Wednesday, March 09, 2016

Thirdhand smoke is real

Thirdhand smoke (THS) results when exhaled smoke gets on surfaces -- clothing, hair, homes and cars. THS has been shown, in mice, to damage the liver and lungs, complicate wound-healing and cause hyperactivity. Add to this list now type 2 diabetes, the most common form of the disease.

Research published in PLOS ONE shows, in mice, that THS exposure causes insulin resistance, a precursor to type 2 diabetes.

If confirmed in humans, our study could greatly impact how people view exposure to environmental tobacco toxins. Children and the elderly are especially vulnerable to THS and its impact on health. Because infants frequently crawl on carpets and touch objects exposed to exhaled smoke, they are at high risk for THS exposure. The elderly are at high risk simply because older organs are more susceptible to disease.

THS consists of tobacco smoke toxins that linger on surfaces and in dust after tobacco has been smoked. This includes toxins that become increasingly toxic with age and are re-emitted into the air or react with other chemicals in the environment to produce new pollutants. Some of these pollutants are carcinogenic.

To rid a house of THS, you have to strip the home of everything -- furniture, appliances, paint, clothes, ducts, ventilation -- that could have THS. It would be more effective to simply move. There are cleaners we can use, but that would mean exposure to other strong chemicals.

Little was known about the specific health implications of human exposure to THS until this study.

Spouse Can Harm, Help Health

From the March 2016 issue of American Journal of Epidemiology

Low physical activity levels are a public health concern. Few studies have assessed the concordance of physical activity change among spouses. We studied this concordance during a 6-year period (baseline: 1987–1989; follow-up: 1993–1995) in 3,261 spousal pairs from the US-based Atherosclerosis Risk in Communities (ARIC) Study. Linear regression was used to examine the association between change in individuals' sport/exercise and leisure physical activity indices (ranging from 1 (low) to 5 (high)) and change in his or her spouse's indices. The association between individual and spousal changes in meeting physical activity recommendations was assessed with logistic regression. Individual changes in the sport/exercise and leisure indices were positively associated with spousal changes. For every standard deviation increase in their wives' sport/exercise index, men's exercise index increased by 0.09 (95% confidence interval: 0.05, 0.12) standard deviation; for every standard deviation increase in their wives’ leisure index, men's leisure index increased by 0.08 standard deviation. Results were similar for women. Individuals had higher odds of meeting physical activity recommendations if their spouse met recommendations at both visits or just follow-up. In conclusion, changes in an individual's physical activity are positively associated with changes in his or her spouse's physical activity. Physical activity promotion efforts should consider targeting couples.

Married couples might be an appropriate target for obesity prevention interventions. In the present study, we aimed to evaluate whether an individual's risk of obesity is associated with spousal risk of obesity and whether an individual's change in body mass index (BMI; weight in kilograms divided by height in meters squared) is associated with spousal BMI change. We analyzed data from 3,889 spouse pairs in the Atherosclerosis Risk in Communities Study cohort who were sampled at ages 45–65 years from 1986 to 1989 and followed for up to 25 years. We estimated hazard ratios for incident obesity by whether spouses remained nonobese, became obese, remained obese, or became nonobese. We estimated the association of participants' BMI changes with concurrent spousal BMI changes using linear mixed models. Analyses were stratified by sex. At baseline, 22.6% of men and 24.7% of women were obese. Nonobese participants whose spouses became obese were more likely to become obese themselves (for men, hazard ratio = 1.78, 95% confidence interval: 1.30, 2.43; for women, hazard ratio = 1.89, 95% confidence interval: 1.39, 2.57). With each 1-unit increase in spousal BMI change, women's BMI change increased by 0.15 (95% confidence interval: 0.13, 0.18) and men's BMI change increased by 0.10 (95% confidence interval: 0.09, 0.12). Having a spouse become obese nearly doubles one's risk of becoming obese. Future research should consider exploring the efficacy of obesity prevention interventions in couples.


Thursday, March 03, 2016

Metformin's Issues

Metformin-related vitamin B12 deficiency might contribute to clinically significant peripheral neuropathy in diabetes patients, new research suggests from the European Association for the Study of Diabetes Meeting.

"The consequences of vitamin B12 deficiency, like neuropathy or mental changes, may be profound. Even more, they may be difficult to diagnose, because they may be ascribed to old age or diabetes itself and may be or become irreversible. On the other hand, vitamin B12 deficiency is relatively easy to diagnose, and treatment is easy, cheap, and effective," the lead researcher commented.

Corroborating with previous research raises concern that the drug may be contributing to peripheral neuropathy separate from the effect of the diabetes itself.

Neurologists Use Mindfulness Protocols

From Practical Neurology 12/2015

Mindfulness training—mindfulness-based cognitive therapy and mindfulness-based stress reduction—is an evidence-based group program for reducing symptoms of anxiety and depression and building long-term capacity for emotion regulation, stress coping and enhancing quality of life.

It combines training of attention to moment-by-moment experience with practising a self-caring attitude and insight into self-defeating patterns of thought and behaviour.

It has been applied effectively in diverse clinical groups, including neurological patients and a variety of physical and mental health conditions.

It may be particularly relevant for people with long-term or deteriorating conditions.

It is best learned in a formal 8-week course. It is worth suggesting self-help and online formats to those who are sufficiently motivated.

Anxiety Takes Its Toll on the Heart

Anxiety has emerged as perhaps the most important risk factor for cardiovascular disease, according to a new study in Current Opinion in Psychiatry. Anxiety increases the risk of major cardiac events in coronary heart disease. There is also a need for elucidating the influence of anxiety in cardiomyopathy and hypertension.

Moreover, the researchers suggest that anxiety is an antecedent risk factor, so it influences the prognosis in patients with cardiovascular disease, and needs to be recognized and managed at every step. Anxiety drives other risk factors, such as depression, smoking, sedentary lifestyle, substance use, and overweight.