Thursday, March 11, 2021

 

Starting small to answer the big questions about photosynthesis

UNIVERSITY OF LEEDS

Research News

New scientific techniques are revealing the intricate role that proteins play in photosynthesis.

Despite being discovered almost 300 years ago, photosynthesis still holds many unanswered questions for science, particularly the way that proteins organise themselves to convert sunlight into chemical energy and at the same time, protect plants from too much sunlight.

Now a collaboration between researchers at the University of Leeds and Kobe University in Japan is developing a novel approach to the investigation of photosynthesis.

Using hybrid membranes that mimic natural plant membranes and advanced microscopes, they are opening photosynthesis to nanoscale investigation - the study of life at less than one billionth of a metre - to reveal the behaviour of individual protein molecules.

Dr Peter Adams, Associate Professor in the School of Physics and Astronomy at the University of Leeds, who supervised the research, said: "For many decades scientists have been developing an understanding of photosynthesis in terms of the biology of whole plants. This research is tackling it at the molecular level and the way proteins interact.

"A greater understanding of photosynthesis will benefit humankind. It will help scientists identify new ways to protect and boost crop yields, as well as inspire technologists to develop new solar-powered materials and components."

The findings are published in the academic journal Small.

Photosynthesis happens when photons or packets of light energy cause pigments inside light-harvesting proteins to become excited. The way that these proteins arrange themselves determines how the energy is transferred to other molecules.

It is a complex system that plays out across many different pigments, proteins, and layers of light-harvesting membranes within the plant. Together, it regulates energy absorption, transfer, and the conversion of this energy into other useful forms.

To understand this intricate process, scientists have been using a technique called atomic force microscopy, which is a device capable of revealing components of a membrane that are a few nanometres in size.

The difficulty is that natural plant membranes are very fragile and can be damaged by atomic force microscopy.

But last year, the researchers at Kobe University announced that they had developed a hybrid membrane made up of natural plant material and synthetic lipids that would act as a substitute for a natural plant membrane - and crucially, is more stable when placed in an atomic force microscope.

The team at the University of Leeds used the hybrid membrane and subjected it to atomic force microscopy and another advanced visualisation technique called fluorescence lifetime imaging microscopy, or FLIM.

PhD researcher Sophie Meredith, also from the School of Physics at the University of Leeds, is the lead author in the paper. She said: "The combination of FLIM and atomic force microscopy allowed us to observe the elements of photosynthesis. It gave us an insight into the dynamic behaviors and interactions that take place.

"What is important is that we can control some of the parameters in the hybrid membrane, so we can isolate and control factors, and that helps with experimental investigation.

"In essence, we now have a 'testbed' and a suite of advanced imaging tools that will reveal the sub-molecular working of photosynthesis."

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The research was supported by the Royal Society, the Biotechnology and Biological Sciences Research Council, the Engineering and Physical Sciences Research Council, the Medical Research Council and the Japan Society for the Promotion of Science.

The paper - Model Lipid Membranes Assembled from Natural Plant Thylakoids into 2D Microarray Patterns as a Platform to Assess the Organization and Photophysics of Light-Harvesting Proteins - is available to download at https://doi.org/10.1002/smll.202006608

For further information, please contact David Lewis in the press office at the University of Leeds: d.lewis@leeds.ac.uk or on +44 (0)7710 013287

The is an image that goes with the story. The caption is: Light is absorbed by light-harvesting proteins in the plant membrane. The energy excites the proteins and the way they arrange themselves determines the way energy is transferred through the plant.

Please credit the image: Sophie Meredith, University of Leeds.

University of Leeds

The University of Leeds is one of the largest higher education institutions in the UK, with more than 37,000 students from more than 150 different countries, and a member of the Russell Group of research-intensive universities. The University plays a significant role in the Turing, Rosalind Franklin and Royce Institutes.

We are a top ten university for research and impact power in the UK, according to the 2014 Research Excellence Framework, and are in the top 100 of the QS World University Rankings 2019.

The University was awarded a Gold rating by the Government's Teaching Excellence Framework in 2017, recognising its 'consistently outstanding' teaching and learning provision. Twenty-six of our academics have been awarded National Teaching Fellowships - more than any other institution in England, Northern Ireland and Wales - reflecting the excellence of our teaching. http://www.leeds.ac.uk

A new model predicts snakebites to save human lives

Tel Aviv University participates in international study

TEL-AVIV UNIVERSITY

Research News

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IMAGE: EYAL GOLDSTEIN view more 

CREDIT: TEL AVIV UNIVERSITY

About 1.8 million envenoming snakebites occur around the world annually, killing about 94,000 people. In tropical areas, especially in Southeast Asia and Sub-Saharan Africa, snakebites are considered a major cause of death, especially among farmers who encounter snakes in their fields. In response, the World Health Organization has launched a strategic plan to reduce snakebites by 50% by 2030. An important basis for attaining this goal is expanding relevant scientific research.

