Posted on Diabetes

60-day bed rest study shows dangers of long-term inactivity for blood sugar levels

60-day bed rest study shows dangers of long-term inactivity for blood sugar levels
60-day bed rest study shows dangers of long-term inactivity for blood sugar levels

Put 20 young men in bed for two months with no physical activity and what do you get? A new study from the University of Bath, published today, shows that long-term inactivity significantly increases blood sugar levels even if you reduce your food intake to avoid gaining weight.

The research, led by a team from the University’s Centre for Nutrition, Exercise and Metabolism, was part of a European Space Agency (ESA) bed rest study. For 60 days, 20 young, fit and healthy male participants stayed in bed with their feet above their heads whilst international researchers assessed numerous health measures. Individuals remained in bed while eating, showering, and going to the toilet.

Research from the team from Bath focused on participants’ metabolic heath: how well your body controls blood sugar. Previous work from the same team in 2018 demonstrated that exercise, even in short bursts, has a major impact on blood sugar in the short term. With this new study, they wanted to understand more about what happens when there is no physical activity or movement over weeks and months. Participants were fed a much-reduced diet to compensate for their physical activity and stop them gaining weight.

The results, published today in the journalClinical Nutrition, show that even when food intake was reduced to match participants’ much lower energy expenditure during bed rest, inactivity negatively and profoundly impacted their blood sugar levels.

Impacts on blood sugar

As a result of taking part in the bed rest study, average blood sugar levels among participants increased by around 6% in the day, and by 10% at night. Their ability to dispose of blood sugar – i.e., to take up blood sugar into muscles – also decreased by nearly a quarter (24%). Participants were struggling to control their blood sugar, which is an important risk factor in developing conditions such as cardiovascular disease or Type II diabetes.

The research team explain that the reduction in calorie intake did prevent participants from experiencing even higher blood sugar levels. They speculate that had they eaten the same amount as normal, given the reduction in the ability to dispose of sugar, their blood sugar concentrations would have risen even higher during the bed rest.

The bed rest study was conducted by ESA to help understand the health effects of crewed future space missions for astronauts. However, the researchers say the implications are also relevant for life back here on Earth, where millions of people face periods of long-term inactivity due to poor lifestyles, chronic conditions, ill health, or injury.

Professor of Human Physiology, Dylan Thompson, at the University of Bath led the research. He explained: “This was a unique study in which 20 young fit and healthy men were subjected to a series of tests over the course of nearly two months during which time they stayed in bed with no physical activity. Such bed rest studies are used to examine deconditioning as a model for microgravity, and this was one of the longest. 

“Our results reveal that the withdrawal of physical activity profoundly impacts physiological health over and above the impact of controlling diet. Whilst the changes were not as large as would be expected had participants maintained the same calorie intake as before the study, because of their inactivity, there was a real increase in participants’ blood sugar levels and a reduction in their ability to take up and use sugar. This shows that adjusting diet alone sadly cannot overcome all the negative effects from reducing physical activity – even if you manage to avoid gaining weight.”

Dr. Angelique Van Ombergen, Discipline Lead for Life Sciences at the ESA, added: “Our spaceflight analogues, of which bedrest is the golden standard, don’t only allow us to do research that can directly benefit our astronauts, but they also allow us to apply this knowledge for people on Earth such as the elderly and the immobilized. This newly published study from Prof. Thompson and his team is a good example of that. ESA is currently planning two new bedrest studies where we will test a combination of countermeasures.”

The team from Bath are working on countermeasures that could help people who are bedbound on Earth as well as people going into space. Recent work from the CNEM team showed that electrical stimulation of leg muscles can help to recreate some of the effects of exercise on the control of blood sugar, which could be developed in extreme cases where individuals have no mobility whatsoever.

Professor Thompson adds: “This study highlights the importance of physical activity for metabolic health. Without movement, long-term inactivity will increase the likelihood that people will develop chronic conditions, such as Type II diabetes. Even in extreme cases where individuals have lost movement completely, we believe there are exciting technological options that could impact muscular contraction for blood sugar control which we are keen to explore and develop.”

According to Diabetes UK, diabetes costs the NHS a staggering £25,000 every minute (£1.5 million an hour and £14 billion year; around 10% of the total NHS budget for England and Wales).

Posted on Autism

Autism and No Sleep Is Common – Does this story ring any bells?

Autism and No Sleep
Autism and No Sleep


She did not sleep for over 40 hours. Our autistic daughter has periods where sleep is just hard to get. We have experienced this throughout her life. As a toddler, she had many 4-hour nights. As a kid, 3 am seems to be her internal alarm clock. It is something we did not know about autism but something we have learned, and we are pretty good about managing the lack of sleep as parents.


Posted on Multiple Sclerosis

MS – Could diet help slow symptoms of multiple sclerosis?

