Posted on Cognitive dysfunction, Dementia, Diabetes, Diet, Obesity

Restricting sugar consumption in utero and in early childhood significantly reduces risk of midlife chronic disease

New research shows combined use of sodium glucose co-transporter 2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP1-RAs) is likely to offer additional protection against heart and kidney disease in patients with diabetes

A new study has found that a low-sugar diet in utero and in the first two years of life can meaningfully reduce the risk of chronic diseases in adulthood. This provides compelling new evidence of the lifelong health effects of early-life sugar consumption.

A study published in the journal Science reveals that children who had sugar restrictions during their first 1,000 days after conception faced up to a 35% lower risk of developing Type 2 diabetes and a 20% reduced risk of hypertension in adulthood. The research indicates that low sugar intake by mothers during pregnancy was sufficient to lower these health risks, and maintaining sugar restrictions after birth further enhanced the benefits.

Using an unintended “natural experiment” from World War II, researchers at the USC Dornsife College of Letters, Arts and Sciences, McGill University in Montreal, and the University of California, Berkeley, examined how sugar rationing during the war influenced long-term health outcomes.

The United Kingdom introduced limits on sugar distribution in 1942 as part of its wartime food rationing program. Rationing ended in September 1953.

The researchers used contemporary data from the U.K. Biobank, a database of medical histories and genetic, lifestyle and other disease risk factors, to study the effect of those early-life sugar restrictions on health outcomes of adults conceived in the U.K. just before and after the end of wartime sugar rationing.

“Studying the long-term effects of added sugar on health presents challenges,” explains Tadeja Gracner, a senior economist at the USC Dornsife Center for Economic and Social Research and the study’s corresponding author. “It is difficult to identify situations where individuals are randomly exposed to different nutritional environments early in life and tracked over a span of 50 to 60 years. The end of rationing provided us with a unique natural experiment that helped us overcome these obstacles.”

On average, during rationing, sugar intake was about 8 teaspoons (40 grams) per day. When rationing ended, sugar and sweets consumption skyrocketed to about 16 teaspoons (80 grams) per day. 

Notably, rationing did not involve extreme food deprivation overall. Diets generally appeared to have been within today’s guidelines set by the U.S. Department of Agriculture and the World Health Organization, which recommend no added sugars for children under two and no more than 12 teaspoons (50g) of added sugar daily for adults. 

The immediate and large increase in sugar consumption but no other foods after rationing ended created an interesting natural experiment: Individuals were exposed to varying levels of sugar intake early in life, depending on whether they were conceived or born before or after September 1953. Those conceived or born just before the end of rationing experienced sugar-scarce conditions compared to those born just after who were born into a more sugar-rich environment.

The researchers then identified those born in the U.K. Biobank data collected over 50 years later. Using a very tight birth window around the end of sugar rationing allowed the authors to compare midlife health outcomes of otherwise similar birth cohorts.  

While living through the period of sugar restriction during the first 1,000 days of life substantially lowered the risk of developing diabetes and hypertension, for those later diagnosed with either of those conditions, the onset of disease was delayed by four years and two years, respectively. 

Notably, exposure to sugar restrictions in utero alone was enough to lower risks, but disease protection increased postnatally once solids were likely introduced. 

The researchers say the magnitude of this effect is meaningful as it can save costs, extend life expectancy, and, perhaps more importantly, improve quality of life.

In the United States, individuals with diabetes face average annual medical expenses of approximately $12,000. Additionally, an earlier diagnosis of diabetes is associated with a significantly reduced life expectancy; specifically, for each decade that diagnosis occurs earlier, life expectancy decreases by three to four years.

The researchers note that these numbers underscore the value of early interventions that could delay or prevent this disease.

Experts continue to raise concerns about children’s long-term health as they consume excessive amounts of added sugars during their early life, a critical period of development. Adjusting child sugar consumption, however, is not easy—added sugar is everywhere, even in baby and toddler foods, and children are bombarded with TV ads for sugary snacks, say the researchers.

“Parents need information about what works, and this study provides some of the first causal evidence that reducing added sugar early in life is a powerful step towards improving children’s health over their lifetimes,” says study co-author Claire Boone of McGill University and University of Chicago.  

Co-author Paul Gertler of UC Berkeley and the National Bureau of Economics Research adds: “Sugar early in life is the new tobacco, and we should treat it as such by holding food companies accountable to reformulate baby foods with healthier options and regulate the marketing and tax sugary foods targeted at kids.” 

