Association between chronological age and DNA methylation age (DNAmAge) estimates obtained by (A) Horvath’s clock, (B) Hannum’s clock, (C) PhenoAge, and (D) GrimAge estimators in younger (21- to 42-year-old) twins. R = Pearson’s correlation coefficient. Credit: The Journals of Gerontology: Series A (2021). DOI: 10.1093/gerona/glab337
In the Western world, life expectancy rapidly increased in the twentieth century, but women still have longer life expectancy than men. In Finland, women live on average five years longer than men. The gap between the sexes was greatest in the 1970s, when life expectancy at birth was almost 10 years higher for women than for men. However, in recent decades, this gap has gradually narrowed. The difference between the sexes can also be seen in biological aging, as revealed by a study recently published in The Journals of Gerontology: Series A.
05 nov 2022--The study investigated whether there are differences in biological aging between men and women and whether the potential differences can be explained by lifestyle-related factors. These differences were investigated in young andolder adults.
Several epigenetic clocks were used as measures of biological aging. Epigenetic clocks enable studying lifespan-related factors during an individual's lifetime. They provide an estimate for biological age in years using DNA methylation levels determined from a blood sample.
"We found that men are biologically older than women of the same chronological age, and the difference is considerably larger in older participants," says Anna Kankaanpää, doctoral researcher at the Gerontology Research Center and the Faculty of Sport and Health Sciences.
More frequent smoking among men explained the sex gap in aging in older but not in young adult twins. In addition, men's larger body size explained a small part of the sex gap in both age groups.
"We observed a sex difference in aging pace, which was not explained by lifestyle-related factors," says Kankaanpää.
"In our study, we also used a quite rare study design and compared aging pace among opposite-sex twin pairs. A similar difference was also observed among these pairs of twins. The male sibling was about one year biologically older than his female co-twin. These pairs have grown in the same environment and share half of their genes. The difference may be explained, for example, by sex differences in genetic factors and the beneficial effects of the female sex hormone estrogen on health," Kankaanpää says.
The results help to understand lifestyle behaviors and sex differences related to biological aging and life expectancy. The results suggest that the decline in smoking among men partly explains why the sex gap in life expectancy has narrowed in recent decades.
The research was carried out in collaboration with the University of Jyväskylä and the University of Helsinki. The subjects were younger (21 to 42 years) and older (50 to 76 years) adult twins from the Finnish Twin Cohort. Lifestyle-related factors including education, body mass index, smoking, alcohol use and physical activity, were measured using questionnaires.
More information: Anna Kankaanpää et al, Do Epigenetic Clocks Provide Explanations for Sex Differences in Life Span? A Cross-Sectional Twin Study, The Journals of Gerontology: Series A (2021). DOI: 10.1093/gerona/glab337
Provided by University of Jyväskylä
Healthy aging requires an understanding of personality types
Relationship between lifestyle factors and different cognitive categories. The figure is color coded based on similarity of covariate. In dark blue are the factors related to financial strain, in shades of orange are the factors that require greater levels of concentration, in shades of green are the factors that relate to physical exercise, in purple and light blue is age and level of education, and in shades of yellow is smoking and drinking. Credit: Frontiers in Aging Neuroscience (2022). DOI: 10.3389/fnagi.2022.98626
New research shows that older adults may be better supported as they age when their personalities are considered—for example, are they more like orchids or dandelions?
05 nov 2022--Researchers from Simon Fraser University's Circle Innovation examined the potential effects of lifestyle activities on the cognitive health of more than 3,500 adults aged 60+, and found that personality–using psychology's orchid-dandelion metaphor—can be a factor in how well supportive programs work.
Their results, published this month in the journal Frontiers in Aging Neuroscience, make a case for policy-makers to consider designing programs tailored to personality types rather than a one-size-fits-all approach.
"These discoveries offer new possibilities to support aging adults and provide substantial evidence for new social prescribing programs," says Circle Innovation CEO and scientific director Sylvain Moreno. "Understanding how personality differences affect an aging population can help decision-makers provide older adults with solutions that fit their individual needs."
