A large team of researchers affiliated with multiple institutions across the U.S. has conducted a review study of the role that social interaction plays in both morbidity and mortality rates. In their paper published in the journal Science, the group describes their review and what they learned from it.
One of the major consequences of COVID-19 pandemic is social isolation. Millions of people around the world have stopped going to work, stopped visiting friends, and stopped leaving the house except out of necessity. Such isolation is necessary to prevent the virus from infecting so many people all at once that hospitals are overwhelmed with cases. But what does isolation do to people emotionally or physically? Scientists have been looking into this. In this new effort, the group in the U.S. conducted a review of prior studies into the impact of social isolation on not just humans, but other animals, such as orcas, dolphins, wild horses, monkeys, bighorn sheep, and even rock hyraxes. They focused their efforts on work that looked into the impact of changes in the social environment exclusively and found that it led to a host of problems for animals of all kinds—including humans.
When circumstances force animals or humans to become isolated, the researchers found, many begin to show signs of stress, such as an increase in inflammation, tumor-like development, and an increase in the likelihood of developing various forms of heart disease—they also tend to have shorter life spans. Such symptoms tend to come about, the researchers note, because the stress of isolation can have a negative impact on sleep and eating patterns.
The researchers note that many of the adverse conditions that tend to arise in animals or people undergoing isolation are the same ones that medical researchers have been describing as preconditions that make people more susceptible to unfavorable outcomes in COVID-19—thus, self-isolating could be increasing people’s chances of having more severe symptoms should they become infected.
It is still not clear what sorts of the medical or emotional impact the global pandemic is actually having on those who have never been infected but have been socially isolated, but scientists will surely be looking into it to learn more about it as a way to address such problems during the next pandemic.
More information: Noah Snyder-Mackler et al. Social determinants of health and survival in humans and other animals, Science (2020). DOI: 10.1126/science.aax9553
Athletes who turn to ketogenic diets to help their performance in high-intensity, short-duration sports may want to think again, according to new research from Saint Louis University.
In a small study, Edward Weiss, Ph.D., associate professor of nutrition and dietetics at Saint Louis University, together with SLU graduate students Kym Wroble, R.D. and Morgan Trott, R.D., examined the exercise performance of 16 men and women after following either a low-carbohydrate ketogenic diet or a high-carbohydrate diet for four days. His team then tested the anaerobic exercise performance of the participants.
The research team found that after following the ketogenic diet, the participants did not perform as well at the exercise tasks.
“In popular discussions, the term ‘ketogenic diet’ often is used as a broader term for low carb diets, including Atkins,” Weiss said. “However, the language is often confused. People often think of low carb and high protein. This is related, but different, as protein can only be at normal levels for a true ketogenic diet.
“The objective of a ketogenic diet is to starve the body of carbohydrates. If there is too much protein in the diet, the body will use the protein to make carbohydrates, which defeats the purpose. When the body is sufficiently deprived of carbohydrates, it manufactures ketone bodies as an alternate fuel. It’s an emergency backup system that allows us to survive when we are at risk of starvation. But, it has side effects.
“Right now in the general public, it’s touted for weight loss. Some studies have shown that it is effective for weight loss. I worry, though, that this may be a lot of smoke and mirrors. A typical diet is 60 percent carbohydrate. So, if you limit carbs, you might find yourself just not eating that much. If you eliminate most food options, you may just be losing weight because you are cutting calories.”
The study has implications both for those who turn to ketogenic diets for weight loss and for athletes who aim to improve their performance.
“The energy metabolism system that’s affected is anaerobic. Watching the summer Olympics, the 100-meter sprint and the triple jump depend on this system. You might say that this doesn’t relate to me. But for someone with low fitness, they use this same metabolism to get up the stairs. Every day people use this kind of metabolism without realizing it. This study shows that this energy system is compromised by this type of diet.”
Weiss has one caveat.
“There are populations that a ketogenic diet may benefit,” Weiss said. “For example, patients who have epilepsy benefit from this diet. For those with abnormal cell metabolism that causes seizures, causing cells to feed on ketones instead can be helpful.”
The bottom line?
“Short-term low carbohydrate, ketogenic diets reduce exercise performance in activities that are heavily dependent on anaerobic energy systems,” Weiss reports. “These findings have clear performance implications for athletes, especially for high-intensity, short-duration activities, and sports.
“This diet is especially hot among people who are trying to optimize their health. What this study tells me is that unless there are compelling reasons for following a low-carb diet, athletes should be advised to avoid these diets.”
More information: Low-carbohydrate, ketogenic diet impairs anaerobic exercise performance in exercise-trained women and men: a randomized-sequence crossover trial, DOI: 10.23736/S0022-4707.18.08318-4
Low-carb, high-fat ketogenic diets, which have attracted public interest in recent years for their proposed benefits in lowering inflammation and promoting weight loss and heart health, have a dramatic impact on the microbes residing in the human gut, collectively referred to as the microbiome, according to a new UC San Francisco study of a small cohort of volunteer subjects. Additional research in mice showed that so-called “ketone bodies,” a molecular byproduct that gives the ketogenic diet its name, directly impact the gut microbiome in ways that may ultimately suppress inflammation, suggesting evidence for potential benefits of ketone bodies as a therapy for autoimmune disorders affecting the gut.
