Writing down your thoughts can boost your mood

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Adapted from Human Givens No 1 2013 Brinol P et al. Treating thoughts as material objects can increase or decrease their impact on evaluation. Psychological Science 24.1, 41-7. 2013.

Writing down negative thoughts, crumpling them up, and throwing them away, as often advocated by therapists, really does reduce negative thinking. Conversely, writing positive thoughts down, and keeping them safe in a purse or pocket helps you feel better.

Teenage School students in Spain were asked to write down either positive or negative thoughts about their bodies and then Mediterranean diet and they were then evaluated on how much they became influenced by their lists later on.

What they found was that people who threw the list in the trash right away were not influenced, those who kept the list in their desk were somewhat influenced, but that those who kept the list more personally in a pocket or purse were most influenced.

To see if the effect worked with word lists via a computer, the experiment was repeated. The thoughts were put into storage or the trash list. Repeating the experiment but simply asking the students to imagine putting the list in a particular location without physically doing anything was also done.

Professor Richard Petty, a co-author of the paper from Ohio University said, ” The more convinced the person is that negative thoughts are really gone, the better. Just imagining that you throw them away doesn’t seem to work”.

So, to get over a difficult event, write it down, and then bin it and be physical.

If you want to boost your mood, write positive facts or feelings and keep it close and personal.

6.5 to 7 hours sleep a night is about average for adults

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Adapted from BMJ 13 Nov 2021 from American Journal of Epidemiology.

Measurements using an Actigraph were taken from 13,000 adults and children in the USA to determine what a “normal” sleep duration was. The amount of sleep taken by individuals can be highly variable, and this can also change due to their age and stage of life and occupation.

For females, the 50th centile, the middle of the sleep range, was 8.3 hours a night, starting from age 6. As a young adult, this reduced to just over 7 hours and stayed constant till there was a small increase at age 65.

For males, the middle of the sleep range was 8.1 hours at age 6 and reduced to 6.5 hours in early adulthood and increased slightly at age 60.

My comment: I’ve always needed a lot more sleep than this. 10 or 11 is better for me and in autumn, just after the clocks change, I can sleep for 14 hours a night if I am not disturbed. I perk up a little bit in the spring and can cope with 9 hours a night. For much of my life, particularly working as a doctor on call and having young children I had a lot less sleep than I really needed. I have seen that sleeping a lot is associated with a higher rate of dementia, but too bad!

In California, a longitudinal study of more than 50,000 women, looked at how environmental influences affected how long it took to get to sleep and how long the sleep lasted.

Shorter sleep duration was associated with exposure to artificial light at night and air pollution. (Associated with cities). Where there was a lot of environmental noise, it took longer to fall asleep.

Contrasting with this, living in areas with more green space led to women falling asleep faster and staying asleep longer.

Consistent exercise improves your survival if you have a heart attack

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Adapted from BMJ 27 Feb 2021

After a heart attack, the risk of sudden death is influenced by your past levels of physical activity.

People who performed moderate levels of leisure time exercise reduced their risk by 33% and those who performed high levels of exercise reduced the risk by 45%.

This study combined data from ten European longitudinal studies and found 30,000 people who had a heart attack. Around 5,000 people (18%) died within 28 days. Of these, 3,000 (62%) died instantly.

European Journal of Preventative Cardiology

Fish oil supplements however had no worthwhile cardioprotective effects according to a Cochrane Systemic Review done several years ago. A study looking at secondary prevention in 70-80 year olds, recently found similar effects. There was no difference between the omega 3 fish oil supplemented group and placebo over two years.

Cochrane Database Systemic Review and Circulation

Babyhood antibiotics increase the risk of type one diabetes in childhood

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Adapted from Diabetes in Control Antibiotic Treatment increases risk for type one diabetes by Chardae Whitner May 15 2021

Both prenatal and first year of life antibiotic exposure may increase the risk for developing type one diabetes in childhood.

It is believed that early life risk factors which include antibiotic treatment can influence the risk of type one diabetes by affecting the gut microbiome. This affects the development of the immune system. Type one diabetes children have been found to have lower microbial diversity in their gut compared to children without diabetes. Antibiotic exposure in early life delays microbiota maturation.

