Thursday, December 13, 2018

How bullying affects the structure of the teen brain

The effects of constantly being bullied are more than just psychological. Research now shows that there may be physical structural differences in the brains of adolescents who are regularly victimized, and this could increase the chance that they suffer from mental illness. This is the conclusion of a study in the journal Molecular Psychiatry which is published by Springer Nature. The research was led by Erin Burke Quinlan of King's College London in the UK and is the first to show that chronic peer victimization during adolescence impacts mental health via structural brain changes.
Burke Quinlan and her colleagues analyzed data, questionnaires and brain scans of 682 participants from England, Ireland, France and Germany. These participants were part of the IMAGEN long-term project that assessed the brain development and mental health of adolescents. As part of this project, high resolution brain scans of participants were taken when they were 14 and 19 years old.
At the ages of 14, 16 and 19 these participants also had to complete questionnaires about whether they had been bullied, and to what extent. Overall, the results showed that 36 of the 682 young people were found to have experienced chronic bullying. The data of these participants were compared with those of the others who had experienced less chronic/severe bullying. Changes in brain volume as well as the levels of depression, anxiety and hyperactivity at age 19 were taken into account.
The subsequent findings validate and extend the literature linking peer victimization with mental health problems. But the novel finding is that bullying is linked to decreases in the volume of parts of the brain called the caudate and putamen. These changes were found to partly explain the relationship between high peer victimization and higher levels of general anxiety at age 19.
"Although not classically considered relevant to anxiety, the importance of structural changes in the putamen and caudate to the development of anxiety most likely lies in their contribution to related behaviours such as reward sensitivity, motivation, conditioning, attention, and emotional processing," explains Burke Quinlan.
She says it is worrying that as much as 30 per cent of young people could be victimized in one way or another by their peers, with some having to endure such treatment on an almost daily basis. Burke Quinlan emphasizes that adolescence is not only a time of new experiences and stresses, but also a period of extensive brain development. Therefore, she recommends that every effort should be made to limit bullying before it becomes a severe problem that might lead to changes in a young person's brain and the development of mental health issues.
Story Source:
Materials provided by SpringerNote: Content may be edited for style and length.

Journal Reference:
  1. Erin Burke Quinlan, Edward D. Barker, Qiang Luo, Tobias Banaschewski, Arun L. W. Bokde, Uli Bromberg, Christian Büchel, Sylvane Desrivières, Herta Flor, Vincent Frouin, Hugh Garavan, Bader Chaarani, Penny Gowland, Andreas Heinz, Rüdiger Brühl, Jean-Luc Martinot, Marie-Laure Paillère Martinot, Frauke Nees, Dimitri Papadopoulos Orfanos, Tomáš Paus, Luise Poustka, Sarah Hohmann, Michael N. Smolka, Juliane H. Fröhner, Henrik Walter, Robert Whelan, Gunter Schumann. Peer victimization and its impact on adolescent brain development and psychopathologyMolecular Psychiatry, 2018; DOI: 10.1038/s41380-018-0297-9