An international research group, including researchers from Tel Aviv University, has recently created an innovative simulation model for predicting snakebites, based on an improved understanding of interactions between farmers and snakes, in both time and space.

The purpose of the model is to determine the probability of a snakebites occurring in certain places (for example in rice fields vs. tea fields) at various times (hours of the day and months of the year). The study is founded upon extensive research and data from Sri Lanka, where about 30,000 envenoming snakebites kill approximately 400 people every year. It focused on 6 types of snakes, some numbered among the most venomous in the world (cobra, Russell's viper, saw-scaled viper, hump-nosed viper, common krait and Ceylon krait), matching them with farmers who grow the three most common crops in the area: rice, tea and rubber. Thus for example, the model predicts that the bites of Russell's viper peak in rice fields during February and August, while the hump-nosed viper prefers rubber plantations in April and May. The model also determines that in the southeastern part of the studied region, the largest number of snakebites are inflicted by Russell's viper, one of the world's most dangerous snakes, while in other parts of this area snakebites of the less lethal hump-nosed viper are the most common.

The study was led by Dr. Takuya Iwamura (currently at Oregon State University) and Eyal Goldstein of the School of Zoology at Tel Aviv University, and Dr. Kris Murray of Imperial College London and the School of Hygiene and Tropical Medicine in London. Other participants included researchers from the Liverpool School of Tropical Medicine, Lancaster University and the University of Kelaniya, Sri Lanka. The paper was published in February 2021 in PLOS Neglected Tropical Diseases.

Eyal Goldstein explains: "We built a first-of-its-kind interdisciplinary model, which includes the behavior patterns of both sides - snakes and humans, identifying risk factors at various times and places, and warning against them. For example, the model can differentiate between low-risk and high-risk areas, a difference that can be manifested in double the number of snakebites per 100,000 people."

Dr. Murray explains that "Both snakes and people go about their business at different times of the day, in different seasons and in different types of habitats - the model captures all of this to predict encounters between people and snakes in areas where farmers are working. We then factor in the aggressiveness of different snake species to work out how likely an encounter is to result in a bite."

Dr. Iwamura emphasizes that "Our approach is to mathematically analyze interactions between snakes and humans, with an emphasis on the ecological perspective. This is a completely new approach to understanding the mechanism that causes snakebites. Unlike most studies, which have so far focused mainly on social and economic risk factors, we chose to focus on the ecological aspects - such as snakes' movements and habitats, the impact of climate and rainfall, and the respective behaviors of farmers and snakes - as a key to predicting potential encounters."

Verified against existing data in Sri Lanka , the model was proved very accurate in predicting snakebite patterns in different areas and different seasons, as well as the relative contribution of various types of snakes to the overall picture as seen in hospital data. Now the researchers intend to implement the model in places that don't yet have accurate snakebite data. They will and also use it to predict future changes resulting from climate change - such as increased rainfall leading to greater snake activity, as well as changes in land use and habitats available to snakes.

Dr. Iwamura concludes: "Our model can help focus the efforts of snakebite reduction policies, and serve as a tool for warning, raising awareness and saving human lives. Moreover, we regard this study as a first stage in a broader project. In the future we intend to develop more complex models of encounters between humans and wildlife, to support both public health and nature preservation policies in the real world."

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Fossilized feeding frenzy

47 million year old fly found with a full belly

UNIVERSITY OF VIENNA

Research News

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IMAGE: © SENCKENBERG view more 

CREDIT: © SENCKENBERG

It was not the fly itself that caught the scientists' attention, but its bulging abdomen suggesting it was still full with the fly's last food intake. Surprisingly, analysis of the stomach content revealed it was full with pollen from different plants. The fossil pollen from the fly's stomach was used to reconstruct the ancient environment inhabited by the fly, the biotic interactions between plant and fly, and the fly's behaviour during feeding.

Flies as pollinators

Today, bees, butterflies and bumblebees are the typical pollinators, which are also known to feed on pollen. That flies also play an important role in pollination is rarely addressed. "The rich pollen content we discovered in the fly's stomach suggests that flies were already feeding and transporting pollen 47 million years ago and shows it played an important role in the pollen dispersal of several plant taxa", says Fridgeir Grímsson from the Department of Botany and Biodiversity Research of the University of Vienna. "Flies were major pollinators in ancient (sub-)tropical equivalent ecosystems and might even have outshined the bees", the scientist concludes.

Short-distance flights for food

The extracted pollen was dominated by grains of Decodon (waterwillow) and Parthenocissus (virgin ivy). Today, the waterwillow is a sub-shrub growing in wetlands and the shallows of lakes, suggesting open low canopy habitat. The co-dominance of virgin ivy also suggests that the fly fed on plants growing at the forest margin surrounding the ancient Messel lake. "It is likely that the fly avoided long-distance flights between food sources and sought pollen from closely associated plants", says Grímsson.