People who may be considered "orchid adults" thrive best under ideal circumstances, since they are more sensitive and biologically reactive, while "dandelion adults" are thought to be resilient and can easily adapt to any environment.
That means orchid individuals could require more nurturing solutions, researchers say. "These older adults are more fragile, like the delicate flower they represent, and hence prone to overreact to ongoing health and housing problems, disturbing news about the economy or global pandemics," says SFU Ph.D. student and study researcher Emma Rodrigues. "On the other hand, dandelion retirees are relatively less environment-sensitive and also more resilient to deterioration in poor environmental conditions."
"The lesson here is that we should stop pigeonholing aging adults into one group of our population. These results demonstrate how aging trajectories can differ depending on whether a person is influenced by the environment."
According to researchers, understanding how modifiable lifestyle factors may maintain or promote cognitive health can lead to a healthier aging population.
People with dementia are likely to have taken more than three medications for other health conditions in the five years directly before their diagnosis, according to new research.
05 nov 2022--The study is the first to provide an in-depth exploration of the links between evolving polypharmacy—which involves a patient being prescribed more than one drug at any given time—and a dementia diagnosis.
Published in the Aging and Disease journal, it is based on an analysis of the records of more than 33,000 dementia patients in Wales between 1990 to 2015.
Experts in e-health used machine learning techniques to identify potentially damaging patterns in a patient's medicine usage, and how these patterns evolve in the run-up to diagnosis.
They found that in the 20 years leading up to them being diagnosed, the proportion of patients taking three or more medications rose from 5.5% (for the period 16 to 20 years prior to diagnosis) to 82.16% among those less than five years from a diagnosis.
Researchers also found that as the development towards dementia progressed, the patterns of polypharmacy shifted from being clearly distinct to being more closely associated with particular medical conditions.
And of those closest to their diagnosis, almost two-thirds (66.55%) were found to be taking multiple medicines for a combination of respiratory or urinary infections, arthropathies and rheumatism, and cardio-vascular disease. A further 22% of patients were found to be taking medicines for infections, arthropathies and rheumatism, cardio-metabolic disease and depression.
The study was supported by the Health Data Research UK and conducted by an international team of researchers from the University of Plymouth, Aptuit (an Evotec company), Swansea University Medical School, and the University of Oxford.
Shangming Zhou, Professor of e-Health at the University of Plymouth, led the study. He said: "Given the rise in dementia cases internationally, the need to understand how patterns of polypharmacy evolve before and after a dementia diagnosis are important for devising a safe treatment program for each patient. Our aim in this study was to help doctors find ways to prescribe multiple items of dementia medication safely and without reducing their effectiveness. The use of machine learning has been vital in helping us understand how these patterns develop, and our hope is we can now use this knowledge to treat patients."
It has previously been established that when multiple types of preventative medication are being prescribed, the benefits of the drugs may be reduced and the chances of harm from drug interaction and side effects increased.
Those requiring hospital treatment who are taking multiple medications are also known to have a higher likelihood of re-admission within three months after being discharged.
With the number of people with dementia in the UK projected to rise to 1.6 million by 2040, researchers hope this new study will inform safe prescribing practices and encourage doctors to prescribe medicine combinations developed with a view to minimizing cognitive impairments.
More information: Identifying Dynamic Patterns of Polypharmacy for Patients with Dementia from Primary Care Electronic Health Records: A Machine Learning Driven Longitudinal Study, Aging and Disease (2022). DOI: 10.14336/AD.2022.0829
Provided by University of Plymouth
The pros and cons of hormone therapy for aging transgender women
An estimated 71% of transgender women use or intend to use gender-affirming hormone therapy (GAHT). Although sample sizes are comparatively small, there are studies that demonstrate psychological advantages of GAHT, whereas others suggest added health risks. A presentation at The North American Menopause Society (NAMS) Annual Meeting in Atlanta, October 12-15, will address the differentiated pros and cons of hormones for transgender women.
