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New research finds that eating more calories in the evening is associated with poorer cardiovascular health in women.
Evidence is accumulating that meal times can impact cardiometabolic health.
One recent study, for example, showed that eating meals earlier in the day can help people lose weight, while eating later in the day may promote weight gain and slow down metabolism.
These studies also showed that later mealtimes raise inflammatory markers that are usually associated with diabetes and heart disease.
Other studies, in mice and human participants, showed that setting strict mealtimes can help control blood sugar levels.
Now, new research adds to this mounting evidence and suggests that eating more calories in the evening may negatively affect women’s cardiovascular health.
The new research is preliminary and will be presented at the American Heart Association’s (AHA’s) Scientific Sessions 2019, which is taking place in Philadelphia, PA.
Nour Makarem, Ph.D., an associate research scientist at the Columbia University Vagelos College of Physicians and Surgeons, in New York, is the lead author of the study.
Studying eating patterns and heart health
Makarem and colleagues recruited 112 healthy women, who were 33 years old, on average, to participate in the study.
The researchers examined the participants’ cardiovascular health at baseline and 1 year later using Life’s Simple 7 — a measure of cardiovascular health that comprises seven modifiable risk factors, as established by the AHA.
Life’s Simple 7 account for blood pressure, cholesterol, blood sugar, physical activity, diet, weight, and smoking status. Based on these factors, the researchers calculated a cardiovascular health score for each participant.
The women also used food diaries on their cell phones to track and report how much, what, and when they ate for 1 week at baseline and another week 12 months later.
The researchers used the data from the electronic diaries to calculate the relationship between cardiovascular health and the timing of the meals.
Fewer late calories may boost heart health
The research revealed that participants who consumed more calories after 6 p.m. tended to have poorer cardiovascular health.
In fact, for each 1% increase in caloric intake after 6 p.m., the cardiovascular health score declined. Blood pressure and body mass index tended to rise, and blood sugar control tended to be poorer.
The analysis yielded similar results for every 1% increase in calories after 8 p.m.
Hispanic women, in particular — who made up 44% of the participants — had higher blood pressure when they ate more calories in the evening.
The study’s lead author comments on the findings saying, “So far, lifestyle approaches to prevent heart disease have focused on what we eat and how much we eat.”
“These preliminary results indicate that intentional eating that is mindful of the timing and proportion of calories in evening meals may represent a simple, modifiable behavior that can help lower heart disease risk.”
Nour Makarem, Ph.D.
The lead researcher also points out that for the findings to be more reliable, they would have to be replicated in a larger sample and in different populations.
Dr. Kristin Newby, a professor of medicine and cardiology at Duke University, in Durham, NC, who was not involved in the research, comments on the results.
“I think it’s an important study,” she says. “It’s foundational more than definitive at this point, but I think it provides some really interesting insights into an aspect of nutrition and how it relates to cardiovascular risk factors that we really haven’t thought about before.”
Previously, scientists have linked the presence of human papillomavirus to an increased risk of certain cancers. In a surprising twist, the latest research finds that the virus might help defend against skin cancer.
Scientists have linked these strains with an increased risk of certain cancers, including those of the cervix, vulva, penis, and anus.
Of the remaining strains of HPV, many are little more than harmless stowaways on our skin.
These so-called commensal viruses are the subject of scrutiny for a group of researchers at Massachusetts General Hospital in Boston.
The scientists recently published a paper in Nature, which concludes that immunity to these HPV strains may protect against skin cancer.
The role of HPV in skin cancer
The authors of the recent study were particularly interested in cutaneous squamous cell carcinoma (SCC), stating that it is the second most common type of cancer.
Ultraviolet (UV) light from the sun is the primary preventable cause of skin cancer, but from 1992 to 2012, the incidence of skin cancer in the United States doubled. Scientists are trying to uncover additional ways of lowering the risk of skin cancer.
Some scientists have theorized that HPV plays a role in SCC. This idea is based on earlier research showing that a genus of HPV called beta-HPV is present in the majority of skin cancers among people who have received an organ transplant.
Individuals belonging to this population have a weakened immune system and are, therefore, more susceptible to cancers that are linked to viral infections. To date, though, scientists have not identified how beta-HPV might increase skin cancer risk.
The authors of the most recent study wanted to investigate the role of beta-HPV in more detail. To do this, they used both animal models and human tissue.
What the scientists found turned the theory of beta-HPV’s role in skin cancer on its head.
HPV, immunity, and cancer
The researchers found that the body’s immune response to beta-HPV is key. In their experiments, mice that demonstrated an immune response to HPV seemed to have protection from the development of SCC following carcinogenic UV or chemical exposure.
Similarly, when the researchers transplanted T cells from those mice into immunocompromised mice, the recipients also developed protection against skin cancer.
