Health News Today Archives - Page 4 of 76

February 18, 2023

How eye tests could help detect diabetes, MS, and dementia

The eyes have long been called the “windows to the soul,” and increasingly, evidence is suggesting that they might be also windows to both the brain and body. Several health conditions can be detected by examination of the eyes, among them diabetes, multiple sclerosis, and even Alzheimer’s disease. Medical News Today spoke to experts in the field to discover how the eye can reveal the body’s secrets.

Asian woman with blonde highlights sporting sunglasses, a bright blue sky behind her — How much could our eyes reveal about our health? Image credit: A.J. Schokora/Stocksy.

Most of us have our eyes tested regularly, but few may be aware that an eye test is not just for checking vision and correcting sight problems.

Because it has a “window” at the front, the eye is the only part of the body where doctors can, non-invasively, examine the inside of an organ. At the back of the eye is the retina, where blood vessels and the optic nerve can be clearly seen.

Thanks to this, optometrists and ophthalmologists could diagnose not only disorders of the eye, but also systemic diseases — those that affect other organs in the body or the whole body.

If a routine eye test raises concerns, the optometrist can refer a person to a medical ophthalmologist who will investigate by carrying out further eye examinations. If their investigations reveal a systemic disease, they can then refer the person to the relevant specialist.

Dr. Hagar Ibrahim, senior specialist trainee (ST6) in medical ophthalmology at St. Paul’s Eye Unit, Liverpool University Hospitals NHS Trust, in the United Kingdom, told Medical News Today that “a routine eye examination in which the pupils are dilated using eye drops can provide a full and clear view of the optic nerve, which connects to the brain, the retina, […] and all the blood vessels supplying the retina.”

“Therefore, pathology in the eye can be clearly seen during [an] eye examination, both in localized eye conditions and in systemic disease, truly making the eye a window into the rest of the body,” she added.

“People are often surprised when an eye doctor diagnoses them with a systemic illness but they shouldn’t be. Many people with systemic illnesses are first diagnosed by their eye doctor, which is just one reason why all adults should have regular eye examinations at least every 2 years.”

– Dr. Philip Storey, a board-certified ophthalmologist and fellowship-trained retina specialist at Austin Retina Health

As well as identifying problems with vision, such as nearsightedness, farsightedness, and astigmatism, a routine eye test will detect other eye disorders, such as glaucoma, and age-related macular degeneration.

By examining the blood vessels in the retina and the optic nerve, the optometrist can also discover a lot about a person’s general health.

This non-invasive process can detect many other health conditions that may seem unconnected to the eyes, among them hypertension, diabetes, thyroid disorders, and neurodegenerative diseases such as Alzheimer’s disease, and multiple sclerosis (MS).

“Ocular inflammation can affect many parts of the eye, and can often be the first sign of a systemic disease. The key to diagnosing the cause is in focused history taking followed by [a] guided investigation of the relevant body systems, including blood tests,” explained Dr. Ibrahim.

Changes in the blood vessels in the retina can be early indicators of both diabetes and hypertension.

Dr. Storey told MNT that “[d]iabetes is the most commonly diagnosed disease given the frequency of the illness as well as the classic findings on retina exam, which can include bleeding, leakage of fluid, and areas of poor blood flow.”

Although a firm diagnosis of diabetes can only be made with a blood glucose test, changes in the blood vessels of the retina can give a strong indication that a person may have diabetes. They can then be referred for further testing.

According to the American Academy of Ophthalmology, the signs of diabetic retinopathy can sometimes be detected by eye examination even before a person suspects they may have diabetes.

Once diagnosed, provided the diabetes is well controlled, the person can then minimize the risk of further eye damage, as Dr. Ibrahim explained: “In addition to localized eye therapies such as laser treatment or intravitreal eye injections, improving blood sugar levels by sticking to the proper pharmacological treatment, restricting sugar intake and making necessary lifestyle changes, can result in regression of diabetic retinopathy.”

However, for those with diabetes, the most important eye tests take place after diagnosis, to monitor changes in the eyes and take steps to prevent further damage, as Dr. Howard R. Krauss, surgical neuro-ophthalmologist and director of Pacific Neuroscience Institute’s Eye, Ear & Skull Base Center at Providence Saint John’s Health Center in Santa Monica, CA, noted:

“In most cases, diabetes is diagnosed before changes become evident in the retina, but the retinal examination is a vital part of routine diabetic evaluations, so as to aid in the management of the disease, and to intervene when indicated, with any of a variety of treatments to reduce the risk of blindness from diabetic retinopathy.”

