Disney Princesses Face Hidden Health Risks, Experts Say

Fairy tale endings could use a dose of real-world wellness advice.
Fairy tale endings could use a dose of real-world wellness advice.

Disney princesses may enchant audiences with their happily-ever-afters. Still, health experts warn that these beloved characters face serious hidden dangers that could jeopardize their well-being in the real world. Writing in the Christmas issue of The BMJ, Sanne van Dijk and colleagues suggest strategies to help Disney’s heroines start living “healthily ever after.

Loneliness and Limited Social Interaction
Take Snow White, for example. Her time as a scullery maid under her wicked stepmother isolates her socially, putting her at risk for cardiovascular disease, depression, and anxiety. While the Seven Dwarfs provide some companionship, her infamous encounter with the poisoned apple proves that not all fairy-tale food choices are health-conscious.

Princess Jasmine faces similar risks growing up isolated within her palace walls. Experts note that her pet tiger, Rajah, adds a layer of danger, including potential zoonotic infections and the ever-present threat posed by living with a predator.

Environmental Hazards
Cinderella’s daily exposure to dust while cleaning leaves her vulnerable to occupational lung diseases. Matters worsen when her fairy godmother sprinkles “magical glitter,” essentially aluminium-coated microplastics, which can harm lung tissue. Instead of a prince, the authors wryly suggest, Cinderella might need respiratory therapy to breathe easily ever after.

Risky Adventures and Overexertion
Pocahontas’ daring cliff dive in pursuit of peace might look graceful on screen, but experts estimate the 252-meter leap would result in more fractures than harmony. Meanwhile, Sleeping Beauty’s long enchanted nap could lead to serious health issues like muscle atrophy, cardiovascular disease, and even pressure ulcers. Prince Philip’s kiss breaks the spell—but the authors note he overlooks the need for consent, raising eyebrows in a modern context.

Animal-Related and Occupational Risks
Belle, who cohabitates with the Beast, faces possible exposure to life-threatening diseases like brucellosis and rabies. Mulan, celebrated for saving China, endures immense family pressure to preserve their honor—a stressor linked to mental health challenges in real-life situations involving honor-based expectations.

And then there’s Rapunzel, whose endlessly long hair isn’t just a tool for escape but also a source of potential health issues. Repeated pulling on her braid could lead to traction alopecia, causing scalp pain, headaches, and even permanent hair loss.

A Call for Wellness Interventions
The authors argue that Disney princesses need more than just fairy-tale fixes. Interventions like mindfulness training, psychotherapy, and education about animal cohabitation could go a long way toward improving their health outcomes. Measures to combat exposure to toxic particles and prevent infectious diseases would also help these characters live more realistic, healthy lives.

“Disney must consider strategies to address these challenges,” the authors conclude. “Only then can its princesses truly enjoy their happily-ever-afters in good health.”

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Live well, think well: Research shows healthy habits tied to brain health

Type 2 diabetes and prediabetes are associated with accelerated brain ageing, according to a new study from Karolinska Institutet in Sweden published in the journal Diabetes Care. The good news is that this may be counteracted by a healthy lifestyle.

In middle-aged people, having risk factors like blood pressure, blood sugar and cholesterol that are not well-controlled, combined with not following certain healthy habits, including exercise, diet and sleep, are linked to a higher risk of stroke, dementia or depression later in life,. 

The eight cardiovascular and brain health factors, known as the American Heart Association’s Life’s Essential 8, are being active, eating better, maintaining a healthy weight, not smoking, maintaining healthy blood pressure, getting enough sleep, and controlling cholesterol and blood sugar levels.

“Brain health is paramount for the optimal well-being of every person, enabling us to function at our highest level and constantly adapt in the world,” said study author Santiago Clocchiatti-Tuozzo, MD, MHS, of Yale University in New Haven, Connecticut, and member of the American Academy of Neurology. “Our study found that making these healthy lifestyle choices in middle age can have meaningful impacts on brain health later in life.”