In ketogenic diets, carbohydrate consumption is dramatically reduced in order to force the body to alter its metabolism to using fat molecules, rather than carbohydrates, as its primary energy source—producing ketone bodies as a byproduct—a shift that proponents claim has numerous health benefits.
“I got interested in this question because our prior research showed that high-fat diets induce shifts in the gut microbiome that promote metabolic and other diseases in mice, yet ketogenic diets, which are even higher in fat content, have been proposed as a way to prevent or even treat disease,” said Peter Turnbaugh, Ph.D., a UCSF associate professor of microbiology and immunology, member of the UCSF Benioff Center for Microbiome Medicine and a Chan Zuckerberg Biohub Investigator. “We decided to explore that puzzling dichotomy.”
In their new study, published May 20, 2020, in Cell, Turnbaugh and colleagues partnered with the nonprofit Nutrition Science Initiative to recruit 17 adult overweight or obese nondiabetic men to spend two months as inpatients in a metabolic ward where their diets and exercise levels were carefully monitored and controlled.
For the first four weeks of the study, the participants were given either a “standard” diet consisting of 50 percent carbs, 15 percent protein, and 35 percent fat or a ketogenic diet comprising 5 percent carbs, 15 percent protein, and 80 percent fat. After four weeks, the two groups switched diets, to allow the researchers to study how shifting between the two diets altered participants’ microbiomes.
Analysis of microbial DNA found in participants’ stool samples showed that shifting between standard and ketogenic diets dramatically changed the proportions of common gut microbial phyla Actinobacteria, Bacteroidetes, and Firmicutes in participants’ guts, including significant changes in 19 different bacterial genera. The researchers focused on a particular bacterial genus—the common probiotic Bifidobacteria—which showed the greatest decrease in the ketogenic diet.
To better understand how microbial shifts on the ketogenic diet might impact health, the researchers exposed the mouse gut to different components of microbiomes of humans adhering to ketogenic diets and showed that these altered microbial populations specifically reduce the numbers of Th17 immune cells—a type of T cell critical for fighting off infectious disease, but also known to promote inflammation in autoimmune diseases.
Follow-up diet experiments in mice, in which researchers gradually shifted animals’ diets between low-fat, high-fat and low-carb ketogenic diets, confirmed that high-fat and ketogenic diets have opposite effects on the gut microbiome. These findings suggested that the microbiome responds differently as the level of fat in the animals’ diet increases to levels that promote ketone body production in the absence of carbs.
The researchers observed that that as animals’ diets were shifted from a standard diet towards stricter carbohydrate restriction, their microbes also began shifting, correlated with a gradual rise in ketone bodies.
“This was a little surprising to me,” Turnbaugh said. “As someone who is new to the keto field, I had assumed that producing ketone bodies was an all-or-nothing effect once you got to a low enough level of carb intake. But this suggests that you may get some of the effects of ketosis quite quickly.”
The researchers tested whether ketone bodies alone could drive the shifts they had seen in the gut’s microbial ecosystem by directly feeding ketone bodies to mice. They found that even in mice who were eating normal amounts of carbohydrates, the mere presence of added ketones was enough to produce many of the specific microbial changes seen in the ketogenic diet.
“This is a really fascinating finding because it suggests that the effects of ketogenic diets on the microbiome are not just about the diet itself, but how the diet alters the body’s metabolism, which then has downstream effects on the microbiome,” Turnbaugh said. “For many people, maintaining a strict low-carbohydrate or ketogenic diet is extremely challenging, but if future studies find that there are health benefits from the microbial shifts caused by ketone bodies themselves, that could make for a much more palatable therapeutic approach.”
Menthol cigarettes will be removed from shelves in the UK this Wednesday (20 May 2020), yet new research has found that tobacco companies failed to use the four-year phasing-in period (from 2016) to prepare for this week’s ban. Instead, they continued to sell and promote menthol products and to develop new products which circumvent the ban.
The University of Bath researchers behind the study—which is out today (Monday 18 May 0001 GMT) in the BMJ’s Tobacco Control – argue this highlights how tobacco companies have exploited a delay in the ban to develop new products, keeping menthol products on the market for as long as possible, rather than phasing them out.
A menthol ban was first agreed in 2014 and originally due to be implemented in 2016, alongside accompanying measures such as standardised packaging. However, after intense lobbying, its implementation was put back four years, until this week when it will be implemented in the midst of Covid-19.
For the new study, the researchers from the Tobacco Control Research Group analysed industry analyst data to track menthol market cigarette share from legislation agreement through to 2018. They also analysed documentary evidence—industry documents, websites and retail publications—to understand tobacco industry activities.