05 nov 2022--Understanding the risks and benefits of GAHT for women in midlife and beyond is important because it's estimated that nearly one-quarter (23%) oftransgenderwomen beginhormone therapyafter the age of 40, with 12% beginning GAHT after age 50. Specific areas of focus include mental, cardiovascular, and breast health.
Multiple studies have confirmed improved mental health benefits and a feeling of overall well-being in transgender women using GAHT. Data collected from the National Transgender Discrimination Study examined qualify-of-life outcomes in transgender women aged older than 60 years and found that those who recently initiated GAHT reported statistically higher quality-of-life scores than their age-matched peers who had not initiated GAHT.
Currently, there is no evidence to support the termination of GAHT in transgender women on the basis of age alone, although in most aging populations, there is concern about increased cardiovascular risk. In transgender women using GAHT who have cardiovascular risk factors, literature supports transdermal estradiol as the preferred route.
Multivariable analyses demonstrate that transgender women experience myocardial infarction at approximately two times higher rates than cisgender women, and similar trends have been seen with ischemic stroke. Studies evaluating the risk of breast cancer in transgender women using GAHT have produced mixed results, largely because of limited sample sizes.
Dr. Sarah Pickle from the University of Cincinnati College of Medicine will present this information during the NAMS Annual Meeting and will discuss current GAHT recommendations and additional treatment considerations for transgender patients.
"For most transgender women and transfeminine persons, the well-documented benefits of gender-affirming hormone therapy largely outweigh potential risks. It is important for health care professionals to understand how to counsel patients and mitigate possible risks of hormone therapy while recognizing that transgender patients are more likely to have deleterious health effects from discrimination, marginalization, and lack of access to health care than they are from side effects of hormone therapy," says Dr. Pickle.
"This study is extremely valuable for health care professionals who are looking for guidance on how to best care for their transgender patients. Among other things, it confirms that more research specific to transgender populations is needed so that health care professionals can make treatment recommendations with greater confidence," says Dr. Faubion, NAMS medical director.
Cambridge scientists have shown that it is possible to spot signs of brain impairment in patients as early as nine years before they receive a diagnosis for one of a number of dementia-related diseases.
05 nov 2022--In research published today inAlzheimers & Dementia, the team analyzed data from the UK Biobank and found impairment in several areas, such as problem solving and number recall, across a range of conditions.
The findings raise the possibility that in the future, at-risk patients could be screened to help select those who would benefit from interventions to reduce their risk of developing one of the conditions, or to help identify patients suitable for recruitment to clinical trials for new treatments.
There are currently very few effective treatments for dementia or other neurodegenerative diseases such as Parkinson's disease. In part, this is because these conditions are often only diagnosed once symptoms appear, whereas the underlying neurodegeneration may have begun years—even decades—earlier. This means that by the time patients take part in clinical trials, it may already be too late in the disease process to alter its course.
Until now, it has been unclear whether it might be possible to detect changes in brain function before the onset of symptoms. To help answer this question, researchers at the University of Cambridge and Cambridge University Hospitals NHS Foundation Trust turned to UK Biobank, a biomedical database and research resource containing anonymized genetic, lifestyle and health information from half a million UK participants aged 40-69.
As well as collecting information on participants' health and disease diagnoses, UK Biobank collected data from a battery of tests including problem solving, memory, reaction times and grip strength, as well as data on weight loss and gain and on the number of falls. This allowed them to look back to see whether any signs were present at baseline—that is, when measurements were first collected from participants (between five and nine years prior to diagnosis).
People who went on to develop Alzheimer's disease scored more poorly compared to healthy individuals when it came to problem solving tasks, reaction times, remembering lists of numbers, prospective memory (our ability to remember to do something later on) and pair matching. This was also the case for people who developed a rarer form of dementia known as frontotemporal dementia.
