Saturday, December 23, 2023

Does losing a parent during childhood contribute to separation anxiety and anxious attachment in women?

WILEY

Women who lost a parent early in life may be more likely to experience separation anxiety with romantic partners during adulthood, according to a study published in Stress and Health. In addition to feeling distressed when separated from their partners, these women may also experience anxious attachment, or worry that significant others will not be available at times of need.

The study included 60 women who lost one or both parents in their youth and 60 who had living parents. Based on participants’ answers to questionnaires, women who lost a parent reported higher levels of anxious attachment and adult separation anxiety from a partner. The groups did not differ, however, in terms of avoidant attachment, or the desire to maintain autonomy and emotional distance from their parents during childhood and from their partners during adulthood.

In women who lost a parent, adult separation anxiety and anxious attachment peaked in the initial 5 years of romantic relationships and gradually declined after a decade.

“A future study is suggested to delve into how the duration of a romantic relationship impacts separation anxiety and anxious attachment among women who have experienced early parental loss in childhood,” said corresponding author Ora Peleg, PhD, of the Max Stern Yezreel Valley College and the Academic College Emek Yezreel, in Israel.

URL upon publication: https://onlinelibrary.wiley.com/doi/10.1002/smi.3356

Additional Information
NOTE: The information contained in this release is protected by copyright. Please include journal attribution in all coverage. For more information or to obtain a PDF of any study, please contact: Sara Henning-Stout, newsroom@wiley.com.

About the Journal
Stress and Health provides an international forum for disseminating cutting-edge theoretical and empirical research that significantly advances understanding of the relationship between stress and health and well-being in humans. Despite the prevalence of stress in society, scientific conceptualizations of stress are less than 100 years old and there is much yet to learn regarding the causes, nature, and outcomes of stress, as well as the mechanisms for coping with such stress.

About Wiley
Wiley is a knowledge company and a global leader in research, publishing, and knowledge solutions. Dedicated to the creation and application of knowledge, Wiley serves the world’s researchers, learners, innovators, and leaders, helping them achieve their goals and solve the world's most important challenges. For more than two centuries, Wiley has been delivering on its timeless mission to unlock human potential. Visit us at Wiley.com. Follow us on Facebook, Twitter, LinkedIn and Instagram.

JOURNAL

Stress and Health

DOI

10.1002/smi.3356

ARTICLE TITLE

How is the loss of a parent in youth related to attachment and adult separation anxiety among women?

ARTICLE PUBLICATION DATE

20-Dec-2023

Why do people age differently?

With $3.5M National Institutes of Health grant, research teams from Case Western Reserve University / University Hospitals Cleveland Medical Center and NYU Grossman School of Medicine / NYU Langone Hospital hope to find out

Grant and Award Announcement

CASE WESTERN RESERVE UNIVERSITY

CLEVELAND—Throughout our lives, changes in our DNA, called genetic mutations, occur in every healthy cell of the human body—mutations which have long been thought to be an important reason why our bodies age.

But it’s not known whether some people accumulate mutations at a faster or slower rate with age, and whether those differences might predict how long we live and the risk for aging-related diseases like cancer.

With a $3.5 million research project grant from the National Institutes of Health (NIH), Jonathan Shoag, a surgeon-scientist at the Case Western Reserve University School of Medicine and urologic oncologist at University Hospitals Cleveland Medical Center's Urology Institute, and Gilad Evrony, a physician-scientist at New York University (NYU) Grossman School of Medicine and NYU Langone Hospital, seek to answer these critical questions.

Shoag and Evrony, together with a team of collaborators, will leverage new sequencing technologies in a large number of people to understand how mutations that arise throughout the lifespan may associate with the risk of aging-related diseases like cancer.

“Our study will help us understand healthy aging and define new predictors for aging-related diseases,” Shoag said. “This has the potential to allow us to try to prevent aging associated diseases sooner with clinical interventions.”

“Much remains unknown about how DNA mutations affect the fundamental process of aging, because only recently have the technologies become available to detect these changes in DNA,” Evrony said. “Studying aging-related mutations on a large scale will reveal how our genome dynamically changes throughout our lives.”