Studies have shown that signs of hypertension, or high blood pressure, are found in the eyes of around 10{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of the adult, diabetes-free population.

On examination, an eye doctor might see traces of narrowing of arterioles in the retina, arteriovenous nicking, retinal hemorrhages, and, as in diabetic retinopathy, microaneurysms. All these are indicators of hypertensive retinopathy.

“Hypertension also presents with classic signs within the eye. The earliest signs of hypertension are narrowing of the vessels, often referred to as ‘silver wiring’ because of their appearance.”

– Dr. Philip Storey

The good news is that if the hypertension is controlled, the damage can be halted, as Dr. Ibrahim explained.

“Early detection means that appropriate precautions are taken and necessary lifestyle changes are made, such as eating a healthy diet and exercising regularly, in addition to starting the proper medical treatment thereby reducing the risk of heart disease,” she told us.

During a routine eye test, the eye doctor will also examine the optic nerve to look for any abnormalities or changes.

Dr. Ibrahim explained why: “The optic nerve connects the eye to the brain and is therefore an extension of the central nervous system. It is the only part of the brain that can be clearly visualized by examining the back of the eye.”

“Optic nerve swelling or inflammation can be detrimental to vision and color vision, and can diagnose MS, [which is] an autoimmune demyelinating disease of the brain and spinal cord, [as well as] neuroinflammatory disorders such as neuromyelitis optica or brain tumor,” she added.

Vision problems in MS, which tend to flare up then resolve within a few weeks, are usually a result of optic neuritis, an acute inflammatory demyelinating disorder of the optic nerve.

Optic neuritis is the first symptom in up to 20{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of people who are subsequently diagnosed with MS, although it can indicate other disorders, or even be the result of a viral infection or vitamin deficiency.

If an optometrist suspects optic neuritis in a routine eye examination, they will refer a person for further testing to confirm the diagnosis and identify the cause.

“Retinal screening of Alzheimer’s disease is an exciting prospect at the forefront of current medical research. The retina […] is made up of multiple layers of specialized neural cells and there is strong evidence that the same changes in the brain can occur in the retina, potentially allowing screening patients for early signs of Alzheimer’s disease.”

– Dr. Hagar Ibrahim

Current methods of diagnosing Alzheimer’s are often lengthy, invasive and expensive, so being able to diagnose the condition from the retina would be a huge advance.

Although this is not yet a disease that can be diagnosed from a routine eye examination, recent research has suggested that doctors could, in the future, diagnose Alzheimer’s through retinal scans.

The new technique, so far tested only in mice, combines the results of two scans to assess the condition of the retina. Those with Alzheimer’s disease have a much rougher retinal surface than those without.

Other research has identified beta-amyloid plaques on the retina as an indication of Alzheimer’s disease, and also in the lens of the eye, both of which can be detected by non-invasive methods.

Dr. Ibrahim explained some of the new developments:

“There are several areas under research. Firstly, looking for the presence of beta-amyloid fragments in the retina, which may be detected by specialist retinal imaging modalities, before symptom onset. […] Secondly, looking at biomarkers detectable on retinal OCT-A images in the form of differences of retinal microvasculature in patients with Alzheimer’s disease and mild cognitive impairment compared to healthy controls.”

Perhaps these findings may lead to easier, earlier diagnosis of Alzheimer’s disease enabling treatment to begin before symptoms become severe.

As well as allowing an optometrist to detect diseases elsewhere in the body, changes in the eyes can tell a physician how a systemic disease is progressing.

So regular eye tests are important, particularly as we get older, as Dr. Benjamin Bert, an ophthalmologist at MemorialCare Orange Coast Medical Center in Fountain Valley, CA, told MNT:

“While eye exams are mostly to check the health of the eyes, they do help to screen for systemic diseases. For adults, if you don’t have any need for glasses or contact lenses, it is still recommended to get an annual exam at least once in your 20s, twice in your 30s, and more regularly after 40. After 40 is when eye-specific ailments can start to become more common — including presbyopia, glaucoma, cataract, and changes to the retina from diabetes or high blood pressure.”

Dr. Krauss reiterated the same advice.

But it is also important to remember that eye examinations are only one tool in monitoring health conditions.

“An examination of the retina often reflects the severity of a disease throughout the body. […] However, patients should not rely on an eye examination to assess how well their systemic disease is controlled,” Dr. Storey cautioned.

“The damage that we see in the eye can take years to occur. Even when a patient’s eye examination is normal, their systemic disease — hypertension or diabetes for example — could be poorly controlled,” he explained.

So, make sure a regular eye test is part of your overall health care, particularly as you get older — it may just detect a condition that you were unaware of, helping you to take control of your health.

