Loneliness is associated with double the risk of developing diabetes

Does prolonged sitting really kill 70,000 people a year in the UK?

A new study published in Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]) finds that feelings of loneliness are linked to a significantly higher risk of developing type 2 diabetes (T2D).

The research was conducted by Associate Professor Roger E. Henriksen and his colleagues at Western Norway University of Applied Sciences. As well as examining the association between loneliness and the risk of developing T2D, it looked at whether depression and insomnia play a role.

A growing body of research has pointed to a link between psychological stress and an individual’s risk of developing T2D. Loneliness creates a chronic and sometimes long-lasting state of distress which may activate the body’s physiological stress response. While the exact mechanisms are not fully understood, this response is believed to play a central role in the development of T2D through mechanisms such as temporary insulin resistance brought on by elevated levels of the stress hormone cortisol.

This process also involves changes in the regulation of eating behaviour by the brain, causing an increased appetite for carbohydrates and subsequent elevated blood sugar levels. Previous studies have found an association between loneliness and unhealthy eating including higher consumption of sugary drinks and foods rich in sugars and fats.

The researchers used data from the HUNT study, a collaboration between the HUNT Research Centre (Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology [NTNU]), Trøndelag County Council, the Central Norway Regional Health Authority and the Norwegian Institute of Public Health. This database contains the health information (from self-reported questionnaires, medical examinations and blood samples) of more than 230,000 people and obtained via four population surveys: HUNT1 (1984-1986), HUNT2 (1995-1997), HUNT3 (2006-2008) and HUNT4 (2017-2019).

Baseline information for 24,024 participants was taken from HUNT2 after excluding individuals with metabolic disorders, type 1 and type 2 diabetes and those for whom blood test data were not available. T2D status was the main outcome variable and was based on HbA1c (glycated haemoglobin – a measure of long-term blood sugar control) being greater than 48mmol/mol when measured in the HUNT4 survey.

Loneliness was gauged from HUNT2 data survey whether they had felt lonely over the previous 2 weeks and was measured on a four-point scale (‘no’, ‘a little’, ‘a good amount’ and ‘very much’). Severity of depression symptoms were assessed using questionnaire completed during HUNT3 which consisted of 7 questions, each scored on a scale of 0-3 for a total of 0-21 points, with higher scores indicating more severe symptoms. Individuals with insomnia were identified based on their answers to the questions: ‘How often in the last 3 months have you: ‘had difficulty falling asleep at night’, ‘woken up repeatedly during the night’ and ‘woken too early and couldn’t get back to sleep’, respectively. These were asked as part of HUNT3 and participants could choose one of three answers: ‘never/seldom’, ‘sometimes’ and ‘several times a week’.

Out of 24,024 people, 1,179 (4.9%) went on to develop T2D over the course of the study (1995-2019). These individuals were more likely to be men (59% vs 44%) and had a higher mean age (48 years vs 43 years) than those without T2D. They were also more likely to be married (73% vs 68%) and have the lowest level of education (35% vs 23%). Feelings of loneliness were reported by 13% of participants.

The study found that higher levels of loneliness at baseline were strongly associated with a higher risk of T2D when measured 20 years later. After adjusting for age, sex and education level they found that participants who responded ‘very much’ when asked whether they had felt lonely were twice as likely to develop T2D than those who did not feel lonely. Further analysis showed that this relationship was not altered by the presence of depression, sleep-onset insomnia or terminal insomnia, although the team did find evidence of a link to sleep maintenance insomnia.

Although their study did not examine the exact mechanisms involved, the researchers note that social support, influence and engagement may have positive effects on health-promoting behaviours. For example, advice and support from a friend may influence an individual’s health-related choices and have a positive effect on their diet, physical activity level and overall feelings of stress. Fewer social ties and a lack of these positive influences can make lonely people more vulnerable to behaviour which could increase the risk of developing T2D.

The researchers advise that loneliness should be included in clinical guidelines relating to T2D. They say: “It is important that healthcare providers are open to dialogue about an individual’s concerns during clinical consultations, including with regard to loneliness and social interaction.”

The authors recommend that further research is carried out into the mechanisms at play in the link between loneliness and T2D as well as the roles played by insomnia and depression. They conclude: “Questions to be answered are the extent to which loneliness leads to the activation of stress responses, the extent to which loneliness affects health-related behaviour and, importantly, how these two pathways interact in terms of contributing to an increased risk of T2D.”

