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Too much, too little sleep linked to elevated heart risks in people free from disease

People who clock six to seven hours of sleep a night had the lowest chance of dying from a heart attack or stroke when compared with those who got less or more sleep.

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Photo by Mpho Mojapelo from Unsplash.com

People who clock six to seven hours of sleep a night had the lowest chance of dying from a heart attack or stroke when compared with those who got less or more sleep, according to a study being presented at the American College of Cardiology’s 70th Annual Scientific Session. This trend remained true even after the research team accounted for other known conditions or risk factors for heart disease or stroke.

The study, according to researchers, is the first to explore the association between baseline cardiovascular risk and duration of sleep and adds to mounting evidence that sleep–similar to diet, smoking and exercise–may play a defining role in someone’s cardiovascular risk.

“Sleep is often overlooked as something that may play a role in cardiovascular disease, and it may be among the most cost-effective ways to lower cardiovascular risk,” said Kartik Gupta, MD, resident, Division of Internal Medicine, Henry Ford Hospital in Detroit and lead author of the study. “Based on our data, sleeping six to seven hours a night is associated with more favorable heart health.”

For the study, Gupta and his team included data from 14,079 participants in the 2005-2010 National Health and Nutrition Examination Survey. Participants were followed for a median duration of 7.5 years to determine if they died due to heart attack, heart failure or stroke. Those surveyed were 46 years old on average, half were women and 53% were non-white. Less than 10% of participants had a history of heart disease, heart failure or stroke.

Researchers divided participants into three groups based on answers to a survey question about their average length of sleep–less sleep (seven hours). Researchers then assessed participants’ atherosclerotic cardiovascular disease (ASCVD) risk scores and levels of C-reactive protein (CRP), a key inflammatory marker known to be associated with heart disease.

The ASCVD risk score, which accounts for age, gender, race, blood pressure and cholesterol, is widely used to predict how likely someone is to have a heart attack or stroke or die from atherosclerosis, a hardening of the arteries, in the next 10 years. An ASCVD risk score less than 5% is considered low risk.

While the median ASCVD risk was 3.5% among all participants, there was a U-shape relationship based on sleep duration such that participants with six to seven hours had the lowest risk. The median 10-year ASCVD risk among people with less than six, six to seven and more than seven hours of sleep were 4.6%, 3.3% and 3.3%, respectively.

“Participants who slept less than six hours or more than seven hours had a higher chance of death due to cardiac causes. ASCVD risk score was, however, the same in those who sleep six to seven hours versus more than seven hours,” Gupta said, adding that the ASCVD risk score may not adequately capture elevated cardiac risk in this subgroup and that results are perhaps stronger for participants sleeping less than six hours a night.

Levels of CRP, a protein made in the liver that rises when there is inflammation in the body, were also higher in participants with longer or shorter durations of sleep.

“Participants who sleep less or more than six to seven hours have higher ASCVD risk scores, which is likely driven by heightened inflammation as measured by CRP, which was found to be higher among those who had less or more sleep,” Gupta said, adding that CRP levels were only collected at the start of the study. “The effect of sleep probably accrues over time; it takes time for the damage to happen.”

According to the researchers, unlike some risk factors for heart disease that can’t be changed, such as age or genetics, sleep habits can be adjusted and should be routinely asked about during medical visits.

“It’s important to talk about not only the amount of sleep but the depth and quality of sleep too. Just because you are lying in bed for seven hours doesn’t mean that you are getting good quality sleep,” Gupta said, adding that this study is limited to sleep quantity, not quality or how well or deeply someone sleeps. For example, sleep apnea, which is a sleep disorder that results in frequent awakenings, is increasingly associated with cardiovascular disease.

The amount of sleep found to be favorable to heart health in this study differs slightly from national recommendations by the National Sleep Foundation and the American Academy of Sleep Medicine, which recommend most adults get seven to nine hours or seven or more hours of sleep a night, respectively. But, as Gupta explains, individuals were limited to choosing hour blocks (six, seven or eight hours, for example) when noting sleep time.

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How to help children build a growth mindset

Consider these three tips to help children build a growth mindset.