Their results show that during the grace period the tobacco industry was given to prepare, the UK market share of menthol cigarettes grew rapidly from 14% of cigarette sales in 2014 to over a fifth (21%) in 2018.
With one in six menthol smokers stating they would quit after the menthol ban, an impact which potentially could reduce UK cigarette sales overall by 3%, the researchers say the menthol ban will be an important driver in the fight against deaths and illness from cigarette smoking.
Dr. Rosemary Hiscock, the lead author, explains: “Our findings suggest the tobacco industry was driving sales of menthol cigarettes right up to the ban—a product whose serious health implications had led to the ban in the first place.”
In the paper, the authors argue that the tobacco industry used the delay to develop and introduce new menthol products that will circumvent the ban once it is implemented: menthol filters and flavour cards which smokers can add to cigarette packs or roll-your-own tobacco pouches to make them minty.
Due to a loophole in the tobacco display ban legislation, these accessories, unlike cigarettes, can be promoted to customers near the cash till in England and Wales (but not Scotland).
They also find that two tobacco companies have introduced cigarette-like ‘cigarillos’ (small cigars) with a flavour capsule. Although cigarillos have a small market share of UK tobacco sales at the moment, Euromonitor forecasts that this market will grow, not least because they are subject to lower taxes than cigarettes and are mostly exempt from plain packaging legislation.
Dr. Hiscock added: “We recommend loopholes in legislation be closed as soon as possible to prevent tobacco companies undermining the intended public health impacts of the legislation. This includes preventing the display of tobacco accessories and extending the menthol ban to all tobacco products, including cigarillos and heated tobacco products.
“In Canada, the menthol ban stops menthol being used at all, whereas UK legislation only stops menthol’s use as a characterising flavour. Banning menthol’s use would stop menthol masking the harsh effects of smoking when it is present at undetectable levels.”
Finally, the researchers highlight how big tobacco companies have created new websites and sponsored retail industry pieces which effectively undermine the intended public health benefit of the ban. These websites push consumers to switch to other products rather than quitting: a key concern is that they promote new heated tobacco products, such as IQOS, which are still allowed to have a menthol flavour.
Professor Anna Gilmore, Director of the Tobacco Control Research Group, explains: “The way tobacco companies are using the ban on menthol cigarettes to promote new menthol tobacco products which are heated rather than burned undermines the very purpose of this ban. It also flies in the face of tobacco company claims that they wish to reduce the harm from smoking. They realise the menthol ban will trigger smokers to quit. Instead, they seek to move the smokers onto new tobacco products which independent evidence indicates are as dangerous as smoking and from which they make even more profit.”
The team conclude that the tobacco industry’s exploitation of the phase-in of the menthol ban repeats what happened during the 12-month phase-in period of standardised packaging, revealed by previous TCRG work. In both cases, tobacco companies misused the phase-in period to find ways to circumvent legislation and to shore up profits at the expense of public health, say the researchers.
The addition of menthol to cigarettes takes away some of the harsh sensations of smoking. Public health experts suggest this can make them more appealing to younger people and could lead them to become more quickly dependent on the nicotine in comparison with non-menthol products. A menthol flavour can be added to cigarettes during the manufacturing process or smokers can add it themselves by crushing a menthol capsule.
Significantly, however, menthol can mask early respiratory disease symptoms, so menthol smokers may carry on smoking after they start to become ill, at a time when smokers of other products might be prompted to quit.
UVA Health’s William Brady, MD, and colleagues have created a guide to the potentially deadly cardiovascular complications caused by COVID-19.
COVID-19 can cause serious cardiovascular complications including heart failure, heart attacks, and blood clots that can lead to strokes, emergency medicine doctors report in a new scientific paper. They also caution that COVID-19 treatments can interact with medicines used to manage patients’ existing cardiovascular conditions.
The new paper from UVA Health’s William Brady, MD, and colleagues aims to serve as a guide for emergency-medicine doctors treating patients who may have or are known to have COVID-19. The authors note that much attention has been paid to the pulmonary (breathing) complications of COVID-19, but less has been said about the cardiovascular complications that can lead to death or lasting impairment.
“In writing this article, we hope to increase emergency physicians’ knowledge and awareness of this new pathogen and its impact on the cardiovascular system,” said Brady, of UVA’s Department of Emergency Medicine. “As we encounter more and more patients with COVID-19-related illness, we are increasing our understanding of its impact on the body in general and the cardiovascular system in particular. The rate of learning on this area is amazingly rapid. Information continues to change weekly, if not daily.”
COVID-19 and Heart Failure
Heart failure is a particular concern in patients with COVID-19. One study, the article authors note, found that almost a quarter of COVID-19 patients – 24% – were suffering acute heart failure when they were first diagnosed with the coronavirus. (This doesn’t mean that 24% of all COVID-19 patients will suffer heart failure. The authors state that it remains unclear if the heart failure was the result of COVID-19 specifically or if the virus was worsening undiagnosed heart failure.)