February 17, 2023

Exercising in the morning may give better results

An athlete jumping over a hurdle as the sun shines from behind — The time of day people today pick out to exercise may affect their fat loss success. Electronic Vision/Getty Illustrations or photos

Work out performs an important role in a person’s in general wellbeing.
Considerably debate nonetheless exists about what the greatest time of working day is for a individual to exercising.
Researchers have located by using a mouse design that exercising in the early morning assists increase fats burn off compared to working out in the evening.

Training performs an critical role in total wellbeing.

Not only can it support with fat reduction, but former reports also demonstrate actual physical exercise can assistance decrease a person’s danger for health conditions like diabetic issues, cardiovascular sickness, stroke, osteoporosis, and substantial blood force.

Even though men and women know they ought to function out, much debate exists more than what is the finest time of working day to work out for the most added benefits.

For example, 1 study in Oct 2021 observed working out in the morning may be additional helpful for people today with weight problems, while another review in September 2021 discovered evening exercise sessions more powerful for chubby adult men.

Now, scientists from the Karolinska Institutet in Sweden uncovered that exercising in the morning helps improve fats burn in comparison to doing the job out in the night in versions of mice.

The study was recently printed in the journal PNAS.

In accordance to Dr. Juleen R. Zierath, a professor in the Office of Molecular Medicine and Surgical procedures and the Department of Physiology and Pharmacology at the Karolinska Institutet in Sweden, and the guide author of this examine, a lot of of our interior rhythms are ruled by an intrinsic molecular clock.

“This clock coordinates a great deal of our physiology, which include system temperature, blood tension response, hormone launch, and even toughness and alertness,” she explained to Medical News Today.

“Therefore, if we can align what we do — for example, our every day work out regimen — with this clock, we may well be capable to fine-tune the health gains,” she included.

For this analyze, Dr. Zierath and her staff examined the adipose tissue of mice soon after they had a session of large intensity training at one particular of two moments throughout the day — a late morning session or a late night session.

Upon assessment, scientists observed that early workout elevated the expression of genes associated in the breakdown of adipose tissue and some other capabilities affiliated with a better metabolic rate.

“The early active section exercising amplified the expression of genes associated to fat burning, warmth creation, and blood vessel production,” Dr. Zierath said.

“These alterations occurred even when ranges of exercising-induced hormones have been identical involving phases, meaning that the sensitivity of overall body body fat to training-induced hormones could differ based on the time of day when the actual physical exercise is executed,” she discussed.

Researchers only uncovered these indicators of greater metabolism in the mice that exercised in the morning.

“We have been shocked that early energetic phase exercising — corresponding to late early morning exercising in human beings — had these a profound impression on boosting metabolic process in body fat cells. At first, we assumed this time-of-day-dependent result was for the reason that of dietary standing.”
— Dr. Juleen R. Zierath

“However, we later on verified that the gene signature of a greater metabolic level was not impacted by food stuff ingestion,” she mentioned.

When questioned what the next steps for this study would be, Dr. Zierath reported the limitation of the present study was that the operate was only performed in healthier mice.

“Our future action is to conduct a identical study in males and women of all ages with [healthy] excess weight or weight problems. It is vital to comprehend if our conclusions can be utilized to fine-tune the well-known positive aspects of exercise on fat burning capacity,” she continued.

“The ideal time appears to be to be critical to the body’s energy equilibrium and to improving the well being rewards to work out, but additional research are wanted to attract any trustworthy conclusions about the relevance of our conclusions to people.”
— Dr. Juleen R. Zierath

Healthcare News Now also spoke with Ryan Glatt, a senior brain overall health mentor and director of the FitBrain System at Pacific Neuroscience Institute in Santa Monica, California, about this examine.

He agreed that the time of day may well have an affect on how physical exercise impacts the human body centered on individual circadian rhythms — or organic clocks centered on time of day — and the numerous variations in hormones that may perhaps commonly fluctuate during the working day in relation to the endocrine outcomes of exercising.

“There is no present scientific settlement on the ‘best time of day’ for work out, as what is likely additional crucial is what is most behaviorally sound for that certain personal. It is also not likely that (the) time of day to complete physical exercise outperforms the thought of ‘energy in compared to energy out’ for in general fat reduction.”
— Ryan Glatt, senior brain health mentor

For the upcoming actions in this investigation, Glatt said he would like to see this variety of examine done in individuals, as there is a difference in mouse vs. human physiology.

