Posted on Diabetes

Empathetic telephone calls improve diabetes control in low-income adults, study shows

Empathy-focused phone calls made by trained, nonmedical community members led to significant improvements in blood sugar control for low-income adults with diabetes, according to a new study from Dell Medical School at The University of Texas at Austin in collaboration with Lone Star Circle of Care. Published today in JAMA Network Open, the study suggests this approach could provide a simple, cost-effective model for managing chronic conditions, particularly for patients with limited access to traditional mental health and support services.
A recent study conducted by Dell Medical School at The University of Texas at Austin, in collaboration with Lone Star Circle of Care, found that empathy-focused phone calls made by trained community members (who are not medical professionals) led to significant improvements in blood sugar control among low-income adults with diabetes. Published today in JAMA Network Open, the study suggests that this approach could serve as a simple and cost-effective model for managing chronic conditions, especially for patients who have limited access to traditional mental health and support services.

In a six-month clinical trial, 260 patients with uncontrolled diabetes were randomly divided into two groups. One group received standard care, while the other received standard care and regular phone calls that emphasized listening and empathy. These calls were made by community members who were trained to provide compassionate support, allowing participants to share their experiences and challenges related to living with diabetes.

“This approach starts by recognizing the real and everyday challenges of living with diabetes,” said Maninder “Mini” Kahlon, Ph.D., the study’s lead author and an associate professor in the Department of Population Health at Dell Med. “By providing sincere and empathetic support, we achieved a health impact equivalent to taking medication. This is because emotional well-being serves as the gateway to the lifestyle changes that enhance the management of the condition—an area where traditional healthcare often falls short.”

Key findings include:

  • Improved Blood Sugar Control: Patients who received empathy-based calls saw an average HbA1c reduction of 0.7%, compared with no significant change in the control group.
  • Greater Impact for Patients With Mild or Greater Depressive Symptoms: Patients reporting mild depressive symptoms saw even larger reductions, with average HbA1c improvements of 1.1%.
  • High Satisfaction: Nearly all participants receiving the calls rated them as very or extremely beneficial to their well-being.

All study participants, who were patients of the Lone Star Circle of Care, had the flexibility to choose how often and for how long they wanted to engage in calls. During the initial stages, they could select between one and five calls per week, gradually tapering as they made progress. This patient-driven approach empowered individuals to receive support at a pace that met their needs and schedules. It helped foster a strong connection with their callers while reinforcing their self-care routines.

“At a time when workforce shortages challenge health care delivery, this study underscores the profound clinical impact nonclinical staff can make,” said Jon Calvin, CEO of Lone Star Circle of Care. “By leveraging trained laypeople, we’re demonstrating that empathy, connection and intentional engagement can lead to measurable health improvements. In a world where medicine is increasingly fast-paced and technology-driven, this work reminds us that human connection remains at the heart of effective care. Empathy not only enhances patient engagement but empowers individuals to take meaningful steps toward better health outcomes.”

This research builds on previous studies highlighting the benefits of empathetic phone calls. In 2021, Kahlon and her team published a study that found “Sunshine Calls”—a series of regular, genuine phone calls made by individuals who were not healthcare professionals—showed promise in alleviating loneliness, depression, and anxiety, as well as improving overall mental health among mainly homebound older adults.

Both studies were funded by the Episcopal Health Foundation, which focuses on person-centered, nonmedical approaches to health.

Looking ahead, researchers hope to explore the long-term effects of empathy-based support on both diabetes control and broader mental health. They also plan to scale this model, aiming to make holistic, empathetic support more widely available to those in need.

Posted on Autism

Sculpting the brain (without chisel or scalpel). Can this help us understand autism better?

Scientists have developed a novel approach to human learning through noninvasive manipulation of brain activity patterns.
Scientists have developed a novel approach to human learning through noninvasive manipulation of brain activity patterns.

Imagine if we could create a new pattern of activity in a person’s brain that enables faster learning or improves the treatment of psychiatric and developmental disorders such as depression or autism. Now, a picture can achieve this without brain surgery or physical manipulation. Does that sound like science fiction?

It still holds. Coraline Iordan, an assistant professor of brain and cognitive sciences and neuroscience at the University of Rochester, has made significant strides in demonstrating that learning new visual categories of objects is possible. This marks the first time such an achievement has been shown.