Shoag and Evrony are also part of the NIH Somatic Mosaicism across Human Tissues consortium, a multi-institutional effort designed to develop technologies to understand these mutations across the body.

###

Case Western Reserve University is one of the country's leading private research institutions. Located in Cleveland, we offer a unique combination of forward-thinking educational opportunities in an inspiring cultural setting. Our leading-edge faculty engage in teaching and research in a collaborative, hands-on environment. Our nationally recognized programs include arts and sciences, dental medicine, engineering, law, management, medicine, nursing and social work. About 6,200 undergraduate and 6,100 graduate students comprise our student body. Visit case.edu to see how Case Western Reserve thinks beyond the possible.

About University Hospitals / Cleveland, Ohio
Founded in 1866, University Hospitals serves the needs of patients through an integrated network of 21 hospitals (including five joint ventures), more than 50 health centers and outpatient facilities, and over 200 physician offices in 16 counties throughout northern Ohio. The system’s flagship quaternary care, academic medical center, University Hospitals Cleveland Medical Center, is affiliated with Case Western Reserve University School of Medicine, Northeast Ohio Medical University, Oxford University, the Technion Israel Institute of Technology and National Taiwan University College of Medicine. The main campus also includes the UH Rainbow Babies & Children's Hospital, ranked among the top children’s hospitals in the nation; UH MacDonald Women's Hospital, Ohio's only hospital for women; and UH Seidman Cancer Center, part of the NCI-designated Case Comprehensive Cancer Center. UH is home to some of the most prestigious clinical and research programs in the nation, with more than 3,000 active clinical trials and research studies underway. UH Cleveland Medical Center is perennially among the highest performers in national ranking surveys, including “America’s Best Hospitals” from U.S. News & World Report. UH is also home to 19 Clinical Care Delivery and Research Institutes. UH is one of the largest employers in Northeast Ohio with more than 30,000 employees. Follow UH on LinkedIn, Facebook and Twitter. For more information, visit UHhospitals.org.

Digital training program improves quality of life for care residents with dementia – even during the COVID-19 pandemic

The iWHELD programme supported care home staff in delivering personalised care and encouraging meaningful social interactions

Peer-Reviewed Publication

UNIVERSITY OF EXETER

Quality of life for people with dementia living in residential and nursing home care substantially improved after staff took part in a digital training programme that was specially adapted to Covid-19 restrictions. The training also led to a significant drop in the prescription of potentially harmful sedative medications to residents.

The iWHELD programme supported care home staff in delivering personalised care and encouraging meaningful social interactions. Through a digital platform featuring live coaching sessions led by trained coaches, the programme supported homes during the Covid-19 pandemic to enhance care and share best practices among peers.

Published Alzheimer’s & Dementia, the journal of the Alzheimer’s Association, the trial was delivered to staff supporting more than 700 residents with dementia across 149 residential homes in the UK, comparing iWHELD with usual care. In the iWHELD group, researchers found particular benefits in residents who contracted Covid-19, those who showed signs of agitation when the study began, and those taking psychiatric medications.

Led by the University of Exeter and King’s College London, and funded by UK Research and Innovation (UKRI), iWHELD is designed to support carers and residents by training staff in delivering personalised care, which puts residents at the heart of decision-making. The programme was specially adapted during the pandemic, so that it could be delivered remotely, with support available for care home staff, even in the most challenging circumstances for care homes.

Joanne McDermid, creator of the iWHELD platform and lead author of the paper, said: “Urgent action is needed to ensure care homes have access to dementia care training and support that is both high quality and shown to be effective. Every person deserves thoughtful and compassionate care and not everyone is receiving it. In response to the unfolding global pandemic, iWHELD was created as a ground-breaking, first-of-its-kind solution, placing care staff and people living with dementia at the heart of support for care homes and nursing homes. iWHELD leverages digital innovation to bring together stories, ideas, and communities. It’s the first programme to provide an effective, evidence based, affordable and scalable solution that can address the needs of care and nursing homes and critically, to improve the lives of the people with dementia.”