Sweden has the highest rates of type one diabetes in the world despite a relatively low antibiotic prescription rate. They studied siblings, some affected by diabetes and some not. They looked at antibiotic prescriptions, mode of delivery, sex, birth year and genetic predisposition to type one diabetes. The children studied were born between 2005 and 2013. 797,318 children were studied.

Overall 800 prescriptions for antibiotics were issued in the first year of life. These were most commonly for ear infections, then respiratory tract infections, urinary tract infections, and then skin and soft tissue infections.

Exposure to antibiotics prenatally was associated with an increase in type one diabetes in childhood of 1.15 (so weakly associated). Antibiotic exposure in the first year of life raised this a little to 1.19. (still weak. You would need to have 1,475 babies have antibiotics to have one extra case of childhood diabetes before the age of ten).

Siblings of type ones have a risk of 1.36, so this is a stronger risk than antibiotic exposure.

Caesarian section did give an increased rate of type one diabetes in childhood but sex, genetic predisposition and birth year did not. The risk was 1.10 in vaginally delivered babies and 1.60 in the little caesars. So this was again a bit stronger than sibling risk.

Wernroth, Mona-Lisa et al. Early childhood antibiotic treatment for otitis media and other respiratory tract infections is associated with risk of type one diabetes. Diabetes Care May 2020.

My comment: My son Steven has type one diabetes and had a strong family history on his dad’s side of autoimmune disorders including type one diabetes in several generations. He also was a caesarian section delivery and also had a peri-orbital skin infection when he was about seven months old that required antibiotics. Poor wee soul! These days no one gets a caesarian section without a good reason and antibiotics are well thought out. There isn’t much you can do about being a sibling of someone with diabetes. What you can do is take vitamin D in pregnancy and give it to your children from birth onwards.

Nick Norwitz:Ketogenic diets may be used to treat mental illness in the future

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Adapted from Ketogenic diet as a metabolic treatment for mental illness by Nicholas Norwitz et al

Wolters Kluwer Health Inc. http://www.co-endocrinology.com 2020

Ketogenic diets have been used to treat drug resistant epilepsy in children for over one hundred years.

Now they are being used for other neurological conditions such as schizophrenia, depression, bipolar disorder and binge eating disorder.

There is strong evidence that common biological pathologies underlie these conditions such as abnormal glucose metabolism, neurotransmitter imbalances, oxidative stress and inflammation. These factors are all improved with a ketogenic diet.

Controlled clinical trials have shown improvement in: Obesity, Type Two Diabetes, Multiple Sclerosis, Epilepsy, Alzheimer’s disease and Autistic Spectrum Disorder.

Uncontrolled clinical trials have shown improvement in: Parkinson’s disease and Schizophrenia.

Case series and animal models have shown improvement in: Cardiovascular Disease, Binge eating disorder, Major Depressive disorder, Bipolar disorder and ADHD.

It is estimated that people who have mental illness live around 7 to 10 years less than those who do not have a mental illness. Sometimes this is due to suicide, but more often it is due to concurrent diabetes, heart disease, respiratory disease, infectious disease and cancer. All of these conditions are raised in people with mental illness. Sometimes this is due to poor health behaviours such as smoking or other lifestyle issues, and drug side effects can also cause problems. But even in people of a healthy weight and who are not on drugs, if they have mental illness, they are also more likely to have physical illness. Could switching the body and brain away from glucose use towards fat and ketone use improve matters?

Cerebral glucose hypometabolism and insulin resistance are features of Alzheimer’s disease, Parkinson’s disease, Schizophrenia, and Epilepsy. In one recent Cochrane review of epilepsy, as many as 55% of patients had complete remission of their fits on a ketogenic diet.

GABA/glutamate imbalance is a feature of Epilepsy and Schizophrenia. Oxidative stress is a feature of Schizophrenia, Bipolar disorder and Major Depressive Disorder. Oxidative stress and inflammation are mutually reinforcing processes. Major Depressive Disorder, Schizophrenia have these issues.