Could diet help slow symptoms of multiple sclerosis? - YouTube


In our morning rounds, a new approach to fight multiple sclerosis — a disease where the body attacks its central nervous system. MS affects about 400,000 people in the United States. It is two to three times more common among women. Current treatments may have severe side effects, and there is no cure. Dr. Tara Narula joins “CBS This Morning” to discuss a cutting edge but low-tech attempt to slow the symptoms.

Posted on Diet, Weight Loss

How better planning and behaviour regulation may lead to eating less fat

New research suggests coaching overweight or obese pregnant women to improve their ability to plan and progress toward goals may be key to helping them lower the amount of fat in their diet.

Maternal diet quality affects prenatal development and long-term child health outcomes. Still, the stress that typically increases during pregnancy – often heightened by concern for fetal health and anxiety over impending parenthood – may derail efforts to focus on healthful eating, previous research has shown.  

In this new study, researchers at The Ohio State University set out to identify the pathway between stress and total fat consumption, with a broader goal to evaluate an intervention designed to improve the diets of pregnant women who are overweight or obese.

Through a series of questionnaires and statistical analysis, the team found that two thinking-related skills – planning, and execution of those plans – were weakened in women whose stress was high, and those skill gaps were associated with higher total fat intake.

These two skills are known as executive functions, a set of multiple thinking processes that enable people to plan, monitor behavior and execute their goals.

“People with a higher level of stress tend to have a higher intake of fat, too. If stress is high, we’re so stressed out that we’re not thinking about anything – and we don’t care what we eat,” said lead author Mei-Wei Chang, associate professor of nursing at Ohio State.

“That’s why we focused on executive functions as a mediator between stress and diet. And with this baseline data, we have reasons to believe that designing an intervention around executive functions could improve dietary outcomes,” she said. “I would anticipate the results could be similar for nonpregnant women, because it’s all about how people behave.”

The study was published recently in the Journal of Pediatrics, Perinatology and Child Health.

The 70 women enrolled in the study had a pre-pregnancy body mass index of between 25 (scores between 25 and 29.9 are categorized as overweight) and 45 (scores of 30 and higher are categorized as obese).

The participants completed questionnaires assessing both overall perceived stress and pregnancy-related stress, as well as executive functions – specifically focusing on metacognition, or the ability to plan, and behavior regulation, the ability to execute those plans. They also completed two 24-hour dietary recalls of their calorie intake and consumption of total fat, added sugar, and fruits and vegetables.

“We were really interested in the mediation role of executive functions. The mediator is what makes everything happen,” Chang said. “We wanted to know: If we focus an intervention on executive functions, would that carry through to behavior change in dietary intake?

“Weight loss interventions often involve a prescribed diet or meal plan, and you are told to follow it. But that doesn’t lead to behavior change in the long term.”

Statistical modeling showed that higher perceived stress was associated with a worsened ability to plan and monitor behavior, and that pathway was linked to higher total fat intake. Similarly, higher levels of pregnancy-related stress were associated with a lower ability to plan, which in turn was associated with worsened ability to monitor behaviors related to carrying out the plan – and these factors were linked to higher fat consumption.

These pathways suggested that an intervention designed to lower stress would function as a starting point to improve the diet, and enhancing skills through coaching – emphasizing the ability to plan, including being flexible with planning, and behavior monitoring, particularly when making food choices – would be key to changing eating patterns.

“You need to improve executive functions, and you also need to lower stress,” Chang said. She and colleagues are now analyzing data on the effectiveness of an intervention for the study participants that emphasized stress management and boosting executive function to promote healthy eating.

Executive functions are regulated by a specific region of the brain, and strengths or weaknesses in these skill areas are thought to be affected by a variety of physiological factors. Previous research has found that executive function deficits are more likely to occur in women who are overweight or obese than in women whose weight is categorized as normal.

“Executive function is not well-studied, and it is not related to intelligence. But people with low executive function are unable to make detailed plans and stick to them, and that’s how they get into trouble,” Chang said. “Metacognition and behavior regulation must go hand in hand – that way you have a much better chance to control your behaviors, and then you will eat better.”

Posted on Infectious Diseases

More than a thousand studies on coronaviruses summarized by researchers at Eötvös Loránd University

Researchers at Eötvös Loránd University (ELTE) have processed the scientific findings on COVID-19 disease severity, which reveal the risk factors and possible causes of the differential course of the disease.

The web of risk factors of severe COVID-19

Researchers at Eötvös Loránd University (ELTE) have processed the scientific findings on COVID-19 disease severity, which reveal the risk factors and possible causes of the differential course of the disease. Their study was published in Viruses. CREDIT Photo: Müller Viktor, Zsichla Levente / Eötvös Loránd University

Researchers at Eötvös Loránd University (ELTE) have processed the scientific findings on COVID-19 disease severity, which reveal the risk factors and possible causes of the differential course of the disease. Their study was published in Viruses.