“Prior reports have executed these kinds of studies in people for results such as getting muscle mass, but the differences amongst the times of day and the results may not be as sizeable as some may possibly count on. Special variables, such as hormonal profile, circadian rhythm, and behavioral preferences, could mediate the interactions of exercise and time of day,” he explained.

February 16, 2023

How does diet affect mortality risk?

two women in orange jumpers chatting in the kitchen while mixing bowls of greens — A healthy diet can help lower a person’s risk of early death. Image credit: MaaHoo/Stocksy.

Unhealthy eating habits are among the leading causes of early death around the world.
Harvard researchers have recently found that a variety of healthy diets may help lower the risk of premature mortality.
In their extensive study, participants who consistently maintained healthy eating patterns were less likely to die from noncommunicable diseases, compared with people who did not.
The results support the current Dietary Guidelines for Americans, which recommend adapting healthy dietary regimens according to personal traditions and preferences.

Growing evidence confirms that dietary choices are key to maintaining health. Research increasingly indicates that unhealthy eating habits can lead to early, preventable deaths.

Until now, though, studies have generally focused on the life-promoting benefits of individual foods or food components.

Researchers at the Harvard T.H. Chan School of Public Health in Boston, MA, recently led a study to see how long-term eating patterns affect mortality risks.

These experts assessed adherence to diets that align with the current Dietary Guidelines for Americans, 2020-2025 (DGAs). They then compared the results with other health data collected over 36 years from more than 100,000 people in two long-term national studies.

Corresponding author Dr. Frank Hu, Fredrick J. Stare professor of nutrition and epidemiology, and chair of the Department of Nutrition notes that “[t]he Dietary Guidelines for Americans are intended to provide science-based dietary advice that promotes good health and reduces major chronic diseases.”

“Thus, it is critical to examine the associations between DGAs-recommended dietary patterns and long-term health outcomes, especially mortality,” he adds.

The study findings appear in JAMA Internal Medicine.

The Harvard researchers analyzed and combined results from the Nurses’ Health Study (NHS) and the Health Professionals Follow-up Study (HPFS).

The NHS, which began in 1976, tracked the health data of female nurses aged 30 to 55 years at baseline. The HPFS, which began in 1986, followed male health professionals aged 40-75.

Dr. Hu and his colleagues defined the baselines as 1984 for the NHS and 1986 for the HPFS, when questionnaires provided enough information to form dietary indices.

Their current work used data compiled from 75,230 NHS participants and 44,085 HPFS participants. All the individuals were free of cardiovascular disease or cancer when the study began.

At the baseline and every 2 to 4 years, the participants completed food frequency questionnaires (FFQs) covering over 130 food items every 2 to 4 years.

They also updated information regarding age, weight, body mass index (BMI), physical activity, smoking status, multivitamin use, menopausal status, and diagnosis of chronic diseases.

In the NHS, participants identified as Hispanic, non-Hispanic Black, non-Hispanic white, and “other.” The HPFS did not collect this information.

Higher scores on at least one of the indexes also correlated with a reduced risk of premature death from all causes, and from cancer, cardiovascular disease, and respiratory diseases.

In the NHS and HPFS study populations, people with higher dietary scores were more likely to be older, nonsmokers, and more physically active. They also had a lower BMI.

Food choices and cancer

Kate Cohen, who was not involved in the present research, is a registered dietitian at the Ellison Clinic at St. John’s Health Center in Santa Monica, CA.

In an interview with Medical News Today, Cohen explained how diet can impact cancer development, saying: “We know that about half to two-thirds of cancers can be avoided through diet and lifestyle changes including staying at a healthy weight, increasing fruits and vegetables, limiting alcohol, and increasing dietary fiber.”

MNT also spoke about these findings with Dr. Monique Gary, a breast surgeon and the Medical Director of the Grand View Health/Penn Cancer Network cancer program. Dr. Gary was not involved in the study.

The oncologist shared that “[t]hese findings reinforce what we tell patients in oncology: that diet and lifestyle modification support all phases of cancer care and decrease [the] risk of recurrence and mortality.”

Diets and neurodegenerative diseases

The study also found that the AMED score and AHEI “were associated with lower risk of mortality from neurodegenerative disease.”

Cohen shared how these diets feature components that contribute to brain health:

“Both AMED and AHEI emphasize healthy fats more so than the other two patterns, which may provide an anti-inflammatory benefit and contribute to a healthy brain. They also both share some similarities to the MIND diet, which was developed at Rush Hospital to prevent dementia and slow down cognitive decline. Similar to MIND, AMED and AHEI limit red meat, sugar, and saturated fat, which may help tip the scales in favor of these diets when it comes to brain health.”

