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Breastfeeding protects against type 1 diabetes but cow’s milk raises risk, research suggests

Babies that were breastfed for longer and those that were breastfed exclusively were less likely to develop T1D.

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Photo by Wes Hicks from Unsplash.com

New research presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD), held online this year, shows that breastfeeding is associated with a lower risk of developing type 1 diabetes (T1D).  Drinking more than two or three glasses of cow’s milk a day in childhood, however, is linked with higher odds of developing T1D.

In T1D, the immune system attacks and destroys the insulin-producing cells in the pancreas.  This prevents the body from producing enough of the hormone to properly regulate blood sugar levels.

What triggers the immune system’s attack is unknown but is thought to involve a combination of a genetic predisposition and an environmental trigger such as a virus or foodstuff. In some cases, the condition may develop in people without a genetic predisposition. 

Incidence of T1D, the most common form of diabetes in children, is increasing worldwide.  The number of diagnoses in young people is rising by an estimated 3.4% annually in Europe and 1.9% in the U.S.

“Type 1 diabetes is a serious condition that requires lifelong treatment,” says Ms Anna-Maria Lampousi of Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden, who led the research. “Over time, high blood sugar levels can damage the heart, eyes, feet and kidneys and can shorten life expectancy.

“Learning more about the causes is key to preventing the type 1 diabetes – and its complications. 

“The identification of foodstuffs and other environmental triggers which can be modified would be particularly valuable.”

Numerous foodstuffs have been linked to islet autoimmunity – the attack on the insulin-producing cells – and T1D but none of the associations have been firmly established and the existence of a link remains controversial.

In the first study of its kind, Ms Lampousi and colleagues at the Karolinska Institutet carried out a systematic review and meta-analysis of the existing research to identify which foods have been consistently linked to T1D.

The Medline, Embase and Cochrane Library databases were searched from formation until October 2020, for studies on diet, T1D and islet autoimmunity.

Of the 5,935 studies identified, 152 were eligible for inclusion. The analysis produced estimates for how much 27 dietary components increased or reduced the risk of developing T1D.  This included foods eaten by the mother in pregnancy and foods consumed in infancy and childhood, as well as being breastfed.

Babies that were breastfed for longer and those that were breastfed exclusively were less likely to develop T1D.

Those breastfed for at least 6-12 months were less than half as likely (61% less likely) to develop T1D than those breastfed for less.  Those given only breast milk for the first 2-3 months were 31% less likely to develop the condition than those who weren’t exclusively breastfed.

The researchers say that breastfeeding promotes the maturation of baby’s immune system.  Plus, breast milk enhances the baby’s gut microbiota – the bacteria, fungi and other microorganisms that live in the digestive tract and help regulate the immune system.

Higher consumption of cow’s milk and dairy products such as butter, cheese, yoghurt and ice-cream during childhood (under 15 years old) was associated with a higher risk of islet autoimmunity and T1D.

For example, those who drank at least two to three glasses of cow’s milk (one glass = around 200ml) a day were 78% more likely to be develop T1D than those who consumed less than this amount of milk.

It isn’t known what is behind the association but some research has suggested that amino acids (the building blocks of proteins) in cow’s milk can trigger the immune system’s attack on the insulin-producing cells of the pancreas.

Early introduction of cow’s milk to the diet was also associated with a higher risk of T1D.  Those who started drinking cow’s milk at two or three months old were 31% less likely to develop T1D than those who started consuming it earlier.

Later introduction of gluten to the diet more than halved the odds of developing T1D. Infants who started eating gluten-containing foods, such as cereal, bread, pastries, biscuits and pasta, at 3-6 months old were 54% less likely to develop T1D than those introduced to the foods earlier.

Waiting until a child was four to six months old to introduce fruit to their diet was associated with a 53% reduction in their likelihood of developing T1D.

The study’s authors say it isn’t clear if delaying introduction to these foods directly protects against T1D or if the infants are benefiting from being breastfed for longer.

