggests that not only does having MetS risk factors increase your risk for PD, but also, the more risk factors you have, the more likely you are to develop PD. That being said, the jury is still out as to what actually causes MetS in the first place.

Many of the risk factors of metabolic syndrome are associated with insulin resistance (IR). More and more studies suggest that IR negatively impacts dopamine functioning in the brain. And PD symptoms – including tremors, stiffness, and slowness of movement – are caused by a lack of dopamine in the brain;  hence, why a drug that replenishes the brain’s reduced supply of dopamine, i.e.,  levodopa, helps diminish those symptoms.

Perhaps the biggest take-away is three-fold:

  1. Improving our understanding of the relationship between the components of MetS and PD could help us better understand the pathophysiology that links the two.
  2. Adopting a healthier lifestyle (better food choices, more exercise and medications, if prescribed) is a well-documented path to halt, and even reverse MetS – which, according to this study, may also reduce your risk for developing PD.
  3. Being able to identify people at increased risk for developing PD is vital information to have, as mounting an early intervention strategy as described above could potentially make a big difference.

Constipation, an easy-to-identify condition, may be a marker for cardiovascular risk factors and increased cardiovascular risk in older women, according to the results of a large analysis. … After those recalculations, the women with severe constipation had a 23% higher risk of cardiovascular events.

UVA Health System revamps aggressive debt collection practices after report

Heather Waldron lost her home to foreclosure proceedings after UVA Health System sued her for $164,000 after she was unable to pay her bills. (Griffin Pivarunas for Kaiser Health News/Photo by Griffin Pivarunas for Kaiser Health News)
Heather Waldron lost her home to foreclosure proceedings after UVA Health System sued her for $164,000 after she was unable to pay her bills. (Griffin Pivarunas for Kaiser Health News/Photo by Griffin Pivarunas for Kaiser Health News)
September 13, 2019 at 7:54 a.m. PDT

The University of Virginia Health System, which sues thousands of patients each year, seizing wages and home equity to collect on overdue bills, said Friday it would increase financial assistance, give bigger discounts to the uninsured and “reduce our reliance on the legal system.”

“This will have a huge impact on patients to the good,” Doug Lischke, UVA Health System’s chief financial officer, said in an interview. The changes will “positively, drastically reduce the legal process” of lawsuits, garnishments and property liens, he added.

Lischke called the new policy “a first step” that could later include additional financial assistance. He said the state-owned health-care system also plans to ask the Virginia General Assembly to change a law requiring state agencies, including health systems, to “aggressively collect” unpaid bills and charge 6 percent interest on the balance.

But independent experts said the policy change, which comes on the heels of a Kaiser Health News investigation published in The Washington Post detailing the public medical center’s aggressive collection practices, still leaves numerous patients exposed to lawsuits and crippling bills. KHN found that UVA sued patients more than 36,000 times over six years ending in June 2018, sending many families into bankruptcy. It routinely billed uninsured patients for far more than what a typical insurance company would have paid.

By leaving family assets vulnerable and not fully discounting list-price charges, the new guidelines remain “very tough on the poor and near-poor who have managed to amass anything of value that will help them with the daily costs of life,” said Sara Rosenbaum, a health policy professor at George Washington University.

The amended policy will make it easier to qualify for financial assistance, awarding aid to families with incomes of up to 400 percent of the federal poverty level, or $103,000 for a family of four. Until now, families making more than half that were ineligible — the most restrictive financial assistance rules of any major hospital system in Virginia, the KHN analysis found.

UVA also said that except in “unusual circumstances,” it will not sue patients unless balances are more than $1,000 and families make more than 400 percent of the poverty guidelines.

“While these changes represent a step in the right direction, it’s unfortunate that UVA, a public institution, insists on still suing patients,” said Marty Makary, a surgeon and researcher at Johns Hopkins Medicine who studies hospital debt collection. “In my conversations with UVA surgeons, they are appalled by the practice of their center in suing patients and want it to stop.”

The health system has not decided what to do about patient lawsuits in the pipeline, Lischke said. Online court records show there are hearings scheduled for hundreds of UVA Medical Center cases over the next few weeks.

Mary Washington Healthcare of Fredericksburg, Va., criticized earlier this summer for a far-smaller number of lawsuits, said it would suspend suing patients and seek to eliminate garnishments. Methodist Le Bonheur Healthcare in Memphis, another on a growing list of hospitals called out for aggressive collections, said it would suspend all court activity for a month.

The changes at UVA are slated to take effect Jan. 1, but officials said they are “committed to working with anyone who currently has an outstanding balance or debt that they are struggling to pay.”

The health system will apply the new policies to patients treated in July 2017 or later, Lischke said. That means patients on current payment plans, or with judgments against them, could have bills eliminated or adjusted. But he said there will be no refunds of payments already made.

Taken together, the changes will cost UVA “millions to tens of millions,” he said, declining to give a more precise figure. UVA Medical Center, the flagship hospital of UVA Health, made an $87 million operating profit on revenue of $1.7 billion in the fiscal year ending in June and held stocks, bonds and other investments worth about $1 billion.

UVA began reviewing its billing and collections policies after being informed of KHN’s findings in August. It examined policies of neighbor hospitals such as Mary Washington, as well as of other major academic medical centers, Lischke said.

Previously just $4,000 in a retirement account could bar UVA patients from financial help, no matter how low their income. Now patients can have at least $50,000 in savings beyond the value of their home and car and still get assistance if they meet the income test, according to the new policy.

The nonprofit health-care system also said it would grant discounts of 40 percent to uninsured patients to better reflect the lower rates negotiated and paid by insurance companies. Until now, uninsured patients got only 20 percent off the list or “chargemaster” price, plus an additional 10 to 15 percent if they paid promptly, which few were able to do.