Katie Ives, manager of Stonebow House care home in Worcestershire, took part in the iWHELD training along with her management team. She said: “We all really enjoyed it, and it’s made a huge difference to some of our residents. As part of the training around personalised care, we’ve realised we need to change our approaches and even our demeanours to communicate effectively with residents – so if someone is quite reserved, being very bubbly is less effective and relatable to that person. We’ve always tailored our approach to residents, but now we offer a wider variety of activities and clubs to suit people’s interests in their lives, and we’re seeing some residents spend more time in communal areas and less time in their rooms as a result.”

Professor Clive Ballard, of the University of Exeter Medical School, senior author on the paper, said: “People with dementia living in residential and nursing home care are among the most vulnerable in society, and care homes and their staff perform an extremely challenging role. iWHELD is an effective, practical, and affordable programme that can enable staff to improve the lives of people with dementia and can be delivered nationally and internationally – even amidst a pandemic.”

The paper is entitled ‘Impact of the iWHELD Digital Person-Centered Care Program on Quality of Life, Agitation and Psychotropic Medications in People with Dementia Living in Nursing Homes during the COVID-19 Pandemic: A Randomized Controlled Trial’, published in Alzheimer’s & Dementia.

The research was supported by the National Institute for Health anc Care Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, the NIHR Exeter Biomedical Research Centre, and the NIHR Applied Research Collaboration South West Peninsula (PenARC).

JOURNAL

Alzheimer s & Dementia

DOI

10.1002/alz.13582

METHOD OF RESEARCH

Randomized controlled/clinical trial

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Impact of the iWHELD Digital Person-Centered Care Program on Quality of Life, Agitation and Psychotropic Medications in People with Dementia Living in Nursing Homes during the COVID-19 Pandemic: A Randomized Controlled Trial’

ARTICLE PUBLICATION DATE

20-Dec-2023

Nearly 30% of caregivers for severe stroke survivors experience psychological distress

Post-traumatic stress was worse among Mexican American caregivers compared to white caregivers.

Peer-Reviewed Publication

MICHIGAN MEDICINE - UNIVERSITY OF MICHIGAN

Stroke is an abrupt, devastating disease that instantly changes a person’s life and has the potentially to cause lasting disability or death. However, the condition also has profound effects on the patient’s loved ones — who are often called to make difficult decisions quickly.

A new study led by Michigan Medicine finds that nearly 30% of caregivers of severe stroke patients experience high levels of anxiety, depression or post-traumatic stress during the first year after the patient leaves the hospital.

The results are published in Neurology.

“As physicians, we usually concentrate on our patients, and it is important to recognize that caregivers may have long-term consequences from a loved one’s severe illness,” said Lewis Morgenstern, M.D., professor of neurology, neurosurgery and emergency medicine at University of Michigan Medical School and professor of epidemiology at the U-M School of Public Health.

“This research suggests that depression, anxiety and post-traumatic stress are common among family members who make life and death decisions for their loved ones who are very sick. Post-traumatic stress may be more common in Mexican American caregivers, who made up about two-thirds of the study population.

The prospective study enrolled stroke survivors and their surrogates in Nueces County, Texas, who made decisions about life sustaining treatment after severe stroke between April 2016 and October 2020.

Between 17 and 28% of caregivers reported high scores on measures of psychological distress, which covered anxiety, depression and PTSD. Up to 16% of caregivers experienced all three conditions related to their role.

Post-traumatic stress was worse among Mexican American caregivers compared to white caregivers. Depression scores also improved more rapidly over time for white caregivers.

“There are important support systems for families in hospitals which include nurses, social workers and the patient’s medical team,” Morgenstern said.

“The role of family-centered care has received a lot of traction in recent years, and this research emphasizes how important that is.”

Additional authors include Christopher J. Becker, M.D., Carmen Ortiz, Guanghao Zhang, Kevin He, Ph.D., Erin Case, and Darin B. Zahuranec, M.D., all of University of Michigan, and Rebecca J. Lank, University of Iowa Carver College of Medicine.

This study was funded by NIH R01NS091112 and R01NS38916.