Weight loss beneficial for individuals with obesity, but not for the lean

Researchers find weight loss may be beneficial for individuals with obesity, but not for the lean


Researchers find weight loss may be beneficial for individuals with obesity, but not for the clean credit Kenny Eliason, Unsplash (CC0, https://creativecommons.org/publicdomain/zero/1.0/)

Intentionally losing weight can bring long-term health benefits for individuals with obesity, regardless of the method or strategy they use, according to a study of almost 200,000 people. Those who lost more than 4.5kg had less weight gain and a lower risk of type 2 diabetes than those who did not lose weight, but lean individuals did not benefit, with weight loss attempts associated with longer-term weight gain and higher risks of type 2 diabetes. The research is publishing September 27thin the open-access journal PLOS Medicine.

Obesity can lead to higher risks of diseases including type 2 diabetes. Controlling weight can be an effective strategy for preventing and managing obesity and related diseases, though long-term weight change and risk of developing type 2 diabetes are not well studied.

Qi Sun and colleagues from the TH Chan Harvard School of Public Health, U.S., included healthy participants from three prospective cohort studies from 1988 – 2017. Individuals were aged between 24-78 and predominantly female — 11.6% male and 14.2% male in the cohorts. They grouped methods that led to weight loss of more than 4.5kg into seven categories: low-calorie diet, exercise, low-calorie diet plus exercise, fasting, commercial weight loss program, diet pills and a combination of fasting, commercial and diet pills (FCP).

Exercise was most effective for long-term weight control and prevention in individuals with obesity and associated with least weight gain after four years — 4.2% overall average less weight than at the start in individuals with obesity, 2.5% weight loss in overweight, and 0.4% in lean people. This was inverted for FCP, which saw individuals with obesity sustaining 0.3% weight loss, overweight people sustaining 2% more weight gain, and lean individuals 3.7% more weight gain.

24 years later, risk of diabetes was reduced for individuals with obesity irrespective of weight loss strategy – ranging from a 21% reduction for exercise to a 13% reduction for diet pills. For overweight individuals, the researchers saw a range of 9% reduction in type 2 diabetes risk for exercise to an increase of 42% risk for those who took pills, and in lean individuals, all weight loss was associated with an increased risk of type 2 diabetes — ranging from a 9% increase for exercise and a 54% increase for pills or FCP.

The authors conclude that while weight loss can be beneficial for those who are overweight and obese, weight loss strategies do not bring the same gains for lean individuals and weight loss strategies should be used only by those who medically need them.

“We were a bit surprised when we first saw the positive associations of weight loss attempts with faster weight gain and higher type 2 diabetes risk among lean individuals,” Sun adds. “However, we now know that such observations are supported by biology that unfortunately entails adverse health outcomes when lean individuals try to lose weight intentionally. Good news is that individuals with obesity will clearly benefit from losing a few pounds and the health benefits last even when the weight loss is temporary.”

Diet high in guar gum fibre limits inflammation, MS symptoms in mice

What To Do With Guar Gum - YouTube

Diets high in guar gum, a common food additive and dietary fibre, limited inflammation and delayed the onset of multiple sclerosis (MS) symptoms in mice, according to new research by members of the University of British Columbia (UBC) Microbiology and Immunology department.

“The rapid increase of autoimmune and inflammatory disorders in industrialized countries in the last few decades indicates dietary choices are one environmental factor contributing to incidence,” said Dr. Lisa Osborne, senior researcher on the study and an assistant professor with UBC Microbiology and Immunology.

“Dietary fibres are potent modulators of immune responses and can control inflammation in multiple diseases, but they’re a very biochemically diverse family. Our study gives us a clearer window into the potential of several sources of fibre in maintaining immune health.”

Dr. Osborne and colleagues exposed groups of mice to a variety of diets—a control five percent cellulose fibre diet, a diet entirely lacking in dietary fibre, or diets enriched (30%) with fibre in either resistant starch, inulin, pectin, or guar gum. Quar gum was the only fibre type that significantly limited the MS-like symptoms. 

Guar gum—guaran—is extracted from guar beans, and is often used as an additive to thicken and stabilize food and animal feed, and in industrial applications. India and Pakistan are major growers of the bean.

“Guar beans aren’t that common in western diets, and the gum isn’t used at these high levels as an additive in the west,” says Naomi Fettig, first author on the study and a PhD student with the Department of Microbiology and Immunology at UBC.