Smoking and sex-based differences

The Harvard scientists reported that “[s]ignificant interactions were detected between 4 dietary scores and total mortality by sex and smoking status.”

Female participants had a greater risk of death than male participants. Likewise, people who currently or had ever smoked had a greater risk of mortality than those who had never smoked.

Cohen believes that the sex-based difference might be due to “the potential role of estrogen and chronic pulmonary inflammation, which may be contributing to the dramatic rise of COPD and lung cancer among women.”

The study results do not suggest that plant-based or animal-based diets offer greater health advantages. The HPDI discourages all animal products, while the AMED score recommends fish.

MNT asked Cohen whether removing meats from the diet is necessary.

She replied that “[w]e have seen in other research […] that diets highest in red and processed meat are associated with several cancers, so it’s likely a good idea to limit red meat and consider eliminating processed meats.”

However, she admitted, “[b]eyond that, we have yet to see a convincing study that shows that including lean animal proteins in the diet increases mortality.”

The Harvard study entails a direct large-scale comparison of healthy dietary patterns over three decades. It steps beyond most current literature that focuses on single foods.

Dr. Gary pointed out that this analysis “highlights the fact that when normalized for race, and irrespective of the particular nuances of the healthy diet, adherence to a healthy diet may decrease mortality among all individuals with chronic illness.”

They did acknowledge certain limitations, though.

Due to dependence on self-reported data, the team felt that some measurement errors were unavoidable. Additionally, as an observational study, the possibility of confounding persists as well.

Moreover, the sample population consisted exclusively of health professionals, limiting the study’s generalizability.

Dr. Gary noted that “[f]urther studies will be helpful to better elucidate the benefits of particular dietary and lifestyle changes that result in a greater advantage for those facing chronic illnesses, including cancer.”

February 15, 2023

Can cinnamon improve learning and memory?

a stack of cinnamon sticks — A examine implies that cinnamon might positively affect mastering and memory, but additional research is needed. Jeff Wasserman/Stocksy

Scientists analyzed 40 scientific studies investigating how cinnamon impacts cognitive functionality.
They identified that consuming cinnamon may increase mastering and memory.
Even more scientific tests are essential right before conclusions can be created.

Cinnamon has a long history in culinary use, as an aroma, and in organic drugs.

Research show that cinnamon confers cognitive gains and anti-inflammatory, anticancer, and immunomodulatory properties.

Some investigate demonstrates that cinnamon probably has neuroprotective consequences, like versus Alzheimer’s ailment.

A compound in cinnamon identified as cinnamaldehyde, for instance, has been demonstrated to inhibit the buildup of amyloid-beta plaques in the brain- a key signal of Alzheimer’s.

Further study of cinnamon’s likely cognitive benefits could help the progress of preventive procedures for cognitive decrease.

Not too long ago, scientists performed a meta-evaluation of 40 studies investigating the results of cinnamon on cognitive purpose.

They uncovered that cinnamon appreciably improves cognitive functionality, described as finding out and memory.

The research seems in Dietary Neuroscience.

For the research, the scientists analyzed 40 reports detailing the partnership among cinnamon and cognitive purpose.

For the evaluation, they involved two scientific research, 5 in vitro research, and 33 in vivo reports, which includes 17 involving rats, 15 in mice, and just one in the typical fruit fly.

To start out, the scientists analyzed reports involving cinnamon extract or powder.

In just one clinical study, the scientists identified that chewing cinnamon gum for 40 times positively afflicted memory in adolescents. The other clinical research, on the other hand, claimed no important alterations in memory when taken orally.

Most in vivo experiments observed cinnamon positively impacted discovering and memory. A single research, however, located that cinnamon decreased mastering and short memory.

Meanwhile, an in-vivo review discovered that methanol extract from cinnamon bark can inhibit amyloid-beta generation.

Following, the scientists investigated cinnamon parts this sort of as eugenol, cinnamic acid, and cinnamaldehyde.

They uncovered that eugenol has cognitive protective results due to its antioxidant properties and capability to inhibit amyloid plaques.

They even more observed that compounds known as cinnamaldehyde and trans-cinnamaldehyde have anti-cell demise and anti-inflammatory consequences that defend versus cognitive impairment in animal types.

The scientists mentioned that their effects were being not dose-dependent, meaning that both small and substantial doses of cinnamon conferred optimistic effects.