Of the patients with heart failure, nearly half were not known to have high blood pressure or cardiovascular disease.
Strokes and Other Concerns
The paper also notes that COVID-19, and other diseases that cause severe inflammation throughout the body, increase the risk that fatty plaque built up in the blood vessels will rupture, leading to heart attacks and stroke. Influenza and certain other viruses have been associated with increased risk of plaque ruptures within the first week after the disease was diagnosed, the authors state in their review of the available COVID-19 medical literature.
Finally, the authors describe potential drug interactions in COVID-19 patients. For example, the highly publicized malaria drug hydroxychloroquine can interact with medications designed to regulate heart rhythm, in addition to causing heart damage and worsening cardiomyopathy. Remdesivir, an antiviral that is the only COVID-19 treatment authorized by the FDA, can cause low blood pressure and abnormal heart rhythm. It’s important for doctors to bear these interactions in mind when treating patients with COVID-19, the authors note.
“As we gain more experience with this new pathogen, we realize that its adverse impact extends beyond the respiratory system,” Brady said. “We will continue to learn more about COVID-19 and the most optimal means of managing its many presentations.”
The article has been published online by the American Journal of Emergency Medicine. In addition to Brady, it was written by Brit Long, MD, of Brooke Army Medical Center; Alex Koyfman, MD, of the University of Texas Southwestern Medical Center; and Michael Gottlieb, MD, of Rush University Medical Center. To keep up with the latest medical research news from UVA, subscribe to the Making of Medicine blog at http://makingofmedicine.virginia.edu.
LEXINGTON, Ky. (May 15, 2020) — As stay-at-home orders are being lifted in some states and extended in others, uncertainty continues to surround the COVID-19 pandemic.
Serious measures have been implemented the world over — from cancellations of major events and large gatherings to closures of schools and non-essential businesses.
You might be wondering — are social distancing policies working?
UK Now recently told you about a study, released by the Institute for the Study of Free Enterprise (ISFE) at the University of Kentucky, that suggests so. According to the report, confirmed COVID-19 cases in the Commonwealth could have reached a staggering 45,000 by April 25 without any state-imposed measures. For comparison, the current total of confirmed COVID-19 cases was fewer than 4,000.
Now, authors of a new study — Charles Courtemanche and Aaron Yelowitz, both professors in the Gatton College of Business and Economics; Anh Le, a doctoral student at UK; Josh Pinston, a professor at the University of Louisville; and Joseph Garuccio, a doctoral student at Georgia State — are going a step further by evaluating measures taken by states and counties across the country.
On Thursday, a new report titled, “Strong Social Distancing Measures in the United States Reduced the COVID-19 Growth Rate” was published in Health Affairs.
The study evaluates the impact of four measures taken by state and local governments to slow the spread of COVID-19 across U.S. counties from March 1-April 27 — bans on large social gatherings, public school closures, the shuttering of entertainment-related businesses and shelter-in-place orders.
The authors found the closing of entertainment businesses — such as restaurants, movie theaters and gyms — and shelter-in-place orders — such as Gov. Andy Beshear’s “Healthy at Home” initiative — resulted in a dramatic reduction in COVID-19 cases.
According to the report, the combination of measures reduced the growth rate of confirmed COVID-19 cases by an amount that grew over time — reaching 9 percentage points after 16 days.
The results imply that by April 27, the number of cases would have been 35 times higher without any of the measures — suggesting the U.S. would have reported 35 million (rather than 1 million) COVID-19 cases.
“The numbers are eye-popping but illustrate the enormous power of exponential growth,” Yelowitz said.
However, the study determined the other two measures — bans on large gatherings and school closures — had a less significant impact.
“There are many potential reasons and our arguments for non-findings are speculative, although we think it could be the case that those measures simply displace social interactions rather than reducing such interactions,” Yelowitz explained. “For example, if parents congregate in parks when schools close, it’s possible that coronavirus is spread approximately the same.”
“Most large events — like March Madness — were already being canceled anyway prior to any official prohibitions, which may have made these prohibitions redundant,” Courtemanche added.
In conclusion, the authors believe the report sheds light on the current re-opening.
“Our results suggest that light measures don’t work, and strong measures do, but they don’t really say anything about intermediate measures — like opening restaurants at reduced capacity or allowing socialization with masks,” Courtemanche said. “Since we don’t know what each intermediate step towards reopening will do, it makes sense to go one step at a time and look carefully for signs that the rate of spread is picking back up.”
“My main policy recommendation would be to strongly encourage states to watch some of the early openers to see what happens,” Yelowitz added. “Given exponential growth, the rise in cases often looks unimpressive until right before things explode.”
For a closer look at the study, visit the Health Affairs website. For other reports authored by ISFE, you can visit the institute’s website.