Paper Cited: “Long-term psychological distress among surrogate decision makers for Mexican American and non-Hispanic White patients with severe stroke,” Neurology DOI: 10.1212/WNL.0000000000207960

JOURNAL

Neurology

DOI

10.1212/WNL.0000000000207960

METHOD OF RESEARCH

Observational study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Long-Term Psychological Distress Among Surrogate Decision Makers for Mexican American and Non- Hispanic White Patients With Severe Stroke

ARTICLE PUBLICATION DATE

19-Dec-2023

URI’s new neuro-learning center to boost brain education

Students in multiple health disciplines gain access to state-of-the-art neurological technology at University of Rhode Island

Grant and Award Announcement

UNIVERSITY OF RHODE ISLAND

Functional Near Infrared Spectroscopy system (fNIRS) — IMAGE:
A YOUNG STUDY PARTICIPANT WEARS A FUNCTIONAL NEAR INFRARED SPECTROSCOPY SYSTEM CAP, WHICH ALLOWS NEURO SCIENTISTS TO MEASURE BRAIN ACTIVITY BY MONITORING CHANGES IN BLOOD FLOW IN THE BRAIN.
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CREDIT: SUBMITTED PHOTO

University of Rhode Island students and faculty members in multiple health disciplines will soon have access to state-of-the-art neuroscientific technology to enhance classroom lessons and research education, thanks to a grant from the Champlin Foundation.

College of Health Sciences Professors Mariusz Furmanek and Alisa Baron, along with collaborators Mark Hartman, Nicole Logan, Ellen McGough and Kunal Mankodiya, will establish a Neuro-Learning Center that includes some of the most cutting-edge equipment available to neuroscientific researchers, allowing for the non-invasive study of relationships between brain activity and behavior, functional brain mapping, and mechanisms of neuroplasticity. The equipment will be available to undergraduate and graduate students as well as faculty in such disciplines as communicative disorders, physical therapy, kinesiology and biomedical engineering.

“We are planning to establish the Neuro-Learning Center, which will allow that interdisciplinary interaction with faculty members from different departments,” Furmanek said. “In the majority of institutions, these are only used for research. Primarily, we would use them for education. There is, of course, a research component with this equipment, but the primary goal is to educate our students in neuroscience and knowledge about the brain.”

The non-invasive technology includes a Transcranial Magnetic Stimulation system, which uses low-intensity magnetic stimulation to facilitate or inhibit neural activity in areas of the brain; and a functional Near Infrared Spectroscopy system (fNIRS), which is an advanced neuroimaging technique used to measure brain activity by monitoring changes in blood flow in the brain. The TMS is used in conjunction with a NeuroNavigation System to target specific areas of the brain for neurostimulation. Basically, the technology will allow students to look at specific areas of the brain and determine which areas of the brain are active and which should be stimulated.

“It’s a cap that’s put on the head and it can be configured in any way depending on the part of the brain you want to look at,” Baron said of the fNIRS system. “You put the sources and detectors in the areas you are interested in on the scalp, and when a participant does a particular task, you can analyze the data to see what part of the brain lights up—the part of the brain that has more blood circulating to it. That shows the part of the brain that is the most active in trying to process that information from whatever task you’re asking the participant to do. This is a non-invasive system that’s used across the lifespan, which is a big benefit since a lot of people think of an MRI when thinking about neuroimaging techniques, having to put people into a scanner that’s quite loud and not child friendly.”

The systems are essential to study, diagnose and treat neurological diseases, such as depression, Alzheimer’s, Parkinson’s, stroke and more. Both systems can be used together by multiple clinicians. For example, the fNIRS system can identify parts of the brain that have died or have decreased function due to a stroke. Physical therapists can then use the TMS system to apply stimulation to those parts of the brain. If needed, a neurosurgeon would use the NeuroNavigation system to improve precision and safety of surgery, then a speech language pathologist could use fNIRS again to examine the post-procedure brain activity and its impact on communication.

“Such a collaborative and interdisciplinary approach will be emphasized when teaching our students to ensure the patient’s comprehensive care and recovery,” the professors wrote in their funding proposal. “There have been rapid advancements in the neuroscience field, including the types of equipment used. University courses and the training they provide must simultaneously evolve to ensure students are familiar with the techniques and technologies that will be utilized during their careers in patient care and research.”

