Posted on autoimmune conditions, Lupus, Rheumatoid arthritis

Chronic Diseases Misdiagnosed as Psychosomatic: A Hidden Crisis

Randomised crossover trial also finds that the benefits of 16-hour fasting are evident in as little as 3 days, even without restricting calories

Groundbreaking Study Unveils the Long-Term Impacts of Misdiagnosing Chronic Diseases

University of Cambridge

In the realm of healthcare, a significant gap often exists between the perspectives of clinicians and patients. This gap can lead to the misdiagnosis of autoimmune diseases like lupus and vasculitis as psychiatric or psychosomatic conditions, resulting in profound and lasting impacts on patients. A study conducted by the University of Cambridge sheds light on this critical issue, revealing the far-reaching consequences of such misdiagnoses.

Unveiling the Hidden Damage

The study, which involved over 3,000 participants including both patients and clinicians, uncovered the long-term physical and mental health impacts of these misdiagnoses. Often termed as “in your head” by patients, these incorrect diagnoses can severely damage patients’ trust in healthcare services and their overall wellbeing.

The Complexity of Autoimmune Diseases

Autoimmune rheumatic diseases such as rheumatoid arthritis, lupus, and vasculitis are chronic inflammatory disorders that affect the immune system and can cause damage to organs and tissues throughout the body. These conditions are notoriously difficult to diagnose due to the wide range of symptoms, many of which are invisible, like extreme fatigue and depression.

Dr. Melanie Sloan from the University of Cambridge led the study, which explored patient-reported experiences from two large groups of over 1,500 patients each, along with in-depth interviews with 67 patients and 50 clinicians. The findings, published in Rheumatology, highlight the critical need for greater awareness among clinicians about the symptoms of these diseases.

The Human Impact of Misdiagnoses

Patients who experienced misdiagnoses reported higher levels of depression, anxiety, and lower mental wellbeing. One patient recounted, “A doctor told me I was making myself feel pain, and those words have stayed with me, causing anxiety and depression.”

Over 80% of patients said their self-worth was damaged, and 72% reported that the misdiagnosis still affected them even decades later. These patients also reported lower satisfaction with medical care and were more likely to distrust doctors, downplay their symptoms, and avoid healthcare services. One patient shared, “It damaged my trust and courage in telling doctors about my symptoms. I even stopped taking my immunosuppressive medicine because of those words.”

Rebuilding Trust and Understanding

Dr. Sloan emphasized the need for better education for clinicians to consider autoimmune diseases earlier in the diagnostic process. While some doctors admitted the difficulty of diagnosing these conditions, they also acknowledged the importance of regaining patients’ trust. One GP from England noted, “They lose trust in anything that anyone says, and it’s challenging to convince them that something is okay when a previous doctor was wrong.”

There is hope for rebuilding trust, as one patient described a positive experience after confronting a clinician about being “gaslit.” The clinician responded with empathy and understanding, transforming the patient’s negative experience into a more positive one.

Moving Forward

Mike Bosley, an autoimmune patient and co-author of the study, stressed the importance of understanding the long-term mental and emotional harm caused by misdiagnoses. He called for clinicians to listen carefully to patients and recognize the unique presentations of autoimmune conditions to avoid long-lasting harm.

The study authors recommend several measures to improve support for patients with autoimmune rheumatological diseases. These include discussing previous misdiagnoses with patients, offering targeted support, and ensuring greater access to psychologists and talking therapies. Additionally, educating clinicians to consider systemic autoimmunity when assessing patients with multiple, seemingly unconnected symptoms can reduce the risk of misdiagnoses.

Professor Felix Naughton from the Lifespan Health Research Centre at the University of East Anglia emphasized, “Diagnosing autoimmune rheumatic diseases can be challenging, but with better awareness among clinicians, we can hopefully reduce the risk of misdiagnoses and lessen the impact on patients.”

This study underscores the importance of accurate diagnoses and empathetic communication in healthcare. By bridging the gap between clinicians and patients, we can improve outcomes and rebuild trust in the healthcare system.

Posted on Diabetes, Obesity

Obesity Starts in the Brain

Non-alcoholic fatty liver disease warning signs

Tübingen study highlights the brain’s central role in the development of obesity.