When asked about limits to the findings, Molly Rapozo, RDN, Registered Dietician Nutritionist & Senior Nutrition and Overall health Educator at Pacific Neuroscience Institute in Santa Monica, CA, not involved in the analyze, explained to Health-related News Right now:

“Only 2 clinical experiments were element of this overview, and one particular of the two did not clearly show a beneficial outcome. Most of the literature incorporated have been rodent versions. As a result a lot more clinical research are required. Additionally, there were being a lot of variations amid the scientific studies for period, dosage, and cinnamon factors employed.”

When reflecting on why 1 of the two medical trials bundled described positive effects, she claimed: “Perhaps cinnamon did not present a beneficial outcome in one particular of the scientific studies for the reason that the dosage, duration, or cinnamon made use of was not as impactful as the blend made use of in the constructive review.”

Dr. Karen D. Sullivan, board licensed neuropsychologist and creator of I Treatment FOR YOUR Brain, not associated in the examine, also told MNT:

“The most important limits are the small quality of many of the involved experiments which even the authors describe as “imprecise.” Many variables have been [poorly-defined, including] the cognitive talents tested, the use of unique parts of cinnamon and various exposures to the compounds.”

“The info on cinnamon inhibiting the pathophysiological mechanisms viewed in Alzheimer’s disorder is really weak and constrained to very little sample measurements in laboratory samples,” she included.

Dr. Jonathan J. Rasouli, Director of Elaborate and Adult Spinal Deformity Medical procedures at Staten Island College Healthcare facility, also not included in the review, told MNT that the human research did not have adequate manage teams, which means it is hard to draw a agency conclusion from the exploration.

“In order to definitively say there is a advantage, we will want a potential, randomized managed demo, and that is however pending,” Dr. Rasouli famous.

“The public ought to know that cinnamon will come in two types: cassia, so-named legitimate cinnamon, and Ceylon, also named Chinese cinnamon,” note Dr. Sullivan.

“Eating superior quantities of cassia cinnamon can damage liver function, raise the chance of lung, liver and kidney cancer, medicine-interactions and owing to higher amounts of coumarin. Also, taking in also a great deal floor cinnamon of possibly sort at when result in coughing and issues breathing because the very fine texture of the spice can get caught in the vacuoles of the lungs. This is especially about for folks with asthma,” she cautioned.

Rapozo, however, famous that cinnamon is regarded as to be a harmless organic medication and has a prolonged heritage in a variety of cultures. This signifies it could conveniently be provided as a component of an obtainable complete foodstuff diet regime for a broad array of persons.

“I suggest culinary herbs and spices as aspect of a mind-healthier anti-inflammatory diet plan. Cinnamon makes a amazing very hot or chilly tea, tastes wonderful with entire grains and fruit, as very well as being critical to savory spice blends all over the world,” she concluded.

February 14, 2023

Phthalate exposure may increase risk in some women

shelves of foods packed in plastic containers at the supermarket — New research indicates that some women may be at an increased risk of diabetes due to phthalates, chemicals often used in food packaging. Image credit: Julien McRoberts/Getty Images.

Phthalates are chemicals widely used in food packaging, cosmetics, and children’s toys.
Research suggests they can interfere with hormone function, and that they are associated with obesity, allergies, and other health concerns in both children and adults.
Phthalates may also increase insulin resistance, raising the risk of diabetes.
Now, a study in women has shown that increased exposure to phthalates over a prolonged period may contribute to a higher risk of diabetes.

Plastics are everywhere, and they are extremely useful. They package our food and drink, they are in many of our clothes, and are also in our personal care products. They are even in the water we drink and the air we breathe in the form of microplastics.

While they may be useful, increasing scientific evidence is suggesting that some components of plastics may be harmful to human health.

Top of the potentially harmful list are phthalates, chemicals added to many plastics to make them flexible. Phthalates have been implicated in many health concerns, including endocrine disruption, obesity, allergies, and reproductive issues.

One hormone likely to be affected by phthalates is insulin, which controls blood glucose (sugar) levels and makes glucose available to cells. A study in adolescents found that increased urinary phthalate levels were associated with increased insulin resistance, which is often a precursor to type 2 diabetes.

Another study made similar observations in older adults, finding that exposure to one particular group of phthalates, diethylhexyl phthalates (DEHP), increased oxidative stress and insulin resistance.

Now, a longitudinal study published in The Journal of Clinical Endocrinology & Metabolism has found that women exposed to high levels of phthalates have an up to 63{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} increased risk of developing diabetes.

“The study subjects were chosen from a larger longitudinal study of midlife women to evaluate an association between phthalates in the urine and [the] development of diabetes. The study found an association between higher levels of certain phthalates and development of diabetes in white women, but not the other races studied — Black and Asian.”