Increased motor activity linked to improved mood

Increasing one's level of physical activity may be an effective way to boost one's mood, according to a new study from a team including scientists at Johns Hopkins Bloomberg School of Public Health in collaboration with the National Institute of Mental Health Intramural Research Program.
The findings were published online December 12 in JAMA Psychiatry.
The researchers found that increases in physical activity tended to be followed by increases in mood and perceived energy level. This beneficial effect was even more pronounced for a subset of the study subjects who had bipolar disorder. For the study, activity trackers and electronic diaries were used for two weeks in a community sample of 242 (150 women and 92 men) adults, ages 15 to 84, with an average age of 48 years. The sample included 54 people with bipolar disorder.
Mobile assessments in the study included wrist-worn devices that automatically recorded levels of physical movement in real time and electronic diaries that assessed mood and perceived energy levels four times per day for two weeks. These real-time mood and energy levels were rated by study participants on a seven-point analogue scale from "very happy" to "very sad" for mood and from "very tired" to "very energetic" for energy.
"Systems regulating sleep, motor activity and mood have typically been studied independently. This work demonstrates the importance of examining these systems jointly rather than in isolation," says Vadim Zipunnikov, PhD, an assistant professor in the Bloomberg School's Department of Biostatistics, who led the data analyses.
The findings showed that on average a higher activity level at one time-point was associated with improved mood and increased perceived energy at the next time-point during the day. (The daily time-points were personalized according to the person's daily schedule, with one in the morning, at lunchtime, at dinnertime and before bed.) Likewise, increased energy at one time-point was associated with increased activity at the next time-point. Importantly, these associations controlled for the current levels of mood, energy and activity, respectively.
Activity was inversely associated with sleep duration -- more activity tended to be followed by less sleep that night, and more sleep tended to be followed by less activity the next day.
Tracking sleep, activity, mood and energy concurrently was particularly important in people with bipolar disorder because the changes in internal psychological states were strongly influenced by both sleep and physical activity. Many of the current interventions for mood, sleep, and physical activity focus on only one of these systems rather than considering the collective impact across multiple systems.
Bipolar disorder affects nearly three percent of the U.S. adult population; depression is even more common, affecting about eight percent of U.S. adults in a given year. The research team is interested in applying this work to interventions that could offset depressive episodes in people with bipolar disorder.
"This study exemplifies the potential for combining the use of physical-activity trackers and electronic diaries to better understand the complex dynamic interrelationships among multiple systems in a real-time and real-life context," says Dr. Zipunnikov.
The team is now exploring how physical activity and sleep interplay with pain, stress and alcohol use through an international consortium, Motor Activity Research Consortium for Health, to increase the generalizability and power of this work.
Story Source:
Materials provided by Johns Hopkins University Bloomberg School of Public HealthNote: Content may be edited for style and length.

Journal Reference:
  1. Kathleen Ries Merikangas, Joel Swendsen, Ian B. Hickie, Lihong Cui, Haochang Shou, Alison K. Merikangas, Jihui Zhang, Femke Lamers, Ciprian Crainiceanu, Nora D. Volkow, Vadim Zipunnikov. Real-time Mobile Monitoring of the Dynamic Associations Among Motor Activity, Energy, Mood, and Sleep in Adults With Bipolar DisorderJAMA Psychiatry, 2018; DOI: 10.1001/jamapsychiatry.2018.3546