The COVID-19 pandemic has ushered in remote work on an unprecedented scale. Will this sudden transition shape the future of a new world of work? Will things ever go back to “normal,” or will we enter a “new normal”? Elizabeth Lyons, an assistant professor of management at UC San Diego’s School of Global Policy and Strategy, predicts the latter while noting both its benefits and drawbacks.
“Many organizations have now made large investments in both physical capital for employees to work from home (e.g. laptops, software), and organizational capabilities required to facilitate this as a result of the pandemic,” said Lyons, an expert on teleworking best practices. “Because the pandemic forced this large, fixed-cost investment required for remote work that many organizations were not otherwise able or willing to make or were putting off, remote work will be easier to facilitate going forward.”
However, to be clear, she said, remote work during the pandemic should not be indicative of what it might look like post-pandemic. “With schools closed and other challenges we face, productivity is suffering,” Lyons said. “Decisions on remote work capabilities should not be made without taking these factors into consideration.”
Lyons, who has 5-month old and 4-year old daughters at home, knows first-hand the predicament many parents are in. “It’s hard because this is not the norm, and I have to remind myself of this too while juggling trying to be productive and responsive to my children,” she said.
In addition to feedback from managers and colleagues, digital professional training can also help remote workers succeed. In a separate study conducted with insurance salespeople in Kenya, Lyons finds that providing remote workers with training programs through mobile phone applications increases productivity, demonstrating that digital technologies can help substitute for in-person management, though some adaption is required.
Organizations and firms that do not learn to make such adjustments to their practices in order to get the most out of remote work will see productivity declines as a result, she predicts.
“Particularly in this time of economic uncertainty, I think that how well firms manage remote work now, will have implications for how likely they are to survive the next year or two,” Lyons said.
Remote work had been growing in popularity in recent years even before the pandemic spurred employees to work from home en masse. A special analysis done by FlexJobs and Global Workplace Analytics found that in the span of one year, from 2016 to 2017, remote work grew by 7.9 percent. Over the last five years, it grew by 44 percent, and over the previous 10 years, by 91 percent.
Reduced costs to companies and organizations have been a major driver of such trends, as remote work lowers costs for organizations by lowering utility bills and reducing the amount of office space they need to provide. For example, in 2011, Sharp HealthCare in San Diego transitioned about 1,100 administrative and other employees to remote work for such reasons.
More women in the workforce
There is evidence that more flexible work arrangements, such as allowing work-from-home, would increase female labor force participation.
Data from the Pew Research Center and UC San Diego research shows women leave the workforce due to family-related concerns at much higher rates than men. Additionally, a survey run on the UK job platform Jobsite shows 76 percent of women in tech say the option to work remotely was a major determinant of whether or not their company could retain them.
Increases in productivity
Remote work also improves performance more among mothers than it does fathers and non-parents, according to a study performed at a life sciences firm, but those other groups also had improved performance.
Other research on working from home has also documented increased productivity. One study found interesting performance results in comparing employees who wanted to telecommute and were allowed, to those who desired to work from home and were not allowed. The employees of a call center for the company Ctrip who were permitted to work from home made 13.5 percent more calls than their co-workers in the office. In addition, they were 50 percent less likely to quit their jobs, which saved the firm money.
Environmental and public health benefits
Lyons also points to the indirect benefits of teleworking on both the environmental and public health fronts. Since the onset of the pandemic, C02 emissions have had a historic drop and air quality has improved. Additionally, UC San Diego’s research from Lyons’ colleague Joshua Graff Zivin, a professor of economics at the School of Global Policy and Strategy, has found better air quality leads to increased worker productivity.
Xerox touts its virtual workforce program, claiming that with 11 percent of its employees working virtually, it was able to reduce greenhouse gas emissions by 40,894 metric tons.
On the health front, people are less likely to catch viruses while working from home, which is why emptying office spaces has been chief among COVID-19 preventative strategies. There are also fewer car accidents with fewer people on the road—all of which could lower health costs and time off work, Lyons said.
Downsides? Remote work can be stifling for creativity
But remote work has downsides, especially when it comes to spurring creative group work.
“The sharing of ideas, experiences, and approaches to problem-solving tends to be very important for high-quality innovative output,” Lyons said.
This sharing requires collaboration, and research has shown that a lot of idea sharing that ends up generating very novel solutions and innovations is not planned, whereas most electronic communication is.
“I think we can all acknowledge that we have different conversations with colleagues when we bump into them in the hallway, the kitchen or when we go for coffee with them than we do over email or even Slack,” Lyons said. “This informal conversation that happens face-to-face is difficult to replicate with remote work, and without it, innovative performance would likely decline.”
Sectors such as research and development, which require “out-of-the-box” thinking to seed innovation, also benefit from in-person interaction. And, jobs like these, which also require onsite work in labs, should not eliminate face-to-face work altogether, Lyons recommends. “I think there’s something about knowing what you are saying is being recorded or will be saved, even on platforms like Zoom, that makes people more inhibited to throwing out ideas, and more averse to risk,” Lyons said.