For the study, researchers evaluated data from 316,127 people, with an average age of 56, who were followed over five years.

Researchers analyzed participants’ scores across the eight essential cardiovascular health factors and organized them into three categories: optimal, intermediate, and poor.

Of the total group, 64,474 had optimal scores, 190,919 had intermediate scores, and 60,734 had poor scores.

Researchers then evaluated health records to identify who developed any of the following neurological conditions: stroke, dementia or late-life depression. Poor brain health was defined as developing these conditions during the follow-up years.

1.2% of participants met the definition for poor brain health, with 3,753 conditions. Of those with optimal Life’s Essential Eight scores, 0.7% met the definition of poor brain health, compared to 1.2% with intermediate scores and 1.8% with poor scores.

After adjusting for factors that could affect the risk of these three neurological conditions, such as age, sex, race and ethnicity, researchers found that people with poor scores on the healthy lifestyle factors were more than twice as likely to develop any of the three neurological conditions compared to those people with optimal scores. Researchers also found that people with an intermediate score had a 37% higher risk of having one of the three neurological conditions than those with an optimal score.

“Because the risk factors we looked at are all ones that people can work to improve, our findings highlight the potential benefits of using these eight cardiovascular and brain health factors to guide healthy lifestyle choices,” Clocchiatti-Tuozzo said. “More research is needed to understand this link between lifestyle habits and brain health, as well as how social factors like race and ethnicity can influence this connection.”

Brighter nights and darker days could lead to an early grave

Are you protecting your children’s eyes from the sun this summer?

A study of more than 13 million hours of data collected from light sensors worn by 89,000 people has found exposure to bright nights and dark days is associated with an increased risk of death.

Researchers investigated whether personal day and night light and lighting patterns that disrupt our circadian rhythms predicted mortality risk.

Published in the journal Proceedings of the National Academy of Sciences, the findings indicate that individuals exposed to high levels of light at night faced a 21% to 34% increased risk of death. In contrast, those exposed to high levels of daylight experienced a 17% to 34% decrease in their risk of death.

“Exposure to brighter nights and darker days can disrupt our circadian rhythms. This disruption can lead to various health issues, including diabetes, obesity, cardiovascular disease, mental health problems, and an increased risk of death,” explains Professor Sean Cain, a senior author and sleep expert from Flinders University.

“These new insights into the potential adverse impact of light have shown us just how important personal light exposure patterns are for your health.”

Associate Professor Andrew Phillips, co-senior author, states that nighttime light exposure disrupts circadian rhythms by shifting their timing (phase-shift) and weakening the signal (amplitude suppression) of the central circadian ‘pacemaker,’ which regulates circadian rhythms throughout the body.

“Disruption to the body’s circadian rhythms is linked to the development of metabolic syndrome, diabetes, and obesity and is also strongly implicated in the development of cardiometabolic diseases, including myocardial infarction, stroke and hypertension,” says Associate Professor Phillips.

“The observed relationships of night light exposure with mortality risk may be explained by night light disrupting circadian rhythms, leading to adverse cardiometabolic outcomes.

“Our findings clearly show that avoiding night light and seeking daylight may promote optimal health and longevity, and this recommendation is easy, accessible and cost-effective,” adds Associate Professor Phillips.

The study authors from FHMRI Sleep Health investigated the relationship between personal light exposure and the risk of all-cause and cardiometabolic mortality in 89,000 participants from the UK Biobank, aged between 40 and 69. Metrics were recorded using wrist-worn sensors, and the National Health Service collected the participants’ mortality data over an approximate follow-up period of eight years.

Sleep duration, sleep efficiency, and midsleep were estimated from motion data. At the same time, cardiometabolic mortality was defined as any cause of death corresponding to diseases of the circulatory system or endocrine and metabolic diseases.

