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How depression negatively impacts heart patients

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Depression, even when undiagnosed, can have many negative effects on patients with cardiovascular diseases, including poor healthcare experiences and higher health costs, say researchers.

The study found that people at high risk of depression were more than five times more likely to have a poor self-perceived health status and almost four times more likely to be dissatisfied with their healthcare.

Patients at high risk of depression had notably worse healthcare-related quality of life. They spent more on overall and out-of-pocket healthcare expenditures yearly.

 

They were more than two times more likely to be hospitalised and have an increased use of the emergency room, said the researchers while presenting the results at the American Heart Association’s Quality of Care and Outcomes Research Scientific Sessions 2018 in Virginia.

“This could be because people at high risk for depression simply haven’t been diagnosed and treated for depression yet,” said Victor Okunrintemi, a research student at Baptist Health South Florida, a US-based non-profit.

In another study, the team found that heart attack patients diagnosed with depression were 54 per cent more likely to be hospitalised and 43 per cent more likely to have emergency room visits, compared to those not diagnosed with depression.

“Depression and heart attack often coexist, which has been associated with worse health experiences for these patients,” Okunrintemi said.

About one-fifth of cardiovascular disease patients suffer from depression.

“While we don’t know which comes first — depression or cardiovascular disease — the consensus is that depression is a risk marker for cardiovascular disease,” Okunrintemi said.

It means that “if you have cardiovascular disease, there is a higher likelihood that you could also have depression, when compared with the risk in the general population”, he added.


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Eggs for breakfast benefit those with Type 2 diabetes

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People with Type 2 Diabetes (TED) should opt for eggs for breakfast, a recent study suggests. According to the findings, a high-fat, low-carb breakfast (LCBF) can help those with T2D control blood sugar levels throughout the day.

“The large blood sugar spike that follows breakfast is due to the combination of pronounced insulin resistance in the morning in people with T2D and because typical Western breakfast foods – cereal, oatmeal, toast and fruit – are high in carbohydrates,” said Jonathan Little, lead author of the study published in the Journal of the American Journal of Clinical Nutrition.

According to Little, breakfast is consistently the “problem” meal that leads to the largest blood sugar spikes for people with T2D. The research shows that eating a low-carb and high-fat meal first thing in the morning, is a simple way to prevent this large spike, improve glycemic control throughout the day, and can perhaps also reduce other diabetes complications.

 

Study participants, with well-controlled T2D, completed two experimental feeding days. On one day, they ate an omelette for breakfast and on another day, they ate oatmeal and some fruit. An identical lunch and dinner were provided on both days. A continuous glucose monitor – a small device that attaches to your abdomen and measures glucose every five minutes – was used to measure blood sugar spikes across the entire day. Participants also reported ratings of hunger, fullness and a desire to eat something sweet or savoury.

Little’s study determined that consuming a very low-carbohydrate high-fat breakfast completely prevented the blood sugar spike after breakfast and this had enough of an effect to lower overall glucose exposure and improve the stability of glucose readings for the next 24 hours.

We expected that limiting carbohydrates to less than 10% at breakfast would help prevent the spike after this meal. But we were a bit surprised that this had enough of an effect and that the overall glucose control and stability were improved. We know that large swings in blood sugar are damaging to our blood vessels, eyes, and kidneys. The inclusion of a very low-carbohydrate high-fat breakfast meal in T2D patients may be a practical and easy way to target the large morning glucose spike and reduce associated complications,” he explained.

He does note that there was no difference in blood sugar levels in both groups later in the day, suggesting that the effect for reducing overall post-meal glucose spikes can be attributed to the breakfast responses with no evidence that a low-carb breakfast worsened glucose responses to lunch or dinner.

“The results of our study suggest potential benefits of altering macronutrient distribution throughout the day so that carbohydrates are restricted at breakfast with a balanced lunch and dinner rather than consuming an even distribution and moderate amount of carbohydrates throughout the day,” Little asserted.

As another interesting aspect of the research, participants noted that pre-meal hunger and their cravings for sweet foods later in the day tended to be lower if they ate the low-carb breakfast. Little suggests this change in diet may be a healthy step for anybody, even those who are not living with diabetes.

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Symptoms of liver disease and ways to keep it healthy

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The liver, which measures about 1,00 grams in weight and 15 cm in length, is responsible for the synthesis of various proteins, coagulation factors, cholesterol, triglycerides and bile including glycogenesis. It is also responsible for detoxifications of drugs, alcohol and control of infections. Located in the upper right part of the abdomen separated from chest cavity by the diaphragm, it is one the most vital organs in the body.