“Experts have consistently been saying fibre is good for you—and a variety of fibre sources is important to immune health—but there hasn’t been very much critical work into identifying how the body responds to different fibre types. It’s fascinating that this particular source has such an impact.”

In the US and Canada, the average daily intake of fibre is 15 grams—current recommendations are double that at 30 grams. The recommended values don’t take into account any specific fibre type. “Incorporating guar beans might be challenging to achieve at the doses we gave to mice,” says Dr. Osborne. “But a guar gum derivative, partially hydrolyzed guar gum, is commercially available as a prebiotic.”

After the gum is broken down by the microbiota of mice, the resulting molecules appeared to reduce the activity and proliferation of a type of CD4+ T cells, Th1 cells, that play a key part in activating the autoimmune response. It’s that response that leads to MS-like symptoms in mice. The effects of fibre on Th1 cells remained largely unknown prior to this study, and these findings suggest that the biochemical differences in fibre structures can influence diverse immune pathways.   

Dr. Osborne and her lab now want to explore the potential benefits in humans—including developing a more detailed understanding of the molecular picture, which might help design therapeutics that offer the benefits of such high guar gum diets in a more practical form. 

Coffee drinking is associated with increased longevity

Coffee drinking is associated with increased longevity
Coffee drinking is associated with increased longevity

 

Drinking two to three cups of coffee a day is linked with a longer lifespan and lower risk of cardiovascular disease compared with avoiding coffee, according to research published today in the European Journal of Preventive Cardiology, a journal of the ESC.1 The findings applied to ground, instant and decaffeinated varieties.

“In this large, observational study, ground, instant and decaffeinated coffee were associated with equivalent reductions in the incidence of cardiovascular disease and death from cardiovascular disease or any cause,” said study author Professor Peter Kistler of the Baker Heart and Diabetes Research Institute, Melbourne, Australia. “The results suggest that mild to moderate intake of ground, instant and decaffeinated coffee should be considered part of a healthy lifestyle.”

There is little information on the impact of different coffee preparations on heart health and survival. This study examined the associations between types of coffee and incident arrhythmias, cardiovascular disease and death using data from the UK Biobank, which recruited adults between 40 and 69 years of age. Cardiovascular disease was comprised of coronary heart disease, congestive heart failure and ischaemic stroke.

The study included 449,563 participants free of arrhythmias or other cardiovascular disease at baseline. The median age was 58 years and 55.3% were women. Participants completed a questionnaire asking how many cups of coffee they drank each day and whether they usually drank instant, ground (such as cappuccino or filtered coffee), or decaffeinated coffee. They were then grouped into six daily intake categories, consisting of none, less than one, one, two to three, four to five, and more than five cups per day. The usual coffee type was instant in 198,062 (44.1%) participants, ground in 82,575 (18.4%), and decaffeinated in 68,416 (15.2%). There were 100,510 (22.4%) non-coffee drinkers who served as the comparator group.

Coffee drinkers were compared to non-drinkers for the incidence of arrhythmias, cardiovascular disease and death, after adjusting for age, sex, ethnicity, obesity, high blood pressure, diabetes, obstructive sleep apnoea, smoking status, and tea and alcohol consumption. Outcome information was obtained from medical records and death records. The median follow up was 12.5 years.

A total of 27,809 (6.2%) participants died during follow up. All types of coffee were linked with a reduction in death from any cause. The greatest risk reduction seen with two to three cups per day, which compared to no coffee drinking was associated with a 14%, 27% and 11% lower likelihood of death for decaffeinated, ground, and instant preparations, respectively.

Cardiovascular disease was diagnosed in 43,173 (9.6%) participants during follow up. All coffee subtypes were associated with a reduction in incident cardiovascular disease. Again, the lowest risk was observed with two to three cups a day, which compared to abstinence from coffee was associated with a 6%, 20%, and 9% reduced likelihood of cardiovascular disease for decaffeinated, ground, instant coffee, respectively.

An arrhythmia was diagnosed in 30,100 (6.7%) participants during follow up. Ground and instant coffee, but not decaffeinated, was associated with a reduction in arrhythmias including atrial fibrillation. Compared with non-drinkers, the lowest risks were observed with four to five cups a day for ground coffee and two to three cups a day for instant coffee, with 17% and 12% reduced risks, respectively.

Professor Kistler said: “Caffeine is the most well-known constituent in coffee, but the beverage contains more than 100 biologically active components. It is likely that the non-caffeinated compounds were responsible for the positive relationships observed between coffee drinking, cardiovascular disease and survival. Our findings indicate that drinking modest amounts of coffee of all types should not be discouraged but can be enjoyed as a heart healthy behaviour.”