The COVID-19 pandemic has affected the whole world, but the number of cases and deaths is very unevenly distributed between geographical regions and individual risk has been significantly influenced by the infected individual, the infectious virus strain and some characteristics of the environment.

The clinical course and outcome of COVID-19 is highly variable.

Understanding why some people become asymptomatic while others lose their lives is essential both to cure the disease and to control the epidemic.

Levente Zsichla, a student of the Institute of Biology at ELTE and his supervisor, Dr. Viktor Müller, Associate Professor at the Institute of Biology at ELTE, analysed more than a thousand studies to provide a comprehensive picture of how processes influence the severity of COVID-19 at the individual level.

In their study, they examined in detail the role of demographic factors (age and biological sex, and related pregnancy), the interactions of the disease with other infectious and non-communicable comorbidities, and the influence of genetic polymorphisms, lifestyle, microbiota and established immune memory. In addition, the impact of genetic variation in the coronavirus (SARS-CoV-2) and environmental factors such as air pollution and socioeconomic status were reviewed.

For each factor, the evidence, sometimes conflicting, for the association with COVID-19 outcomes was examined and possible mechanisms of action were outlined. They also reviewed the complex interactions between different risk factors and the feedback effects of epidemic closures on these factors. We review some examples from their study.

WHAT IS ALREADY KNOWN – AGE AND UNDERLYING DISEASES

Advanced age is among the strongest risk factors for COVID-19 mortality. This effect was first reported in early 2020 and has since been confirmed by numerous studies. These findings show that

the risk of death in adults doubles approximately every 6-7 years of life,

and (in the case of the first major wave of the pandemic) has already exceeded 1% in the 65-75 age group. Ageing of lung tissue and the immune system, and the age-related increase in sterile systemic inflammation levels may also be responsible for this phenomenon.

Some chronic diseases also increase the risk of severe COVID-19, but there are exceptions and controversial cases. While obesity, diabetes, hypertension, chronic kidney disease and cardiovascular disease are certainly risk factors, the results for several immunological, neurological and mental diseases are still inconclusive. There is also such controversy within lung diseases. While chronic obstructive pulmonary disease seems to have a clear aggravating effect, in the majority of studies allergic asthma has been found to be a neutral or even risk-reducing underlying condition. This may be because, although both conditions are associated with shortness of breath, chest tightness, wheezing and coughing, the causes and mechanisms of the two conditions are largely different.

MEN ARE MORE VULNERABLE, WOMEN HAVE MORE COMPLICATIONS

Data show that men are at about twice the risk of serious COVID-19 infection, not only among older people but also regardless of age. Similar associations have also been shown for other viral respiratory diseases (e.g. influenza) and infectious pneumonia, so the mechanism is probably not unique to COVID-19. The role of several X-linked genes and the differential expression of other genes that play a key role in the immune system may underlie this phenomenon. In addition, men with severe COVID-19 often have immunological problems involving a family of immune molecules produced against viruses, interferons. In a significant proportion of patients, the production of these interferons is disturbed or the body starts to produce antibodies against them, inactivating the otherwise protective proteins.

Women have a lower risk of severe COVID-19 disease, but a higher rate of post-COVID-19 syndrome. Pregnancy is a particular risk factor for the course of the infection, with pregnant infected women more likely to develop gestational hypertension, more often being admitted to intensive care and the consequences for the foetus/infant.

INDIRECT EFFECTS OF THE ENVIRONMENT

Poor socioeconomic status, including poverty, poor housing conditions or belonging to an ethnic minority, has been shown to be a risk factor in many countries. It also affects people’s lifestyle, nutrition, exposure to air pollution and infectious respiratory diseases, and the availability and quality of health care. Unsurprisingly, and supported by research evidence, regular physical activity and a healthy diet are beneficial for overall health and COVID-19 outcomes, while excessive alcohol consumption increases the risk of serious disease. Even more surprisingly, the impact of smoking, which significantly impairs respiratory function, on the clinical outcome of SARS-CoV-2 infection remains undetermined. In contrast, a growing body of research links long-term exposure to high concentrations of particulate matter with severe coronavirus disease.

SIGNIFICANCE OF THE REVIEW

There have been several summaries of factors influencing the outcome of COVID-19, but these have either covered a small area or provided only a sketchy summary of a wider range of risk factors. The new study provides the most comprehensive overview of risk factors,

highlighting the dominant role of age, biological sex, certain chronic underlying diseases, previously acquired specific immunity, and the infectious virus strain in the course of the disease.

If you take the time to read it – and we recommend it to our brave and persistent readers – you will see how complex the science is and how often it is difficult to draw clear conclusions. It also reveals the amazing scientific collaboration that has taken place over the past few years as the international scientific community has joined forces to find answers and solutions to the pandemic threatening the world. Fortunately, with the development of effective vaccines and the immunity of those who have been affected, the pandemic has gradually been pushed into the background. Nevertheless, as the virus is expected to be with us for a long time to come, the conclusions of this study will be needed well into the future.