Age at introduction to formula milk, meat and vegetables was not linked to risk of T1D.  Nor were there any associations between a mother’s intake of gluten and vitamin D in pregnancy and her child’s odds of the condition.

Ms Lampousi concludes: “Diet in infancy and childhood may influence the risk of type 1 diabetes. The strongest findings were for the beneficial effects of breastfeeding and the harmful effects of early introduction to cow’s milk, gluten and fruit.

“However, most of the evidence to-date is of limited quality and further high-quality research is necessary before any specific dietary recommendations can be made.”

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Acetaminophen reduces sepsis patients’ risk of having organ injury

Intravenous acetaminophen was safe for all the sepsis patients, with no difference in liver injury, low blood pressure, or other adverse events compared to the placebo group. Among secondary outcomes, they also found that organ injury was significantly lower in the acetaminophen group, as was the rate of acute respiratory distress syndrome onset within seven days of hospital admission.

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Intravenous acetaminophen reduced sepsis patients’ risk of having organ injury or developing acute respiratory distress syndrome, a serious condition that allows fluid to leak into the lungs.

This is according to a study, “Phase 2b Randomized Trial of Acetaminophen for Prevention and Treatment of Organ Dysfunction in Critically Ill Sepsis Patients”, that appeared in JAMA.

As FYI: Sepsis is the body’s uncontrolled and extreme response to an infection. In sepsis, red blood cells become injured and die at abnormally high rates, releasing so called “cell-free hemoglobin” into the blood. The body becomes overwhelmed and can’t remove this excess hemoglobin which can lead to organ damage.

While the trial did not improve mortality rates in all patients with sepsis regardless of severity, the researchers found that acetaminophen gave the greatest benefit to the patients most at risk for organ damage. With the therapy, those patients needed less assisted ventilation and experienced a slight, though statistically insignificant, decrease in mortality.

To test the therapeutic potential of acetaminophen more fully in a mid-stage clinical trial, researchers enrolled 447 adults with sepsis and respiratory or circulatory organ dysfunction at 40 US academic hospitals from October 2021 to April 2023.

Patients were randomized to receive either acetaminophen or a placebo intravenously every six hours for five days. The researchers then followed the patients for 28 days to see how they fared. They also completed a special analysis using data only from the patients with levels of cell-free hemoglobin above a certain threshold. The team’s primary interest overall was the number of patients who were able to stay alive with no organ support, such as mechanical ventilation or kidney failure treatment.

Scientists note that identifying high levels of cell-free hemoglobin as a biomarker that could be tested when patients are first admitted to the hospital would be a breakthrough, because it could help quickly determine which patients with sepsis might benefit from acetaminophen therapy.

The researchers found that intravenous acetaminophen was safe for all the sepsis patients, with no difference in liver injury, low blood pressure, or other adverse events compared to the placebo group. Among secondary outcomes, they also found that organ injury was significantly lower in the acetaminophen group, as was the rate of acute respiratory distress syndrome onset within seven days of hospital admission.

When looking more closely at the patients with higher cell-free hemoglobin, the researchers found that just 8% of patients in the acetaminophen group needed assisted ventilation compared to 23% of patients in the placebo group. And after 28 days, 12% of patients in the acetaminophen group had died, compared to 21% in the placebo group, though this finding was not statistically significant.

“While the anticipated effects of acetaminophen therapy were not realized for all sepsis patients, this study shows that it still holds promise for the most critically ill” said James Kiley. “Though, more research is needed to uncover the mechanisms and validate these results.”

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Extreme heat associated with children’s asthma hospital visits

Daytime heat waves were significantly associated with 19 percent higher odds of children’s asthma hospital visits, and longer duration of heat waves doubled the odds of hospital visits. They did not observe any associations for nighttime heat waves.

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For children seeking care at urban pediatric health centers, extreme heat events were associated with increased asthma hospital visits.

This is according to research published at the ATS 2024 International Conference.  