– Dr. Ishita Prakash Patel, board-certified endocrinologist, Texas Diabetes and Endocrinology, not involved in the study

Researchers from the University of Michigan School of Public Health studied 1,308 women from the Study of Women’s Health Across the Nation (SWAN) for 6 years.

All the women were aged between 42 and 52 years (median age 49.4 years), and not taking any exogenous reproductive hormones for the last 3 months — such as the birth-control pill or hormone replacement therapy (HRT) — when they enrolled in the study in 1996–’97.

The study looked at phthalate exposure and incident diabetes in these women in the 6 years between 1999–2000 and 2005–2006.

At the start, and in 2002–2003, all the women gave urine samples in PET (polyethylene terephthalate) tubes. PET is a plastic that does not release phthalates when stored at cool temperatures. The researchers froze the urine samples at -80 degrees Celsius until analysis in 2017–’18.

Using mass spectroscopy (HPLC-MS), the researchers measured the concentration of 12 different phthalates and phthalate metabolites in the urine samples.

The women attended nine follow-up visits during the study. Researchers classified diabetes if a woman reported using antidiabetic medications, had a doctor’s diagnosis of diabetes, and/ or had fasting blood glucose greater than 126 milligrams per deciliter (mg/dL) for two consecutive visits.

In the 6 years of the study, 61 women (4.7{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}) developed diabetes. These women had significantly higher concentrations of all except two phthalate metabolites than women who did not develop diabetes.

“Our research is a step in the right direction towards better understanding phthalates’ effect on metabolic diseases, but further investigation is needed,” says co-author Dr. Sung Kyun Park, of the University of Michigan School of Public Health in Ann Arbor, MI.

When the researchers stratified their results by race/ethnicity, they found a positive association between phthalate metabolites and incident diabetes in white, but not Black or Asian women. The authors state that it is “unclear what might explain such racial/ethnic differences”.

Dr. Patel agreed that the reasons for this finding were unclear, telling Medical News Today that “[t]he findings could have been skewed by a selection bias — for example, missing many cases of earlier onset diabetes.”

“Another possible reason could be that products were administered differently, leading to some forms causing more harm than others,” she hypothesized.

The researchers note that those who were younger, Black, current smokers, or obese generally had higher concentrations of phthalate metabolites. They also note that of the women who developed diabetes, 89.9{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} had overweight or obesity at the start of the study.

Because it was a longitudinal study, the researchers could demonstrate that phthalate exposure occurred before diabetes diagnosis, suggesting a causative effect.

Also, the population of women in the study was diverse, with white, Black, Chinese, Japanese, and Hispanic women participating. However, the researchers noted that “given inconsistent associations across racial/ethnic groups and phthalate metabolites, a causal relationship between phthalates and diabetes remains uncertain.”

The researchers note several limitations of their study. First, phthalate concentrations in single urine samples may not reflect habitual exposure to phthalates.

Secondly, they relied on fasting glucose to diagnose diabetes. Thirdly, the follow-up time was relatively short, and the sample was relatively small. And fourthly, other environmental factors may have affected the results.

Mindful of these limitations, they call for more research into the impact of phthalates on glucose homeostasis and diabetes, saying that, “[g]iven widespread exposure to phthalates and the enormous costs of diabetes to individuals and societies, ongoing investments in the research on phthalates’ metabolic effects are warranted.”

Although this study cannot prove that phthalates cause diabetes, it does raise the possibility, and phthalates are known to have other health effects. The European Chemicals Agency states that they can “interfere with our hormonal systems and cause allergies.”

But avoiding phthalates is not always easy, as they are found in many plastics. However, some steps are being taken to reduce people’s exposure to phthalates.

Many countries have limited the use of phthalates in children’s toys and other products, as there is evidence that exposure in childhood may adversely affect normal development.

Recently, the Food and Drug Administration (FDA) limited the use of phthalates in food packaging, reducing the risk of these chemicals being absorbed into foods

And some cosmetic manufacturers are now using other ingredients in place of phthalates. People can check whether plastics contain phthalates by looking at the recycling information.

So perhaps, to be on the safe side, we should follow the advice of Dr. Patel:

“It is probably best to limit exposure to chemicals like phthalates, which can be absorbed through the skin or digestive system, as much as reasonably possible.”

February 13, 2023

High coffee consumption may triple kidney disease risk in some people

Three coffee beans in a line, standing vertically. — The amount of coffee and caffeine someone consumes can affect their kidney health. Antonia Gros/EyeEm/Getty Images

A new study finds that people who metabolize caffeine slowly are three times more likely to develop kidney dysfunction.
Other research has suggested that coffee promotes health, including kidney health.
The slow metabolism, says the new study, is the result of a gene variant present in half the population at large. They propose that this may account for the conflicting conclusions of previous studies.