Having the advanced equipment available to undergraduate students will be unique to URI. Furmanek and Baron are unaware of any other institutions that have the equipment for training undergraduate students and early-career graduate students, despite their widespread use by researchers and clinicians in the field. As important as the research capabilities is the educational component for students seeking careers in multiple health disciplines.

“The huge benefit to these systems is their portability. We can actually take them into the classroom so students can see how to use it, how to put it on someone, how to analyze the data, all in the classroom without having to pull them out of the class into the lab,” Baron said. “A lot of these technologies are only available in laboratory spaces, which creates a lot of inequity for students. We’re getting students access to these technologies early so they can understand and get comfortable using them, so that’s one more marketable skill when they go on the job market.”

Baron and Furmanek expect to begin acquiring the advanced technology in the spring, and expect to have it available for classroom use by fall 2024. The Neuro-Learning Center and the equipment will be housed between Furmanek’s and Baron’s labs in Independence Square on the Kingston campus.

Groundbreaking hip-focused physical therapy reduces low back pain

First-of-its-kind clinical trial emphasizes precision medicine for older adults often overlooked in musculoskeletal research

Grant and Award Announcement

UNIVERSITY OF DELAWARE

Back pain breakthrough — IMAGE:
UNIVERSITY OF DELAWARE PROFESSOR GREGORY HICKS, A RESEARCH CHAMPION AIMING TO IMPROVE THE HEALTH OF OLDER ADULTS, IS SHOWN MONITORING TREATMENT WITH PHYSICAL THERAPIST NATASHA LOBO AT THE PHYSICAL THERAPY CLINIC ON UD’S SCIENCE, TECHNOLOGY AND ADVANCED RESEARCH (STAR) CAMPUS.
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CREDIT: ASHLEY BARNAS LARRIMORE/ UNIVERSITY OF DELAWARE

When the University of Delaware’s Gregory Hicks started his research career two decades ago, he was one of only a few people in the United States studying chronic low back pain in people over 60 years old.

Fast-forward to today, the research on back pain has ramped up, yet studies of older adults with the problem are still sparse.

“Unfortunately, the societal attitude is that older people don’t warrant the same level of care that younger people do when it comes to musculoskeletal problems,” said Hicks, Distinguished Professor of Health Sciences at UD. “But I don’t believe that for a minute.”

Hicks, a research champion aiming to improve the health of older adults, “has their back” in more ways than one.

“I’ve always loved working with this age group,” he said. “Just as there are health disparities due to race and ethnicity, being older leads to under-treatment of pain. Older people are told there’s really nothing we can do about it, but that’s simply not true.”

With support from the National Institute on Aging, part of the National Institutes of Health, Hicks recently led a clinical trial with researchers at UD, Duke University and the University of Pittsburgh to test new ways of treating chronic low back pain in adults 60 to 85 years old.

The study, called the Manual Therapy and Strengthening the Hip (MASH) Trial, is believed by the research team to be the first clinical trial to assess the efficacy of a tailored physical therapy intervention matched to an at-risk subgroup of older adults with chronic low back pain and coexisting hip pain and muscle weakness.

Conducted between November 2019 and April 2022, the study involved 184 participants who were randomly assigned to either hip-focused or spine-focused therapies delivered at the researchers’ locations over an eight-week period, including at the Physical Therapy Clinic on UD’s Science, Technology and Advanced Research (STAR) Campus. The study participants were evaluated for pain-related disability, walking performance (speed and endurance) and the ability to rise after being seated in a chair.

The findings, published in the Dec. 18 issue of The Lancet Rheumatology, indicate that while both therapies improved walking speed similarly, the hip-focused therapy resulted in a greater reduction in disability from low back pain immediately following the eight-week intervention, but no difference at six months.

“So essentially, the people who received the hip-focused intervention get better faster, in terms of low back pain disability,” Hicks said. “The other group with the spine-focused therapy catches up, but it takes longer.”