This study is the first of a larger research effort exploring how early-life sugar restrictions affected a broader set of economic and health outcomes in later adulthood, including education, wealth, and chronic inflammation, cognitive function and dementia. 

Posted on A to Z of Medical Conditions, Diabetes, Obesity

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.”

Posted on Autism, Patient Talk

Autistic traits shape how we explore

Autistic traits shape how we explore

Curiosity-driven exploration study Credit Francesco Poli & Maran Koolen (created using Pixabay and DALL-E, CC-BY 4.0, https://creativecommons.org/licenses/by/4.0/)

A new study published this week in PLOS Computational Biology, led by Francesco Poli from Radboud University in the Netherlands, found that individuals with more vital autistic traits demonstrated unique exploration patterns and increased persistence while playing a computer game. As a result, they performed better than those with lower levels of autistic traits.

Scientists understand that individuals exhibit curiosity and explore their surroundings to gain knowledge. The choices a person makes regarding what to explore significantly impact their learning. Research has demonstrated that the levels of exploration vary greatly among individuals.

In a recent study, researchers tested 77 university students using a curiosity-driven exploration task. In this task, participants needed to learn the hiding patterns of multiple characters to predict their locations. The participants’ levels of autistic traits were assessed through both self-reported questionnaires and those reported by their parents regarding social behaviour.

People with lower scores of general autistic traits were less persistent and sought learning opportunities by engaging with characters more in the early stages of exploration. People with higher scores of autistic traits were more persistent and explored for longer times, even when learning was not easy. This meant that they performed better on this task.

Posted on Autism

Autistic psychiatrists who don’t know they’re autistic may fail to spot autism in patients

Dr Mary Doherty, Clinical Associate Professor at UCD School of Medicine

Dr Mary Doherty, Clinical Associate Professor at UCD School of Medicine

Recent groundbreaking research examining the experiences of autistic psychiatrists has found that those who are unaware of their autism may struggle to recognize the condition in their patients. This study, conducted by researchers from University College Dublin, London South Bank University, and Brighton and Sussex Medical School, is the first of its kind to explore the lives of neurodivergent psychiatrists. It was published today in BJPsych Open.

Dr. Mary Doherty, a Clinical Associate Professor at UCD School of Medicine, stated, “Understanding that you are autistic can be a transformative experience.” She also noted that over 187,000 people in England are currently waiting for an autism assessment. The situation becomes even more challenging when psychiatrists, who may be unaware of their autism, misdiagnose patients. Greater recognition of autism could provide benefits for both psychiatrists and their patients.

The research team, consisting of medical professionals and academics identifying as neurodivergent, conducted in-depth interviews with eight senior psychiatrists based in the UK. Six of these psychiatrists are consultants working within the NHS. Their specialities include various areas, including Child and Adolescent Mental Health and adult services, including intellectual disabilities.

The study examined how psychiatrists came to realize they were autistic, often through personal experiences like their child’s diagnosis or by noticing similarities between themselves and their autistic patients. Notably, some were even identified as autistic by their patients.

Once self-recognition took place, psychiatrists began to notice that many of their colleagues—particularly those specializing in autism or ADHD—might also be autistic without realizing it. This lack of awareness can lead to significant consequences, as these psychiatrists may unintentionally overlook the diagnosis in their autistic patients. However, after becoming aware of their neurodivergence, the psychiatrists found it easier to recognize autism in others and to establish therapeutic solid relationships.

The study also revealed that understanding their autism had a positive impact on the psychiatrists’ self-esteem and mental health. However, the researchers pointed out that many patients miss out on this benefit when assessed by psychiatrists who, while sharing their experiences, do not recognise they are also autistic.

Posted on Infectious Diseases

Not going out is the “new normal” post-Covid, say experts

Change Your Home, Work, & Life For Less Chronic Pain
Responses from 34,000 people across the US suggest staying home is the new ‘going out.’

Since the COVID-19 pandemic, people have been spending nearly an hour less each day on activities outside their homes, a change researchers believe is a lasting consequence of the pandemic.

A recent study published in the Journal of the American Planning Association found that since 2019, the daily time spent on out-of-home activities has decreased by approximately 51 minutes. Additionally, the study indicates that time spent on daily travel, including driving and using public transportation, has been reduced by nearly 12 minutes.