Excess body weight responsible for nearly 4 percent of cancers worldwide

Policies, economic systems, and marketing practices that promote the consumption of energy-dense, nutrient-poor food, changing behavioral patterns that couple high total energy intake with insufficient physical activity, and human-built environments that amplify these factors are driving a worldwide rise in excess body weight, according to a new report. The report, appearing early online in CA: A Cancer Journal for Clinicians, a peer-reviewed journal of the American Cancer Society, says excess body weight accounted for approximately 3.9% of all cancers worldwide in 2012, a figure that will undoubtedly rise in the coming decades given current trends.
The review, co-authored by investigators at the American Cancer Society, Imperial College London, and the Harvard T.H. Chan School of Public Health, presents global and regional patterns in excess body weight, as well as factors driving the epidemic, a summary of the evidence linking excess body weight to cancer risk, and policy actions that could help address the issue. American Cancer Society scientist Hyuna Sung, Ph.D., is lead author of the report.
The prevalence of excess body weight has been increasing worldwide since the 1970s. In 2016, approximately 40% of adults and 18% of children (ages 5-19 years) had excess body weight, equating to almost 2 billion adults and 340 million children around the globe. The report says the prevalence of excess body weight has increased rapidly in most countries across all population groups. Some of the steepest increases are in low- and middle-income countries, likely the result of the spread of the "Western lifestyle," consisting of energy-dense, nutrient-poor foods alongside reduced physical activity levels.
In 2015, an estimated 4 million deaths were attributable to excess body weight. The worldwide economic impact of illness related to excess body weight is estimated at $2.0 trillion. In 2012, excess body weight accounted for approximately 544,300 cancers, 3.9% of all cancers worldwide, with the proportion varying from less than 1% in low-income countries to 7% or 8% in some high-income Western countries and in Middle Eastern and Northern African countries.
Overweight and obesity has been linked to an increased risk of 13 cancers: cancers of the breast (postmenopausal), colon and rectum (colorectal), corpus uteri, esophagus (adenocarcinoma), gallbladder, kidney, liver, ovary, pancreas, stomach (cardia), and thyroid, as well as meningioma and multiple myeloma. More recently, overweight has been labeled a probable cause of advanced prostate cancer as well as cancers of the mouth, pharynx, and larynx.
National wealth is the most apparent systematic driver of population obesity. The economic transition to a wealthier economy brings with it an environment that precipitate obesity. Each $10,000 increase in average national income is associated with a 0.4 increase in body mass index among adults. However, prosperity is not always correlated with excess body weight; obesity prevalence is quite low in high-income Asian Pacific countries (range, 4%-7%), which is likely a result of adherence to traditional dietary habits, which are conducive to lower calorie consumption, and an active transportation system that usually entails walking as part of daily activity. Meanwhile, the prevalence of obesity is very high in some lower-income countries, such as some Pacific Island nations (range, 40%-65%) and Egypt (43% among women and 24% among men).
Halting the rise in obesity is one of the World Health Organization (WHO)'s nine 2025 targets to address the growing global burden of noncommunicable diseases, including cancer. While the current pace of increasing and existing challenges makes achieving this goal appears unlikely, the WHO says high-priority strategies that should be adopted by governments, industries, and civil societies include population-wide, policy-led interventions to rectify the production, distribution, and marketing of unhealthy foods and changes in the built environment to promote adequate levels of physical activity.
Those interventions include eliminating trans-fats through the development of legislation to ban their use in the food chain; reducing sugar consumption through effective taxation on sugar-sweetened beverages; implementing subsidies to increase the intake of fruits and vegetables; limiting portion and package size to reduce energy intake and the risk of excess body weight; ensuring that urban design incorporates the core elements of residential density, connected street networks that include sidewalks, easy access to a diversity of destinations, and access to public transport; and providing convenient and safe access to quality public open space and adequate infrastructure to support walking and cycling.
"There is emerging consensus on opportunities for obesity control through the multisectoral coordinated implementation of core policy actions to promote an environment conducive to a healthy diet and active living," the authors write. "The rapid increase in both the prevalence of excess body weight and the associated cancer burden highlights the need for a rejuvenated focus on identifying, implementing, and evaluating interventions to prevent and control excess body weight."
Story Source:
Materials provided by American Cancer SocietyNote: Content may be edited for style and length.

Journal Reference:
  1. Hyuna Sung, Rebecca L. Siegel, Lindsey A. Torre, Jonathan Pearson‐Stuttard, Farhad Islami, Stacey A. Fedewa, Ann Goding Sauer, Kerem Shuval, Susan M. Gapstur, Eric J. Jacobs, Edward L. Giovannucci, Ahmedin Jemal. Global patterns in excess body weight and the associated cancer burdenCA: A Cancer Journal for Clinicians, 2018; DOI: 10.3322/caac.21499