“We found that both daily high heat events and extreme temperatures that lasted several days increased the risk of asthma hospital visits,” said corresponding author Morgan Ye, MPH, research data analyst, Division of Pulmonary and Critical Care Medicine, University of California, San Francisco School of Medicine. “Understanding the impacts of climate-sensitive events such as extreme heat on a vulnerable population is the key to reducing the burden of disease due to climate change.”

For this study, Ye and colleagues looked at 2017-2020 electronic health records from the UCSF Benioff Children’s Hospital Oakland, which included data on asthma hospital visits by patients of the hospital, some of whom are from Benioff Oakland’s Federally Qualified Health Center, and demographics including patients’ zip codes. They used data from the PRISM Climate Group of Oregon State University to determine the timing of daily maximum (daytime heat waves) and minimum (nighttime heat waves) for each zip code. The researchers restricted their analyses to the region’s warm season (June to September). To evaluate the potential range of effects of different heat wave measurements, they used 18 different heat wave definitions, including the 99th, 97.5th and 95th percentile of the total distribution of the study period for one, two or three days.

They designed the study in a way that allowed them to determine the association between each heat wave definition and a hospital visit. They repeated the analysis for Bay Area and Central California zip codes.

The team discovered that daytime heat waves were significantly associated with 19 percent higher odds of children’s asthma hospital visits, and longer duration of heat waves doubled the odds of hospital visits. They did not observe any associations for nighttime heat waves. 

According to Ye, “We continue to see global temperatures rise due to human-generated climate change, and we can expect a rise in health-related issues as we observe longer, more frequent and severe heat waves. Our research suggests that higher temperatures and increased duration of these high heat days are associated with increased risk of hospital visits due to asthma. Children and families with lower adaptation capacity will experience most of the burden. Therefore, it is important to obtain a better understanding of these heat-associated health risks and susceptible populations for future surveillance and targeted interventions.”

The authors note that past research has suggested positive associations between extreme heat and asthma, but findings regarding hospitalizations and emergency room visits have been conflicting. Additionally, many other studies have focused on respiratory hospitalizations and not hospitalizations for asthma, specifically, and have not included or had a focus on children. This study is also unique because it investigated the effect of daily high temperatures but also the effects of persistent extreme temperatures.

This study demonstrates that even milder extreme heat temperatures may significantly impact health. These effects are more pronounced in climate-susceptible populations, including children and those who are medically vulnerable, such as those served by the urban pediatric health center in this study. The authors hope these study results will lead to more equitable health outcomes and reduce racial/ethnic disparities observed in climate-sensitive events.

“These results can be used to inform targeted actions and resources for vulnerable children and alleviate health-related stress during heat waves,” they conclude.

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Pru Life UK employees participate in annual blood donation drive with Philippine Red Cross

The life insurer also advocates health and safety protection, especially for families in need. In partnership with the Philippine Red Cross, Pru Life UK employees are engaged in blood donation drives, contributing to a safe and quality blood supply for the Filipino community.

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Pru Life UK’s commitment to supporting communities goes beyond financial education and inclusion. The life insurer also advocates health and safety protection, especially for families in need. In partnership with the Philippine Red Cross, Pru Life UK employees are engaged in blood donation drives, contributing to a safe and quality blood supply for the Filipino community.

The blood donation drive has been an integral part of Pru Life UK’s community investment programs since 2016. To date, close to 500 bags of life-saving blood have been donated by PRU employees and agents. Sustainability Changemakers, Pru Life UK’s volunteerism program, engages its people to take part in supporting communities in need.

“My younger brother needed to get immediate surgery during pandemic. Imagine the feeling of being helpless with hospitals saying no to my brother’s surgery. People experience this most of the time, so I want to help even with the simple gesture of donating blood. Since then, I’ve donated four times through Pru Life UK’s employee blood donation initiative. More than just donating, bloodletting reminds me of how fragile life is and that we should take care of our health in any way we can.” PRULifer Jonel Yulas shared following the company’s recent blood donation drive.

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