The research also showed a disrupted circadian rhythm predicted higher mortality risk, which the authors were able to determine using computer modelling. Findings accounted for age, sex, ethnicity, photoperiod, and sociodemographic and lifestyle factors.

Lead author Dr Daniel Windred says that the findings demonstrate the importance of maintaining a dark environment during the late night and early morning hours, when the central circadian ‘pacemaker’ is most sensitive to light, and seeking bright light during the day to enhance circadian rhythms.

“Protection of lighting environments may be significant in those at risk for circadian disruption and mortality, such as in intensive care or aged-care settings,” says Dr Windred.

“Across the general population, avoiding night light and seeking daylight may lead to a reduction in disease burden, especially cardiometabolic diseases, and may increase longevity.”

Newsflash – Costs still on the rise for drugs for neurological diseases, especially Multiple Sclerosis

A USC study of prescription data shows that people with Medicaid or Medicare Part D may be missing out on powerful new obesity and diabetes drugs

The costs that individuals pay out-of-pocket for branded medications to treat neurological diseases such as multiple sclerosis (MS), Alzheimer’s disease, and Parkinson’s disease continue to rise, particularly for MS drugs. According to a study published in the online issue of Neurology®, the medical journal of the American Academy of Neurology, on October 30, 2024, the average out-of-pocket expenses for MS medications increased by 217% over a nine-year period.

Costs have dropped for medications where generic versions have been introduced.

“In some instances, the out-of-pocket costs for patients have risen significantly more than the total cost of the drug itself, indicating that patients are bearing an unfair share of these cost increases,” said Amanda V. Gusovsky, MPH, PhD, from The Ohio State University in Columbus. “In other cases, when generic drugs were introduced and overall costs decreased, the out-of-pocket expenses for patients did not fall, meaning they did not benefit from these reductions.”

For the study, researchers used a large private healthcare claims database to analyse the costs of medications for five common neurological diseases from 2012 to 2021. The study included 186,144 individuals with epilepsy, 169,127 with peripheral neuropathy, 60,861 with Alzheimer’s disease or other forms of dementia, 54,676 with multiple sclerosis (MS), and 45,909 with Parkinson’s disease.

MS drugs had the largest cost increase, with the average out-of-pocket drug cost increasing from $750 per year in 2012 to $2,378 per year in 2021. All MS drugs had increasing out-of-pocket costs.

“MS medications costs remain exceptionally high and pose a substantial financial burden to people with this devastating disease,” Gusovsky said. “It’s imperative that we develop policy solutions such as caps on costs, value-based pricing and encouraging production of generic drugs to address this issue.”

The study found that the cost of several drugs for these diseases decreased by 48% to 80% in the years after introducing a generic version.

Gusovsky said both neurologists and patients should consider using generic or biosimilar drugs where available to control costs. She noted that previous studies have shown that high costs can create burdens such as medical debt, skipping food or other essentials, or not taking drugs as often as prescribed, which can possibly lead to complications and higher costs later.

Understanding how mutations affect diseases such as diabetes

Natália Ružičková Institute of Science and Technology Austria

PhD student Natália Ružičková

Many statistical models and algorithms scientists use can be imagined as a “black box.” These powerful models give accurate predictions, but their internal workings are not easily understood. In an era dominated by deep learning, where an ever-increasing amount of data can be processed, Natália Ružičková, a physicist and PhD student at the Institute of Science and Technology Austria (ISTA), chose to take a step back at least in the context of genomic data analysis.

Ružičková, along with recent ISTA graduate Michal Hledík and Professor Gašper Tkačik, has proposed a model to analyze polygenic diseases—conditions where multiple regions of the genome contribute to dysfunction. This model also aids in understanding the role of these identified genomic regions in developing these diseases. Their research provides valuable findings by integrating advanced genome analysis with fundamental biological insights. The results have been published in the Proceedings of the National Academy of Sciences (PNAS).