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A new year is a perfect time to consider the habits you want to keep and the ones you’d like to develop. One resolution to consider is helping your children develop a growth mindset this year.

“We know one of the greatest boosts to parents’ confidence over the past year came from knowing their children’s whole selves are being nurtured, and we want to see that trend continue,” said Carter Peters from KinderCare Learning Center’s education team. “A growth mindset helps children try new things despite fear of failure. It’s the kind of thinking that allows inventors and creative thinkers to get excited about trying something new and ensures they have the cognitive flexibility and problem-solving skills to work through hurdles.”

Adults can often easily spot when children are engaged in creative thinking and prideful of their work, but that confidence may be lost as failures turn into insecurities. By nurturing a growth mindset and showing children they can learn and develop new skills in any area, it better sets them up for long-term success.

Consider these three tips to help children build a growth mindset:

Photo by Markus Spiske from Unsplash.com

1. Praise effort

It’s easy to fall into the habit of praising successes. However, praising effort encourages children to try new things without the fear of failing. It also teaches children personal growth and achievement are possible, even if their overall effort wasn’t a success.

“Young children often get excited to try something new,” Peters said. “By praising effort and showing children they’ll still be loved and valued despite the outcome, you can reframe how they approach challenges and teach them that difficult doesn’t mean impossible.”

2. Encourage the process

People often withhold praise until there’s a result, which leads children to hurriedly scribble a picture to hold up for a “good job” instead of taking time to focus on their efforts. When children know adults will encourage them during the process, instead of only upon the achievement, they’re more likely to try new things or master a new skill. For example, try providing encouragement such as, “I can see you’re focused on drawing that tree. It looks so lifelike because you’re putting so much thought into what you’re doing.” Once their project is finished, continue the encouragement by hanging up their artwork or school projects in a prominent place.

3. Model a growth mindset

You can model a growth mindset for children by narrating your actions when you are facing a challenge: “I am having a difficult time putting this shelf together, but it’s OK. I’ll take a break then read the instructions again.” Remove negative words from your vocabulary, such as “I can’t” or “I’m stupid.” Even when you are joking, children may not be able to tell the difference. You can also ask your children to join you in problem-solving. Take time to hear their ideas and try them even if you think they won’t work. This not only supports the development of their growth mindset, but the quality time and encouragement reinforces their sense of self-worth and builds confidence.

For more tips to help children develop a growth mindset, visit kindercare.com.

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Signs of a Healthy Marriage

Although there are many different ways to define a healthy marriage, these three qualities are essential for any lasting and fulfilling relationship.

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A healthy marriage is built on trust, respect, and communication. Couples with these qualities in their relationship tend to be more satisfied with their marriage and overall life. They also report feeling closer to their partner and having stronger well-being. With 2.3 out of every 1000 people in the US experiencing divorce in 2022, it is important to frequently check in on the health of your marriage.

Although there are many different ways to define a healthy marriage, these three qualities are essential for any lasting and fulfilling relationship.

Signs of a Healthy Marriage

A healthy marriage is built on trust, communication, and mutual respect. If you and your partner can effectively communicate and share a mutual level of respect, then your relationship is off to a good start. Trust is also important in a healthy marriage, as it allows you and your partner to feel secure in your relationship and rely on each other.

Many other signs can indicate whether or not a marriage is healthy. For example, couples who can spend quality time together and enjoy shared activities usually do well. Couples who can openly discuss their relationship with each other and work through difficulties together are also more likely to have a happy and healthy marriage. Finally, marriages, where both partners feel like they can be themselves without judgment from their spouse tend to be the strongest and most lasting.

Freedom to be yourself

In a healthy marriage, partners feel free to be themselves. They don’t have to put on a facade or pretend to be someone they’re not. They can be open and honest with each other and feel comfortable sharing their thoughts, feelings, and desires.

Both partners should pursue their interests and hobbies without compromising or sacrificing for the sake of the relationship. There’s no need to agree on everything – in fact, it’s healthy to have some separate interests – but overall, both partners should feel like they’re able to be true to themselves within the relationship.