However, further analyses found that 46% of participants in the hip-focused group and 33% in the spine-focused group had a substantial improvement in disability scores (50% or greater reduction in disability scores) while 53% of the hip-focused participants and 60% of the spine-focused participants had substantial improvement in gait speed. In addition, the hip-focused treatment was associated with greater improvements in chair-rise performance at six months and walking endurance at eight weeks and at six months.

All low back pain is not the same

The MASH clinical trial builds on the results of Hicks’ previous NIH-funded research, which was a longitudinal study following older adults with chronic low back pain for one year, specifically examining the role of hip impairments relative to low back pain and overall physical function.

“It’s becoming quite clear,” Hicks said, “if you make the assumption that all low back pain is the same, you’re wrong. If you can identify sub-groups of low back pain patients with similar traits, you can develop matched treatments, which hopefully lead to better outcomes.”

Distinct chronic low back pain sub-groups came to light with the aid of artificial intelligence and modeling tools — one sub-group had significant issues with hip weakness and hip pain, another had significant hip weakness without hip pain, and yet another had no issues with the hip at all.

As each sub-group emerges, so does the prospect of precision medicine and precision rehabilitation.

“My training is in epidemiology, in identifying risk factors,” Hicks said. “We observe first, understand what’s happening, and then intervene. We’ve made the first step into intervention now for this low back pain subgroup with hip weakness and pain — the hip-focused group did better than the spine-focused group in pain-related disability, chair rise performance and walking endurance. We have more work to do to refine this hip-focused physical therapy intervention. So, in our next clinical trial, we will be working to tighten that up and develop treatment approaches for the other two subgroups.

“I’ve always had this sort of special place in my heart for this older age group,” Hicks said. “When I started this work, there were a lot of naysayers. I’d tell them, ‘Read the literature — why are we excluding older adults from low back pain research?’ We all hope to get older. Why ignore a place in time where we all hope to end up?”

According to the World Health Organization, low back pain is the leading cause of disability globally. Cases around the world have increased 60% in the past 30 years.

This research was supported by National Institute on Aging grant R01AG041202. ClinicalTrials.gov identifier: NCT04009837.

Mediterranean diet ‘a straightforward approach’ among many nutritional options for improving the chance of success in IVF

Peer-Reviewed Publication

REPRODUCTIVE BIOMEDICINE ONLINE

Hart - nutritional supplements poster (RBMO) — IMAGE:
HART - NUTRITIONAL SUPPLEMENTS AND IVF (RBMONLINE, 2023)
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CREDIT: REPRODUCTIVE BIOMEDICINE ONLINE, 2023

Adjuvant therapies to help infertile women conceive by IVF - especially those whose treatments have been unsuccessful in the past - are now a common feature both before and during the treatment cycle. Now, a new analysis of the evidence for many nutritional supplements and diets thought to improve outcome in IVF has concluded that adopting a Mediterranean diet during treatment would offer a single ‘straightforward approach’ with good evidence of benefit in contrast to that of a Western diet.

Evidence from studies of nine commonly used nutritional supplements was found to be inconsistent and not always of good quality. The analysis, by Professor Roger Hart, University of Western Australia and City Fertility, Perth, Australia, is published today in the peer-reviewed journal Reproductive Biomedicine Online.

He explained that the extent to which nutritional supplements are used in IVF is largely unknown. ‘Nutritional supplements are usually not prescribed,’ explained Professor Hart, ‘but bought online or over-the-counter. They’re self-medicated and solid data on usage is impossible to determine. Our information is largely anecdotal but it’s quite clear from online IVF discussion forums that they are widely used and of great public interest.’

The nutritional supplements analysed in the study were dehydroepiandrosterone (DHEA), melatonin, co-enzyme Q10 (CoQ1O), carnitine, selenium, Vitamin D, myo-inositol, Omega-3, Chinese herbs and several diets (as well as weight loss). Many were reviewed as adjuvants for poor response to previous IVF treatment, of which DHEA and COQ10 appeared in studies to have more benefit than control therapies. Similarly, there was some evidence of benefit from melatonin, but it remains unclear which patient groups might benefit, nor at which dose.