People who went on to develop Alzheimer's were more likely than healthy adults to have had a fall in the previous 12 months. Those patients who went on to develop a rare neurological condition known as progressive supranuclear palsy (PSP), which affects balance, were more than twice as likely as healthy individuals to have had a fall.
For every condition studied—including Parkinson's disease and dementia with Lewy bodies—patients reported poorer overall health at baseline.
First author Nol Swaddiwudhipong, a junior doctor at the University of Cambridge, said, "When we looked back at patients' histories, it became clear that they were showing some cognitive impairment several years before their symptoms became obvious enough to prompt a diagnosis. The impairments were often subtle, but across a number of aspects of cognition.
"This is a step towards us being able to screen people who are at greatest risk—for example, people over 50 or those who have high blood pressure or do not do enough exercise—and intervene at an earlier stage to help them reduce their risk."
Senior author Dr. Tim Rittman from the Department of Clinical Neurosciences at the University of Cambridge added, "People should not be unduly worried if—for example—they are not good at recalling numbers. Even some healthy individuals will naturally score better or worse than their peers. But we would encourage anyone who has any concerns or notices that their memory or recall is getting worse to speak to their GP."
Dr. Rittman said the findings could also help identify people who can participate in clinical trials for potential new treatments. "The problem with clinical trials is that by necessity they often recruit patients with a diagnosis, but we know that by this point they are already some way down the road and their condition cannot be stopped. If we can find these individuals early enough, we'll have a better chance of seeing if the drugs are effective."
More information: Pre-Diagnostic Cognitive and Functional Impairment in Multiple Sporadic Neurodegenerative Diseases, Alzheimers & Dementia (2022). DOI: 10.1002/alz.12802
Provided byUniversity of Cambridge
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Talk therapy could improve mental health of people with dementia
People living with dementia may benefit from talking therapies available on the NHS, if they suffer from anxiety or depression, finds a new study led by UCL researchers.
05 nov 2022--Mental health problems such as depression andanxietyare very common in people with dementia, and previous studies estimate that 38% of people with mild dementia are affected by the conditions.
However, the new study published in eClinicalMedicine is the first to assess whether talking therapies that are routinely delivered within health care settings might be helpful to relieve symptoms. Researchers examined data from 2,515,402 people who had clinically significant anxiety or depression and completed a course of treatment via the national "Improving Access to Psychological Therapies" (IAPT) service in England between 2012 and 2019.
IAPT is a free NHS service and offers evidence-based therapies for treating anxiety and depression, including CBT (cognitive behavioral therapy), counseling, and guided self-help, with sessions delivered either face-to-face individually, in groups, or online.
To be counted in the study, participants had to have either:
Clinical levels of depressive symptoms as measured using a standard questionnaire that considered factors such as a lack of interest in doing things, issues with sleep, and feelings of low mood
Clinical levels of anxiety based on a standard measure that asked patients questions about how much they worried or had trouble relaxing.
To examine outcomes for people living with dementia, the researchers looked at all those who had a dementia diagnosis before starting IAPT treatment, which was 1,549 people.
They also used a control group of 1,329 people to assess whether therapy outcomes for those living with dementia differed from those without dementia, by selecting a group of people from the full dataset who were similar to the people with dementia in terms of age, gender, depression and anxiety severity when starting treatment.
The researchers found that among people with dementia, the treatment proved to be clinically beneficial and 63% of them saw a reduction in symptoms of depression and anxiety following IAPT. Meanwhile, approximately 40% recovered completely.
Comparatively, in the control group, 70% of participants saw an improvement in symptoms and 47% recovered.
Lead author, Ph.D. candidate Georgia Bell (UCL Psychology & Language Sciences), said, "Anxiety and depression are very common in people with dementia. They are extremely debilitating and associated with worse outcomes for both the person with dementia and their caregivers. This is the largest ever study to investigate outcomes of psychological therapies in people living with dementia.