Are You Ready for Your First Pool?

Installing a pool on your property is a huge commitment of both time and money. However, having somewhere to relax with friends and family on a hot summer afternoon is priceless. But, before you go all in, you should familiarize yourself with the process. Today’s post is just one of many great pool owner resources brought to you by Patient Talk.

Above Or Below Ground?

For most people, there are two choices: an above ground pool or an inground pool. Above ground swimming pools have the financial advantage, as they are often a fraction of the cost of inground. Many people choose an above ground pool to avoid the exponential cost of excavation. An inground pool, however, can be easier to maintain since, depending on how it’s built, you likely won’t have to worry about ripping the liner. Others choose an inground pool because they blend with the landscape better. Another option is a semi-inground pool, which is a hybrid of both.

Finding the Right Installation Company

Something else to consider before you make a decision is the rules and regulations in your area. In most places, you’ll have to have a licensed contractor to install your pool and a licensed electrician to run electricity to the pump and filter. It’s important that you hire the right people for this job, especially with all you are investing in the project. Once you have decided the type of pool you want and where you want it located, look online for well-rated pool installation companies. Call a few different companies and provide a clear description of what you want done. Enquire about their experience, their pricing, and their timelines. Once you have heard from your best options, make a decision quickly to move the project forward.

If you live in a cooler area, you might want to look into having solar panels installed to heat your pool. Look for a search engine that lets you input specifics about your project, and investigate pricing for solar paneling specifically for pools. This is a less common application for solar these days, so it might be a little harder to find contractors who handle it, but once you can relax in your warm pool on a brisk fall evening, it will all be worth it.

Rules and Regulations

It’s important that your installer is familiar with the pool rules and regulations for your area. Often, you’ll be required to build your pool a certain number of feet from utility and other easements. To find out if and where these exist, visit your local City Hall or property assessor’s office.

Aside from the cost of the pool, you will also be required to ensure that it is inaccessible to the general population and safe for those that do use it. For this, you will almost certainly have to have a fence around your pool. Keep in mind that this can add an extra $4,500 to your overall cost, but this might be much more if you choose to add a wooden privacy fence instead of a chain-link fence. You’ll have to have a separate contractor for this as well, and you want to read reviews and go over all of your needs with each service provider before you move forward. All of your contractors will need to be aware of easements and utility lines, such as gas, underground electric, and sewer. You will also likely be required to have a pool alarm.

Benefits to Health and Well-Being

Yes, having a pool is a big commitment, but it can also be a great opportunity to help your body and mind. Swimming is great aerobic exercise, but it is also low impact, which is great if you suffer from joint pain. In fact, swimming can be great for pain relief. According to Southside Pain Specialists, swimming can provide relief while also helping you build your stamina, muscle strength, and flexibility. You may find yourself heading to the pool for the fun, but benefiting from the health benefits, too.

Ongoing Financial Commitment

Having a home swimming pool might let you skip a few vacations, which is important if you’re on a tight budget. It can cost up to $500 each season simply by opening and closing your pool. This doesn’t even include the cost of repairing malfunctioning equipment, replacing the liner, or making other repairs. You will also be on the hook for the extra electricity it takes to run the pool pump during the summer (or all year, depending on where you live). In The Swim acknowledges that a variable or two-speed pump can help reduce these costs.

You must also factor in whether adding a swimming pool to your property will make your home more sellable or if it will be a liability. Regardless of the type of features you add, you might want to take before and after pics and hold onto any receipts and information showing improvements you’ve made to the property. Finally, don’t forget about the added cost you’ll incur to keep your pool beautiful. In addition to chemicals and maintenance equipment, you may also have to pay for landscaping, a deck, or a patio.

Enjoy the Benefits

Deciding to install a pool is a big decision that shouldn’t be taken lightly. There are many factors to consider, such as the cost of installation and maintenance, the size and shape of your yard, and how much use you think the pool will get. If you decide a pool is right for you, make sure to hire qualified contractors who can help you navigate all the permitting and construction process. Pools add value to your home and can provide hours of fun for friends and family members during the summer months- making the decision even easier!

Pools can be great low-impact exercise and even help to ease the pain that accompanies chronic conditions. If you are interested in more information about what it’s like to live with particular conditions from the patients themselves, visit Patient Talk.