Moreover, research from Graff Zivin outlines how risk is critical in R&D’s ability to enhance scientific discovery and economic prosperity.
Academia requires similar novel output and many academics and researchers work remotely, but not exclusively remotely. With high-quality research requiring collaboration from experts around the world, it translates to the majority of collaboration between co-authors occurring online.
“While, we see each other occasionally at a conference and in-person writing sessions, the main ways I communicate with co-authors are through email, Skype or Google Hangouts, text and phone calls,” Lyons said. “For co-authors in very different time zones, email and text are particularly important.”
In today’s era, where most face-to-face interactions for employees are not an option because of the public health crisis, Lyons recommends that the best way to overcome this obstacle is being reachable online whenever it’s not harming productivity, and encouraging people to ping each other for idea-sharing and feedback.
“Establishing a culture of non-judgment is even more important in online work because ideas are written down and can be easily recalled (relative to a hallway conversation), and people are more hesitant to say something embarrassing as a result,” she said. “You don’t want so much thought-sharing that no one gets work done, but you want to set up the culture and infrastructure that allows for spontaneous throwing around of ideas at unscheduled times.”
The same call center for Ctrip that showed increased productivity among staff who both wanted to telecommute and were allowed also revealed another side effect of remote work: increased loneliness.
Half of the employees in this group decided to return to the office because of the lack of social contact.
“We know for adults, work is a primary place where they get social interactions, so policymakers may want to consider these psychological effects,” said Lyons.
Meanwhile, employees missing their co-workers during the pandemic can still connect. Zoom “happy hours” or “coffee chats” are useful for maintaining good relationships between co-workers, ensuring they keep up their knowledge of each other and the ability to communicate, according to Lyons.
Treatment with disulfiram, normally prescribed to treat alcohol use disorder, shows health benefits in an animal study.
Mice made obese from a high-fat diet were switched to a diet dosed with disulfiram, which helped them lose weight and improve their metabolic health.iStockPhoto
An off-label experiment in mice using disulfiram, which has been used to treat alcohol use disorder for more than 50 years, consistently normalized body weight and reversed metabolic damage in obese middle-aged mice of both sexes. The international study was led by researchers at the National Institute on Aging (NIA), part of the National Institutes of Health. The results were published online in the journal Cell Metabolism on May 14.
The scientific team studied groups of 9-month-old lab mice who had been fed a high-fat diet for 12 weeks. As expected, this diet made the mice overweight and they started to show signs of pre-diabetes-like metabolic problems, such as insulin resistance and elevated fasting blood sugar levels. Next, the scientists divided these mice into four groups to be fed four different diets for an additional 12 weeks: a standard diet alone, a high-fat diet alone, a high-fat diet with a low amount of disulfiram, or a high-fat diet with a higher amount of disulfiram. As expected, the mice who stayed on the high-fat diet alone continued to gain weight and show metabolic problems. Mice who switched to standard diet alone gradually saw their body weight, fat composition, and blood sugar levels return to normal.
The mice in the remaining two groups, with either a low or high dose of disulfiram added to their still-fatty food, showed a dramatic decrease in their weight and related metabolic damage. Mice on the high disulfiram dose lost as much as 40% of their body weight in just four weeks, effectively normalizing their weight to that of obese mice who were switched back to a standard diet. Mice in either disulfiram dose diet group became leaner and showed significant improvement in blood glucose levels on par with the mice who were returned to a standard diet. Disulfiram treatment, which has few harmful side effects in humans, also appeared to protect the pancreas and liver from damage caused by pre-diabetic type metabolic changes and fat build-up usually caused by eating a high-fat diet.
The NIA scientists, Michel Bernier, Ph.D., and Rafael de Cabo, Ph.D., collaborate frequently with researchers at NIH and beyond on studies into how changes in dietary patterns like intermittent fasting could lead to cognitive and physical health benefits. They first became interested in disulfiram after reading about the benefits this class of drug has shown in treating type 2 diabetes in rats, coupled with the growing interest in repurposing drugs that may also improve healthy aging.
“When we first went down this path, we did not know what to expect, but once we started to see data showing dramatic weight loss and leaner body mass in the mice, we turned to each other and couldn’t quite believe our eyes,” Bernier said.
According to the study’s research team, the key to the positive results seems to stem from disulfiram’s anti-inflammatory properties, which helped the mice avoid imbalances in fasting glucose and protected them from the damage of fatty diet and weight gain while improving metabolic efficiency. Both groups of obese mice (control and disulfiram) were not subjected to any form of exercise, nor did they demonstrate noticeable spontaneous behavioral changes. Based on the evidence they observed, the researchers believe the beneficial results of disulfiram stem solely from the drug. They did not observe any negative side effects of disulfiram in the mice.