"Our findings suggest that while people with dementia are less likely to improve or recover than those without dementia, psychological therapies offered in primary care mental health services can be beneficial for them. Consequently, our findings support the use of IAPT to treat anxiety and depression in people with dementia. We hope this study will have implications for encouraging referrals and adaptations to increase access and enhance outcomes for people living with dementia."
Previously, there was limited evidence that talking therapies were adequately effective for people with dementia, but a review of evidence led by UCL researchers confirmed their efficacy earlier this year. This latest study adds to that by confirming that NHS treatment offerings can confer such a benefit.
Dr. Richard Oakley, Associate Director of Research at Alzheimer's Society, said, "Many people living with dementia also have depression and anxiety, making it even harder for them and their caregivers to cope with symptoms and for some people even leading to a faster decline in memory and thinking problems. Consistent and accessible mental health support after a diagnosis is vital."
He added that the "...research is the first study looking at the effectiveness of therapy for people living with dementia in a real-world setting. It showed that people living with dementia showed a significant improvement in symptoms of anxiety and depression when treated with therapy, even though their response wasn't as strong as that shown in the general population."
"This research underpins the importance of timely access to mental health support, as revealed in our recent Left To Cope Alone report. We found 61% of people affected by dementia are currently in need of mental health support, and yet, in 2018, of 1 million annual referrals to Improving Access to Psychological Therapies (IAPT) services, just 0.2% were for people with dementia. Though this study didn't compare the types of therapy, types of dementia, or if there were adaptations made for people living with the disease, it still highlights the urgent need to improve real-world therapy for those living with dementia—with adaptations to improve its effectiveness and accessibility," he concluded.
Study limitations
Researchers were unable to infer causal relationships between receiving therapy and having an improvement in symptoms, as the study was observational in nature and a randomized control design would be needed to establish this causality. Furthermore, while there is evidence to suggest that questionnaires for measuring anxiety and depression can be validly completed by people with dementia, the anxiety scale used has not been validated for use in a sample of people living with dementia, meaning it may not accurately measure anxiety.
Researchers could also not distinguish the type of therapy given to the patients during their IAPT treatment so it is unclear whether one type of therapy may be better than any other in treating anxiety and depression in people living with dementia.
Additionally, the identification of people living with dementia was based on linked records, so some who attended IAPT may have been missed. And the severity of dementia could also not be accounted for at the time of psychological treatment.
More information: Effectiveness of primary care psychological therapy services for the treatment of depression and anxiety in people living with dementia: evidence from national healthcare records in England, eClinicalMedicine (2022). DOI: 10.1016/j.eclinm.2022.101692
Provided by University College London
Why centenarians consistently present a younger epigenetic age than their chronological age
by Impact Journals LLC
Description of the four DNA methylation-based epigenetic clocks used in our study. Credit: 2022 Daunay et al.
Aging is a progressive time-dependent biological process affecting individuals differentially. Some may present exceptional longevity. One of the hallmarks of aging is epigenetic alterations, which comprise the epigenetic drift and clock at DNA methylation level.
05 nov 2022--In a new study published in Aging, researchers Antoine Daunay, Lise M. Hardy, Yosra Bouyacoub, Mourad Sahbatou, Mathilde Touvier, Hélène Blanché, Jean-François Deleuze, and Alexandre How-Kit from Foundation Jean Dausset—CEPH, Laboratory of Excellence GenMed, Sorbonne Paris Nord University, University of Paris (CRESS), and Institut François Jacob investigated the DNA methylation-based age (DNAmage) of long-lived French individuals in the CEPH Aging Cohort using four epigenetic clocks.
"In the present study, we estimated the DNA methylation-based age (DNAmage) using four epigenetic clocks based on a small number of CpGs in French centenarians and semi-supercentenarians (CSSC, n=214) as well as nonagenarians' and centenarians' offspring (NCO, n=143) compared to individuals from the French general population (CG, n=149)," report the researchers.
