Hydration Linked With Lower Disease Risk, study finds

You may know that being adequately hydrated is important for day-to-day bodily functions such as regulating temperature and maintaining skin health. But drinking enough water is also associated with a significantly lower risk of developing chronic diseases, a lower risk of dying early or lower risk of being biologically older than your chronological age, according to a National Institutes of Health study published Monday in the journal eBioMedicine.

“The results suggest that proper hydration may slow down aging and prolong a disease-free life,” said study author Natalia Dmitrieva, a researcher in the Laboratory of Cardiovascular Regenerative Medicine at the National Heart, Lung and Blood Institute, a division of NIH, in a news release.

Learning what preventive measures can slow down the aging process is “a major challenge of preventive medicine,” the authors said in the study. That’s because an epidemic of “age-dependent chronic diseases” is emerging as the world’s population rapidly ages. And extending a healthy life span can help improve quality of life and decrease health care costs more than just treating diseases can.

The authors thought optimal hydration might slow down the aging process, based on previous similar research in mice. In those studies, lifelong water restriction increased the serum sodium of mice by 5 millimoles per liter and shortened their life span by six months, which equals about 15 years of human life, according to the new study. Serum sodium can be measured in the blood and increases when we drink less fluids.

Using health data collected over 30 years from 11,255 Black and White adults from the Atherosclerosis Risk in Communities study, or ARIC, the research team found adults with serum sodium levels at the higher end of the normal range — which is 135 to 146 milliequivalents per liter (mEq/L) — had worse health outcomes than those at the lower end of the range. Data collection began in 1987 when participants were in their 40s or 50s, and the average age of participants at the final assessment during the study period was 76.

Adults with levels above 142 mEq/L had a 10% to 15% higher chance of being biologically older than their chronological age compared with participants in the 137 to 142 mEq/L range. The participants with higher faster-aging risk also had a 64% higher risk for developing chronic diseases such as heart failure, stroke, atrial fibrillation, peripheral artery disease, chronic lung disease, diabetes and dementia.

And people with levels above 144 mEq/L had a 50% higher risk of being biologically older and a 21% higher risk of dying early. Adults with serum sodium levels between 138 and 140 mEq/L, on the other hand, had the lowest risk of developing chronic disease. The study didn’t have information on how much water participants drank.

“This study adds observational evidence that reinforces the potential long-term benefits of improved hydration on reductions in long-term health outcomes, including mortality,” said Dr. Howard Sesso, an associate professor of medicine at Harvard Medical School and associate epidemiologist at Brigham and Women’s Hospital in Boston, via email. Sesso was not involved in the study.

However, “it would have been nice to combine their definition of hydration, based on serum sodium levels only, with actual fluid intake data from the ARIC cohort,” Sesso added.

Biological age was determined by biomarkers that measure the performance of different organ systems and processes, including cardiovascular, renal (relating to the kidneys), respiratory, metabolic, immune and inflammatory biomarkers.

High serum sodium levels weren’t the only factor associated with disease, early death and faster aging risk — risk was also higher among people with low serum sodium levels. This finding is consistent with previous reports of increased mortality and cardiovascular disease in people with low regular sodium levels, which has been attributed to diseases causing electrolyte issues, the authors said.

The study analyzed participants over a long period of time, but the findings don’t prove a causal relationship between serum sodium levels and these health outcomes, the authors said. Further studies are needed, they added, but the findings can help doctors identify and guide patients at risk.

“People whose serum sodium is 142 mEq/L or higher would benefit from evaluation of their fluid intake,” Dmitrieva said. Sesso noted that the study did not strongly address accelerated aging, “which is a complicated concept that we are just starting to understand.”

“Two key reasons underlie this,” Sesso said. The study authors “relied on a combination of 15 measures for accelerated aging, but this is one of many definitions out there for which there is no consensus. Second, their data on hydration and accelerated aging were a ‘snapshot’ in time, so we have no way to understand cause and effect.”

Drink enough fluids every day

About half of people worldwide don’t meet recommendations for daily total water intake, according to several studies the authors of the new research cited.

“On the global level, this can have a big impact,” Dmitrieva said in a news release. “Decreased body water content is the most common factor that increases serum sodium, which is why the results suggest that staying well hydrated may slow down the aging process and prevent or delay chronic disease.”

Our serum sodium levels are influenced by liquid intake from water, other liquids, and fruits and vegetables with high water content.

“The most impressive finding is that this risk (for chronic diseases and aging) is apparent even in individuals who have serum sodium levels that are on the upper end of the ‘normal range,’” said Dr. Richard Johnson, professor at the University of Colorado School of Medicine, via email. He was not involved in the study.

“This challenges the question of what is really normal, and supports the concept that as a population we are probably not drinking enough water.”

More than 50% of your body is made of water, which is also needed for multiple functions, including digesting food, creating hormones and neurotransmitters, and delivering oxygen throughout your body, according to the Cleveland Clinic.

The National Academy of Medicine (formerly known as the Institute of Medicine) recommends women consume 2.7 liters (91 ounces) of fluids daily, and that men have 3.7 liters (125 ounces) daily. This recommendation includes all fluids and water-rich foods such as fruits, vegetables and soups. Since the average water intake ratio of fluids to foods is around 80:20, that amounts to a daily amount of 9 cups for women and 12 ½ cups for men.

People with health conditions should talk with their doctor about how much fluid intake is right for them.

“The goal is to ensure patients are taking in enough fluids, while assessing factors, like medications, that may lead to fluid loss,” said study coauthor Dr. Manfred Boehm, director of the Laboratory of Cardiovascular Regenerative Medicine, in a news release. “Doctors may also need to defer to a patient’s current treatment plan, such as limiting fluid intake for heart failure.”