Published by: Deutsches Zentrum fuer Diabetesforschung DZD

In recent decades, obesity has become a pressing issue, impacting millions worldwide and posing significant challenges for healthcare systems. But did you know that the hormone insulin plays a crucial role in the brain’s involvement in obesity? A recent study by the University Hospital of Tübingen, the German Center for Diabetes Research (DZD), and Helmholtz Munich delves into this fascinating connection, offering new insights into the origins of type 2 diabetes and obesity.

Obesity: A Growing Epidemic

Officially recognized as a disease in Germany since 2020, obesity is known to contribute to various illnesses, including diabetes, heart attacks, and even cancer. With over one billion individuals affected globally and nearly 16 million in Germany alone, obesity has reached epidemic proportions. While poor diet and lack of exercise are often blamed, the mechanisms behind obesity are more complex than they appear.

The Brain’s Role in Obesity and Insulin Sensitivity

Unhealthy body fat distribution and chronic weight gain are linked to the brain’s sensitivity to insulin. What role does insulin play in the brain, and how does it affect those of normal weight? Prof. Dr. Stephanie Kullmann and her team at Tübingen University Hospital found that even a brief consumption of highly processed, unhealthy foods can significantly alter the brain of healthy individuals. This alteration may be the initial trigger for obesity and type 2 diabetes.

“In a healthy state, insulin has an appetite-suppressing effect in the brain. However, in people with obesity, insulin no longer properly regulates eating behavior, leading to insulin resistance,” explains Prof. Kullmann. She adds, “Interestingly, in our healthy participants, the brain shows a similar decrease in insulin sensitivity after short-term high-calorie intake as observed in people with obesity. This effect can persist even a week after returning to a balanced diet.”

Focusing on the Brain

Prof. Dr. Andreas Birkenfeld, Medical Director of Internal Medicine IV and DZD Board Member, suggests that the brain’s insulin response adapts to short-term dietary changes before any weight gain occurs, promoting the development of obesity and other secondary diseases. He calls for further research to explore the brain’s role in obesity and metabolic disorders.

A Short-Term Study with Long-Term Implications

The study involved 29 male volunteers of average weight, divided into two groups. For five days, one group supplemented their regular diet with 1500 kcal from high-calorie snacks, while the control group did not. Using magnetic resonance imaging (MRI), researchers examined liver fat content and brain insulin sensitivity.

The results were striking: the liver fat content increased significantly in the high-calorie group, and their brain’s insulin sensitivity remained lower even a week after returning to a regular diet. This effect, previously observed only in obese individuals, highlights the brain’s critical role in the early stages of obesity development.

As obesity challenges global health, understanding the brain’s role in this complex condition may pave the way for new strategies to combat it.

Posted on Autism

Guidelines for Creating Accessible Consent Materials and Procedures: Insights from Research with Autistic Adults

Autism in Adulthood

Credit Mary Ann Liebert, Inc.

A new article in Autism in Adulthood offers essential guidelines for crafting consent materials and procedures that are accessible to autistic adults and individuals with intellectual disabilities. The authors stress the significance of using various methods—such as auditory and visual formats—to accommodate different abilities and communication needs.

Dr. Kelly Beck from the University of Pittsburgh and the Working to Increase Inclusivity in Research Ethics (WIRE) Consortium share valuable lessons from major U.S. research institutions. Their findings highlight the importance of adapting consent materials to address standard information processing and communication differences in autism and intellectual disabilities.

“These guidelines emphasize the need for multiple modes of content delivery to create materials accessible to a diverse range of abilities, communication needs, and experiences,” the authors explain.

Dr. Rebecca Flower, Executive Editor of Autism in Adulthood and a member of the Human Research Ethics Committee at La Trobe University, adds, “These guidelines are invaluable for researchers. They help improve the accessibility and respectfulness of their work with autistic individuals and people with intellectual disabilities, ultimately supporting more ethically sound research practices.”

About Autism in Adulthood

Autism in Adulthood is a peer-reviewed journal dedicated to the most pressing issues affecting adults on the autism spectrum, from emerging adulthood to later life. Led by Editor-in-Chief Dr. Christina Nicolaidis from Portland State University, the journal is a premier source for original research, in-depth analysis, and inter-professional dialogue, providing insights and evidence to drive practice, systems, and policy change.