DNA methylation analysis of the nine CpGs included in the epigenetic clocks showed high correlation with chronological age (-0.66>R>0.54) and also the presence of an epigenetic drift for four CpGs that was only visible in CSSC. DNAmage analysis showed that CSSC and to a lesser extend NCO present a younger DNAmage than their chronological age (15-28.5 years for CSSC, 4.4-11.5 years for NCO and 4.2-8.2 years for CG), which were strongly significant in CSSC compared to CG (p-values<2.2e-16).
These differences suggest that epigenetic aging and potentially biological aging are slowed in exceptionally long-lived individuals and that epigenetic clocks based on a small number of CpGs are sufficient to reveal alterations of the global epigenetic clock.
"This suggests a decelerated epigenetic and biological aging in these two groups of individuals, confirming the results of three other studies performed on Italian, Australian and Israeli long-lived individuals. In addition, our study also demonstrated the possibility of using epigenetic clocks based on a small number of CpG sites to reveal DNAmage and chronological age differences between individuals with different life expectancy."
More information: Antoine Daunay et al, Centenarians consistently present a younger epigenetic age than their chronological age with four epigenetic clocks based on a small number of CpG sites, Aging (2022). DOI: 10.18632/aging.204316
Provided by Impact Journals LLC
Nutrition education should be 'on the menu' of all healthcare professionals' education—new research
All healthcare professionals should study a curriculum of nutrition education during their studies in order to help better support public health—new paper suggests.
05 nov 2022--Nutritional researchers from Aston University, with colleagues from other universities and leading nutritional groups, worked with the Association of Nutrition (AfN) to help develop acurriculumthat can be rolled out amongst all undergraduate medical school students with potential for modules to be taught to other healthcare professional courses.
The paper jointly published in the British Journal for Nutrition and BMJ Nutrition, Prevention and Health examined the development of a new curriculum aimed at undergraduate medical students and made recommendations on its roll out nationally, with a view to it subsequently being implemented into other healthcare courses.
The AfN Undergraduate Curriculum in Nutrition for medical doctors has been designed to be presented to medical students as an integral part of their general undergraduate training, making it clear how nutrition interrelates with the study of other systems and contributes to an inclusive understanding of health and disease.
Dr. Duane Mellor, clinical dietitian and senior lecturer at Aston Medical School at Aston University and co-author on the paper, said:
"At present, lifestyle related health problems from living with obesity, through to high blood pressure, type 2 diabetes, heart disease and several cancers can all be linked to diet across our communities. Whereas in hospitals around a third of patients coming in can be undernourished.
"Nutrition and food play a key role to both keeping us healthy and helping to manage disease, which is why it is imperative we educate our future doctors and other health professionals about the role of nutrition in patient care."
The paper sets out not only the need for nutrition education and the gaps, but how it can be included as part of what is already a very busy and content heavy curriculum. It builds on areas of the curriculum where nutrition could even be used to help teach concepts such as epidemiology.
It highlights how historically medical education along with the education of many health professionals not specialising in nutrition often have only a few hours of teaching on the subject.
Dr. Glenys Jones, deputy chief executive at the Association for Nutrition, who led the curriculum development project and is co-author on the recent paper, said:
"Nutrition is a key and modifiable determinant of health and wellbeing, therefore it is essential our future medical and healthcare professionals are equipped to be able to identify when nutrition could be involved in a patient's condition in order for this to form part of their care.
"The curriculum is not designed to turn our doctors into nutritionists or dietitians, but to give them the knowledge and skills to be able to think about whether nutrition could be playing a role and having the confidence and knowledge of who, when and how to refer on to suitable nutrition professionals when this is needed."
Aston University is a pioneer in the key area of nutrition education of the future healthcare workforce. As one of few UK universities with a dietitian or nutritionist as part of the teaching team within its medical school, these skills are now being developed to benefit the training of other health professionals.
Dr. Mellor added: "As one of a few dietitians and nutritionists embedded into the teaching team at Aston Medical School, we have been able to integrate nutrition across our curriculum.
"It is great to be able to highlight how nutrition links to the basic science areas such as biochemistry through to how you can encourage a patient to think about changing their diet in clinical skills'.