In short, it is not beta-HPV that encourages SCC in immunocompromised individuals. Instead, it is the loss of immune function that increases the risk of SCC.
According to lead author Dr. Shawn Demehri, “This is the first evidence that commensal viruses could have beneficial health effects both in experimental models and also in humans.”
“The role of these commensal viruses, in this case, papillomaviruses, is to induce immunity that then is protecting patients from skin cancers.”
Dr. Shawn Demehri
Looking to the future
These findings open interesting new avenues that might lead to new ways of reducing the risk of SCC. The authors write:
“T cell-based vaccines against commensal HPVs may provide an innovative approach to boost this antiviral immunity in the skin and help prevent warts and skin cancers in high risk populations.”
To treat skin cancer, doctors sometimes use a type of immunotherapy called immune checkpoint blockade therapy. The authors also hope that “increasing anti-HPV immunity may improve the efficacy” of this type of treatment.
Currently, gut bacteria and the microbiome at large are receiving a great deal of attention. However, research into the virome — the sum of all the viruses living on or in our bodies — is also beginning to heat up.
As some viruses attack bacteria, thereby influencing bacterial populations, the complex interplay between the two will be difficult to unfurl.
Researchers investigating the role of viruses in human disease, and particularly in cancer, are likely to publish an increasing number of studies over the coming years.
Are e-cigarettes less harmful than conventional cigarettes that contain tobacco? From a cardiovascular point of view, at least, new research answers with a resounding “no.” In fact, says one study author, “e-cigs may confer as much and potentially even more harm to users” than traditional cigarettes.
The two new studies examine the effect of e-cigarettes on cardiovascular health, more specifically. In this respect, there appears to be insufficient evidence to draw a firm conclusion.
However, the two new studies emphasize the possibility that e-cigarettes are just as, if not more harmful than regular cigarettes.
Dr. Sana Majid, a postdoctoral fellow in vascular biology at the Boston University School of Medicine in Massachusetts, is the lead author of the first study, which looked at cholesterol, triglycerides, and glucose levels in cigarette smokers.
Dr. Florian Rader, M.S., medical director of the Human Physiology Laboratory and assistant director of the Non-Invasive Laboratory at the Cedars-Sinai Medical Center in Los Angeles, CA, led the second study, which looked at heart blood flow.
E-cigarettes and cholesterol
In the first study, Dr. Majid and team compared markers of cardiovascular health among healthy adults who smoked regular cigarettes, adults who used e-cigarettes, healthy adults who did not smoke, and adults who smoked both e-cigarettes and conventional cigarettes.
The 476 study participants were between 21 and 45 years old; they had no history of cardiovascular disease and were not taking any daily medication.The researchers accounted for potential confounders, such as age, race, and sex, in their analysis.
They also adjusted their analysis to examine non-smokers, sole e-cigarette or traditional cigarette users, or dual users.
The analysis revealed that people who used only e-cigarettes had higher levels of low-density lipoprotein (LDL) cholesterol, or “bad” cholesterol, and lower levels of total cholesterol than non-smokers.
High-density lipoprotein (HDL), or “good” cholesterol, was lower in people who smoked both traditional cigarettes and e-cigarettes.
“Although primary care providers and patients may think that the use of e-cigarettes by cigarette smokers makes heart health sense, our study shows e-cigarette use is also related to differences in cholesterol levels.”
Dr. Sana Majid
“The best option is to use FDA-approved methods to aid in smoking cessation, along with behavioral counseling,” Dr. Majid adds.
Possibly even more harmful to users
In the second study, Dr. Rader and his colleagues examined the heart blood flow of 19 adults aged between 24 and 32 before and after smoking traditional cigarettes or e-cigarettes.
More specifically, they looked at the participants’ coronary vascular function using myocardial contrast echocardiography (MCE) scans.
MCE scans use gas-filled microbubbles that travel inside the vascular space, just like red blood cells, to assess myocardial microcirculation.
The researchers used an MCE scan when the participants were resting and after they had simulated physiological stress with a handgrip exercise test.
Dr. Rader reports, “In smokers who use traditional cigarettes, blood flow increased modestly after traditional cigarette inhalation and then decreased with subsequent stress. However, in smokers who use e-cigs, blood flow decreased after both inhalation at rest and after handgrip stress.”
Study co-author Dr. Susan Cheng, M.M.Sc., M.P.H., who is a director of Public Health Research at Cedars-Sinai Medical Center, says, “We were surprised by our observation of the heart’s blood flow being reduced at rest, even in the absence of stress, following inhalation from the e-cigarette.”
“Providers counseling patients on the use of nicotine products will want to consider the possibility that e-cigs may confer as much and potentially even more harm to users and especially patients at risk for vascular disease.”
However, some mild-to-moderate CSF symptoms may get better without any treatment.
Certain medications can also help manage the symptoms of CSF leaks.