Friday, November 30, 2018

Intermittent fasting: No advantage over conventional weight loss diets

Intermittent fasting helps lose weight and promotes health. However, it is not superior to conventional calorie restriction diets, scientists from the German Cancer Research Center (DKFZ) and Heidelberg University Hospital have found out in a study called HELENA -- the largest investigation on intermittent fasting to date.The scientists conclude that there are many paths leading to a healthier weight. Everybody must find a diet plan that fits them best and then just do it!
Feasting eight hours and then fasting the following 16 hours? Or is it even better to fast two whole days a week and then enjoy eating without regrets for the rest of the week? Intermittent fasting, also known as 16:8 diet or 5:2 diet, is trendy. Numerous popular self-help books on this topic promise weight loss without yo-yo effect as well as sustained changes in metabolism and resulting health benefits. The German Nutrition Society (DGE), on the other hand, warns that intermittent fasting is not suitable for long-term weight regulation. In addition, according to DGE, there is not enough scientific evidence on the long-term effects of this dieting method.
"There are in fact only a few smaller studies on intermittent fasting so far, but they have come up with strikingly positive effects for metabolic health," says DKFZ's Ruth Schübel. "This made us curious and we intended to find out whether these effects can also be proven in a larger patient group and over a prolonged period."
In collaboration with a team of DKFZ researchers and scientists from Heidelberg University Hospital, Schübel examined 150 overweight and obese study participants over one year as part of the HELENA study. At the start of the study, they were randomly classified in three groups: One third followed a conventional calorie restriction diet that reduced daily calorie intake by 20 percent. The second group kept to a 5:2 dietary plan that also saved 20 percent of calorie intake over the whole week. The control group followed no specific diet plan but was advised, like all other participants, to eat a well-balanced diet as recommended by DGE. Following the actual dieting phase, the investigators documented the participants' weight and health status for another 38 weeks.
The result may be as surprising as it is sobering for all followers of intermittent fasting. The HELENA researchers found that improvements in health status were the same with both dietary methods. "In participants of both group, body weight and, along with it, visceral fat, or unhealthy belly fat, were lost and extra fat in the liver reduced," Schübel reported.
The changes in body weight distribution in the study participants were exactly determined using special MRT imaging executed by Johanna Nattenmüller at Heidelberg University Hospital. The good news is: a small dieting success is already a big gain for health. Those who reduce their body weight by only five percent, lose about 20 percent of dangerous visceral fat and more than a third of fat in the liver -- no matter which dietary method they have used.
The investigators also did not find any difference between the two dieting methods in any other metabolic values that were analyzed or biomarkers and gene activities under investigation.
Although the HELENA study does not confirm the euphoric expectations placed in intermittent fasting, it also shows that this method is not less beneficial than conventional weight loss diets. "In addition, for some people it seems to be easier to be very disciplined on two days instead of counting calories and limiting food every day," explained Tilman Kühn, leading scientist of the trial. "But in order to keep the new body weight, people must also permanently switch to a balanced diet following DGE recommendations," he added.
According to Kühn, the study results show that it is not primarily the dietary method that matters but that it is more important to decide on a method and then follow through with it. "The same evidence is also suggested in a current study comparing low-carb and low-fat diets, that is, reducing carbohydrates versus reducing fat intake while otherwise having a balanced diet," said Kühn. In this study, participants also achieved comparable results with both methods.
The scientists' credo is therefore: "Just do it!" Body and health will benefit from weight loss in any case, as long as it is achieved by a reliable dieting method and on the basis of a well-balanced diet.
Story Source:
Materials provided by German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ)Note: Content may be edited for style and length.

Journal Reference:
  1. Ruth Schübel, Johanna Nattenmüller, Disorn Sookthai, Tobias Nonnenmacher, Mirja E Graf, Lena Riedl, Christopher L Schlett, Oyunbileg von Stackelberg, Theron Johnson, Diana Nabers, Romy Kirsten, Mario Kratz, Hans-Ulrich Kauczor, Cornelia M Ulrich, Rudolf Kaaks, Tilman Kühn. Effects of intermittent and continuous calorie restriction on body weight and metabolism over 50 wk: a randomized controlled trialThe American Journal of Clinical Nutrition, 2018; 108 (5): 933 DOI: 10.1093/ajcn/nqy19