While some research has linked the consumption of coffee to kidney damage, other research has reported no association between caffeine intake and the development of chronic kidney disease. A new study from researchers at the universities of Toronto, Canada, and Padova, Italy may offer an explanation for the differing conclusions.

It also finds that for some people, coffee can indeed be damaging to one’s kidneys.

The new study finds that the presence of a particular gene variant can result in coffee being three times more likely to cause kidney dysfunction.

The researchers say it is all about the speed at which a person metabolizes caffeine. In the study, about half of the participants had the rs762551 variant of the CYP1A2 gene, a variant that caused them to metabolize caffeine more slowly. This group was determined to be at a higher risk of kidney damage.

The authors say that this is about the same percentage of slow caffeine metabolizers in the general population.

The study assessed kidney health by tracking three accepted markers of kidney dysfunction: albuminuria, hyperfiltration, and hypertension.

The study is published in JAMA Network Open.

The observational study spanned about 16 years. It involved a population of 1,180 participants ages 18 to 45 years, with each regularly being assessed over a 7.5-year follow-up period. All participants had untreated stage 1 hypertension and had been recruited as part of the separate Hypertension and Ambulatory Recording Venetia Study.

Dr. Sara Mahdavi, was the lead author of the study as a researcher with the Department of Community and Family Medicine at the University of Toronto.

After identifying those with the problematic CYP1A2 variant, Dr. Mahdavi said:

“It was remarkable to see just how striking the effects of coffee were in the group that had this genetic variant, yet no effect whatsoever in those who did not.”

People who metabolized caffeine slower and who drank three or more cups of coffee each day were 2.7 times more likely to develop kidney dysfunction.

They were also 2.8 times more likely to develop hypertension.

Medical News Today reached out to nephrologist Dr. Francis Perry Wilson, associate professor at Yale School of Medicine, who was not involved in the study. He expressed concern about the accuracy of the authors’ conclusions:

“While the study shows an interesting association between coffee intake and the risk of kidney disease in a subgroup of the population, I have some concerns about the statistical analysis that make the conclusions difficult to interpret.”

“Particularly, the fact that the event curves go to 0 implies that every participant is assumed to experience the event over time, when in fact, that is biologically not possible. This can sometimes arise when individuals followed for longer in a study are significantly different from those followed for a shorter time,” he elaborated.

“Caffeine is the most widely studied substance in coffee and can be found in other beverages like tea, cola, and energy drinks. Coffee contains many substances that can have various effects on the body, both beneficial as well as harmful,” noted Dr. Mahdavi.

The study suggests that it is only harmful in people whose ability to quickly detoxify caffeine out of their system is impaired.

“This implicates caffeine, specifically, as the component in coffee that can damage the kidneys. It also suggests that caffeine from any source can be harmful in those individuals who have this genetic variant that impairs their ability to eliminate caffeine from their system,” she explained.

The authors hope the study’s findings will prompt a re-examination of the current guidelines approving up to 400 milligrams, or four or five cups, of brewed coffee per day.

“[D]ecaffeinated coffee is virtually devoid of caffeine, those who consume decaf would not have a higher risk of kidney dysfunction, regardless of their genetics.”
— Dr. Sara Mahdavi, lead author

There are general guidelines as to the relative amounts of caffeine one can expect to find in different caffeinated beverages such as coffee, espresso, and tea.

However, there are a surprising number of factors that determine a specific cup’s caffeine content. These include the species of bean, brewing time, the temperature of the water, pressure, the extent of roasting and grinding, the type of water, and the coffee/water balance.

According to the study’s senior investigator, the University of Toronto’s Dr. Ahmed El-Sohemy, the CYP1A2 enzyme metabolizes certain compounds such as caffeine, some medications, and several dietary substances.

“Although the enzyme detoxifies caffeine, it can actually activate some pro-carcinogens that are found on the surface of barbecued meat,” Dr. El-Sohemy noted.

In addition to the rs762551 variant, he said, there were a “number of factors that can either increase or decrease the activity of CYP1A2, regardless of whether a person is a fast or slow metabolizer.”

Dr. El-Sohemy said that hormonal contraceptives may decrease the activity of CYP1A2, “and effectively turn fast metabolizers into slow metabolizers.”

Cruciferous vegetables, he added, can speed up CYP1A2 activity.

The rs762551 CYP1A2 variant has also been implicated in the development of cancer. There are genetic companies that can test a person for the presence of this variant.