Aston University has also started to explore with the Association for Nutrition the potential need for nutrition education in other professions. From this an outline of a core curriculum for nutrition for a range of health professionals is in development.
Dr. Mellor also plans to work with colleagues to further develop nutrition teaching at Aston University, thus helping students across subjects such as optometry and pharmacy to gain a better understanding of nutrition and how it impacts on their areas of expertise.
For more information about Aston Medical School please visit our website.
More information: Glenys Jones et al, Putting nutrition education on the table: development of a curriculum to meet future doctors' needs, British Journal of Nutrition (2022). DOI: 10.1017/S0007114522001635
Glenys Jones et al, Putting nutrition education on the table: development of a curriculum to meet future doctors' needs, BMJ Nutrition, Prevention & Health (2022). DOI: 10.1136/bmjnph-2022-000510
Provided by Aston University
Researchers reveal why shingles can lead to stroke
Scientists investigating why people who have had shingles are at a higher risk of stroke, now believe the answer lies within lipid vesicles called exosomes that shuttle proteins and genetic information between cells, according to new research from the University of Colorado Anschutz Medical Campus.
05 nov 2022--The study, published today inThe Journal of Infectious Diseases, details the mechanisms behind the link betweenshinglesand strokes.
"Most people know about the painful rash associated with shingles, but they may not know that the risk of stroke is elevated for a year after infection," said the study's lead author Andrew Bubak, Ph.D., assistant research professor in the Department of Neurology at the University of Colorado School of Medicine. "Importantly, the rash is often completely healed and individuals feel normal but nonetheless are walking around with this significant elevation in stroke risk."
Herpes zoster (HZ) or shingles is caused by the varicella zoster virus which causes chicken pox. The virus lingers in the ganglionic neurons and can reactivate causing excruciating pain. But researchers have found that shingles can also increase the risk of stroke especially for those under age 40 where the shingles vaccine is not typically recommended.
The risk is greatest in people with the rashes on their faces, perhaps due to the proximity to the brain.
To better understand how this works, Bubak and his team began looking more closely at exosomes.
"Exosomes carry pathogenic cargo that can cause thrombosis and inflammation distant from site of actual infection," Bubak said. "That could ultimately lead to a stroke in patients."
Researchers collected plasma samples from 13 patients with shingles and 10 without. The samples were taken at time of infection and at 3-month follow-ups for a subset of patients and exosomes were extracted from the plasma.
The researchers found prothrombotic exosomes which could cause blood clots in those with the infection. They also discovered proinflammatory exosomes that also pose risks for stroke at the 3-month follow-up.
Bubak said the findings suggest that in a subset of people with shingles, the virus may not return to latency or the circulating exosomes that induce a prolonged prothrombotic state may persist even after therapy is done and the rash is gone. He said using antiviral agents longer with the addition of antiplatelet and anti-inflammatory agents could help.
"As well as initiatives to increase HZ vaccine uptake to decrease stroke risk, particularly in individuals with known preexisting stroke risk factors," said Bubak. "If these findings are confirmed with a larger longitudinal study, then this could change clinical practice."
Most physicians are unaware of the connection between shingles—which has an effective vaccine—and stroke.
"But it's really important and so easily mitigated," Bubak said. "Send them home with antiplatelet agents."
More information: Zoster-associated prothrombotic plasma exosomes and increased stroke risk, The Journal of Infectious Diseases (2022). DOI: 10.1093/infdis/jiac405
Provided by CU Anschutz Medical Campus
Fermented foods and fiber may lower stress levels, says new study
Foods such as kimchi are great to include in a psychobiotic diet. Credit: Nungning20/ Shutterstock
When it comes to dealing with stress, we're often told the best things we can do are exercise, make time for our favorite activities or try meditation or mindfulness.