Posted on Diet, Exercise

The Dark Side of Fitness Apps: Could They Be Hurting Your Health?

Isabella Anderberg, PhD student, College of Education, Psychology and Social Work, Flinders University

Isabella Anderberg, PhD student, College of Education, Psychology and Social Work, Flinders University Credit Flinders University

With New Year resolutions in full swing and fitness apps at our fingertips, new research highlights a worrying connection between these apps and disordered eating, body image issues, and excessive exercise.

While diet and fitness apps are marketed as tools for better health, they might have unintended negative effects. They can create pressure to meet goals, cause concerns about body image, and even provoke feelings of guilt if goals aren’t achieved.

Researchers from Flinders University reviewed 38 studies and found that people who regularly use health and fitness apps are more likely to develop problematic habits related to food and exercise. Young adults, in particular, who use these apps often experience harmful eating behaviours, such as restrictive diets, and have negative thoughts about their body image.

The study found that the focus on dietary restriction and weight loss in these apps can lead to restrictive or excessive behaviors, especially in those who already have concerns about their weight or body image.

While some users reported positive experiences, like increased awareness and motivation, the broader mental health implications need careful consideration, particularly for vulnerable groups like adolescents.

The researchers emphasized app developers’ responsibility to consider their products’ psychological impacts. As more people turn to apps for health guidance, it’s crucial to ensure that mental health is prioritized alongside fitness goals.

The study also highlighted the importance of promoting healthy body image and exercise behaviours among young adults and being aware of the potential risks associated with diet and fitness apps.

More research is needed to understand the benefits and risks of using these apps. As new diet and fitness apps are developed, it’s vital to continue exploring their potential advantages and any unintended consequences.

So, while fitness apps can be helpful tools, it’s essential to use them mindfully and be aware of their potential impacts on mental health.

Posted on Diet, Obesity

Can Cutting Ultra-Processed Foods Change Your Life?

Researchers found ultra-processed foods, even diet ones, bring distinct risks for people with diabetes.

Most diet programs aim to help people lose weight or follow U.S. nutrition guidelines, which don’t mention ultra-processed foods (UPFs). These mass-produced, packaged products—like chips and candy—contain little to no natural ingredients and are linked to higher risks of diseases and early death.

Recognizing the gap, researchers from Drexel University’s College of Arts and Sciences created an intervention program specifically targeting the problematic aspects of UPFs, including their addictive nature. Their program includes education about UPFs, mindfulness and acceptance strategies to cope with cravings, one-on-one meal planning, involving a household member in the process, and financial support to purchase healthy foods like fresh fruits and vegetables.

Recently published in Obesity and Science Practice, the researchers tested their two-month intervention with 14 adults who regularly consumed UPFs. The results were promising: participants cut their UPF intake nearly in half.

“Reducing UPF intake can be extremely difficult because the food industry wants us hooked on these ultra-delicious, convenient, cheap, and omnipresent foods,” said lead author Charlotte Hagerman, PhD.

The program participants halved their UPF consumption and reduced their calorie intake by an average of over 600 calories per day. They cut their sugar intake by 50%, saturated fat by 37%, and sodium by 28%. On average, participants lost 7.7 pounds and reported improved mood and energy.

Interestingly, the study found no significant increase in fruit and vegetable consumption, suggesting that further encouragement might be needed to improve overall dietary habits.

The intervention involved weekly group sessions with health behaviour change coaches, discussions, and activities. Participants learned to identify UPFs and their harmful effects and developed strategies to cope with cravings and reduce UPF intake. They also received a $100 grocery store gift card for meal planning.

Participants reported everything they ate over the past 24 hours to assess dietary intake using the Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA-24). The data helped the team track changes in UPF, sodium, sugar, and saturated fat intake, as well as weight and fruit/vegetable intake.

“The findings suggest that with the right tools, people can reduce their UPF intake and be enthusiastic about interventions designed for this purpose,” said Hagerman. “Reducing UPF intake can lead to meaningful health improvements such as weight loss and better mood in as short as eight weeks.”

The research team plans to continue testing the intervention with a larger sample and different populations to confirm its effectiveness and explore its components further.