The Virta Health Group has demonstrated that a ketogenic diet is a well tolerated and effective strategy for treating type two diabetes. It reversed the condition in 54% of patients compared to 5% who received standard care. Alzheimer’s patients also improved on a ketogenic diet and also benefitted from medium chain triglyceride supplementation. (MCTs). Parkinson’s disease, Huntington’s disease and Multiple Sclerosis patients also showed improvement in studies. About 50 to 80% of patients with Alzheimer’s disease have cross over symptoms with schizophrenia, Bipolar disorder and major depressive disorder. These conditions all share common metabolic abnormalities.

It is thought that the ketogenic diet affects the gut microbiome and gut issues are thought to influence Autistic Spectrum Disorder. Two clinical trials reported sometimes complete symptom remission in patients with Childhood Autism when treated with a ketogenic diet.

Some case studies involve psychiatric patients who embarked on ketogenic diets for weight loss and gut problems, only to find a massive improvement in their mental conditions as well. Dr Christopher Palmer reported about an elderly woman with over 50 years of schizophrenia who was able to stop all her antipsychotic medication and has been symptom free for over 12 years. Another middle aged woman who had schizophenia and depression went into complete remission and was able to get her degree and a full time job in the last four years. Both remain unmedicated and on their ketogenic diets.

Results with Binge eating disorder have also been impressive. These patients are usually on 20-30g of carbohydrate a day.

Fibromyalgia likely due to autoimmune attack

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From Geobel A et al Journal of Clinical Investigation 1 Jul 2021

Many of the symptoms in fibromyalgia syndrome (FMS) are caused by antibodies increasing the activity of pain sensing nerves throughout the body according to new research led by the Institute of Psychiatry, Psychology and Neuroscience at King’s College London.

This is at odds of the currently held view that the condition arises centrally in the brain.

The researchers injected mice with antibodies of people who have FMS and saw that the mice rapidly developed increasing sensitivity to pressure and cold as well as reduced movement grip strength.

In contrast, mice who were injected with antibodies from healthy people were unaffected.

The injected mice recovered from their symptoms after a few weeks once they had cleared the antibodies from their systems. The researchers wonder if treatments that would reduced antibodies in patients with FMS could become an effective treatment.

Dr David Andersson, the lead investigator said, ” Treatment for FMS is currently focused on gentle aerobic exercise, and drug and psychological therapies designed to manage pain, although these have been proven to be ineffective in patients. There is an enormous unmet clinical need. Our work has uncovered a whole new area of possible therapeutic options and should give real hope to fibromyalgia patients”.

See your pals once every week or two, or maybe get a dog?

Adapted from Human Givens Volume 27 No2 2020

Frequent social contact has been associated with better health and longer life but is there an optimal contact frequency?

The European Social Survey results suggested that monthly or weekly was enough to see benefits among 350 thousand people over 35 countries.

A second German study found that more contact than this was not associated with better health and in some cases was related to worse health and greater mortality risks. My comment: Of course, friends and relatives may have been visiting more frequently BECAUSE their friend was indisposed.

Psychological and Personality Science 2020

Researchers from Ontario, Quebec and Oxford found that having strong interpersonal relationships was critical for survival across the entire lifespan. Social isolation is a significant predictor of the risk of death. Insufficient social stimulation affects reasoning and memory, hormone balance, brain structure, connectivity and function, and resilience to physical and mental disease.

Feelings of loneliness can cause negatively skewed social perception and in older people it can precipitate dementia.

Professor Dunbar from Oxford said, ” Loneliness has accelerated in the past decade. Given the potentially severe consequences, exacerbated by national policy responses to Covid-19, we have launched the Campaign to End Loneliness. This is a network of over 600 national, regional and local organisations that want to create the right conditions to reduce loneliness in later life.

https://www.campaigntoendloneliness.org

Bzdok D and Dunbar RIM (2020) The neurobiology of social distance. Trends in Cognitive Sciences.

If you are at the other end of the age spectrum, particularly an only child, a pet can be a great advantage to you.

The Longitudinal Study of Australian Children found that children who had pets had lower emotional symptoms, fewer problems relating to other children and had more positive social behaviour compared to the non pet owning children. The positive social behaviour effect was magnified in only children.