The research team stresses that these results are based on animal studies, and they cannot be extrapolated to any potential benefits for humans at this point. It is recommended that disulfiram not be used off-label for weight management outside of the context of clinical trials. Still, given the findings, they are planning future steps for studying disulfiram’s potential, including a controlled clinical study to test if it could help individuals with morbid obesity lose weight, as well as a deeper investigation into the drug’s molecular mechanisms and potential for combining with other therapeutic interventions.
The research was supported by NIA through its intramural research program, NIA grants AG031782 and AG038072, in collaboration with colleagues from the National Institute of Alcohol Abuse and Alcoholism, Yale University, Albert Einstein College of Medicine, Korea Research Institute of Bioscience and Biotechnology, and University of Sydney, Australia.
This press release describes a basic research finding. Basic research increases our understanding of human behavior and biology, which is foundational to advancing new and better ways to prevent, diagnose, and treat disease. Science is an unpredictable and incremental process— each research advance builds on past discoveries, often in unexpected ways. Most clinical advances would not be possible without the knowledge of fundamental basic research.
About the National Institute on Alcohol Abuse and Alcoholism (NIAAA): The National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health, is the primary U.S. agency for conducting and supporting research on the causes, consequences, diagnosis, prevention, and treatment of alcohol use disorder. NIAAA also disseminates research findings to general, professional, and academic audiences. Additional alcohol research information and publications are available at https://www.niaaa.nih.gov/.
About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
NIH…Turning Discovery Into Health®
Bernier et al. Disulfiram prevents and treats diet-induced obesity and related co-morbidities in mice. Cell Metabolism. 2020 May 14. doi:TBD
London’s Dreadful Visitation, or, A Collection of all the Bills of Mortality for this Present Year (London: E. Cotes, 1665)
Epidemics are on all our minds right now. Probably many of us could use a break from the relentless stream of statistics, percentages, and predictions related to Covid-19. Still, we thought a look at some statistics from an era when modern medicine had not yet been born might provide a little perspective. It was a need for a historical perspective that, in fact, pushed Ellen Cotes to publish London’s Dreadful Visitation, which collected all the “bills of mortality” printed in London during the Great Plague of 1665 (in which 100,000 people, or a quarter of the city’s population, perished). Lamenting the disappearance of the bills from the earlier “Great Plague” of forty years before (“the sight of them hath been much desired these times”), Cotes “resolved to communicate unto the Nation, these subsequent leaves” so that “Posterity may not anymore be at such a loss”.
But what were these “bills of mortality”, and how did they come about? As early as 1592, London parish officials had instituted a system for keeping track of deaths in the city, trying to curb the spread of the plague by tracking it and quarantining victims and those who lived with them. Since it was not then legally required to report deaths to a central authority, the officials hired “searchers of the dead”, whose job it was to locate corpses, examine them, and determine the cause of death. These “searchers” were not trained in any kind of medicine. Typically they were poor, illiterate, older women whose contact with the infected isolated them socially and often brought their lives to an early end. They were also, in one of the more gruesome examples of gig work offered by history, paid per body.
The causes of death reported by searchers were recorded by sextons and clerks on weekly bills of mortality — sheets sold like broadsides for a penny, meant to let citizens know where the disease had spread.
Bill of mortality for the week of 19th–26th September 1665, which saw the highest death toll from the plague.
The bill of mortality featured above comes from a week in September 1665, when the epidemic was at its height. As you can see toward the bottom right-hand corner, a total of 7,165 people in 126 parishes were proclaimed to have died of “Plague” — a number most historians believe to be low, considering how many people (Quakers, Anabaptists, Jews, and the very poor, among others) were not taken into account by the recording Anglicans.
In addition to the alarming number of plague deaths, Londoners, of course, continued to die by other means, both familiar and strange.
Many familiar maladies hide behind the enigmatic naming. “Rising of the Lights”, dreamy though it sounds, was a seventeenth-century term for any death associated with respiratory trouble (“lights” being a word for lungs). “Griping in the guts” and “Stopping of the stomach” were similarly used for deaths accompanied by gastrointestinal complaints. “Spotted feaver” was most likely typhus or meningitis.
Many labels — such as “suddenly”, “frighted”, and “grief” — speak of the often approximate nature of assigning a cause (not carried out by medical professionals but rather the “searchers”). “Planet” referred to any illness thought to have been caused by the negative influence/position of one of the planets at the time (a similar astrological source lies behind the name Influenza, literally influence).
Other causes of death endemic to seventeenth-century England practically litter the bills. Tuberculosis, both in the form of “Consumption” and of “Kingsevil” (a tubercular swelling of the lymph glands which was thought to be curable by the touch of royalty), killed hundreds of people every month. “Surfeit”, meaning overindulgence in food or drink, could sometimes be interchangeable with “Gowt” (gout) or “Dropsie” (edema). And the toll childbearing took on both mother and infant is also painfully evident on the bill, with its entries for “Childbed”, “Infants”, “Stillborn”, “Abortive”, “Teeth” (babies who died while teething), and “Chrisomes” (a catch-all for children who died before they could talk).