However, the evidence in favour of a Mediterranean diet is much stronger and includes several well designed randomised clinical trials, showing benefits in both embryo development and pregnancy outcome (even from a six-week intervention programme). Professor Hart explained that the common features of these favourable diets were those with high intakes of fruits and vegetables, whole grains, legumes, nuts, fish, and monounsaturated or polyunsaturated oils, but with a limited intake of highly processed foods. ‘These diets are high in B-vitamins, antioxidants, omega-3 poly-unsaturated fatty acids and fibre and are low in saturated fat, sugar and sodium,’ he said. Omega-3 fatty acids, often taken as combined preparations, are the most studied dietary fatty acids in the IVF literature, largely, said Professor Hart, because of their perceived benefits in general health and reproduction. The evidence suggests that omega-3 fatty acids ‘may be beneficial’ in improving IVF clinical outcomes and embryo quality.

Similarly, antioxidants are usually taken as combinations of supplements but evidence from one major review (of 63 antioxidant studies in reproduction) described them as of low quality and was unable to demonstrate any benefit in terms of live birth rate.

Thus, from this mass of evidence Professor Hart advised that a simple nutritional approach to assist conception via IVF would be the adoption of a Mediterranean diet. The use of COQ-10 and DHEA before starting IVF may be a useful adjunct for women who had a previously poor response to ovarian stimulation, while supplementation with omega-3 free-fatty acids may indeed improve some clinical and embryological outcomes.

Professor Hart also advised that all women attempting to conceive should be taking adequate folate supplementation and should seek the advice of their general practitioner or specialist to ensure they are in their best general health for conception.

* This press release is in support of
Hart RJ, Nutritional supplements and IVF: an evidence based approach. Reproductive Biomedicine Online 2023; doi; https://doi.org/10.1016/j.rbmo.2023.103770

* For more information on this press release, the published paper and interview opportunities, please contact:
Duncan Nicholas, RBM Online Development Editor, dev.editor@rbmonline.com

JOURNAL

Reproductive BioMedicine Online

DOI

10.1016/j.rbmo.2023.103770

METHOD OF RESEARCH

Literature review

SUBJECT OF RESEARCH

Human embryos

ARTICLE TITLE

Nutritional supplements and IVF: an evidence based approach

ARTICLE PUBLICATION DATE

20-Dec-2023

Slimming significantly alters your microbiome and brain activity

Weight loss via intermittent energy restriction results in synchronized changes throughout brain-gut microbiome axis

Peer-Reviewed Publication

FRONTIERS

Worldwide, more than one billion people are obese. Obesity is a risk factor for cardiovascular disease, diabetes, and some cancers. But permanently losing weight isn’t easy: complex interactions between body systems such as gut physiology, hormones, and the brain are known to work against it. One method for weight loss is intermittent energy restriction (IER), where days of relative fasting alternate with days of eating normally.

“Here we show that an IER diet changes the human brain-gut-microbiome axis. The observed changes in the gut microbiome and in the activity in addition-related brain regions during and after weight loss are highly dynamic and coupled over time,” said last author Dr Qiang Zeng, a researcher at the Health Management Institute of the PLA General Hospital in Beijing.

The fast track to weight loss

The authors used metagenomics on stool samples, blood measurements, and functional magnetic resonance imaging (fMRI) to study changes in the composition of the gut microbiome, physiological parameters and serum composition, and brain activity in 25 obese Chinese women and men on an IER diet. Participants were on average 27 years old, with a BMI between 28 and 45.

“A healthy, balanced gut microbiome is critical for energy homeostasis and maintaining normal weight. In contrast, an abnormal gut microbiome can change our eating behavior by affecting certain brain area involved in addiction,” explained coauthor Dr Yongli Li from the Department of Health Management of Henan Provincial People’s Hospital in Henan, China.

First, the participants underwent a ‘high-controlled fasting phase’ of 32 days where they received personalized meals designed by a dietician, with a caloric value decreasing stepwise to one quarter of their basic energy intake. They then spent 30 days in a ‘low-controlled fasting phase’, where they were given a list of recommended foods: participants who adhered perfectly to this diet would receive 500 calories per day for women and 600 calories per day for men.