Learning typically occurs when our brains change due to experience, study, or instruction. However, Iordan and his colleagues at Yale and Princeton have successfully tested a novel approach to teaching the brain to learn through external manipulation and neural feedback, which they call “sculpting” brain activity patterns.

“Our method allows us not only to influence complex patterns in the brain by guiding them toward known patterns but also—for the first time—to insert a new pattern into the brain directly. We can then measure the effects this has on a person’s behaviour,” says lead author Iordan.

Brain sculpting—a new approach to learning?

The scientists employed real-time neuroimaging and second-by-second neurofeedback to alter how the brain represents and processes information about visual objects. In a functional magnetic resonance imaging (fMRI) machine, study participants viewed objects projected onto a mirror above their heads resembling a small screen. The object—an abstract shape that some participants interpreted as a petal, plant bulb, or butterfly—pulsed gently on the mirror until participants learned to “move” it by using their thoughts. This movement was based on a specific pattern of brain activity, which the scientists had chosen in advance and was monitored via fMRI in real-time. The researchers instructed participants to “generate a mental state” that would reduce the shape’s oscillation, but they did not teach the participants how to achieve this mental state.

“One of the study’s notable findings is that neural responses and related behaviours to new categories happened without explicit awareness of those categories. This demonstrates that a long-standing tradition in psychology regarding implicit processing—defined as the capacity to respond meaningfully to information without conscious awareness—also applies to the learning and forming new neural representations,” says coauthor Jonathan Cohen, a cognitive neuroscientist at Princeton University.

The immediate feedback provided to the study participants allowed them to stop the wobbling image in the mirror once they successfully altered their representation of a visual object to align more closely with a brain activity pattern designated by the researchers. This approach did not involve directly teaching participants what the categories of visual objects were; instead, the scientists developed a method that changed how participants’ brains processed and represented the individual objects within those categories. Essentially, they facilitated the learning of new object categories by modifying the participants’ brain activity.

“Instead of teaching you something and measuring how your brain changes, we wrote a new category into your brain that would have appeared had you learned it yourself,” explains Iordan. “Then we tested whether you saw the new category that we had inserted. Turns out you did.”

To ensure study participants were highly motivated to succeed, they were rewarded monetarily if they managed to stop the image wobble, which over six daily sessions could amount to a sizeable bonus.

Future applications

Scientists are working to better understand what exactly happens to brain function in people with a variety of neuropsychiatric, developmental, or psychological disorders, such as major depression, visual agnosias (the inability to recognize everyday items), and autism. According to Iordan, a method like theirs may eventually play a role in clinical treatment by modifying the brain patterns of patients to make theirs look more similar to the brain patterns found in the neurotypical population, which down the road could lead to new approaches for treatment, either by itself or in conjunction with already existing therapies.

“This study is one of the most powerful demonstrations yet of brain training with real-time fMRI. Dr. Iordan used neurofeedback to help humans create a category in their mind that then influenced their behavior,” says coauthor Nicholas Turk-Browne, a psychologist at Yale University. “In the future, this discovery could inform the development of brain-computer interfaces and clinical interventions.”

At its core lies the scientists’ ability to access the brain in a way that hasn’t been done before.

“We essentially turned learning on its head and taught your brain something that caused you to vicariously gain information, even though you were never explicitly given that information,” says Iordan. “That tells us we have access to the building blocks of learning in the brain in a way that we haven’t had before—for learning things that are much more complicated, such as entire categories of items, complex visual things, or potentially even beyond that someday.

Posted on Exercise, Multiple Sclerosis

Exercise modifications help manage multiple sclerosis

Regular aerobic exercise has been shown to alleviate symptoms of multiple sclerosis (MS), a disease that affects the central nervous system. Dr Eoin Flanagan, a neurologist at Mayo Clinic, explains how individuals with MS can adjust their exercise routines to avoid worsening symptoms such as poor balance and heat intolerance.

Posted on Cognitive dysfunction, Exercise, Sleep disorders

Short-term cognitive boost from exercise may lasts till the next day

Autism and exercise
A study led by researchers at UCL (University College London) found that exercise provides a short-term boost in brain function that lasts the next day. Previous research in a laboratory setting has shown that people’s cognitive performance improves in the hours after exercise, but how long this benefit lasts is unknown.