A recent analysis based on a survey of 34,000 Americans is the first to examine the differences between out-of-home and in-home activities following the pandemic. Researchers from Clemson University and UCLA have noted a trend of decreasing out-of-home time that has been ongoing since at least 2003. However, the COVID-19 pandemic and its aftermath have significantly accelerated this shift towards staying at home.

The trend of “going nowhere fast” is set to impact individuals and society on various levels, including psychology, sociology, and economics. The authors of this paper, who are urban planners, suggest that the decrease in people leaving their homes necessitates reevaluating numerous planning and transportation policies.

Their recommendations include repurposing office and retail real estate, given the increase in working and shopping from home. Restrictions on converting commercial buildings to housing should also be relaxed, and curb space for delivery vehicles should be increased, given the rise in online shopping.

“In a world where cities cannot rely on captive office workers and must work to attract residents, workers, and customers, local officials might seek to invest more heavily in their remaining strengths,” says lead author Eric A. Morris, Professor of City and Regional Planning at Clemson University.

“These include recreation, entertainment, culture, arts, and more opportunities. Central cities might shift toward becoming centres of consumption more than production.”

For example, city centres might capitalize on their strengths by creating the dense, multiunit housing often favoured by younger residents and others who prefer more urban lifestyles. Such changes might also generally benefit lower-income households and society by lowering housing and transportation costs.

In terms of transportation, “policy might focus less on expensive and invasive investments and policies to accommodate waxing peak period travel demand…and more on increasing pedestrian and cyclist safety and serving the basic mobility needs of disadvantaged travelers.”

Although it may involve change and some dislocation, going nowhere faster may also have significant benefits, such as less time spent travelling, which may reduce fuel use and emissions and save people valuable time and money. On the other hand, more cocooning in the home might have downsides, such as social isolation.

The authors found that advancements in information technology and how individuals adapted to using this technology during the pandemic were key drivers behind this trend.

The researchers analyzed work and leisure habits by utilizing data from the American Time Use Survey (ATUS). This survey, conducted annually since 2003 by the United States Census Bureau with sponsorship from the Bureau of Labor Statistics, provides insights into how Americans spend their time. The data were compiled from the ATUS-X website, which is managed by the Universities of Minnesota and Maryland.

The authors—who also include Professor Brian D. Taylor and Samuel Speroni from UCLA’s Institute of Transportation Studies—assessed the years before, during, and after the pandemic, namely 2019, 2021, 2022, and 2023. The year 2020 was excluded because it was not completely affected by the pandemic and because data gathering was halted at the height of the outbreak. The study examined the behaviour of adults aged 17 and over.

The authors grouped time use into 16 activities in the home, such as sleep, exercise, work, and using information technology, plus 12 out-of-home activities, including arts and sporting events, shopping, work, and religious observance. Separately, they analyzed travel by car, walking, and public transport (though they excluded air travel).

Results showed that the time spent on 8 of the 12 out-of-home activities fell from 2019 to 2021, while 11 of the 16 in-home activities rose. The average time for out-of-home activities fell from 334 minutes per day in 2019 to 271 in 2021—roughly from 5.5 hours per day out-of-home to 4.5 hours. The authors note that work from home explains part of this trend, but there were large diminutions in other out-of-home time uses as well.

A similar trend was observed for travel, with participants spending an estimated 13 fewer minutes a day in cars and other forms of transport. The authors say this downward trend could not be attributed solely to the reductions in the daily commute during Covid.  

Further, time spent away from home time has only modestly recovered post-pandemic, rebounding by just 11 minutes from 2021 to 2023, from 270 minutes to 281. This has been reduced by 53 minutes in time away from home since 2019. All out-of-home time, all forms of travel, and seven out-of-home activities remained notably lower in 2023 than in 2019, while eight in-home activities remained higher.

Also, the trend toward staying home seems to be holding post-pandemic, as 2023 out-of-home time was virtually unchanged from 2022.

Other results of note include the fact more shopping was carried out online but this did not amount to a large increase in in-home shopping time, a finding the authors propose is due to online shopping not taking nearly as long as in-person shopping. Perhaps surprisingly, television watching did not increase apart from in the early peaks of the pandemic. More sports and exercise activities are now being done at home, most likely because people bought in-home gym equipment.