In this video, I discuss the treatment of neuropathic pain in multiple sclerosis.
Autistic Menopause & Ageing
How often do you hear or read about older autistic adults and our ageing process? Not often, I bet. Thanks to Christine Jenkins and the Autistic Menopause research team, autistic ageing and menopause are finally coming to the forefront. There are many of us who have been privately discussing how perimenopause impacts our sensory systems and our experience of burnout. Join me today to learn more about Autistic Menopause & Aging with the co-author of Spectrum Women – Christine Jenkins.
Intermittent fasting improves blood sugar control in people at risk of diabetes
Limiting the daily eating window to 8 hours has been shown to significantly improve blood glucose control in adults at risk of type 2 diabetes, regardless of whether the eating window is earlier or later in the day.
“Our study found that limiting eating to an 8-hour window per day significantly improved the amount of time spent with normal blood glucose levels and reduced fluctuations in blood glucose levels. However, changing the timing of the 8-hour eating window earlier or later in the day did not seem to provide extra benefits,” said Dr. Kelly Bowden Davies, the lead author from Manchester Metropolitan University, UK.
She stated, “Our findings show that the benefits of time-restricted eating can be attributed to the 16-hour fasting window rather than the time of eating or changes in energy intake. It is also noteworthy that the positive impact of time-restricted eating can be observed within just three days. While time-restricted eating is gaining popularity, there have been no other studies examining the effects of a tightly controlled diet and altered the timing of an eight-hour eating window on glycemic control in individuals at risk of type 2 diabetes.”
Previous studies suggest that time-restricted eating (TRE), which restricts the timing of meals but not the type of food, can enhance insulin sensitivity (the body’s ability to respond to insulin) and reduce glycated hemoglobin (HbA1c), which reflects average blood sugar levels over weeks and months, in individuals at risk of type 2 diabetes.
However, it is not clear how time-restricted eating (TRE) affects fluctuations in blood glucose levels. Previous studies have linked the positive effects of TRE to reduced energy intake. This study aimed to investigate changes in meal timing when participants were in energy balance, meaning their energy intake matched their energy expenditure.
In order to learn more, researchers studied the effects of time-restricted eating (TRE) with diets tailored to meet energy needs based on factors like sex, age, weight, height, and activity level. They compared an early eating window (ETRE, between 8:00 AM and 4:00 PM) to a late eating window (LTRE, between 12:00 PM and 8:00 PM) on glycemic control in overweight, sedentary adults.
Fifteen sedentary individuals (9 females/6 males; average age 52 years; BMI 28 kg/m^2; HbA1c 37.9 mmol/mol), who typically consume food over a period exceeding 14 hours per day, were divided into two groups and followed different eating patterns for 3-day intervals.
Researchers conducted a study comparing the effects of two different eating regimens with the usual eating habits. The first regimen involved eating only between 8:00 a.m. and 4:00 p.m. (ETRE), while the second regimen involved eating only between midday and 8:00 p.m. (LTRE). The participants had a standard diet with specific proportions of carbohydrates, fat, and protein during the eating regimen periods, while they were free to eat their own diets during normal living conditions.
Continuous glucose monitoring was used to measure the amount of time spent in euglycemia (normal blood glucose concentration of 3.9-7.8 mmol/l) and assess markers of glycemic variability, such as mean absolute glucose (MAG), coefficient of variation (CV), and mean amplitude of glucose excursions (MAGE) on a daily basis.
The analysis revealed that compared to eating throughout the day (more than 14 hours), time-restricted eating (8 hours a day) led to a significant increase in the amount of time spent within the normal blood glucose range by an average of 3.3%. Additionally, it reduced markers of glycemic variability, including a decrease in mean amplitude of glycemic excursions (MAG) by 0.6 mmol/l, coefficient of variation (CV) by 2.6%, and mean amplitude of glycemic excursions (MAGE) by 0.4 mmol/l.
However, no significant differences in glycaemic control were found between the ETRE and LTRE regimens.
“Counting calories can be difficult to maintain long-term for many people, but our study indicates that keeping track of the time when eating may be a simple way to enhance blood sugar control in individuals at risk of type 2 diabetes. This seems to be effective regardless of the specific 8-hour eating window. Further research in larger studies over an extended period is needed to explore this potential.” – Dr. Bowden Davies
Mindfulness for ADHD folks
ADHD is a developmental brain condition with symptoms such as inattention, hyperactivity, and impulsivity. People with ADHD struggle with self-control and may also experience anxiety, depression, academic challenges, and low self-confidence. These symptoms can be alleviated through holistic approaches such as mindfulness-based stress reduction and mindfulness-based cognitive therapy. These practices help patients focus on the present moment with purpose and without judgment. However, these meditation practices, which involve sitting in specific postures, can be challenging for patients with high ADHD tendencies.
“Even though mindfulness programs have been created for patients with ADHD, there are challenges with mindfulness meditation. To address this, we have researched different postures that can be used by both high and low ADHD tendencies patients to make meditation easier without the need for special tools,” explained Dr. Fukuichi.
In this study, the participants were divided into four groups: combined, hyperactive/impulsive, inattentive, and without ADHD tendencies. They were then asked to perform body-scan meditations in upright, slumped, leaning-back sitting, and supine postures and answer a questionnaire. To assess their responses to various postures during meditation, researchers developed the Mindfulness Encouraging Reactions Scale (MERS) and the Mindfulness Discouraging Reactions Scale (MDRS).
The researchers discovered that individuals with a tendency for hyperactivity and impulsivity found body-scan meditation to be more challenging when performed in a slumped posture, but easier when done in supine or upright postures. These findings suggest that individuals with hyperactivity and impulsivity tendencies may benefit from adopting an upright or supine posture when practising body-scan meditation in order to facilitate sustained focus and attention.
Multiple sclerosis – Early high-efficacy treatment reduces disability in children
The study used data from the French MS Registry, Italian MS Register, and the global MSBase Registry to analyze the outcomes of 282 patients with pediatric-onset MS. These patients began experiencing symptoms before the age of 18. They were divided into two groups based on when they started monoclonal antibody treatment: between the ages of 12 and 17 or 20 and 22.
To ensure an accurate comparison of the groups, the researchers used inverse probability treatment weighting based on propensity scores. This method took into account the initial differences between the groups in factors such as gender, age at symptom onset, time from onset to clinically definite MS, and the number of relapses. This approach allowed for a clear evaluation of how the timing of starting high-efficacy therapy influences disability outcomes for individuals aged 23 and older.
In a study using the Expanded Disability Status Scale (EDSS) to measure and monitor disability progression in MS, it was found that patients who started treatment between the ages of 12 and 17 (39% of the study group) had an average increase of only 0.40 points on the EDSS. In comparison, those who began treatment later (61% of the study group) had a 0.95-point increase on the EDSS.rease on the EDSS.
Between the ages of 23 and 27, the increase in EDSS scores from baseline was 0.57 points lower in the early treatment group compared to the late treatment group. The benefits of early treatment persisted throughout the median follow-up period of 10.8 years. Dr. Sifat Sharmin, research fellow in the Clinical Outcomes Research (CORe) Unit at the University of Melbourne and leader of the study, states, “The substantially lower risk of progressing to higher disability levels in the early treatment group was particularly evident in the moderate disability range, where further progression was reduced by up to 97%.”
“This study emphasizes the critical importance of early intervention in pediatric-onset MS,” emphasizes Dr. Sharmin. “Our findings indicate that starting high-efficacy therapies like ocrelizumab, rituximab, or natalizumab during childhood can significantly improve long-term outcomes, preserving neurological function and reducing disability progression.”