05 nov 2022--But the kinds of foods we eat may also be an effective way of dealing withstress, according to research published by me and other members ofAPC Microbiome Ireland. Our latest study, now published inMolecular Psychiatry, has shown that eating more fermented foods and fiber daily for just four weeks had a significant effect on lowering perceived stress levels.
The mechanisms underpinning the effect of diet on mental health are still not fully understood. But one explanation for this link could be via the relationship between our brain and our microbiome (the trillions of bacteria that live in our gut). Known as the gut-brain axis, this allows the brain and gut to be in constant communication with each other, allowing essential body functions such as digestion and appetite to happen. It also means that the emotional and cognitive centers in our brain are closely connected to our gut.
While previous research has shown stress and behavior are also linked to our microbiome, it has been unclear until now whether changing diet (and therefore our microbiome) could have a distinct effect on stress levels.
This is what our study set out to do. To test this, we recruited 45 healthy people with relatively low-fiber diets, aged 18–59 years. More than half were women. The participants were split into two groups and randomly assigned a diet to follow for the four-week duration of the study.
Around half were assigned a diet designed by nutritionist Dr. Kirsten Berding, which would increase the amount of prebiotic and fermented foods they ate. This is known as a "psychobiotic" diet, as it included foods that have been linked to better mental health.
This group was given a one-on-one education session with a dietitian at both the start and halfway through the study. They were told they should aim to include 6–8 servings daily of fruits and vegetables high in prebiotic fibers (such as onions, leeks, cabbage, apples, bananas and oats), 5–8 servings of grains per day, and 3–4 servings of legumes per week. They were also told to include 2–3 servings of fermented foods daily (such as sauerkraut, kefir and kombucha). Participants on the control diet only received general dietary advice, based on the healthy eating food pyramid.
Participants were told to eat foods high in prebiotic fibres, such as apples. Credit: gowithstock/ Shutterstock
Less stress
Intriguingly, those who followed the psychobiotic diet reported they felt less stressed compared with those who followed the control diet. There was also a direct correlation between how strictly participants followed the diet and their perceived stress levels, with those who ate more psychobiotic foods during the four-week period reporting the greatest reduction in perceived stress levels.
Interestingly, the quality of sleep improved in both groups—though those on the psychobiotic diet reported greater improvements in sleep. Other studies have also shown that gut microbes are implicated in sleep processes, which may explain this link.
The psychobiotic diet only caused subtle changes in the composition and function of microbes in the gut. However, we observed significant changes in the level of certain key chemicals produced by these gut microbes. Some of these chemicals have been linked to mental health, which could potentially explain why participants on the diet reported feeling less stressed.
Our results suggest specific diets can be used to reduce perceived stress levels. This kind of diet may also help to protect mental health in the long run as it targets the microbes in the gut.
While these results are encouraging, our study is not without its limitations. First, the sample size is small due to the pandemic restricting recruitment. Second, the short duration of the study could have limited the changes we observed—and it's unclear how long they would last. As such, long-term studies will be needed.
Third, while participants recorded their daily diet, this form of measurement can be susceptible to error and bias, especially when estimating food intake. And while we did our best to ensure participants didn't know what group they'd been assigned to, they may have been able to guess based on the nutrition advice they were given. This may have affected the responses they gave at the end of the study. Finally, our study only looked at people who were already healthy. This means we don't understand what effect this diet could have on someone who may not be as healthy.
Still, our study offers exciting evidence that an effective way to reduce stress may be through diet. It will be interesting to know if these results can also be replicated in people suffering from stress-related disorders, such as anxiety and depression. It also adds further evidence to this field of research, showing evidence of an association between diet, our microbiome and our mental health.
So the next time you're feeling particularly stressed, perhaps you'll want to think more carefully about what you plan on eating for lunch or dinner. Including more fiber and fermented foods for a few weeks may just help you feel a little less stressed out.
More information: Kirsten Berding et al, Feed your microbes to deal with stress: a psychobiotic diet impacts microbial stability and perceived stress in a healthy adult population, Molecular Psychiatry (2022). DOI: 10.1038/s41380-022-01817-y