First risk genes for ADHD found

A major international collaboration headed by researchers from the Danish iPSYCH project, the Broad Institute of Harvard and MIT, Massachusetts General Hospital, SUNY Upstate Medical University, and the Psychiatric Genomics Consortium has for the first time identified genetic variants which increase the risk of ADHD. The new findings provide a completely new insight into the biology behind ADHD.
Our genes are very important for the development of mental disorders -- including ADHD, where genetic factors capture up to 75% of the risk. Until now, the search for these genes had yet to deliver clear results. Researchers from the Psychiatric Genomics Consortium have compared genetic variation across the entire genome for over 20,000 people with ADHD and 35,000 who do not suffer from it -- finding twelve locations where people with a particular genetic variant have an increased risk of ADHD compared to those who do not have the variant.
The results of the study have just been published in the scientific journal Nature Genetics.
"The large amount of data enabled us to find, for the first time, locations in the genome where people with ADHD stand out from those who are healthy. The search for such genetic risk variants for ADHD has spanned decades but without obtaining robust results. This time we really expanded the number of study subjects substantially, increasing the power to obtain conclusive results significantly. In particular, we included a large number from the Danish iPSYCH cohort representing more than 2/3 of the total international study sample," explains Associate Professor Ditte Demontis from Aarhus University.
She along with Raymond Walters of Massachusetts General Hospital are the lead authors of the study, working as part of the ADHD group of the Psychiatric Genomics Consortium, an international consortium of researchers dedicated to uncovering the genetics factors that give rise to ADHD.
These genetic discoveries provide new insights into the biology behind developing ADHD. For example, some of the genes have significance for how brain cells communicate with each other, while others are important for cognitive functions such as language and learning.
"Overall, the results show that the risk variants typically regulate how much a gene is expressed, and that the genes affected are primarily expressed in the brain," explains Professor Demontis.
The same genes affect impulsivity in healthy people
In the study, the researchers have also compared the new results with those from a genetic study of continuous measures of ADHD behaviours in the general population. The researchers discovered that the same genetic variants that give rise to an ADHD diagnosis also affect inattention and impulsivity in the general population.
"The risk variants are thus widespread in the population. The more risk variants you have, the greater your tendency to have ADHD-like characteristics will be as well as your risk of developing ADHD," says Professor Anders Børglum from Aarhus University. He is research head at iPSYCH and one of the leading researchers who directed the study along with Professors Stephen Faraone of SUNY Upstate Medical University and Benjamin Neale of Massachusetts General Hospital and the Broad Institute.
"We also studied the genetic overlap with other diseases and traits. Through this we found a strong negative genetic correlation between ADHD and education. This means that on average genetic variants which increase the risk of ADHD also influence performance in the education system negatively for people in the general population who carry these variants without having ADHD," says Ditte Demontis.
Conversely, the study found a positive correlation between ADHD and obesity, increased BMI and type-2 diabetes, which is to say that variants that increase the risk of ADHD also increase the risk of overweight and type-2 diabetes in the population.
"These findings and results also underscore the importance of collaboration to advance discovery efforts. It is only through data sharing and working together that we were able to find these regions of the genome," explains Dr. Benjamin Neale.
"The new findings mean that we now -- after many years of research -- finally have robust genetic findings that can inform about the underlying biology and what role genetics plays in the diseases and traits that are often cooccurring with ADHD. In addition, the study is an important foundation for further research into ADHD. We can now target our studies, so we can achieve a deeper understanding of how the risk genes affect the development of ADHD with the aim of ultimately providing better help for people with ADHD," says Anders Børglum.
"We have laid the foundation for future work that will clarify how genetic risks combine with environmental risks to cause ADHD. When the pieces of that puzzle come together, researchers will be able to improve the diagnosis and treatment of ADHD" says Professor Stephen Faraone.
Story Source:
Materials provided by Aarhus University. Original written by Annette Bang Rasmussen. Note: Content may be edited for style and length.

Weight cycling is associated with a higher risk of death

Weight cycling is associated with a higher risk of death, according to a new study published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism.
Weight cycling, or the constant losing and gaining of weight (usually from diet), leads to adverse health outcomes. By some estimates, 80 percent of people who lose weight will gradually regain it to end up at the same weight or even heavier than they were before they went on a diet. The Endocrine Society's Scientific Statement on the causes of obesity found this was because once an individual loses weight, the body typically reduces the amount of energy expended at rest, during exercise and daily activities while increasing hunger. This combination of lower energy expenditure and hunger creates a "perfect metabolic storm" of conditions for weight gain.
"This study shows that weight cycling can heighten a person's risk of death," said lead study author Hak C. Jang, M.D., Ph.D., Professor, Seoul National University (SNU) College of Medicine and Seoul National University Bundang Hospital in Seongnam, Korea. "However, we also concluded that weight loss as a result of weight cycling can ultimately reduce the risk of developing diabetes in people with obesity."
In the 16-year prospective cohort study, researchers examined 3,678 men and women from the Korean Genome and Epidemiology Study and found weight cycling was associated with a higher risk of death. Interestingly, people with obesity who experienced more weight cycling were less likely to develop diabetes than other study participants. The health benefits of weight loss overshadowed the adverse effects of weight cycling for individuals with obesity looking to lower their diabetes risk.
Story Source:
Materials provided by The Endocrine SocietyNote: Content may be edited for style and length.

