May people believe stronger MS medications are better despite the increased risks. But should you take them long term? Is it safe to “deescalate” to a more conservative approach to reduce the risk of side effects (especially infections with immunosuppressants). I review the scientific evidence and multiple observational studies.
Patient Talk
Healthy diet with less sugar is linked to younger biological age
Researchers at UC San Francisco have found a link between following a diet that is rich in vitamins and minerals, especially one without much added sugar, and having a younger biological age at the cellular level.
They looked at how three different measures of healthy eating affected an “epigenetic clock” – a biochemical test that can approximate both health and lifespan – and found that the better people ate, the younger their cells looked. Even when people ate healthy diets, each gram of added sugar they consumed was associated with an increase in their epigenetic age.
“The diets we examined align with existing recommendations for preventing disease and promoting health, and they highlight the potency of antioxidant and anti-inflammatory nutrients in particular,” said Dorothy Chiu, PhD, a postdoctoral scholar at the UCSF Osher Center for Integrative Health and first author of the study, “From a lifestyle medicine standpoint, it is empowering to see how heeding these recommendations may promote a younger cellular age relative to chronological age.”
The study is one of the first to show a link between added sugar and epigenetic aging, and the first to examine this link in a heterogenous group of women – both Black and white – in midlife. Most studies on the topic have involved older white participants.
The study helps deepen our understanding of why sugar is so detrimental to health, added study co-senior author Elissa Epel, PhD, a UCSF professor in the Department of Psychiatry and Behavioral Sciences.
“We knew that high levels of added sugars are linked to worsened metabolic health and early disease, possibly more than any other dietary factor,” Epel said. “Now we know that accelerated epigenetic aging is underlying this relationship, and this is likely one of many ways that excessive sugar intake limits healthy longevity.”
Women in the study reported consuming an average of 61.5 grams of added sugar per day, though the range was large: from 2.7 to 316 grams of added sugar daily. A bar of milk chocolate has about 25 grams of added sugar, while a 12-ounce can of cola has about 39 grams. The U.S. Food and Drug Administration recommends adults consume no more than 50 grams of added sugar per day.
A nutrient-based approach
For the cross-sectional study, researchers analyzed food records from 342 Black and white women with a mean age of 39 years from Northern California. Then, they compared their diets with epigenetic clock measures, which were derived from saliva samples.
Researchers scored the women’s diets to see how they compared to a Mediterranean-style diet rich in anti-inflammatory and antioxidant foods and then to a diet linked to lower risk for chronic disease.
Finally, they scored the women’s diets against a measure they created called the “Epigenetic Nutrient Index (ENI)”, which is based on nutrients (not foods) that have been linked to anti-oxidative or anti-inflammatory processes and DNA maintenance and repair. These include Vitamins A, C, B12 and E, folate, selenium, magnesium, dietary fiber and isoflavones.
Adherence to any of the diets was significantly associated with lower epigenetic age, with the Mediterranean diet having the strongest association.
The researchers examined sugar intake separately and found that consuming foods with added sugar was associated with accelerated biological aging, even in the presence of an otherwise healthy diet.
“Given that epigenetic patterns appear to be reversible, it may be that eliminating 10 grams of added sugar per day is akin to turning back the biological clock by 2.4 months, if sustained over time,” said co-senior author Barbara Laraia, PhD, RD, a UC Berkeley professor in the Food, Nutrition and Population Health program. “Focusing on foods that are high in key nutrients and low in added sugars may be a new way to help motivate people to eat well for longevity.”
Large study confirms: Siblings of autistic children have 20% chance of autism
Siblings of autistic children have a 20% chance of being autistic themselves — about seven times higher than the rate in infants with no autistic siblings.
That’s the key finding of a new paper by UC Davis MIND Institute researcher Sally Ozonoff and the Baby Siblings Research Consortium. The consortium is a collection of more than 20 research groups at universities worldwide.
The new study is based on a large, diverse group of families at research sites across the United States, Canada, and the United Kingdom. It confirms the same research group’s 2011 findings about the likelihood of autism in siblings.