The new study, published in the International Journal of Behavioral Nutrition and Physical Activity, found that, on average, people aged 50 to 83 who did more moderate to vigorous physical activity than usual on a given day did better in memory tests the day after.
Less time spent sitting and six hours or more of sleep were also linked to better memory test scores the next day.
More deep (slow-wave*) sleep also contributed to memory function, and the research team found this accounted for a small portion of the link between exercise and better next-day memory.
The research team analysed data from 76 men and women who wore activity trackers for eight days and took cognitive tests daily.

Lead author Dr Mikaela Bloomberg (UCL Institute of Epidemiology & Health Care) said: “Our findings suggest that the short-term memory benefits of physical activity may last longer than previously thought, possibly to the next day instead of just a few hours after exercise. More sleep, profound sleep, seems to add to this memory improvement.
“Moderate or vigorous activity means anything that gets your heart rate up – this could be brisk walking, dancing or walking up a few flights of stairs. It doesn’t have to be a structured exercise.
“This was a small study, so it needs to be replicated with a larger sample of participants before we can be certain about the results.”
In the short term, exercise increases blood flow to the brain and stimulates the release of neurotransmitters such as norepinephrine and dopamine, which help with a range of cognitive functions.
These neurochemical changes are understood to last up to a few hours after exercise. However, the researchers noted that other brain states linked to exercise were more long-lasting. For instance, evidence suggests exercise can enhance mood for up to 24 hours.
A 2016 study published by a separate research team also found more synchronised activity in the hippocampus (a marker of increased hippocampal function, which facilitates memory function) for 48 hours after high-intensity interval training (HIIT) cycling.  
Co-author Professor Andrew Steptoe (UCL Institute of Epidemiology & Health Care) said: “Among older adults, maintaining cognitive function is essential for good quality of life, wellbeing, and independence. It’s helpful to identify factors that can affect mental health daily.
“This study provides evidence that the immediate cognitive benefits of exercise may last longer than we thought. It also suggests that good sleep quality contributes to mental performance separately.
“However, we can’t establish from this study whether these short-term boosts to cognitive performance contribute to longer-term cognitive health, and though there is plenty of evidence to suggest physical activity might slow cognitive decline and reduce dementia risk, it’s still a matter of some debate.”
For the new study, the researchers looked at data from wrist-worn activity trackers to determine how much time participants spent being sedentary, doing light physical activity, and doing moderate or vigorous physical activity. They also quantified sleep duration and time spent in lighter (rapid eye movement, or REM) sleep and more profound, slow-wave sleep.
In looking at the links between different types of activity and next-day cognitive performance, the research team adjusted for a wide variety of factors that might have distorted the results, including the amount of moderate or vigorous physical activity participants did on the day of the tests.
They also accounted for participants’ average levels of activity and sleep quality across the eight days they were tracked, as participants who are habitually more active and typically have higher-quality sleep perform better in cognitive tests.
The team found that more moderate or vigorous physical activity compared to a person’s average was linked to better working memory and episodic memory (memory of events) the next day. More sleep overall was linked to improved episodic and working memory and psychomotor speed (a measure of how quickly a person detects and responds to the environment). More slow-wave sleep was linked to better episodic memory.
Conversely, more time spent being sedentary than usual was linked to worse working memory the next day.
Posted on Diabetes, Diet

Jabuticaba peel improves nutritional characteristics of bread and lowers glycemic peaks 

Consumption of bread supplemented with jabuticaba peel flour, which is rich in fiber and antioxidants, lowers glycemic peaks and prolongs satiety.
Consumption of bread supplemented with jabuticaba peel flour, which is rich in fibre and antioxidants, lowers glycemic peaks and prolongs satiety.

Researchers at the State University of Campinas (UNICAMP) in São Paulo, Brazil, have developed a sourdough bread formulation enriched with jabuticaba peel. This bread may serve as an alternative for individuals with diabetes and others who need to manage their blood sugar levels. The research findings and test results are published in the journal Foods.

The article highlights that bread’s high carbohydrate content can significantly increase blood sugar levels, risking hyperglycemia. As a result, there is a growing demand for healthier bread options. Artisanal bakers are responding by diversifying their products with recipes that offer added nutritional value and utilize fermentation methods that promote a milder glycemic response.