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Publication in Current Biology: S. Wedmann, T. Hörnschemeyer, M.S. Engel, R. Zetter, F. Grímsson. The last meal of an Eocene pollen-feeding fly. Current Biology (2021) DOI: 10.1016/j.cub.2021.02.025

Marjoram supports health and weight gain in carps, say biologist from RUDN University

RUDN UNIVERSITY

Research News

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IMAGE: BIOLOGISTS FROM RUDN UNIVERSITY SUGGESTED ADDING A MARJORAM-BASED SUPPLEMENT TO THE DIET OF COMMON CARP TO SUPPORT THE GROWTH OF THE FISH AND IMPROVE THEIR RESISTANCE TO BACTERIAL INFECTIONS. view more 

CREDIT: RUDN UNIVERSITY

Biologists from RUDN University suggested adding a marjoram-based supplement to the diet of common carp to support the growth of the fish and improve their resistance to bacterial infections. The results of the study were published in the Fish & Shellfish Immunology journal.

Cyprinus carpio is a type of large omnivore fish that grows 35-40 cm long in three to five years. 4 mln tons of carps were bred in aquacultural farms in 2010. Such farms protect natural populations of Cyprinus carpio while at the same time satisfying the market demand. However, as farmers strive for higher productivity, aquacultural farms become more and more crowded which leads to the lack of nutrients and harms the health of the fish. A team of veterinarians from RUDN University tested the effect of a dietary supplement based on marjoram (a herb from the genus Origanum) on farm-bred carps.

"The profitability of a fish farm directly correlates with the stability and efficiency of production which is based on the health of the fish. Fish under stress are more susceptible to disease, and after being treated with antibiotics for some time they develop resistance. Moreover, antibiotics are harmful to the environment and can potentially affect the health of consumers. The best way to combat diseases is via dietary supplements that suppress stress, improve the health of the fish, and support their immunity," said Morteza Yousefi, PhD, an assistant professor at the Department of Veterinary Medicine, RUDN University.

The team divided 360 fish into four groups and fed them dietary supplements with different concentrations of marjoram for eight weeks. A control group did not receive marjoram at all, while the other three got 100, 200, and 400 mg per 1 kg of body mass, respectively. After 60 days of the diet, 30 fish from each group were injected with the bacterial culture of Aeromonas hydrophila, one of the most dangerous pathogens for carps that breaks down hemoglobin, enters the organs of a fish body, and then begins to produce aerolysin, a toxic substance that causes cell death and tissue damage. Then, the team spent 10 days monitoring the survival rates of the infected fish.

Only 50% of the fish from the control group successfully overcame the infection, while the share of survivors among the fish that received marjoram was 80%. The group that received 200 mg of the supplement demonstrated the most prominent positive effect including a 1.5 times increase in erythrocyte count and hemoglobin, immunoglobulins, lysozyme, and alkaline phosphatase levels. This group also showed the lowest feed conversion rate, i.e. it required less food to gain 1 kg of weight (1.32 mg against 1.62 mg in the control group). According to the veterinarians, it indicated higher immune activity and better barrier functions of the mucus in the fish that received the marjoram supplement.

"The fish that received 200 mg/kg of marjoram demonstrated the highest survival rate. Our study confirms that marjoram extract is an effective dietary supplement for the common carp: it stimulates growth, the production of antioxidants, and the work of the immune system. All these factors helped the fish infected with Aeromonas hydrophila combat the disease," added Morteza Yousefi from RUDN University.

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PERSEPHONE'S FRUIT

Lower risk of brain injury for at-risk infants whose mothers consumed pomegranate juice

Preliminary findings from a randomized controlled trial suggest pomegranate juice may provide neuroprotection in pregnancies with intrauterine growth restriction

BRIGHAM AND WOMEN'S HOSPITAL

Research News

Intrauterine growth restriction (IUGR) is common and concerning, but few therapeutic options exist for pregnant mothers who receive this diagnosis. IUGR is a condition in which a baby in the womb is measuring small for its gestational age, often because of issues with the placenta, resulting in compromised or insufficient transfer of oxygen and nutrients to the growing fetus. The developing fetal brain is particularly vulnerable to these effects. One out of every 10 babies is diagnosed with IUGR, and infants with IUGR are at increased risk of death and neurodevelopmental impairment. Recent research on polyphenol-rich pomegranate juice has suggested that it may help protect the brain from injury. In an exploratory, randomized, controlled clinical trial, supported by philanthropic funding and a gift from POM Wonderful, the largest grower and producer of fresh pomegranates and pomegranate juice in the United States, investigators at Brigham and Women's Hospital enrolled pregnant mothers whose infants were diagnosed with IUGR. The team found evidence that drinking pomegranate juice daily may reduce risk of brain injury in IUGR infants, especially during the third trimester when the infant brain may be particularly vulnerable. Findings are published in Scientific Reports.