Christian H et al. Pets are associated with fewer peer problems and emotional symptoms and better prosocial behaviour. Findings from the Longitudinal Study of Australian Children. J Pediatr 2020;200:200-206.

University College London: Diabetes has trebled in England in the last 25 years

Researchers from UCL analysed the results the latest results from the Health Survey for England.

Data from 8,200 adults and 2,000 children living in private households showed that diabetes has risen in men from 3% to 9% and from 2% to 6% in women since 1994.

Those from poorer households and those with obesity are much more likely to be affected than the slim and affluent. 16% from the poorest homes had diabetes compared to 7% in the highest income group. If you are of normal weight there is a 5% chance of diabetes, 9% if you are overweight and 15% if you are obese.

Obesity is a marker for poverty. 39% of women in deprived areas were obese compared to 22% from least deprived areas. The weight of children was closely correlated with their parents.

Professor Jennifer Mindell said,” Diabetes has become more common in both high and low income countries over the last few decades. It increases the risks of circulatory diseases and cancers. This year we have also seen a rise in serious infection and death such as with Covid-19. Obesity reduction would help all of these problems.”

The survey also asked about GP visits. 69% of men and 82% of women had consulted a GP in the previous six months. GP consultations are more common in older ages, especially among men and those who are overweight or obese. 84% said they went about their physical health problems, 11% for physical and mental problems and 5% for an emotional or mental health problem. Women tended to seek more help for mental health problems than men.

Echoing all the other parameters, consultations for mental health problems were more frequent in those with lower incomes. 25% consulted from the lowest income group compared to 15% from the most affluent group.

Elizabeth Fuller, Research Director at NatCen said, ” One in five women and one in eight men screened positive for a possible eating disorder. This can mean eating too much or too little, obsessing with weight or body shape, having strict routines around food or purging after eating. People who are obese, younger adults and women are more likely to be affected.”

Public health collaboration online conference 2021

Sam Feltham has done it again. This year’s conference is now available on you tube right now.

Last weekend there were many contributors from diverse fields including members of the public, doctors, academics, and the scientific journalist Gary Taubes who gave the opening talk about ketogenic diets.

The courses that particularly interested me were about the experiences of type one diabetics who had adopted the low carb approach, how to achieve change, and how to increase your happiness.

There are talks about eating addiction and eating disorders, statins, and vegetable oil consumption.

Much of the material will be familiar to readers of this blog. There are some new speakers and topics which do indicate that a grassroots movement in changing our dietary guidelines is gaining ground.

BMJ: Low carbing for six months can put type two diabetes into remission without adverse effects.

Adapted from Efficacy and safety of low and very low carb diets for type two diabetes remission. Systemic review and meta-analysis by Goldenber JZ et al. BMJ 2021;372:m4743

My comment: Now, we all know this, but there still is a great deal of resistance to the idea that cutting out sugar and especially starch from your diet, can put type two diabetes into remission. Lately there has been a lot more emphasis that very low calorie diets are good for diabetes remission, but let’s face it, starving yourself is no fun at all, and eventually, even if you do manage to keep to a very low calorie diet for many months, you need to do something to maintain that remission, rather than yo-yo back into diabetes. This is why I was pleased to see this report in the BMJ.

This study looked at randomised controlled trials that evaluated low carb diets for at least 12 weeks in adults with type two diabetes. Their definition was less than 130 g of carb a day or 26% of the diet from carbohydrates. A very low carb diet was defined as less than 50g of carb a day or 10% of dietary carbs a day.

They wanted to see if remission was achieved. This was deemed to be a HbA1c of less than 6.5% or a fasting blood sugar of less than 7.0 mmol/L with or without the use of diabetes medication. They also looked at weight loss, HbAIc, fasting glucose and adverse events.

Compared to control diets, low carb diets produced remission at six months in 57% versus 31% in the control diets.

The population studied were 1,357 people aged 47 to 67 years of age and most were overweight or obese. 23 studies were looked at and 14 of these included patients who were on insulin. There was very little in the way of adverse consequences.