Journal Reference:
  1. Tae Jung Oh, Jae Hoon Moon, Sung Hee Choi, Soo Lim, Kyong Soo Park, Nam H Cho, Hak Chul Jang. Body-weight fluctuation and incident diabetes mellitus, cardiovascular disease, and mortality: a 16-year prospective cohort studyThe Journal of Clinical Endocrinology & Metabolism, 2018; DOI: 10.1210/jc.2018-01239

Wednesday, November 21, 2018

How to Recover From a Hernia

Getting a hernia from lifting weights or being athletic is a horrible experience. Hernia surgery involves a long road to recovery — one that’s effective as long as you stick to the process and take your time through it. As a lifter and coach who’s undergone hernia surgery, I’ll tell you what you need to know if you find yourself in similar shoes.

But First, What Is a Hernia?

Truthfully, hernias can come in different forms. Umbilical hernias are located around the midstomach region, and inguinal hernias are located in the lower pelvic region. In each case, the lining of the abdominal wall is compromised, allowing for tissue underneath to push through. Depending on the severity and nature of the injury, this can be painful and even require emergency surgery.
The urgency of the hernia really depends not only on its location but also the tissue type that’s escaped. When the abdominal lining is torn, often a fatty tissue known as the omentum is what causes the protrusion. Often, this can create a bulge with minimal pain symptoms (as was the case with my own inguinal hernia). This generally means you can still carefully function while you prepare for surgical repair in the coming weeks or months. In other cases, organ tissue can begin to fall through and surgery needs to be arranged as soon as possible to put the organ (in the case of inguinal hernias, usually the intestine) back into place.
Whatever the nature, surgery is the ultimate answer. Naturally, most people who go under the knife wonder whether they’ll ever be able to return to the same level of capability they had before getting injured.
You Can!
And that is good news. I had my strongest PRs in major lifts well after my surgery in 2011. If you’re recovering from hernia surgery, these guidelines will set you on the right path to positive results without setbacks. On a similar note, many of these points can benefit a lifter who’s healthy and trying to avoid a hernia.

Ask Your Parents

Like many aliments, potential for getting a hernia from exercise is heightened depending on whether you’re genetically inclined to get one. Ask your parents if they’ve ever had any, and if yes, you’ll know you’re probably more susceptible to one than the next guy is. With that said, training smart matters tenfold.

Everybody, Breathe!

Like the subheading suggests, this one applies to both recovering hernia patients and healthy individuals who have never been injured. Improper breathing technique is one major player in exercise that can be a huge cause of hernias. Understand the importance of exhaling on the exertion phase of your lifts, remaining braced, creating intra-abdominal pressure and limiting the amount of strain you place on areas like your pelvic floor. All exercise starts with good breathing. Practice it under light weight and get used to it. If you’ve been injured, it will only matter that much more.

Be Careful With Anti-Extension Work

It took me a long time before I could get back to exercises like ab wheel rollouts, hand walkouts and barbell strict presses. The common thing among these movements is the anti-extension capacity of the abdominals. They place the abdominal tissue into a stretch that a strong contraction negates (in order to keep the spine neutral and intact).
Remember, you’ve been stitched up because your abdominal wall was torn open. With that in mind, you can easily reinjure yourself if you’re not careful. Start your abdominal work in a neutral position and not an extended one. Work with short plank variations before pushing the envelope. If you’re healthy, pay special attention to your spine position during heavy overhead presses and rollouts. Just because it doesn’t “hurt” to fall into extension, don’t try to be a hero. Lower your load on presses (or range of motion on rollouts) and do what you can with your glutes and abs remaining engaged.

Take a Closer Look at Your Hip Complex

Don’t forget that many muscles cross through the core junction, and the hip joint is a complex one. The iliacus, psoas, transverse abdominal muscle, rectus abdominis and more are all part of the region between the bellybutton and the upper thigh. When you’ve had a hernia repair, regardless of its location, plenty of scar tissue will be a byproduct of the healing process, which will severely limit your range of motion to start. You’ll be limited in what you can do at the beginning, but creating more flexibility within your bounds is key.
Gentle stretching and rolling can do your body good, especially focusing on muscles that surround the site (think quads, glutes, IT band). You risk reinjury if you get right back into weight training without paying attention to your mobility and flexibility.

Listen to the Doc

In conclusion, no one wants to go under the knife. In the training community, everyone who does seems to want to set a world record for recovery time, and then post their exploits on social media with trite motivational quotes. Instead, let recovery be the name of the game and take the time you need to get better. No one’s trying to be a hero — especially not a recreational lifter with a day job.