"There are dietary factors that may influence neuroprotection, especially in high-risk settings such as during labor and delivery," said co-author Terrie Inder, MBCHB, chair of the Department of Pediatric Newborn Medicine at the Brigham. "We were intrigued by findings from preclinical research suggesting that polyphenols, which are found at high concentrations in pomegranate juice, might be highly protective. Our clinical trial provides the most promising evidence to date that polyphenols may provide protection from risk of brain injury in IUGR infants."

"While exploratory, our results are promising and suggest that being able to intervene before birth may aid in protecting the newborn brain from the devastating effects of brain injury," said corresponding author Lillian G. Matthews, PhD, a neuroscientist at Monash Biomedical Imaging and Turner Institute for Brain and Mental Health in Australia. Prior to joining Monash, Matthews was at Harvard Medical School and the Brigham in the Department of Pediatric and Newborn Medicine, where she maintains a current affiliation.

Polyphenols are part of a class of antioxidants found in certain foods and beverages, including almonds, berries, red wine and teas. Pomegranate juice is a particularly rich source of these molecules. Polyphenols are known to cross the blood-brain barrier, and studies in animal models have demonstrated protective effects against neurodegenerative diseases.

For their clinical trial, Inder and colleagues recruited 99 pregnant mothers at the Brigham. The participants were randomly assigned to consume either 8 ounces of pomegranate juice or a polyphenol-free beverage matched for color, taste and calorie-count. Participants drank the juice daily from the time of enrollment until delivery.

The team performed fetal MRI measurements on approximately half of the participants prior to mothers starting the juice regimen and found no evidence of fetal brain injury at that time. After delivery, neonatal MRI measurements showed that infants whose mothers consumed pomegranate juice were less likely to have brain injury compared to those randomized to placebo. Infants had lower risk of cortical grey matter injury and white matter injury. The team also found no evidence of ductal constriction, a potential safety concern.

Given the exploratory nature of the study and its limited size, the authors caution that larger controlled trials are needed. The team also plans to continue studying infants enrolled in their study over the next 2-3 years to assess the infants' neurodevelopmental outcome.

"Our neurodevelopmental follow-up studies are ongoing, and we encourage other investigators studying high-risk infant populations to consider the influence of polyphenols for neuroprotection," said Inder. "My dream is that we will one day be able to offer women a way to help shield their infant's brain from potential injury. In the meantime, we'll continue to follow participants to provide further insight into the potential clinical implications of prenatal pomegranate juice."

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This work was supported by the Brigham and Women's Hospital Program for Interdisciplinary Neuroscience Award and a gift to Brigham and Women's Hospital from POM Wonderful, Los Angeles.

Paper cited: Ross MM et al. "A randomized controlled trial investigating the impact of maternal dietary supplementation with pomegranate juice on brain injury in infants with IUGR" Scientific Reports DOI: 10.1038/s41598-021-82144-0

Healthy Diet Index supports diet quality assessment and dietary counselling in healthcare

UNIVERSITY OF EASTERN FINLAND

Research News

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IMAGE: DIETARY COUNSELLING PLAYS A CRUCIAL ROLE IN THE PREVENTION AND TREATMENT OF CHRONIC LIFESTYLE DISEASES. THE HEALTHY DIET INDEX DEVELOPED BY FINNISH NUTRITION EXPERTS FACILITATES THE ASSESSMENT OF DIET QUALITY. view more 

CREDIT: UEF/RAIJA TÖRRÖNEN

The Healthy Diet Index developed by Finnish nutrition experts facilitates the assessment of diet quality. Its effectiveness was demonstrated in a recently published study.

Dietary counselling plays a crucial role in the prevention and treatment of chronic lifestyle diseases. In healthcare settings, dietary counselling is often provided by professionals without specific training in nutrition, and there is a demand for tools for reliable and easy assessment of diet quality. One such tool is the Healthy Diet Index developed in the recently completed Stop Diabetes (StopDia) project.

The Healthy Diet Index describes the quality of the diet in relation to nutrition recommendations, and to a diet that prevents type 2 diabetes. The scale of the index is from 0 to 100. In addition, the Healthy Diet Index also gives a score to different domains of the diet, including meal pattern, grains, fruit and vegetables, fats, fish and meat, dairy and snacks and treats. The aim was to create scoring method that is sensitive even to minor changes in eating habits, which facilitates the monitoring of changes and may give additional motivation to implement dietary changes.

The Healthy Diet Index was created in collaboration between nutrition experts from the Finnish Institute for Health and Welfare, the University of Eastern Finland, Tampere University Hospital and Pirkanmaa Hospital District. The Healthy Diet Index is based on a validated food intake questionnaire previously developed and used as part of Finland's national programme for the prevention and care of diabetes (DEHKO). However, it is difficult to perceive the whole diet on the basis of individual questions. Dietary counselling is easier and more concrete for the client when the diet is assessed as a whole instead of individual nutrients, and when food-specific advice is given.