Synchronous changes in brain activity and gut microbiome

By the end of the study, their body weight had decreased by an average of 7.6kg, or 7.8%. As expected, they had undergone reductions in body fat and waist circumference.

Likewise, their blood pressure and serum levels of fasting plasma glucose, total cholesterol, HDL and LDL had decreased, and the activity of key liver enzymes. These suggest that IER helps to reduce obesity-related comorbidities like hypertension, hyperlipidemia, and liver dysfunction.

The authors observed decreases after IER in the activity of brain regions implicated in the regulation of appetite and addiction. Within the gut microbiome, the abundance of the bacteria Faecalibacterium prausnitzii, Parabacteroides distasonis, and Bacterokles uniformis increased sharply, while that of Escherichia coli fell.

Further analyses showed that the abundance of E. coli, Coprococcus comes, and Eubacterium hallii bacteria were negatively associated with the activity of the brain’s left orbital inferior frontal gyrus – known to play a key role in executive function, including our will to lose weight. In contrast, the abundance of the bacteria P. distasonis and Flavonifractor plautii were positively correlated with the activity brain regions associated with attention, motor inhibition, emotion, and learning.

Weighing the evidence

These results suggest that changes in the brain and microbiome during and after weight loss are linked – either because they cause each other, or because an unknown other factor causes both. Because the study is correlational, it can’t resolve the direction of the underlying causality.

“The gut microbiome is thought to communicate with the brain in a complex, two-directional way. The microbiome produces neurotransmitters and neurotoxins which access the brain through nerves and the blood circulation. In return the brain controls eating behavior, while nutrients from our diet change the composition of the gut microbiome,” said coauthor Dr Xiaoning Wang from the Institute of Geriatrics of the PLA General Hospital.

Coauthor Dr Liming Wang, likewise from the Health Management Institute in Beijing, said: “The next question to be answered is the precise mechanism by which the gut microbiome and the brain communicate in obese people, including during weight loss. What specific gut microbiome and brain regions are critical for successful weight loss and maintaining a healthy weight?”

JOURNAL

Frontiers in Cellular and Infection Microbiology

DOI

10.3389/fcimb.2023.1269548

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Dynamical alterations of brain function and gut microbiome in weight loss

ARTICLE PUBLICATION DATE

20-Dec-2023

How does the inability to burp affect daily life?

Peer-Reviewed Publication

WILEY

The inability to burp—called retrograde cricopharyngeus dysfunction (R-CPD)—is caused by failure of the throat’s cricopharyngeal muscle to relax to allow the outward passage of gas. An interview-based study in Neurogastroenterology & Motility that included 199 adults affected by the condition reveals the impact of R-CPD on quality of life.

Most participants reported abdominal bloating, socially awkward gurgling noises, excessive flatulence, and difficulty vomiting. Only half discussed their symptoms with their primary care clinician, and 90% felt they did not receive adequate help. Participants also reported embarrassment, anxiety/depression, negative impacts on relationships, and work disruption due to R-CPD.

“R-CPD encompasses more than just the physical challenge of being unable to burp; it also significantly impacts people’s daily lives, relationships, and mental well-being,” said corresponding author Jason N. Chen, a medical student at Texas Tech University Health Sciences Center. Future efforts should concentrate on raising awareness about R-CPD, which can help increase identification and treatment rates.”

URL upon publication: https://onlinelibrary.wiley.com/doi/10.1111/nmo.14721

About the Journal
The field of gastrointestinal motility has undergone phenomenal growth and change in the past three decades since it emerged as a distinct speciality. Neurogastroenterology & Motility provides a forum where current issues and advances relating to the motor function of the GI tract can be presented and discussed. It is of interest to both clinicians and researchers.

JOURNAL

Neurogastroenterology & Motility

DOI

10.1111/nmo.14721

ARTICLE TITLE

Retrograde Cricopharyngeus Dysfunction: How does the inability to burp affect daily life?

ARTICLE PUBLICATION DATE

20-Dec-2023