Decoding the human genome

In 1990, the Human Genome Project was launched to decode human DNA fully—the genetic blueprint that defines humanity. By 2003, the project was completed, leading to numerous scientific, medical, and technological breakthroughs. By deciphering the human genetic code, scientists aimed to learn more about diseases linked to specific mutations and variations in this genetic map. The human genome comprises approximately 20,000 genes and even more base pairs, which are the letters of the blueprint. This complexity made ample statistical power essential, resulting in the development of “genome-wide association studies” (GWAS).

GWAS approach the issue by identifying genetic variants potentially linked to organismal traits such as height. Notably, they also include the propensity for various diseases. The underlying statistical principle is relatively straightforward: participants are divided into two groups—healthy and sick individuals. Their DNA is then analyzed to detect variations—changes in their genome—that are more prominent in those affected by the disease.  

An interplay of genes

When genome-wide association studies emerged, scientists expected to find just a few mutations in known genes linked to a disease that would explain the difference between healthy and sick individuals. The truth, however, is much more complicated. “Sometimes, hundreds or thousands of mutations are linked to a specific disease,” says Miss Ružičková. “It was a surprising revelation and conflicted with our understanding of biology.”

Each individual mutation contributes only minimally to the risk of developing a disease. However, when combined, these mutations can provide a better—though not complete—understanding of why some individuals develop the disease. Such diseases are known as “polygenic.” For instance, type 2 diabetes is considered polygenic because it cannot be attributed to a single gene; rather, it involves hundreds of mutations. Some of these mutations influence insulin production, insulin action, or glucose metabolism, while many others are found in genomic regions that have not been previously linked to diabetes or have unknown biological functions.

The omnigenic model

In 2017, Evan A. Boyle and colleagues from Stanford University proposed a new conceptual framework called the “omnigenic model.” They proposed an explanation for why so many genes contribute to diseases: cells possess regulatory networks that link genes with diverse functions.

“Since genes are interconnected, a mutation in one gene can impact others, as the mutational effect spreads through the regulatory network,” Ružičková explains. Due to these networks, many genes in the regulatory system contribute to a disease. However, until now, this model has not been formulated mathematically and has remained a conceptual hypothesis that was difficult to test. In their latest paper, Ružičková and her colleagues introduce a new mathematical formalization based on the omnigenic model named the “quantitative omnigenic model” (QOM).

Combining statistics and biology

To demonstrate the new model’s potential, they needed to apply the framework to a well-characterized biological system. They chose the typical lab yeast model Saccharomyces cerevisiae, better known as the brewer’s yeast or the baker’s yeast. It is a single-cell eukaryote, meaning its cell structure is similar to that of complex organisms such as humans. “In yeast, we have a fairly good understanding of how regulatory networks that interconnect genes are structured,” Miss Ružičková says.

Using their model, the scientists predicted gene expression levels—the intensity of gene activity, indicating how much information from the DNA is actively utilized—and how mutations spread through the yeast’s regulatory network. The predictions were highly efficient: The model identified the relevant genes and could clearly pinpoint which mutation most likely contributed to a specific outcome.

The puzzle pieces of polygenic diseases

The scientists’ goal was not to outdo the standard GWAS in prediction performance but rather to go in a different direction by making the model interpretable. Whereas a standard GWAS model works as a “black box,” offering a statistical account of how frequently a particular mutation is linked to a disease, the new model also provides a chain-of-events causal mechanism for how that mutation may lead to disease.

In medicine, understanding the biological context and such causal pathways has huge implications for finding new therapeutic options. Although the model is far from any medical application, it shows potential, especially for learning more about polygenic diseases. “If you have enough knowledge about the regulatory networks, you could also build similar models for other organisms. We looked at the gene expression in yeast, which is just the first step and proof of principle. Now that we understand what is possible, one can start thinking about applications to human genetics,” says Miss Ružičková.