The recently published study compared the Healthy Diet Index to the nutrient intake calculated from food diaries (n = 77). The researchers also examined the association of the Healthy Diet Index score with the risk factors of chronic diseases in 3,100 people who had an elevated risk of developing type 2 diabetes, and who participated in the StopDia study. The Healthy Diet Index score was found to associate with the intake of energy nutrients, fibre, and several vitamins and minerals. In the StopDia dataset, a higher Healthy Diet Index score was associated with a lower body mass index, waist circumference, and blood glucose and triglyceride levels in both men and women. The study was published in International Journal of Environmental Research and Public Health.

"The results provide support for the importance of dietary changes in the prevention of chronic diseases such as type 2 diabetes. Even minor improvements to eating habits are important for health, when they are repeated daily. The impact on health is visible even if a person's weight does not go down," says Early Stage Researcher Kirsikka Aittola, who is writing a PhD thesis on the StopDia Study at the University of Eastern Finland.

Scoring methods measuring diet quality have been developed also in the past, including the DASH index for the prevention of high blood pressure, but these often require completing a time-consuming food frequency questionnaire.

"The new Healthy Diet Index is fairly similar to previous scoring methods, but it also assesses the meal pattern, which has often been highlighted as a stumbling block in weight management when working with patients. Importantly, the Healthy Diet Index has been created on the basis of the nutrition recommendations," Professor of Nutrition Therapy Ursula Schwab from the University of Eastern Finland says.

The food intake questionnaire is easy and quick to fill out but computing the Healthy Diet Index requires automation.

"An automated and clearly visualised Healthy Diet Index would be an excellent tool for healthcare professionals to support dietary counselling. It would therefore be important to integrate it into electronic healthcare services and different digital care paths. It could also serve as a self-monitoring tool for patients, and it could include clear tips on how to make dietary changes based on one's own responses," Aittola says.

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Research article: Lindström, J.; Aittola, K.; Pölönen, A.; Hemiö, K.; Ahonen, K.; Karhunen, L.; Männikkö, R.; Siljamäki-Ojansuu, U.; Tilles-Tirkkonen, T.; Virtanen, E.; Pihlajamäki, J.; Schwab, U. Formation and Validation of the Healthy Diet Index (HDI) for Evaluation of Diet Quality in Healthcare. Int. J. Environ. Res. Public Health 2021, 18, 2362. https://doi.org/10.3390/ijerph18052362 Link: https://www.mdpi.com/1660-4601/18/5/2362

The food intake questionnaire and the scoring of the Healthy Diet Index are available at: https://sites.uef.fi/stopdia/material-bank/?lang=en

Children's dietary guidelines need to change, experts say

Parents need better advice on how to encourage kids to eat veggies

IRONIC SINCE MILLENIALS AND GEN Z ARE VEGANS


FLINDERS UNIVERSITY

Research News

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IMAGE: FLINDERS UNIVERSITY PROFESSOR REBECCA GOLLEY, DEPUTY DIRECTOR OF THE CARING FUTURES INSTITUTE view more 

CREDIT: FLINDERS UNIVERSITY

Dietary and infant feeding guidelines should be strengthened to include more practical advice on the best ways to support children to learn to like and eat vegetables, say nutrition and dietetics researchers from the Flinders University Caring Futures Institute.

With the Australian Health Survey showing only 6% of children aged 2-17 years are eating the recommended amount of veggies, experts say more tailored practical advice is needed on how to offer vegetables to young children through repeated exposure and daily variety in order to increase their intake.

A recent paper co-authored by researchers from Caring Futures Institute and CSIRO, Australia's national science agency, published in the American Journal of Clinical Nutrition, suggests that up to 10 or more exposures to a particular vegetable when the child is between the age of 6 months and five years can lead to greater chances of them liking vegetables and eating more of them.

While the strategy of repeatedly exposing young children to vegetables to assist flavour familiarity and ultimately intake is not new science, there is a gap between evidence and dietary advice.

"There is an opportunity to improve children's vegetable intake by including practical advice - the 'how to' in our recommendations to parents and caregivers," says Flinders Caring Futures Institute Deputy Director and co-lead author of the paper Professor Rebecca Golley.

Prof Golley says food preferences are established within a child's first five years of life. Therefore, it's crucial to establish healthy eating behaviours early to support growth, development, and dietary habits.

"We know that a lack of vegetable consumption across the lifespan has effects on health, including an increased risk of chronic diseases, obesity and being overweight," she says.

"That is why getting children to like a variety of vegetables such as green beans, peas, carrots and even Brussel sprouts from an early age is so important.

"Early eating behaviours are impressionable and babies and young children can be supported to try different foods and to learn to like them."