Probably the entries that strike us most, because they set us telling a story in our minds, are those that read like captions in an Edward Gorey book: “Killed by a fall from Belfrey at Alhallowes the Great”, “Burnt in his Bed by a Candle at St. Giles Cripplegate”, or “Drowned in a Tub of Wash in a Brewhouse at St. Giles in the Fields”.
Title page to London’s Dreadful Visitation, or, A Collection of all the Bills of Mortality for this Present Year
A useful overview, from 1908, of the history of the Bills of Mortality can be read here, and another from 1843, here. And from a more poetic response to such bills, see William Cowper’s Stanzas on Mortality, a collection of his poems that were attached to the bills of mortality for the parish of Northampton from 1787–93.
Fatty food may feel like a friend during these troubled times, but new research suggests that eating just one meal high in saturated fat can hinder our ability to concentrate—not great news for people whose diets have gone south while they’re working at home during the COVID-19 pandemic.
The study compared how 51 women performed on a test of their attention after they ate either a meal high in saturated fat or the same meal made with sunflower oil, which is high in unsaturated fat.
Their performance on the test was worse after eating the high-saturated-fat meal than after they ate the meal containing a healthier fat, signaling a link between that fatty food and the brain.
Researchers were also looking at whether a condition called leaky gut, which allows intestinal bacteria to enter the bloodstream, had any effect on concentration. Participants with leakier guts performed worse on the attention assessment no matter which meal they had eaten.
The loss of focus after a single meal was eye-opening for the researchers.
“Most prior work looking at the causative effect of the diet has looked over a period of time. And this was just one meal—it’s pretty remarkable that we saw a difference,” said Annelise Madison, lead author of the study and a graduate student in clinical psychology at The Ohio State University.
Madison also noted that the meal made with sunflower oil, while low in saturated fat, still contained a lot of dietary fat.
“Because both meals were high-fat and potentially problematic, the high-saturated-fat meal’s cognitive effect could be even greater if it were compared to a lower-fat meal,” she said.
The study is published today (May 12) in the American Journal of Clinical Nutrition.
Madison works in the lab of Janice Kiecolt-Glaser, professor of psychiatry and psychology and director of the Institute for Behavioral Medicine Research at Ohio State. For this work, Madison conducted a secondary analysis of data from Kiecolt-Glaser’s study assessing whether high-fat meals increased fatigue and inflammation among cancer survivors.
Women in the study completed a baseline assessment of their attention during a morning visit to the lab. The tool, called a continuous performance test, is a measure of sustained attention, concentration, and reaction time based on 10 minutes of computer-based activities.
The high-fat meal followed: eggs, biscuits, turkey sausage, and gravy containing 60 grams of fat, either a palmitic acid-based oil high in saturated fat or the lower-saturated-fat sunflower oil. Both meals totaled 930 calories and were designed to mimic the contents of various fast-food meals such as a Burger King double whopper with cheese or a McDonald’s Big Mac and medium fries.
Five hours later, the women took a continuous performance test again. Between one and four weeks later, they repeated these steps, eating the opposite meal of what they had eaten on the first visit.
Researchers also analyzed participants’ fasting baseline blood samples to determine whether they contained an inflammatory molecule that signals the presence of endotoxemia—the toxin that escapes from the intestines and enters the bloodstream when the gut barrier is compromised.
After eating the meal high in saturated fat, all of the participating women were, on average, 11 percent less able to detect target stimuli in the attention assessment. Concentration lapses were also apparent in the women with signs of leaky gut: Their response times were more erratic and they were less able to sustain their attention during the 10-minute test.
“If the women had high levels of endotoxemia, it also wiped out the between-meal differences. They were performing poorly no matter what type of fat they ate,” Madison said.
Though the study didn’t determine what was going on in the brain, Madison said previous research has suggested that food high in saturated fat can drive up inflammation throughout the body, and possibly the brain. Fatty acids also can cross the blood-brain barrier.
“It could be that fatty acids are interacting with the brain directly. What it does show is the power of gut-related dysregulation,” she said.
The statistical analysis accounted for other potential influences on cognition, including depressive symptoms and the participants’ average dietary saturated fat consumption. The women in the study ate three standardized meals and fasted for 12 hours before each lab visit to reduce diet variations that could affect their physiological response to the high-fat meals.
The findings suggest concentration could be even more impaired in people stressed by the pandemic who are turning to fatty foods for comfort, Kiecolt-Glaser said.
“What we know is that when people are more anxious, a good subset of us will find high-saturated-fat food more enticing than broccoli,” she said. “We know from other research that depression and anxiety can interfere with concentration and attention as well. When we add that on top of the high-fat meal, we could expect the real-world effects to be even larger.”
More information: Afternoon distraction: a high-saturated-fat meal and endotoxemia impact postmeal attention in a randomized crossover trial. American Journal of Clinical Nutrition, doi.org/10.1093/ajcn/nqaa085