However, the graph of liver disease in India has grown over the decade and the dynamics has changed drastically, says Dr (Prof) Gourdas Choudhuri, executive director, Department of Gastroenterology and Hepatobiliary Sciences, Fortis Memorial Research Institute.

“Earlier liver diseases were synonyms with Hepatitis B and C only, but today we see lot of cases of liver failure, fatty liver, and every year about 10 lakh people with new liver disease are diagnosed in our country,” he says.

 

On World Liver Day, which is observed every year on April 19 to create awareness and understand the importance of the liver, he lists a few liver diseases and also shares tips on how to take care of the organ:

A few known liver diseases:

  1. Hepatitis A, B or C
  2. Non-alcoholic fatty liver disease
  3. Alcoholic fatty liver
  4. Fatty liver
  5. Cirrhosis of the liver
  6. Alcoholic hepatitis
  7. Hemochromatosis

You must visit a doctor in case you have the follow symptoms:

  1. Unexplained abdominal pain and swelling which is continuous in nature.
  2. Itchy and red skin around the stomach. Regular red patches around the stomach and skin are primary indication of something being wrong inside.
  3. Dark urine is another early sign of liver disease. No matter how hydrated you are, if your urine is dark in colour you must visit a doctor.
  4. Loss of appetite.
  5. Blood in stool, or pale or tar-coloured stool.
  6. Swelling in legs and ankles.
  7. Nausea or vomiting.

To prevent liver diseases you must keep your lifestyle and weight in check, he suggests. Protection is the best cure for liver diseases.

“Protect yourself from hepatitis infected people and alcohol. Vaccination is another important part to avoid liver disease although there are no vaccination for all liver diseases but there are for Hepatitis A & B. Sharing of drugs and needles are also the major cause of liver disease, avoid it at any cost. Unprotected sex, tattoo and piercing from same needles or infected needles with same drugs has the highest risk of liver disease,” Dr (Prof) Gourdas Choudhuri adds.

Tips for liver care:

  1. Adopt a healthy lifestyle and have a balanced diet.
  2. Eat foods from all the food groups: grains, proteins, dairy products, fruits, vegetables and fats. Include green leafy vegetables, broccoli, cauliflower, cabbage, carrot, apple and walnut in your diet.
  3. Eat foods that have lot of fibre such as fresh fruits and vegetables, whole grain breads, rice and cereals such as quinoa, millet and buckwheat.
  4. Ensure safe blood transfusions to avoid contracting hepatitis A, B, C.
  5. Maintain personal hygiene and be sure to wash hands after using the washroom.
  6. Avoid tap water when travelling.
  7. Say no to alcohol, tobacco and drugs.
  8. Exercise regularly.

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BP drug shows promise for treating Parkinson’s

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Felodipine, a prescribed drug to treat high blood pressure, has shown promise against Parkinson’s, Huntington’s and forms of dementia in studies carried out in mice and zebrafish at the University of Cambridge.

In a study published in the journal Nature Communications, scientists have shown in mice that felodipine may be a candidate for re-purposing.

A common feature of neurodegenerative diseases is the build-up of misfolded proteins.

 

These proteins, such as huntingtin in Huntington’s disease and tau in some dementias, form “aggregates” that can cause irreversible damage to nerve cells in the brain.

A team led by Professor David Rubinsztein used mice that had been genetically modified to express mutations that cause Huntington’s disease or a form of Parkinson’s disease, and zebrafish that model a form of dementia.

Felodipine was effective at reducing the build-up of “aggregates” in mice with the Huntington’s and Parkinson’s disease mutations and in the zebrafish dementia model. The treated animals also showed fewer signs of the diseases.

“This is the first time that we’re aware of that a study has shown that an approved drug can slow the build-up of harmful proteins in the brains of mice using doses aiming to mimic the concentrations of the drug seen in humans,” said Professor Rubinsztein.

The hypertension drug was able to slow down progression of these potentially devastating conditions and “so we believe it should be trialled in patients,” he added. In healthy individuals, the body uses a mechanism to prevent the build-up of such toxic materials.

This mechanism is known as autophagy, or ‘self-eating’, and involves cells eating and breaking down the materials. “This is only the first stage, though. The drug will need to be tested in patients to see if it has the same effects in humans as it does in mice. We need to be cautious, but I would like to say we can be cautiously optimistic,” said Professor Rubinsztein.

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