The paper, Supporting strategies for enhancing vegetable liking in the early years of life: an Umbrella review of systematic reviews' is an output of the five-year VegKIT project, funded by Hort Innovation and undertaken by a consortium led by CSIRO, including Flinders University and Nutrition Australia Victoria Division.

An umbrella review was undertaken on the diverse body of existing international research around sensory and behavioural strategies that support children to like certain foods including vegetables.

The project examined 11 systemic reviews to determine the effectiveness of strategies including repeated exposure and variety of vegetables, for which promising evidence was found.

Emerging evidence was found for other strategies such as offering vegetables as a first food (not fruit), using non-food rewards to encourage the eating of veggies and reading children vegetable-based story books.

The report also highlights that foundations for vegetable liking can even be laid before a child is born.

"It appears that the maternal diet also plays a part through exposure to vegetable flavours in-utero and increasing children's chances of liking and eating them later, and the same goes for the mothers' diet while breastfeeding," Professor Golley says.

However, she says these strategies must be backed by more research if they are to be underpinning advice for parents, health professionals and policymakers.

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Lucinda K Bell, Claire Gardner, Esther J Tian, Maeva O Cochet-Broch, Astrid A M Poelman, David N Cox, Sophie Nicklaus, Karen Matvienko-Sikar, Lynne A Daniels, Saravana Kumar, Rebecca K Golley, Supporting strategies for enhancing vegetable liking in the early years of life: an umbrella review of systematic reviews, The American Journal of Clinical Nutrition, 2021; DOI 10.1093/ajcn/nqaa384


Lifestyle intervention is beneficial for most people with type 2 diabetes, but not all

WAKE FOREST BAPTIST MEDICAL CENTER

Research News

WINSTON-SALEM, N.C. - March 11, 2021- For people who are overweight or obese and have type 2 diabetes, the first line of treatment is usually lifestyle intervention, including weight loss and increased physical activity. While this approach has cardiovascular benefit for many, it can be detrimental for people who have poor blood sugar control, according to a study conducted by researchers at Wake Forest School of Medicine.

In the study, published in the current issue of the journal Diabetes Care, the researchers re-evaluated the National Institutes of Health Action for Health in Diabetes (Look AHEAD) study that found intensive lifestyle intervention (ILI) neither helped nor hurt people with diabetes.

"Contrary to the initial findings of Look AHEAD, our work found that lifestyle interventions reduced potential cardiovascular harm and optimized benefits for 85% of those in the trial," said the study's lead investigator, Michael P. Bancks, Ph.D., assistant professor of public health sciences at Wake Forest School of Medicine, part of Wake Forest Baptist Health.

"However, for those who had poor blood sugar control, lifestyle intervention increased the risk of major cardiovascular events. Based on our findings, doctors may want to consider alternative options, such as glucose-lowering drugs, before trying lifestyle modification for those people."

Look AHEAD randomized 5145 participants with type 2 diabetes (T2D) who were overweight or obese to 10 years of ILI or a control group that received diabetes support and education. ILI focused on weight loss through decreased caloric intake and increased physical activity.

In the Wake Forest School of Medicine study, the researchers divided the study participants into four subgroups: diabetes onset at older age, poor glycemic control, severe obesity and younger age at onset. These subgroups were determined based on diabetes diagnosis, body mass index, waist circumference, measure of blood sugar value (glycemic control) and the age of diabetes onset.

Bancks and his team examined each group's response to the intensive lifestyle intervention and its association with major cardiovascular events. In the subgroup with poor glycemic control, the intervention was associated with 85% higher risk of having a cardiovascular event as compared to the control group. Among the three other diabetes subgroups analyzed, ILI was not associated with an increased risk of fatal and non-fatal cardiovascular events.

"Although the interest in diabetes subgroups is growing, our study is one of the first to apply it to lifestyle intervention," Bancks said. "So for clinicians, determining which subgroup their patient most closely resembles should help them determine the best treatment option and reduce any potential harm for that individual."

These results provide support for further investigation into whether these findings apply to other diabetes complications, including cognitive issues, and to assess what interventions would be beneficial for those individuals, Bancks said.

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Support for the study was provided by the National Institute of Diabetes and Digestive and Kidney Diseases.

Unhealthy weight gains, increased drinking reported by Americans coping with pandemic stress

Stress in America™ poll reveals secondary pandemic health crisis; parents, essential workers, communities of color more likely to report mental, physical health consequences

AMERICAN PSYCHOLOGICAL ASSOCIATION

Research News

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IMAGE: PARENTS' MENTAL, PHYSICAL HEALTH IMPACTED SINCE START OF PANDEMIC view more 

CREDIT: AMERICAN PSYCHOLOGICAL ASSOCIATION

WASHINGTON -- As growing vaccine demand signals a potential turning point in the global COVID-19 pandemic, the nation's health crisis is far from over. One year after the World Health Organization declared COVID-19 a global pandemic, many adults report undesired changes to their weight, increased drinking and other negative behavior changes that may be related to an inability to cope with prolonged stress, according to the American Psychological Association's latest Stress in America™ poll.