Lots of good communication

In a healthy marriage, partners can communicate effectively. It means expressing needs and wants and listening and responding to what the other person is saying. There are mutual respect’s opinions, even if there are disagreements. Couples in a healthy marriage feel comfortable communicating with each other about both the good and the bad.

Good sex life

A good sex life can be a major sign of a healthy marriage. A lack of sexual activity can be an early warning sign that something is wrong in the relationship. Often, couples who have a good sex life are more connected emotionally and physically. They are also more likely to trust each other and communicate openly.

Trust in each other

In any relationship, trust is essential. Without trust, there is no foundation for the relationship to grow. In a marriage, trust is even more important. Trusting your spouse means you feel confident in their ability to support you emotionally and financially. It also means that you feel safe sharing your innermost thoughts and feelings with them.

When you trust your spouse, you know they have your best interests. You feel comfortable being yourselves around each other and sharing your hopes, dreams, and fears. Openness and honesty in your relationship allow you to be vulnerable with each other. This vulnerable honesty creates a deeper level of intimacy in your marriage.

When you trust each other, you can be more forgiving when mistakes are made. You know that everyone makes mistakes and that nobody is perfect. You also understand that your spouse is human and capable of making mistakes like anyone else. If they make a mistake, you are more likely to forgive them because you know they are sorry and will try not to make the same mistake again.

Trust is one of the most important foundations of a healthy marriage. If you want your marriage to thrive, build trust in each other.

A successful, strong marriage takes work, but with communication, trust, respect, vulnerability, and affection as its core components, you can together create a partnership that will be long-lasting.

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Obesity linked to macular degeneration

Immune cells are also activated when the body is exposed to stressors such as excess fat in obesity, making being overweight the number one non-genetic risk factor for developing AMD, after smoking.

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A Canadian study published in the prestigious journal Science elucidates a new molecular mechanism that may cause age-related macular degeneration (AMD).

The research at Hôpital Maisonneuve-Rosement, in Montreal, shows how life stressors such as obesity reprogram immune system cells and make them destructive to the eye as it ages.

“We wanted to know why some people with a genetic predisposition develop AMD while others are spared,” said Université de Montréal ophtalmology professor Przemyslaw (Mike) Sapieha, who led the study by his postdoctoral fellow Dr. Masayuki Hata.

“Although considerable effort has been invested in understanding the genes responsible for AMD, variations and mutations in susceptibility genes only increase the risk of developing the disease, but do not cause it,” Sapieha explained.

“This observation suggests that we must gain a better understanding of how other factors such as environment and lifestyle contribute to disease development.”

AMD is a major cause of irreversible blindness worldwide and affected approximately 196 million people in 2020. It comes in two forms:

  • dry AMD, characterized by the accumulation of fatty deposits at the back of the eye and the death of nerve cells in the eye,
  • and wet AMD, which is characterized by diseased blood vessels that develop in the most sensitive part of the sight-generating tissue, called the macula.

Contact with pathogens

It is already known that the immune system in the eye of a person with AMD becomes dysregulated and aggressive. Normally, immune cells keep the eye healthy, but contact with pathogens such as bacteria and viruses can make them go awry.

At the same time, immune cells are also activated when the body is exposed to stressors such as excess fat in obesity, making being overweight the number one non-genetic risk factor for developing AMD, after smoking.

In their study, Sapieha and Hata used obesity as a model to accelerate and exaggerate the stressors experienced by the body throughout life.

They found that transient obesity or a history of obesity leads to persistent changes in the DNA architecture within immune cells, making them more susceptible to producing inflammatory molecules.

“Our findings provide important information about the biology of the immune cells that cause AMD and will allow for the development of more tailored treatments in the future,” said Hata, now an ophthalmology professor at Kyoto University, in Japan.

The researchers hope their discovery will lead other scientists to broaden their interest beyond obesity-related diseases to other diseases characterized by increased neuroinflammation, including Alzheimer’s disease and multiple sclerosis.

About this study

“Past history of obesity triggers persistent epigenetic changes in innate immunity and exacerbates neuroinflammation,” by Mike Sapieha and Masayuki Hata, was published in Science.

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