According to the article’s data, adding jabuticaba peel flour increased the bread’s fibre content by more than 50%. It raised its antioxidant capacity by between 1.35 times and 3.53 times, depending on the proportion of jabuticaba peel flour added to the formulation. This supplementation increased nutrients’ bioavailability and enhanced the final product’s nutritional composition.

The researchers conducted a crossover trial to assess the glycemic peak (the highest blood sugar level reached) after consumption of regular bread made by the long fermentation method (which tends to induce a lower glycemic peak) and consumption a week later of bread containing jabuticaba peel flour. Blood sugar peaked 30 minutes after ingesting the regular bread without jabuticaba peel flour, remaining high for another 15 minutes and then trending down. In the case of the bread supplemented with jabuticaba peel flour, the peak was lower, occurring 45 minutes after ingestion, and blood sugar fell slowly for two and a quarter hours.

Metabolism

Blood sugar rises after ingestion of bread and other carbohydrate-rich foods. Digestion releases glucose, telling the pancreas to secrete insulin, which induces a return to prior blood sugar levels. Flaws in this process lead to health problems, and it is essential to observe the extent to which blood sugar spikes in response to eating.

“If we can lower the spikes in sugar and insulin levels that occur after meals, we reduce the likelihood of developing diabetes and metabolic syndrome. For individuals already experiencing hyperglycemia, managing these post-meal spikes can decrease the risk of heart disease. Additionally, this approach can help extend the lifespan of insulin-producing cells,” said Bruno Geloneze.

The thesis supervisor, who formed the basis for the article, noted that the main challenge in producing the bread for the trials was effectively deploying the technology while preserving its nutritional and functional value. Jabuticaba peel flour has unique sensory characteristics, and its inclusion needs to be evaluated carefully.”

“Jabuticaba peel flour has particular sensory characteristics, and its inclusion had to be evaluated concerning both the technological characteristics of breadmaking and the processing and conservation of the bioactive compounds involved,” she said.

Conservation is relevant because the improvement in blood sugar control and insulin response is associated with the phenolic compounds in jabuticaba peel, such as anthocyanins, which account for the fruit’s dark purple colour. Therefore, it is essential to avoid their “loss” during processing.

Another important finding relates to satiety. The participants felt fuller 60 minutes after eating the bread with jabuticaba peel flour than after they ate the control bread. The authors of the article note that satiety is generally found to improve when blood sugar returns to baseline more slowly, as it does with foods with a low glycemic index.

Antioxidant capacity was monitored for three hours after the bread was consumed. After the bread with jabuticaba peel flour was consumed, the neutralization of free radicals increased significantly and lasted longer. 

“This improvement in antioxidant capacity is important because the development of metabolic disorders, cardiovascular disease and cancer, and the ageing process, involve protein oxidation mechanisms in the body.  The antioxidant capacity of a food can be beneficial in all these mechanisms,” Geloneze said.

Another significant finding was the extension of shelf life to seven days, which, according to the researchers, showed that the bacteria in jabuticaba peel and metabolites formed during the fermentation process can act as natural preservatives in long-fermentation products, inhibiting the growth of pathogenic microorganisms.

Jabuticaba

The article notes that researchers have focused in recent years on the inclusion of ingredients with high biological value in food products, especially agroindustrial byproducts, given the large quantities produced, their nutraceutical potential, and the environmental impact associated with their disposal.

Consumption of jabuticaba (Plinia jaboticaba) and other red and purple berries is known to help prevent or delay the emergence of non-transmissible chronic diseases. “Jabuticaba peel contains phenolic compounds and fibres that have been shown in several studies to contribute to the control of blood sugar and cholesterol,” Maróstica said.

The juice of this berry has also been shown to reduce insulin resistance and increase the production of GLP-1. This hormone helps regulate digestion, satiety and glycemia (as emulated by medications such as semaglutide and liraglutide).

The results of all this research are promising, and the group comprising scientists from UNICAMP’s medical and food engineering schools continue to investigate the fruit’s bioactive compounds. They are now conducting in vivo trials with animal models to find out whether and how these compounds can combat depression and help prevent colorectal cancer.