Increasing autism rates prompt new study
“The rate of autism diagnosis in the general community has been steadily increasing since our previous paper was published,” Ozonoff explained.
The latest estimates from the Centers for Disease Control and Prevention show that about 1 in 36 children has autism. In 2011, the estimate was 1 in 68.
Ozonoff noted that there have also been changes in autism diagnostic criteria over the past decade. In addition, there is a growing awareness of autism in girls.
“So, it was important to understand if these had any impact on the likelihood of autism recurrence within a family,” she said.
The 2011 paper found a recurrence rate of 18.7%, while the new paper found a rate of 20.2% — a small but not significant increase.
“This should reassure providers who are counseling families and monitoring development. It should also help families plan for and support future children,” Ozonoff said.
A larger, more diverse study
The new study included data from 1,605 infants at 18 research sites. All infants had an older autistic sibling.
“This study was much larger than the first and included more racially diverse participants,” Ozonoff said. The original study included 664 children.
Researchers followed the children from as early as 6 months of age for up to seven visits. Trained clinicians assessed the children for autism at age 3 using the Autism Diagnostic Observation Schedule (ADOS-2), a well-validated tool. The data were gathered from 2010 to 2019.
Sex of first autistic child, multiple autistic siblings key factors
Researchers found that the sex of the first autistic child influenced the likelihood that autism would recur within a family.
“If a family’s first autistic child was a girl, they were 50% more likely to have another child with autism than if their first autistic child was a boy,” Ozonoff said. “This points to genetic differences that increase recurrence likelihood in families who have an autistic daughter.”
The researchers also found that a child with multiple autistic siblings has a higher chance of autism (37%) than a child with only one sibling on the spectrum (21%).
The sex of the infant was also associated with the likelihood of familial recurrence. If the later-born infant was a boy, they were almost twice as likely as a girl to be diagnosed themselves.
“The familial recurrence rate if the new baby was a boy was 25%, whereas it was 13% if the new baby was a girl,” Ozonoff explained. “This is in line with the fact that boys are diagnosed with autism about four times as often as girls in general.”
Race, maternal education level influence recurrence
The researchers found that race and the mother’s education level were likely factors as well. In non-white families, the recurrence rate was 25%. In white families, the recurrence rate was about 18%. In families where the mother had a high school education or less, recurrence was 32%. With some college, the rate was 25.5%, and with a college degree the rate was 19.7%. When the mother had a graduate degree, it dropped to 16.9%.
“These findings are new — and critical to replicate,” Ozonoff explained. “They do mirror the recent CDC findings that autism is more prevalent in children of historically underrepresented groups.” She noted that this reversed a longtime trend of lower prevalence in those groups.
Most importantly, said Ozonoff, if these findings are replicated, they may indicate that there are social determinants of health that may lead to higher rates of autism in families. She emphasized that this study was not designed to answer those critical questions, and more research is needed.
Tracking outcomes
Unlike the first study, the researchers also tracked families who dropped out of the three-year study to see if their outcomes differed from those who did. “We wondered whether families who stayed in the study may have had children who were more affected — making them more worried about their development,” she explained.
That could have biased the estimates of recurrence to be higher than they really were. The current study showed that was not the case.
“So, now we have two large, independent studies that report familial recurrence in the same range,” Ozonoff said. “This reinforces how important it is that providers closely monitor the siblings of autistic children for delays in social development or communication. This is especially true in families who have reduced access to care, because early diagnosis and intervention are critical.”
Fibromyalgia and Fatigue 4 Reasons Why You Flare Up and Get Stuck
One of my readers with fibromyalgia asked why it’s difficult to increase exercise tolerance despite pacing and lighter workouts. In the video, I explain the reasons behind these limitations and offer strategies to build strength and endurance.
Cannabis and Rheumatoid Arthritis
How does cannabis help patients with Rheumatoid Arthritis? Learn that and more in today’s video!