APA's survey of U.S. adults, conducted in late February 2021 by The Harris Poll, shows that a majority of adults (61%) experienced undesired weight changes - weight gain or loss -- since the pandemic started, with 42% reporting they gained more weight than they intended. Of those, they gained an average of 29 pounds (the median amount gained was 15 pounds) and 10% said they gained more than 50 pounds, the poll found. Such changes come with significant health risks, including higher vulnerability to serious illness from the coronavirus. For the 18% of Americans who said they lost more weight than they wanted to, the average amount of weight lost was 26 pounds (the median amount lost was 12 pounds). Adults also reported unwanted changes in sleep and increased alcohol consumption. Two in 3 (67%) said they have been sleeping more or less than desired since the pandemic started. Nearly 1 in 4 adults (23%) reported drinking more alcohol to cope with their stress.

"We've been concerned throughout this pandemic about the level of prolonged stress, exacerbated by the grief, trauma and isolation that Americans are experiencing. This survey reveals a secondary crisis that is likely to have persistent, serious mental and physical health consequences for years to come," said Arthur C. Evans Jr., PhD, APA's chief executive officer. "Health and policy leaders must come together quickly to provide additional behavioral health supports as part of any national recovery plan."

CAPTION

1 in 4 Essential Workers Diagnosed With Mental Health Disorder Since Start of Pandemic

CREDIT

American Psychological Association


The pandemic has taken a particularly heavy toll on parents of children under 18. While slightly more than 3 in 10 adults (31%) reported their mental health has worsened compared with before the pandemic, nearly half of mothers who still have children home for remote learning (47%) reported their mental health has worsened; 30% of fathers who still have children home said the same. Parents were more likely than those without children to have received treatment from a mental health professional (32% vs. 12%) and to have been diagnosed with a mental health disorder since the coronavirus pandemic began (24% vs. 9%). More than half of fathers (55%) reported gaining more weight than they wanted to, and nearly half (48%) said they have been drinking more alcohol to cope with stress.

The majority of essential workers (54%), such as health care workers and people who work in law enforcement, said they have relied on a lot of unhealthy habits to get them through the pandemic. Nearly 3 in 10 (29%) said their mental health has worsened, while 3 in 4 (75%) said they could have used more emotional support than they received since the pandemic began. Essential workers were more than twice as likely as adults who are not essential workers to have received treatment from a mental health professional (34% vs. 12%) and to have been diagnosed with a mental health disorder since the coronavirus pandemic started (25% vs. 9%).

Further, people of color reported unintended physical changes during the pandemic. Hispanic adults were most likely to report undesired changes to sleep (78% Hispanic vs. 76% Black, 63% white and 61% Asian), physical activity levels (87% Hispanic vs. 84% Black, 81% Asian and 79% white) and weight (71% Hispanic vs. 64% Black, 58% white and 54% Asian) since the pandemic began. Black Americans were most likely to report feelings of concern about the future. More than half said they do not feel comfortable going back to living life like they used to before the pandemic (54% Black vs. 48% Hispanic, 45% Asian and 44% white) and that they feel uneasy about adjusting to in-person interaction once the pandemic ends (57% Black vs. 51% Asian, 50% Hispanic and 47% white).

"It's clear that the pandemic is continuing to have a disproportionate effect on certain groups," said APA President Jennifer Kelly, PhD. "We must do more to support communities of color, essential workers and parents as they continue to cope with the demands of the pandemic and start to show the physical consequences of prolonged stress."

Overall, Americans are hesitant about the future, regardless of vaccination status. Nearly half of adults (49%) said they feel uneasy about adjusting to in-person interaction once the pandemic ends. Adults who received a COVID-19 vaccine were just as likely as those who had not received a vaccine to say this (48% vs. 49%, respectively).

The full report and more graphics are available at http://www.stressinamerica.org.

CAPTION

Slightly More than 6 in 10 U.S. Adults Report Undesired Weight Change Since Start of Pandemic

CREDIT

American Psychological Association





Methodology

This Stress in America™ survey was conducted online within the United States by The Harris Poll on behalf of the American Psychological Association between Feb. 19 and 24, 2021, among 3,013 adults age 18+ who reside in the U.S. Interviews were conducted in English and Spanish. Data were weighted to reflect their proportions in the population based on the 2020 Current Population Survey (CPS) by the U.S. Census Bureau. Weighting variables included age by gender, race/ethnicity, education, region, household income and time spent online. Hispanic adults were also weighted for acculturation, taking into account respondents' household language as well as their ability to read and speak in English and Spanish. Country of origin (U.S./non-U.S.) was also included for Hispanic and Asian subgroups. Weighting variables for Gen Z adults (ages 18 to 24) included education, age by gender, race/ethnicity, region, household income, and size of household, based on the 2019 CPS. Propensity score weighting was used to adjust for respondents' propensity to be online.