If you’re having trouble staying hydrated, you might need help working the habit into your usual routine. Try leaving a glass of water at your bedside to drink when you wake up, or drink water while your morning coffee is brewing. Anchor your hydration habit to a location you’re in a few times per day, behavioral science expert Dr. B.J. Fogg, founder and director of the Stanford University Behavior Design Lab, previously told CNN.

Source: Hydration linked with lower disease risk, study finds | CNN

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Related contents:

The Impact of Hydration on Disease and Longevity Runners’ World

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A Brain Expert Shares His 7 Hard Rules For Boosting Memory and Fighting Off Dementia

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The average human brain shrinks by approximately 5% per decade after the age of 40. This can have a major impact on memory and focus. What’s more, brain disorders are on the rise. In 2020, 54 million people worldwide had Alzheimer’s disease or other dementias, and that number is expected to grow.

But serious mental decline doesn’t have to be an inevitable part of aging. In fact, certain lifestyle factors have a greater impact than your genes do on whether you’ll develop memory-related diseases. As a neuroscience researcher, here are seven hard rules I live by to keep my brain sharp and fight off dementia.

1. Keep blood pressure and cholesterol levels in check

Your heart beats roughly 115,000 times a day, and with every beat, it sends about 20% of the oxygen in your body to your brain. High blood pressure can weaken your heart muscle, and is one of the leading causes of strokes. Ideally, your blood pressure should be no higher than 120/80.

Cholesterol is critical to your brain and nervous system health, too. The American Heart Association recommends getting your cholesterol levels measured every four to six years.

2. Manage sugar levels

Blood sugar is the primary fuel of the brain. Not enough of it, and you have no energy; too much, and you can destroy blood vessels and tissue, leading to premature aging and cardiovascular disease.

Keep in mind that sugar isn’t enemy, excess sugar is. It’s easy for grams of sugar to add up, even if you think you’re being careful — and usually, sugar will sneak in through packaged foods.

Where is the sugar hidden? Look for these in the ingredients list:

  • Dextrose
  • Fructose
  • Galactose
  • Glucose
  • Lactose
  • Maltose
  • Sucrose

And be wary of any product that includes syrup, such as agave nectar syrup or high-fructose corn syrup.

3. Get quality sleep

Studies show that people with untreated sleep apnea raise their risk of memory loss by an average of 10 years before the general population. For most people, a healthy brain needs somewhere between seven and nine hours of sleep a night.

My tips for memory-boosting, immune-enhancing sleep:

  • Keep a consistent bedtime and wake-up schedule.
  • Turn off devices one hour before bedtime.
  • Do something relaxing before bedtime, like listening to soft music or doing mindful breathing exercises.
  • Go outside and get in natural sunlight as soon as you can after waking up.

4. Eat a nutritious diet

One way I keep things simple is to have most, if not all, of these items in my grocery cart:

  • Fatty fish like salmon
  • Avocados
  • Nuts
  • Blueberries
  • Cruciferous veggies like arugula, broccoli, Brussels sprouts and collard greens

When food shopping, I ask myself three questions to help determine whether something is good for my brain:

1. Will it spoil? In many cases, perishable is a good thing. The additives and preservatives that keep food from spoiling wreak havoc on your gut bacteria.

2. Are there tons of ingredients in that packaged food? And for that matter, can you pronounce the ingredients? Or does it look like the makings of a chemical experiment? Also avoid anything where sugar is one of the first few ingredients.

3. Do you see a rainbow on your plate? The chemicals that give fruits and vegetables their vibrant colors help boost brain health.

5. Don’t smoke (and avoid secondhand and thirdhand smoke)

Smokers have a 30% higher risk of developing dementia than non-smokers. They also put those around them at risk: Secondhand smoke contains 7,000 chemicals — and at least 70 of them can cause cancer.

Then there’s thirdhand smoke, which is not actually smoke. It’s the residue of cigarette smoke that creates the telltale smell on clothing or in a room. That residue alone can emit chemicals that are toxic to the brain.

6. Make social connections

In a recent study, people over the age of 55 who regularly participated in dinner parties or other social events had a lower risk of losing their memory. But it wasn’t because of what they ate, it was the effect of the repeated social connection.

To lessen isolation and loneliness, you can also boost brain chemicals like serotonin and endorphins by performing small acts of kindness:

  • Wish others well or check in with somebody.
  • Give a compliment without expecting anything in return.
  • Make a phone call to somebody you don’t usually reach out to.

7. Continuously learn new skills

Maintaining a strong memory is not all about brain games like Sudoku, Wordle and crossword puzzles.

Learning skills and acquiring information are much more effective ways to make new connections in the brain. The more connections you make, the more likely you are to retain and even enhance your memory.

When you think about learning something new, approach it the way you would with fitness training. You want to work out different muscles on different days. The same goes for the brain.

Over the course of this week, try cross-training your brain by mixing mental activities (learning a new language or reading a book) and physical learning activities (playing tennis or soccer) .

By: Marc Milstein

Marc Milstein, PhD, is a brain health expert and author of “The Age-Proof Brain: New Strategies to Improve Memory, Protect Immunity, and Fight Off Dementia.” He earned both his PhD in Biological Chemistry and his Bachelor of Science in Molecular, Cellular, and Developmental Biology from UCLA, and has conducted research on genetics, cancer biology and neuroscience. Follow him on Twitter and Instagram.

Source: A brain expert shares his 7 ‘hard rules’ for boosting memory and fighting off dementia

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Massive Study Finds Coffee Drinkers Will Probably Outlive The Rest of Us

White coffee mug with a heart on the side(Catherine Falls Commercial/Moment/Getty Images)

While the research doesn’t claim drinking more coffee adds years to your life, it’s nevertheless an intriguing association that scientists are keen to investigate further. It’s also important to weigh the findings against previous studies linking brain shrinkage and an increased risk of dementia with a daily habit of six or more cups of coffee.

“In this large, observational study, ground, instant and decaffeinated coffee were associated with equivalent reductions in the incidence of cardiovascular disease and death from cardiovascular disease or any cause,” says electrophysiologist Peter Kistler, from the Baker Heart and Diabetes Institute in Australia.

“The results suggest that mild to moderate intake of ground, instant and decaffeinated coffee should be considered part of a healthy lifestyle.”The UK Biobank is a large-scale database containing records on individuals’ genetics, health, and lifestyle. In this study, the sample provided an average of 12 and a half years’ worth of health and dietary information on 449,563 people with a median age of 58.

The participants were grouped according to their daily coffee consumption, and what type of coffee they usually drank – with just over 100,000 people reporting that they didn’t drink coffee at all. As part of the analysis, the researchers factored in the effects of age, sex, ethnicity, obesity, high blood pressure, diabetes, obstructive sleep apnoea, smoking status, and tea and alcohol consumption.

From there, Kistler and colleagues could compute differences in heart health outcomes and death from any cause for all coffee drinkers over the study time period, compared to those who didn’t drink coffee. Drinking instant, ground and even decaffeinated coffee were all associated with a lower likelihood of death. Those who drank two or three cups of coffee a day had better odds of living longer than those who didn’t drink any.

Researchers can only guess what might be behind the relationship. If it is the coffee itself, a wide variety of potential compounds could be responsible. “Caffeine is the most well-known constituent in coffee, but the beverage contains more than 100 biologically active components,” says Kistler.

“It is likely that the non-caffeinated compounds were responsible for the positive relationships observed between coffee drinking, cardiovascular disease and survival.” Digging deeper, the team found coffee consumption was also linked with the development of cardiovascular disease, with the lowest risk seen amongst those who consumed two to three cups a day.

There were slightly different findings for the risk of arrhythmia or an abnormal heart rhythm – here ground and instant coffee, but not decaffeinated, were linked to a lower likelihood of developing the condition. Once again, just a couple of cups each day seemed to be the sweet spot.

As a lot of previous research has shown, coffee is a complex substance that interacts with the body in a number of complex ways – ways that scientists are still trying to understand. That this study covered so many people over an extended period only adds weight to the link between coffee drinking and longevity.

However, there are some limitations to consider. The database records were predominantly Caucasian, making it harder to generalize the findings across a more ethnically diverse population. Coffee drinking was also self-reported rather than monitored, and the database doesn’t factor in changes in coffee consumption or coffee type over time.

For now, sip that morning brew guilt free – chances are it’s doing you some good. “Our findings indicate that drinking modest amounts of coffee of all types should not be discouraged but can be enjoyed as a heart healthy behavior,” says Kistler.

By David Nield

Source: Massive Study Finds Coffee Drinkers Will Probably Outlive The Rest of Us : ScienceAlert

Critics by Donald Hensrud, M.D.

While past studies hinted that coffee might have a dark side, newer research suggests that it may actually have health benefits.

Why the reversal? It’s hard to look at just one aspect of diet and connect it to a health condition because so many other factors that could play a role. For example, early research on coffee didn’t always take into account that heavy coffee drinkers also tended to use tobacco and be sedentary.

When newer studies adjusted for such factors, they found a possible association between coffee and decreased mortality. Coffee may offer some protection against:

  • Parkinson’s disease
  • Type 2 diabetes
  • Liver disease, including liver cancer
  • Heart attack and stroke

Coffee still has potential risks, mostly due to its high caffeine content. For example, it can temporarily raise blood pressure. Women who are pregnant, trying to become pregnant or breastfeeding need to be cautious about caffeine. High intake of boiled, unfiltered coffee has been associated with mild increase in cholesterol levels.

The bottom line? Your coffee habit is probably fine and may even have some benefits. But if you have side effects from coffee, such as heartburn, nervousness or insomnia, consider cutting back.

Related contents:

Poole R, Kennedy OJ, Roderick P, Fallowfield JA, Hayes PC, Parkes J (November 2017). “Coffee consumption and health: umbrella review of meta-analyses of multiple health outcomes”. BMJ. 359: j5024. doi:10.1136/bmj.j5024. PMC 5696634. PMID 29167102.open access

Boekema PJ, Samsom M, van Berge Henegouwen GP, Smout AJ (1999). “Coffee and gastrointestinal function: facts and fiction. A review”. Scandinavian Journal of Gastroenterology. Supplement. 34 (230): 35–39. doi:10.1080/003655299750025525. PMID 10499460.

Cornwall HL, Edwards BA, Curran JF, Boyce S (May 2020). “Coffee to go? The effect of coffee on resolution of ileus following abdominal surgery: A systematic review and meta-analysis of randomised controlled trials”. Clinical Nutrition. 39 (5): 1385–1394. doi:10.1016/j.clnu.2019.06.003. PMID 31253438. S2CID 195766007.

Eamudomkarn N, Kietpeerakool C, Kaewrudee S, Jampathong N, Ngamjarus C, Lumbiganon P (November 2018). “Effect of postoperative coffee consumption on gastrointestinal function after abdominal surgery: A systematic review and meta-analysis of randomized controlled trials”. Scientific Reports. 8 (1): 17349. Bibcode:2018NatSR…817349E. doi:10.1038/s41598-018-35752-2. PMC 6255780. PMID 30478433.

Freedman ND, Park Y, Abnet CC, Hollenbeck AR, Sinha R (May 2012). “Association of coffee drinking with total and cause-specific mortality”. The New England Journal of Medicine. 366 (20): 1891–1904. doi:10.1056/NEJMoa1112010. PMC 3439152. PMID 22591295.

Crippa A, Discacciati A, Larsson SC, Wolk A, Orsini N (October 2014). “Coffee consumption and mortality from all causes, cardiovascular disease, and cancer: a dose-response meta-analysis”. American Journal of Epidemiology. 180 (8): 763–775. doi:10.1093/aje/kwu194. PMID 25156996.

Hildebrand JS, Patel AV, McCullough ML, Gaudet MM, Chen AY, Hayes RB, Gapstur SM (January 2013). “Coffee, tea, and fatal oral/pharyngeal cancer in a large prospective US cohort”. American Journal of Epidemiology. 177 (1): 50–58. doi:10.1093/aje/kws222. PMID 23230042.

Je Y, Giovannucci E (April 2014). “Coffee consumption and total mortality: a meta-analysis of twenty prospective cohort studies”. The British Journal of Nutrition. 111 (7): 1162–1173. doi:10.1017/S0007114513003814. PMID 24279995. Archived from the original on 31 August 2022. Retrieved 23 February 2022.

Zhao Y, Wu K, Zheng J, Zuo R, Li D (May 2015). “Association of coffee drinking with all-cause mortality: a systematic review and meta-analysis”. Public Health Nutrition. 18 (7): 1282–1291. doi:10.1017/S1368980014001438. PMID 25089347.

Gunter MJ, Murphy N, Cross AJ, Dossus L, Dartois L, Fagherazzi G, et al. (August 2017). “Coffee Drinking and Mortality in 10 European Countries: A Multinational Cohort Study”. Annals of Internal Medicine. 167 (4): 236–247. doi:10.7326/M16-2945. PMC 5788283. PMID 28693038.

Wu JN, Ho SC, Zhou C, Ling WH, Chen WQ, Wang CL, Chen YM (November 2009). “Coffee consumption and risk of coronary heart diseases: a meta-analysis of 21 prospective cohort studies”. International Journal of Cardiology. 137 (3): 216–225. doi:10.1016/j.ijcard.2008.06.051. PMID 18707777.

Mostofsky E, Rice MS, Levitan EB, Mittleman MA (July 2012). “Habitual coffee consumption and risk of heart failure: a dose-response meta-analysis”. Circulation. Heart Failure. 5 (4): 401–405. doi:10.1161/CIRCHEARTFAILURE.112.967299. PMC 3425948. PMID 22740040.

Ding M, Bhupathiraju SN, Satija A, van Dam RM, Hu FB (February 2014). “Long-term coffee consumption and risk of cardiovascular disease: a systematic review and a dose-response meta-analysis of prospective cohort studies”. Circulation. 129 (6): 643–659. doi:10.1161/circulationaha.113.005925. PMC 3945962. PMID 24201300.

Brown OI, Allgar V, Wong KY (November 2016). “Coffee reduces the risk of death after acute myocardial infarction: a meta-analysis”. Coronary Artery Disease. 27 (7): 566–572. doi:10.1097/MCA.0000000000000397. PMID 27315099. S2CID 7980392. Archived from the original on 2 April 2022. Retrieved 23 February 2022.

D’Elia L, La Fata E, Galletti F, Scalfi L, Strazzullo P (February 2019). “Coffee consumption and risk of hypertension: a dose-response meta-analysis of prospective studies”. European Journal of Nutrition. 58 (1): 271–280. doi:10.1007/s00394-017-1591-z. PMID 29222637. S2CID 7264285. Archived from the original on 6 November 2020. Retrieved 29 September 2020.

Grosso G, Micek A, Godos J, Pajak A, Sciacca S, Bes-Rastrollo M, et al. (August 2017). “Long-Term Coffee Consumption Is Associated with Decreased Incidence of New-Onset Hypertension: A Dose-Response Meta-Analysis”. Nutrients. 9 (8): 890. doi:10.3390/nu9080890. PMC 5579683. PMID 28817085.

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Doctors on TikTok: The Dark Side of Medical Influencers

A doctor examines a TikTok of an x-ray of ribs on a giant iPhone.

Medical data is supposed to be confidential. But social media is threatening the privacy and dignity of patients. For years, Martin Jugenburg—a Toronto-based plastic and reconstructive surgeon who goes by Dr. 6ix on social media—shared dozens of before-and-after photos and videos on Instagram of the altered bodies that had passed through his hands. There were tummy tucks, Brazilian butt lifts, and breast augmentations, all of them sorted into a kind of virtual assembly line for his thousands of followers to see.

But many of the women he featured in his posts—sometimes depicted post-op and sedated, their genitals and breasts blurred out—hadn’t consented to having their images circulated, according to an ongoing class action lawsuit, and some were only alerted of their presence online due to an investigation by CBC journalists. Unbeknownst to his patients and followers, investigators later found that Jugenburg was using a covert network of cameras in his clinic to perform a rigorous feat of surveillance, documenting thousands surgical procedures.

Women who realized he had posted images of them told investigators they felt violated; they were upset, embarrassed, and distressed. Dr. 6ix’s loose approach to respecting patient privacy on social media is hardly unusual in the world of “med Twitter” and “MedTok,” or medical TikTok. On Twitter, orthopedic surgeons complain about chronic pain “crazies,” nurses mock women who choose to give birth without an epidural, and doctors complain about “liars,” “Googlers,” and patients with conditions they are struggling to diagnose.

TikTok is worse. In a post by someone with the username Nurse Johnn, whose derogatory skits about dementia patients he claims are fiction, the nurse mockingly dances in blue-green scrubs on a hospital bed, imitating someone under his care. One nurse filmed themselves holding the hand of a patient they said was dying of COVID-19. There is a video of someone in what appears to be a psychiatric crisis and another of a patient having their toenails cut. A Miami-based doctor posted about how he “walks in the footsteps of giants” in reference to porn star Johnny Sins, who impersonates a doctor having sex with his patients.

To scroll through many medical social media accounts is to wade into a virtual subculture where patients have become fodder for derision, their privacy and dignity regularly violated. But since there isn’t really any oversight of this virtual world, patients must bear the repercussions.

Medical professionals spilling these traumatic, “hilarious” stories about their patients can lead to people not going to the doctor, says Shayna Hermann, a graduate student at the University of North Texas who studies criminology. This means the underlying health issue can “get worse and worse,” she adds—often with dire consequences.

The concealment of a patient’s medical information is an ancient custom, for such knowledge is a “holy secret,” according to the Hippocratic Oath. Medical students still refer to a doctrine of “doing no harm” that is based on the Hippocratic oath, and harm, to Hippocrates, included the dissemination of information shared between a patient and their doctor. Otherwise, trust in medicine could be undermined, disrupting treatment and diagnosis. Medicine is about acting but also about not acting.

The Enlightenment enshrined patient confidentiality as one of the formative values of the modern biomedical model. Ideals cherished under liberalism, like the individual’s right to autonomy over their body, would be impossible to respect without the guarantee that their medical records remained private. Those ideas would persist throughout the twentieth century. In 1948, the World Medical Association, an international body that now represents 115 medical associations worldwide, produced the Declaration of Geneva for the purposes of unifying an international standard for medical practice.

The document reads: “I will respect the secrets that are confided in me, even after the patient has died.” Today, a patient’s right to privacy has been legally protected in both Canada and the United States. If it is violated, doctors can be sanctioned and even lose their medical licence, temporarily or permanently. Despite this basis for the preservation of confidentiality, the growing presence of practitioners on social media presents a risk for breaches.

Physicians, like many of us, have used platforms like Twitter and Instagram since their inception, with 90 percent reporting they used social media to find information related to their patients and practice in 2017, according to a report by market analyst Research2Guidance. Today, lists of the top twenty-five “medical influencers” include accounts of family physicians and doctors who have been endorsed by celebrities and have millions of followers. And, at times, their posts contain jokes involving patient information.

A 2020 study by Wasim Ahmed of Newcastle University, which analyzed 348 tweets about living patients, found that nearly 47 percent contained details that would likely make patients identifiable to themselves. In some ways, packaging patient information for public consumption is in line with lesser-known traditions of the medical world. The history of medicine is also a history of performance; health care workers have advanced their careers through the exhibition of less powerful people for hundreds of years.

Despite the progress made around patient confidentiality during the Enlightenment, during the seventeenth and eighteenth centuries it wasn’t uncommon for both students and the public to pay an entry fee to witness dissections that took place as part of medical education in Europe. Many people viewed the practice as necessary for scientific advancement, but physicians used, almost universally, bodies of the poorest subjects, stealing cadavers from graves without consent and then displaying them for the public.

In the era before anesthetic was widely used, surgeons would operate on conscious patients before an audience of, at times, 700 to 800 onlookers. In an article for JSTOR Daily, Rebecca Rego Barry wrote that surgeons “seemed to revel in the showmanship aspect of their work,” receiving applause at the moment they entered what one medical college called the “pit.” It was this performative aspect of medicine—perpetrated by practitioners and revered by observers—that helped usher in the era of the celebrity doctor.

Of course, the conditions health care professionals train and work in have always encouraged physicians to establish public influence. Canadian hospitals and medical schools reward and publicly promote their most prestigious students, researchers, and clinicians; competition for esteem and funding from donors encourages already-high-achieving people to differentiate themselves and build lucrative research reputations. But television fundamentally changed the way we think about doctors, commodifying the act of giving medical care so that it could be sold as entertainment on a mass scale.

Just look at celebrities like Dr. Drew and Dr. Oz or shows like Dr. 90210 and Botched. Every week, viewers tune in to watch the assessment, diagnosis and treatment of patients, despite the criticisms these shows have received for exploitative practices. Reality shows like ABC’s NY Med used footage from actual emergency rooms and operating theatres, sometimes filming surgeries without consent from patients.

Joel M. Geiderman, an LA emergency physician, told Emergency Medicine News that he knows people who consented to being filmed while stressed and in the emergency department, then regretted the publicization of their medical treatment in the media. So, while the disclosure of medical secrets to the public is not particularly new, technology has made it much easier.

There is certainly a place for doctors online. Medical misinformation and vaccine hesitancy need to be confronted, especially in the era of COVID-19, and many clinicians have made invaluable contributions to online discussions about medical racism, homophobia, ableism, and misogyny. A number of physicians use social media to help patients with conditions underrepresented in medical literature self-advocate. Others advise oppressed patients on how to ensure they’re getting the best care possible and answer pressing questions about the pandemic.

But growing distrust in the medical establishment, which the violation of patient confidentiality encourages, must be reckoned with just as seriously. According to a recent survey by NORC at the University of Chicago, since the start of COVID, 32 percent of respondents decreased their trust in the health care system. This distrust is often particularly present in Black, Indigenous, and LGBTQ+ communities, which have been subjected to medical exploitation, experimentation, and harm for centuries.

Research shows suspicion of pharmaceutical companies continues to drive vaccine hesitancy. “COVID put physicians in the forefront of the cultural mainstream,” says Stephanie Lee, a hematologist at St. Michael’s Hospital in Toronto. “Everyone was looking to physicians for guidance on what was happening.” She adds that, for many physicians, there was a feedback loop of wanting more attention and likes on social media.

While she believes health care practitioners generally have good intentions, “when the well runs dry of content on COVID, people wanted to mine their professional lives to maintain their status. COVID accelerated what was already an issue.” The targets of these posts are, overwhelmingly, the oppressed. Faithful to the history of medical theatre, women with mental illness and patients who are geriatric, disabled, fat, impoverished, or perceived as uneducated are subjected to the majority of ridicule.

And it’s not uncommon for patients in similar situations to see these posts. Reacting to discussions of trans healthcare by physicians on Twitter, one person tweeted, “My lived experience/identity has been distilled to a saccharine and self-serving Aesop[’s fable].” Another nurse, who posted that she knew when patients were faking symptoms, inspired a #PatientsAreNotFaking hashtag used by thousands of people.

“Whenever I see nurses and doctors on TikTok . . . disparaging their patients . . . it makes it hard, for not just me but a lot of people, to be vulnerable to their doctors,” says the University of North Texas’s Hermann. She adds that patients who grew up in poverty, like herself, already distrust health care professionals, and social media has the potential to make it worse. Patients have already expressed a variety of concerns in the comments sections of these platforms:

“TikTok singlehandedly made me not seek medical care recently,” wrote one user; another posted about their anxieties around having emergency surgery, writing, “I was literally fearful of my nurses having their phones on them and videoing me while I’m vulnerable.” With no real oversight in place to monitor online behaviour, it’s clear that the regulations around patient confidentiality must evolve to capture these new concerns.

The Canadian Medical Association does have a data-stewardship policy that covers patient privacy, but it only mentions the sharing of patient details over email—nothing about social media. The issue has been addressed in the College of the Physicians and Surgeons of Ontario’s new set of guidelines for the use of social media by physicians, which includes the recommendation that doctors “exercise caution when posting information online that relates to an actual patient” and asks them to “bear in mind that an unnamed patient may still be identified through a range of their information such as a description of their clinical condition.”

These are, however, just guidelines, and they are still violated constantly online. Both Hermann and Lee think that social media use should be addressed in medical curricula; hospitals and medical boards already have disciplinary mechanisms in place for violations of patient confidentiality, which should be implemented when health care practitioners post derogatory content online with the same consistency that they are when practitioners are careless with physical copies of patient data.

Directives, they added, should take into account that comments deriding or ridiculing sick people in general can be as harmful to the public’s relationship with the medical system as individual violations of patient confidentiality. Lee believes that, when done correctly, patient narratives shared on social media can have a constructive and positive function. “There’s an opportunity to do a lot of good,” she says. “

But physicians need to take stock of how this is really helping our patients. Is there really a net material benefit to patients by posting this? Is there an alternative way that preserves the patient’s dignity better, maintains their anonymity better?” Asking for consent to post about a patient online is complicated, however. The power differential between patients and doctors, in most cases, is enormous.

It is difficult to imagine conditions in which patients wouldn’t potentially feel coerced into agreeing to let their physician share their information on a public social media account. “Hospital fundraising campaigns share patient information all the time, but the big difference is the patients’ stories are shared after the acute issue has been resolved,” says Lee, adding that, often, those narratives are shared in the patient’s own words, sometimes written in partnership with their former health care providers. “You have to empower the patient to be part of the process, to be part of sharing their story,” she says.

In 2021, following his disciplinary hearing at the College of Physicians and Surgeons of Ontario, Martin Jugenburg was suspended from his job for six months. At some point, he removed all the patient content predating November 2019 from his Instagram account. The committee wrote that there was a “troubling pattern of Dr. Jugenburg pursuing his own interests . . . in publicity and in cultivating a strong social media presence, at the expense of the privacy of his patients.” His “seeming indifference to these issues was appalling and is deserving of significant sanction,” the committee added.

Jugenburg has since resumed his career at the Toronto Cosmetic Surgery Institute and has publicly vowed to fight attempts made by patients to seek financial compensation for the damages done. His Instagram account is still public, and he has begun posting new post-op images of his patients—presumably with permission this time. It’s almost business as usual.

For patients, the situation remains unchanged. Questions about the function of social media in medicine have yet to be posed with seriousness, and solutions have not been identified or implemented. Meanwhile, influencer-doctors continue to practise the tradition of performance, prolonging a hidden history of sickness as spectacle.

“It’s really easy to detach empathy when you’re doing a TikTok. It’s really easy for those viewers to not see that person as a person,” says Hermann. “[But] I think, now, it’s coming to a head.”

Source: Doctors on TikTok: The Dark Side of Medical Influencers | The Walrus

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Daily Multi Vitamins May Improve Brain Function In Older People

A daily multivitamin and mineral supplement may reduce cognitive decline in older people, according to a US study that is the first to demonstrate they may benefit ageing brain function.

The trial, involving more than 2,200 over-65s, suggests that daily supplements may slow cognitive decline by about 60%, or nearly two years, with the most substantial effects seen in older people with a history of cardiovascular disease.

But while experts in Alzheimer’s disease and dementia are encouraged by the findings, they caution that larger studies are needed to confirm the effect before recommending daily multivitamins to help protect older people from cognitive decline. Previous tests of dietary supplements have had no effect on the disease.

“We provide the first evidence in a long-term, randomised controlled trial of older women and men that daily use of a safe, readily accessible, and low-cost multivitamin-mineral can improve cognition,” the researchers wrote in Alzheimer’s and Dementia, the Journal of the Alzheimer’s Association. “This finding could have important public health implications for brain health and resilience against future cognitive decline.”

With populations ageing around the world, dementia has become one of the leading global health challenges, but there are no drugs that can cure any of the common types. In the UK, about 850,000 people live with dementia, most of which is Alzheimer’s disease or “vascular dementia”. People over 65, and those with diabetes, high blood pressure, high cholesterol and depression, are most at risk.

Researchers at Wake Forest University in North Carolina and Brigham and Women’s Hospital in Boston investigated whether a daily cocoa extract or multivitamins with minerals improved memory and other mental tasks in 2,262 people aged 65 and over. The researchers rated the participants’ “global cognition” before and during the three-year trial through tests involving word lists, number problems, verbal fluency and story recall.

Cocoa extract is rich in substances called flavanols and past research has suggested that they may have some benefit for brain function. But the latest trial found daily cocoa supplements made no difference to people’s cognitive performance. Daily multivitamin-mineral supplements, however, appeared to improve cognitive scores, in particular for those with cardiovascular disease, a known risk factor for dementia. The results suggest “either greater relative improvement or more protection from cardiovascular disease-related cognitive decline”, the authors wrote.

Prof Laura Baker, co-principal investigator on the Cosmos study at Wake Forest University, said it was too early to recommend daily multivitamins to prevent cognitive decline. “While these preliminary findings are promising, additional research is needed in a larger and more diverse group of people. Also, we still have work to do to better understand why the multivitamin might benefit cognition in older adults,” she said.

Prof Tara Spires-Jones, group leader at the UK Dementia Research Institute at Edinburgh University, said the study was well conducted, but noted that most people involved were highly educated white people.

“It will be important to confirm that the results hold up in the wider population,” she said. “It is also not clear from this study whether multivitamin use will prevent diseases affecting cognition like Alzheimer’s disease. Several dietary supplements have been tested as treatments for Alzheimer’s disease and so far none have been effective.”

Dr Maria Carrillo, chief scientific officer at the Alzheimer’s Association, said: “This is the first positive, large-scale, long-term study to show that multivitamin-mineral supplementation for older adults may slow cognitive ageing. While the Alzheimer’s Association is encouraged by these results, we are not ready to recommend widespread use of a multivitamin supplement to reduce risk of cognitive decline in older adults.

“Independent confirmatory studies are needed in larger, more diverse study populations,” she added. “It is critical that future treatments and preventions are effective in all populations.”

By:  

Source: Daily multi-vitamins may improve brain function in older people – US study | Health | The Guardian

Critics by Johns Hopkins Medicine

Half of all American adults—including 70 percent of those age 65 and older—take a multivitamin or another vitamin or mineral supplement regularly. The total price tag exceeds $12 billion per year—money that Johns Hopkins nutrition experts say might be better spent on nutrient-packed foods like fruit, vegetables, whole grains and low-fat dairy products.

The researchers concluded that multivitamins don’t reduce the risk for heart disease, cancer, cognitive decline (such as memory loss and slowed-down thinking) or an early death. They also noted that in prior studies, vitamin E and beta-carotene supplements appear to be harmful, especially at high doses.

“Pills are not a shortcut to better health and the prevention of chronic diseases,” says Larry Appel, M.D., director of the Johns Hopkins Welch Center for Prevention, Epidemiology and Clinical Research. “Other nutrition recommendations have much stronger evidence of benefits—eating a healthy diet, maintaining a healthy weight, and reducing the amount of saturated fat, trans fat, sodium and sugar you eat.”

The exception is supplemental folic acid for women of child-bearing potential, Appel says. “Folic acid prevents neural tube defects in babies when women take it before and during early pregnancy. That’s why multivitamins are recommended for young women.” The Centers for Disease Control and Prevention recommends that all women of reproductive age get 400 micrograms of folic acid daily. The amount of iron in a multivitamin may also be beneficial for women of child-bearing potential, Appel adds.

“I don’t recommend other supplements,” Appel says. “If you follow a healthy diet, you can get all of the vitamins and minerals you need from food.”

Whole grains: Grains such as whole wheat, brown rice and barley still have their fiber-rich outer shell, called the bran, and inner germ. It provides vitamins, minerals and good fats. Choosing whole grain side dishes, cereals, breads and more may lower the risk for heart disease, type 2 diabetes and cancer and improve digestion, too.

Saturated fat: A type of fat found in abundance in butter, whole milk, ice cream, full-fat cheese, fatty meats, poultry skin, and palm and coconut oils. Saturated fat raises levels of heart-threatening LDL cholesterol in your bloodstream. It can also interfere with your body’s ability to absorb blood sugar easily. Limiting saturated fat can help control your risk for heart disease.

Omega-3 fatty acids (oh-may-ga three fah-tee a-sids): Healthy polyunsaturated fats that the body uses to build brain-cell membranes. They’re considered essential fats because our body needs them but can’t make them on its own; we must take them in through food or supplements. A diet rich in omega-3s—found in fatty fish, like salmon, tuna and mackerel, as well as in walnuts, flaxseed and canola oil—and low in saturated fats may help protect against heart disease, stroke, cancer and inflammatory bowel disease.

The amounts of each vitamin type in multivitamin formulations are generally adapted to correlate with what is believed to result in optimal health effects in large population groups. However, these standard amounts may not correlate what is optimal in certain subpopulations, such as in children, pregnant women and people with certain medical conditions and medication.

The health benefit of vitamins generally follows a biphasic dose-response curve, taking the shape of a bell curve, with the area in the middle being the safe-intake range and the edges representing deficiency and toxicity.[16] For example, the Food and Drug Administration recommends that adults on a 2,000 calorie diet get between 60 and 90 milligrams of vitamin C per day. This is the middle of the bell curve. The upper limit is 2,000 milligrams per day for adults, which is considered potentially dangerous.

In particular, pregnant women should generally consult their doctors before taking any multivitamins: for example, either an excess or deficiency of vitamin A can cause birth defects. Long-term use of beta-carotene, vitamin A, and vitamin E supplements may shorten life and increase the risk of lung cancer in people who smoke (especially those smoking more than 20 cigarettes per day), former smokers, people exposed to asbestos, and those who use alcohol.

Many common brand supplements in the United States contain levels above the DRI/RDA amounts for some vitamins or minerals. Severe vitamin and mineral deficiencies require medical treatment and can be very difficult to treat with common over-the-counter multivitamins. In such situations, special vitamin or mineral forms with much higher potencies are available, either as individual components or as specialized formulations.

Multivitamins in large quantities may pose a risk of an acute overdose due to the toxicity of some components, principally iron. However, in contrast to iron tablets, which can be lethal to children, toxicity from overdoses of multivitamins are very rare. There appears to be little risk to supplement users of experiencing acute side effects due to excessive intakes of micronutrients.There also are strict limits on the retinol content for vitamin A during pregnancies that are specifically addressed by prenatal formulas.

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PodKastr                 https://jvz1.com/c/202927/369500/
Postradamus                              https://jvz6.com/c/202927/108695
Power Reviews                     https://jvz8.com/c/202927/384625/
Powrsuite                       https://jvz1.com/c/202927/376361
PR Rage                        https://jvz4.com/c/202927/343405
prime stocks                              https://jvz8.com/c/202927/369164  prime stocks
Profile mate                           https://jvz4.com/c/202927/358049
Promovidz                      https://jvz8.com/c/202927/375692/
Push Button Traffic         https://jvz2.com/c/202927/301402
QR Verse                      https://jvz3.com/c/202927/383865/
Quintex Capital                         https://quintexcapital.com/?ref=arminham
Quit Smoking                           https://jvz3.com/c/202927/359081/
Reputor                 https://jvz8.com/c/202927/380159/
ReviewReel                        https://jvz6.com/c/202927/382663/
Rewriter                      https://jvz4.com/c/202927/353373/
RSI SEO                              https://jvz6.com/c/202927/384381/
Scriptdio                       https://jvz4.com/c/202927/385387/
Seniors Income                        https://jvz2.com/c/202927/383888/
Senuke                                  https://jvz6.com/c/202927/279944
ShopABot                           https://jvz2.com/c/202927/291955
ShopFunnels                        https://jvz3.com/c/202927/384069/
SocialAgency360                 https://jvz1.com/c/202927/385357/
SociCake                       https://jvz2.com/c/202927/321987
Socifeed                          https://jvz6.com/c/202927/375706
SociJam                    https://jvz2.com/c/202927/309649
Soronity                                 https://jvz6.com/c/202927/368736
SqribbleEbook                 https://jvz6.com/c/202927/283867
Stackable Picture                        https://jvz1.com/c/202927/385046/
Steven Alvey’s                      https://jvz2.com/c/202927/351754
Stoodaio                                    https://jvz1.com/c/202927/372094
Storymate                         https://jvz3.com/c/202927/320972
StreamPilot                        https://jvz2.com/c/202927/385431/
Studioninja                       https://jvz1.com/c/202927/374965
Sunday Freebie                             https://jvz1.com/c/202927/267113/
Super backdrop                https://jvz8.com/c/202927/376524
Superbackdrop                 https://jvz8.com/c/202927/376524
Survai                      https://jvz8.com/c/202927/380933/
Syndranker                          https://jvz3.com/c/202927/378143/
Talkingfaces                      https://jvz2.com/c/202927/375358
Talkingfaces                    https://jvz3.com/c/202927/375550
The Internet Marketing                https://jvz2.com/c/202927/289944
Tonai Voice Content           https://jvz8.com/c/202927/383119/
Toon Video Maker                   https://jvz2.com/c/202927/357201
TrafficFor                https://jvz8.com/c/202927/381950/
TrafficForU                   https://jvz3.com/c/202927/381950/
Trendio                       https://jvz3.com/c/202927/381003/
TubePal                        https://jvz6.com/c/202927/379863/
Tubeserp                        https://jvz3.com/c/202927/370472
TubeTargeter                   https://jvz6.com/c/202927/377211
TV Boss Fire                https://jvz6.com/c/202927/379480/
Ultrafunnels A.I                 https://jvz2.com/c/202927/381129/
VIADZ Ad Template                    https://jvz4.com/c/202927/379307/
Vidcentric                             https://jvz4.com/c/202927/376095
Viddeyo                                https://jvz6.com/c/202927/382326/
Videevolve                       https://jvz4.com/c/202927/381011/
Video Games                            https://jvz3.com/c/202927/184902/
VideoEnginePro                https://jvz2.com/c/202927/372916
VideoGameSuite                     https://jvz3.com/c/202927/366537/
VideoRobot Enterprise                https://jvz8.com/c/202927/291061
VidKreate                        https://jvz6.com/c/202927/386029/
VidMingo                           https://jvz6.com/c/202927/378359/
VidSnatcher                           https://jvz3.com/c/202927/342585
VidVoicer                      https://jvz1.com/c/202927/379983/
Vidzura                       https://jvz4.com/c/202927/385754/
Viral dash                            https://jvz6.com/c/202927/375959
VirtualReel                       https://jvz8.com/c/202927/376849
Vocalic                    https://jvz2.com/c/202927/383848/
VoiceBuddy                      https://jvz1.com/c/202927/342854
WebCop                         https://jvz4.com/c/202927/378683/
Webinarkit                       https://jvz3.com/c/202927/383937/
Webprimo                   https://jvz1.com/c/202927/379455/   Website Builder
WordPress Mastery                       https://jvz1.com/c/202927/386249/
WOW Backgrounds                      https://jvz3.com/c/202927/381615/
WOW Backgrounds                   https://jvz2.com/c/202927/381556/
WowBackgraounds                       https://jvz2.com/c/202927/381556/
WP GDPR                                https://jvz8.com/c/202927/299907
WP Simulator                    https://jvz3.com/c/202927/46987/
writing job                                  https://jvz8.com/c/202927/213027
XBrain Forex                           https://jvz3.com/c/202927/372305/
XFUNNELS                         https://jvz2.com/c/202927/310335
Xinemax                        https://jvz6.com/c/202927/381749/
Xinemax                    https://jvz1.com/c/202927/381749/
YoDrive                    https://jvz2.com/c/202927/384700/
Your 3DPal                https://jvz2.com/c/202927/381685/
Your3DPal Ultimate             https://jvz4.com/c/202927/381689/
YTSuite                       https://jvzoo.com/c/202927/381179
YTSuite                     https://jvz2.com/c/202927/381179/

 

 

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