High Cholesterol Can Cause Tendon Pathology

A recent literature review by Yang et al. suggests that high blood cholesterol is a risk factor in the development and progression of tendon pathology. They found that cholesterol levels were directly correlated with the severity of tendon problems. There is evidence that elevated cholesterol levels lead to inflammatory, structural and mechanical changes in tendons which predispose patients with high cholesterol levels to an increased risk of developing tendinopathies.

Higher Fibre Intake Improves Health

Last month Reynolds et al. published an article in The Lancet that looked into the relationship between carbohydrate quality and health. They carried out a series of systematic reviews and meta-analyses that evaluated around 135 million person-years of data from 185 prospective studies as well as 58 clinical trials with 4635 adults. They found that those with higher intakes of fibre had lower body weight, lower systolic blood pressure and lower total cholesterol. Those with higher fibre intakes also had a decreased incidence of coronary heart disease, stroke, type 2 diabetes and colorectal cancer, which may explain the 15-30% decrease in all-cause mortality between the groups with high and low fibre intake. Daily intake of fibre between 25g-30g seemed to confer the greatest risk reduction, although they note that “higher intakes of dietary fibre could confer even greater benefit“.

Pain and Sleep

A few days ago, Krause et al. from the University of California (Berkeley), published the results of their research on the relationship between pain and sleep. They found that poor sleep quality was linked to increases in pain experience, whereas better sleep quality decreased pain. Krause notes that “the results clearly show that even very subtle changes in nightly sleep – reductions that many of us think little of in terms of consequences – have a clear impact on your next-day pain burden”. In the laboratory, they were able to identify that sleep deprivation amplifies the reactivity in parts of the brain (somatosensory cortex) responsible for the perception of pain. Whilst deactivating the responses from some pain relieving centres (insula and nucleus accumbens).

The irony is that pain often disrupts sleep, and thus the pain experience gets magnified and a vicious cycle is created.

Bad Moods Can Increase Inflammation

Jennifer Graham-Engeland et al. from Pennsylvania State University have recently found a link between negative moods and inflammation. The main author stated that, “Because affect is modifiable, we are excited about these findings and hope that they will spur additional research to understand the connection between affect and inflammation, which in turn may promote novel psychosocial interventions that promote health broadly and help break a cycle that can lead to chronic inflammation, disability, and disease.”

Decreasing Social Media Use Improves Mental Health

Hunt et al., from the University of Pennsylvania, have recently published their findings on the effects of social media use on well-being. After baseline monitoring, 143 undergraduates were randomly split into 2 groups. The first group (control group) continued to use Facebook, Instagram and Snapchat as usual whereas the second group was restricted to 10 min per platform per day i.e. 30 min/day in total. The authors found that “the limited use group showed significant reductions in loneliness and depression over three weeks compared to the control group. Both groups showed significant decreases in anxiety and fear of missing out over baseline, suggesting a benefit of increased self-monitoring. Our findings strongly suggest that limiting social media use to approximately 30 minutes per day may lead to significant improvement in well-being.”

It would be interesting to know whether limiting use even further could yield better results. Also, could some social media platforms be worse for mental health than others?

Stress Affects Brain Function and Structure

Echouffo-Tcheugui et al., from Harvard Medical School, recently published a paper studying the effects of stress on brain function and structure in over 2000 middle-aged participants from the Framingham Heart Study. They measured early morning serum cortisol as an indicator of stress levels. They found that “higher cortisol was associated with worse memory and visual perception, as well as lower total cerebral brain and occipital and frontal lobar gray matter volumes. The association of cortisol with total cerebral brain volume varied by sex (p for interaction = 0.048); higher cortisol was inversely associated with cerebral brain volume in women (p = 0.001) but not in men (p = 0.717)“.

The authors commented on the importance of finding ways to manage stress, “such as getting enough sleep, engaging in moderate exercise and incorporating relaxation techniques into their daily lives“.

“The dream of my life

Is to lie down by a slow river

And stare at the light in the trees –

To learn something by being nothing

A little while

but the rich

Lens of attention.”

Mary Oliver

How Does Cannabis Relieve Pain?

The use of cannabis to relieve pain is controversial, not just for legal reasons but also because of the conflicting research findings with regards to its efficacy. A recent study by Martin De Vita et al., from Syracuse University in New York, looked into the effects of cannabis on pain. They selected, reviewed and analysed studies that had researched the effect of cannabis on experimentally induced pain. De Vita et al. conclude that “although the cannabinoids examined in this review may prevent the onset of laboratory-induced pain by increasing pain thresholds, they do not appear to reduce the intensity of experimental pain that is already being experienced. Instead, these substances make experimental pain feel less unpleasant and more tolerable, suggesting a notable influence on affective processes. The cumulative research synthesized in this review has helped characterize how cannabis and cannabinoids affect different dimensions of pain reactivity.”

There are 2 components to pain: the purely sensory component and the affective (emotional) component. It’s been known for a while that opioids and our endogenous opioid pathways play an important role in sensory pain perception. It now appears that cannabis and our endogenous cannabinoid pathways play a part in the emotional dimension of pain. Interestingly, mindfulness meditation, which has proven effects on pain relief, doesn’t use opioid pathways. In fact, the mechanisms underlying mindfulness meditation’s pain-relieving effects are as yet unknown. Could it be possible that they employ cannabinoid receptors and pathways?

Low Carbohydrate Diets Are Bad For Health

Yesterday professor Banach, from the Medical University of Lodz in Poland, released the findings of his research at the European Society of Cardiology. The prospective study looked at the relationship between low carbohydrate diets, all-cause mortality and deaths specifically from coronary heart disease, stroke and cancer. The study group consisted of almost 25,000 adults from the US National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010. Over an average 6.4-year follow-up, compared to the group with the highest consumption of carbohydrates, the group with the lowest consumption had an increased risk of all-cause mortality (32%) and an increased risk of death from coronary heart disease (51%), stroke (50%) and cancer (35%). These results were backed up by the findings of a meta-analysis of several studies involving close to 450,000 people.

Professor Banach said: “Low carbohydrate diets might be useful in the short term to lose weight, lower blood pressure, and improve blood glucose control, but our study suggests that in the long-term they are linked with an increased risk of death from any cause, and deaths due to cardiovascular disease, cerebrovascular disease, and cancer. The reduced intake of fibre and fruits and increased intake of animal protein, cholesterol, and saturated fat with these diets may play a role. Differences in minerals, vitamins and phytochemicals might also be involved. Our study highlights an unfavourable association between low carbohydrate diets and total and cause-specific death, based on individual data and pooled results of previous studies. The findings suggest that low carbohydrate diets are unsafe and should not be recommended.“

Plant-Based Diets Improve Health

Last month “Nutrition 2018” was held in Boston. It was the inaugural flagship meeting of the American Society for Nutrition. Evidence from several studies was presented showing that a primarily plant-based diet is linked to numerous health benefits. Obviously, the quality of the food was important as well. Here is a summary of 5 papers that were presented:

• A 13 year study of 6000 people in the Netherlands found that a higher proportion of dietary plant protein to animal protein was linked to lower risks of developing heart disease.
• A study of 4500 Brazilians showed that those eating more plant-based protein were 60% less likely to have coronary artery plaque than those consuming more animal-based protein.
• South Asians living in the US that followed a vegetarian diet had a lower number of risk factors for heart disease and diabetes (lower body mass index, smaller waist circumference, less abdominal fat, lower cholesterol levels, lower blood sugar levels) than those that ate meat.
• A 4-year American study of over 125,000 adults showed that a whole food plant-based diet (whole grains, fruits, vegetables, nuts, etc.) led to less weight gain than a processed plant-based diet (sweets, refined grains, fries, etc.).
• A study on 30,000 American adults demonstrated that improving the quality of the plant-based component of diet decreased mortality by 30% whereas improving the quality of the animal-based components had little effect. Among people with chronic health problems these beneficial effects were even more pronounced.

These recent research findings add to the mounting body of evidence supporting the health benefits of a whole food plant-based diet.