Parents are defined as U.S. adults ages 18+ who have at least one person under the age of 18 living in their household at least 50% of the time for whom they are the parent or guardian.

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The American Psychological Association, in Washington, D.C., is the largest scientific and professional organization representing psychology in the United States. APA's membership includes nearly 220,000 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance the creation, communication and application of psychological knowledge to benefit society and improve people's lives.

More heart infections and strokes in the US linked to national opioid epidemic

American Stroke Association International Stroke Conference -- presentation P658

AMERICAN HEART ASSOCIATION

Research News

DALLAS, March 11, 2021 — The ongoing U.S. opioid epidemic may have led to an increase in the number of strokes due to more bacterial infections of the heart, or infective endocarditis, according to preliminary research to be presented at the American Stroke Association’s International Stroke Conference 2021. The virtual meeting is March 17-19, 2021 and is a world premier meeting for researchers and clinicians dedicated to the science of stroke and brain health.

According to the most recent comprehensive data (January 2020) from the Centers for Disease Control and Prevention (CDC), stroke is the fifth leading cause of death in the United States and a major contributor to long-term disability. Typically each year in the United States, up to 47,000 people are treated in the hospital for endocarditis, which increases stroke risk. This serious, sometimes deadly infection occurs when bacteria in the bloodstream reach the heart lining, valves or blood vessels. While endocarditis is uncommon, people with certain heart conditions are at greater risk.

Another risk factor for endocarditis is intravenous (IV) drug use. During IV drug use, bacteria from the injection needle enter the blood stream. In light of the ongoing, two decades-long national opioid epidemic, researchers wanted to understand the risk of stroke among patients with endocarditis from IV drug use compared to patients with endocarditis due to other causes. They also measured the frequency of endocarditis related to IV drug use.

This study included 351 patients treated for endocarditis at Ohio State University’s Wexner Medical Center between January 1, 2014 and July 1, 2018. Nearly half of the patients had a history of IV drug use.

The researchers found:

  • Over the four-year study, the occurrence of endocarditis from IV drug use increased by 630%.
  • Patients with endocarditis due to IV drug use were much more likely (26%) than those with endocarditis from other causes (14%) to have a stroke.
  • Patients with endocarditis from IV drug use were more likely than other patients to be homeless, unemployed and uninsured.

“Patients who are known IV drug users who have endocarditis should be more carefully screened for symptoms of cardiovascular disease,” said the study’s corresponding author Shahid M. Nimjee, M.D., Ph.D., associate professor of neurosurgery and surgical director of the Comprehensive Stroke Center at Ohio State University Wexner Medical Center in Columbus, Ohio.

“The wider societal impact of the opioid epidemic is not well understood,” Nimjee said. “Our research suggests that the impact of the opioid epidemic is far-reaching and contributes to increased costs in the criminal justice, health care systems and the workplace. The increased costs can be particularly substantial for stroke care.”

Medical costs were more than two times higher among patients with endocarditis from IV drug use than among those with endocarditis from other causes. This translated into a difference of more than $100,000 in health care costs during admission per patient, Nimjee noted.

The study did not control for other factors that could have affected stroke risk, and it included patients from only one hospital, therefore, the findings may not apply to other groups of patients.

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Co-authors are Nguyen Hoang, M.D.; Varun Shah, B.S.; Bipul Gnywali, B.S.; Jessica Granger, B.A.; Victoria Schuneman, M.D.; David Dornbos III, M.D.; H. Francis Farhadi, M.D., Ph.D.; Patrick P. Youssef, M.D.; and Ciaran J. Powers, M.D., Ph.D. The study authors report no funding or disclosures.

Additional Resources:

Statements and conclusions of studies that are presented at the American Heart Association’s scientific meetings are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers are available here, and the Association’s overall financial information is available here.

The American Stroke Association’s International Stroke Conference (ISC) is the world’s premier meeting dedicated to the science and treatment of cerebrovascular disease. ISC 2021 will be held virtually, March 17-19, 2021. This 3-day conference will feature more than 1,200 compelling presentations in 21 categories that emphasize basic, clinical and translational sciences as they evolve toward a better understanding of stroke pathophysiology with the goal of developing more effective therapies. Engage in the International Stroke Conference on social media via #ISC21.

About the American Stroke Association

The American Stroke Association is devoted to saving people from stroke — the No. 2 cause of death in the world and a leading cause of serious disability. We team with millions of volunteers to fund innovative research, fight for stronger public health policies and provide lifesaving tools and information to prevent and treat stroke. The Dallas-based association officially launched in 1998 as a division of the American Heart Association. To learn more or to get involved, call 1-888-4STROKE or visit stroke.org. Follow us on FacebookTwitter

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