However, researchers are yet to prove the effectiveness of most of these. In fact, some of these medications may carry serious health risks, including disability.
Some medications for CSF leak symptoms include:
antinausea medications such as ondansetron
nonopiate pain medications
Epidural blood patch
People with CSF leaks may also need to undergo an epidural blood patch (EBP). This is a procedure wherein a doctor injects 10–100 milliliters of a person’s own blood into the epidural space in their spinal canal.
This creates a patch on the outer layer of the meninges, which seems to reduce CSF loss.
A doctor will perform an EBP procedure at the location of a leak, or in the middle or lower parts of the spine if they do not know the exact location of the leak.
Health professionals do not know exactly why this procedure seems to help manage CSF leaks. However, at the very least, it seems to help relieve symptoms and confirm the diagnosis.
People should try to avoid strenuous activities or bending over for 4–6 weeks after undergoing an EBP procedure.
Blood patching usually brings instant relief of symptoms, but its effect can wear off, causing the need for multiple procedures.
In severe or chronic cases, or when the precise location of the leak is known, doctors may perform surgery. The type and extent of the surgery depends on individual factors.
Several different types of surgery may be necessary to remove or repair structural abnormalities or abnormal growths, such as tumors, malformations, or cysts.
There is no cure for POTS. However, increasing blood volume and helping regulate circulatory conditions can help.
Some medications and lifestyle changes that may assist in this include:
bowel movements that are difficult or painful to pass
feeling unable to empty the bowels
Many factors can cause constipation. Common causes of constipation are dehydration, a lack of physical activity, and a poor diet — for example, not eating enough fiber.
Stress can also lead to constipation. When psychological stress leads to physical symptoms, they are known as somatic symptoms.
The effects that stress hormones have on the body can cause constipation. In addition, when a person is stressed, they are more likely to eat an unhealthful diet, get less exercise or sleep, or forget to stay hydrated. These factors can lead to constipation.
In stressful situations, the body’s adrenal glands release a hormone called epinephrine, which plays a role in the so-called fight-or-flight response. It causes the body to divert blood flow from the intestines toward vital organs, such as the heart, lungs, and brain. As a result, intestinal movement slows down, and constipation can occur.
In response to stress, the body releases more corticotrophin-releasing factor (CRF) in the bowels. This hormone acts directly on the intestines, which it can slow down and cause to become inflamed. The intestines have different types of CRF receptors, some of which speed up processes in the intestines, while others slow them down.
Stress causes increased intestinal permeability. This permeability allows inflammatory compounds to come into the intestines, which can lead to a feeling of abdominal fullness — a common complaint among people who struggle with constipation.
Stress may affect the normal healthy bacteria in the gut. Research has not confirmed this theory, but many people believe that stress may reduce the number of healthy gut bacteria in the body, thus slowing digestion.
While researchers have come a long way in discovering links between stress and constipation, there is still more to learn. Research into stress hormones and their effects on the body is ongoing.
Stress and constipation may affect children, as well. In a study of school-aged children, researchers found a link between exposure to stressful life events and constipation.
The researchers found that young people who had experienced life stresses, such as severe illness, a failed exam, or the loss of a caregiver’s job, were more likely to report constipation.
Dandruff refers to the dry, itchy flakes of skin that develop on the scalp. It is a symptom, not a specific diagnosis.
Many factors can cause dandruff, such as dry skin, diet, stress, and some shampoos and hair products.
Dandruff itself does not cause hair loss. However, severe dandruff can cause a person to scratch their scalp so hard that they injure it.
Repeated inflammation in the hair follicles can cause damage and scarring, slowing or stopping hair growth. This can cause weak or thinning hair. Twisting the hair, aggressively brushing it, or scratching the scalp may make this type of hair loss worse.
People often binge eat in response to loneliness, boredom, sadness, or other triggers.
Identifying these triggers can help people avoid or manage them, reducing the likelihood of binge eating.
Keeping a food diary allows people to track what they eat and how they feel at the time.
Once someone has identified their triggers, they can take steps to address them. For example, if boredom is the cause, people can try distracting themselves with an activity, such as exercising, reading, or meeting friends.
There is a strong link between binge eating and low self-esteem. If a low sense of self-worth is a trigger for people, they may wish to consider seeing a therapist.
Medical professionals often recognize shock because of its characteristic signs, including low blood pressure.
The treatment for shock will vary based on the underlying cause. For instance, a person experiencing anaphylaxis may need a shot of epinephrine, which can treat severe allergic reactions.
If a person has sepsis, they may need antibiotics, oxygen, and intravenous (IV) fluids.
People with hypovolemic shock may need a blood transfusion and IV fluids. Doctors may start blood transfusions or other measures to help restore proper blood flow, even if they do not know the underlying cause.
The medical team may run various tests to determine the cause of shock, including: