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Hearing loss linked to heightened heart failure risk

Both the participants who used hearing aids and those with poor hearing had a similarly significant increase in the risk of incident [heart failure], suggesting that while hearing aids can improve auditory function, they may not address the underlying vascular issues that contribute to the risk of [heart failure].

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Hearing loss is linked to a heightened risk of developing heart failure, with the psychological distress caused by the impairment taking a key role in the observed association, finds a large long term study, published online in the journal Heart.

Hearing loss is increasingly common, particularly as people age, while the prevalence of heart failure is also on the rise, affecting around 64 million people worldwide, note the researchers.

While impaired hearing is associated with an increased risk of cardiovascular disease, principally, it is thought, as a result of the resulting social detachment, no study has comprehensively examined the association between objectively measured hearing ability and the risk of developing heart failure.

In a bid to plug this knowledge gap, the researchers mined the data of 164,431 participants from the UK Biobank, 4369 of whom wore hearing aids. None had heart failure to begin with. The average age of participants was 56, and 89,818 (around 55%) were women.

Their hearing ability was objectively measured using the validated Digit Triplets Test and the speech-reception-threshold (SRT).  Participants (160,062) who didn’t wear hearing aids were categorised into three groups according to their performance on the DTT: normal (140,839; 88%); insufficient (16,759;10.5%); and poor (2464; 1.5%).

Comprehensive background information on current health, lifestyle, and psychosocial factors was collected via questionnaires.  

Social isolation was assessed using a composite definition in the UK Biobank derived from scores (1-3) for the number of people living in the household, frequency of friend or family visits, and leisure or social activities. Those with a score of 2 or 3 were classified as socially isolated.

Psychological distress was assessed using a four-item version of the Patient Health Questionnaire (PHQ-4), with a score ranging from 0 to 12. Neuroticism, a depression-related personality trait, was assessed using 12 questions from the Eysenck Personality Questionnaire-Revised Short Form.

The development of heart failure among those who were not genetically predisposed to the condition was identified through medical records and death certificates during an average follow up of 11½  years.

During this period, 4449 (nearly 3%) of the participants developed heart failure. SRT levels were significantly positively associated with the risk of developing the condition in participants who didn’t wear hearing aids. 

Compared with those with normal hearing, the adjusted heightened risks of developing heart failure were 15% and 28%, respectively, for insufficient and poor hearing, and 26% for hearing aid use.  

The associations between SRT levels and heart failure risk were stronger in those without coronary heart disease or stroke at the start of the study.

SRT levels were significantly positively associated with social isolation, psychological distress, and neuroticism among those who didn’t wear hearing aids. And these factors had a substantial role in the observed associations in participants who didn’t wear hearing aids, accounting for 3%, 17%, and 3%, respectively, of the heightened risk of heart failure development. 

When the scores for social isolation, psychological distress, and neuroticism were combined among those who had full data on these factors, the total mediating effect was just over 9%. 

This was less than the sum of the mediating effects of each individual factor,  which amounted to 19.5%, suggesting overlap and interaction between these three factors, say the researchers.

This is an observational study, and as such, can’t establish cause and effect. And data on hearing were collected only at the start of the study, while the participants in the current study were mainly of European descent and healthier than the UK general population, they acknowledge.

But there are plausible biological explanations for their findings, they say. “The rich distribution of capillaries in the…cochlea and the high metabolic demand of the inner ear may render these regions more sensitive to systemic vascular disorders rather than just local circulatory issues,” they suggest. 

“Therefore, hearing impairment may reflect vascular health and serve as an early and sensitive predictor of cardiovascular disease, including [heart failure],” they add.

“Of note, both the participants who used hearing aids and those with poor hearing had a similarly significant increase in the risk of incident [heart failure], suggesting that while hearing aids can improve auditory function, they may not address the underlying vascular issues that contribute to the risk of [heart failure],” they continue.

And they explain: “Because hearing problems can lead to difficulties in speech comprehension and poor engagement in social activities, people with hearing impairment are more likely to experience social isolation, psychological distress, anxiety and depression than people without hearing impairment. 

“These psychological factors may increase the activity of the sympathetic nervous system and the hypothalamic-pituitary adrenal axis, and enhance inflammation and oxidative stress, thereby accelerating atherosclerosis, increasing peripheral stress, and promoting the development of cardiac remodelling.”

The findings highlight the importance of integrating hearing health assessments into broader cardiovascular risk evaluation frameworks, they conclude. And strengthening psychological intervention in people with hearing impairment may be key to curbing the risk of heart failure, they suggest.

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Drinking any amount of alcohol likely increases dementia risk

Even light drinking—generally thought to be protective, based on observational studies—is unlikely to lower the risk, which rises in tandem with the quantity of alcohol consumed.

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Drinking any amount of alcohol likely increases the risk of dementia, suggests the largest combined observational and genetic study to date, published online in BMJ Evidence Based Medicine.

Even light drinking—generally thought to be protective, based on observational studies—is unlikely to lower the risk, which rises in tandem with the quantity of alcohol consumed, the research indicates.

Current thinking suggests that there might be an ‘optimal dose’ of alcohol for brain health, but most of these studies have focused on older people and/or didn’t differentiate between former and lifelong non-drinkers, complicating efforts to infer causality, note the researchers.

To try and circumnavigate these issues and strengthen the evidence base, the researchers drew on observational data and genetic methods (Mendelian randomisation) from two large biological databanks for the entire ‘dose’ range of alcohol consumption.

These were the US Million Veteran Program (MVP), which includes people of European, African, and Latin American ancestry, and the UK Biobank (UKB), which includes people of predominantly European ancestry.

Participants who were aged 56–72 at baseline, were monitored from recruitment until their first dementia diagnosis, death, or the date of last follow-up (December 2019 for MVP and January 2022 for UKB), whichever came first. The average monitoring period was 4 years for the US group, and 12 for the UK group. 

Alcohol consumption was derived from questionnaire responses—over 90% of participants said they drank alcohol—and the Alcohol Use Disorders Identification Test (AUDIT-C) clinical screening tool. This screens for hazardous drinking patterns, including the frequency of binge drinking (6 or more drinks at a time).

In all, 559,559 participants from both groups were included in observational analyses, 14,540 of whom developed dementia of any type during the monitoring period:10,564 in the US group; and 3976 in the UK group. And 48,034 died: 28,738 in the US group and 19,296 in the UK group. 

Observational analyses revealed U-shaped associations between alcohol and dementia risk: compared with light drinkers (fewer than 7 drinks a week) a 41% higher risk was observed among non-drinkers and heavy drinkers consuming 40 or more drinks a week, rising to a 51% higher risk among those who were alcohol dependent. 

Mendelian randomisation genetic analyses drew on key data from multiple large individual genome-wide association studies (GWAS) of dementia, involving a total of 2.4 million participants to ascertain lifetime (rather than current) genetically predicted risks.

Mendelian randomisation leverages genetic data, minimising the impact of other potentially influential factors, to estimate causal effects: genomic risk for a trait (in this case, alcohol consumption) essentially stands in for the trait itself. 

Three genetic measures related to alcohol use were used as different exposures, to study the impact on dementia risk of alcohol quantity, as well as problematic and dependent drinking. 

These exposures were: self-reported weekly drinks (641 independent genetic variants);  problematic ‘risky’ drinking (80 genetic variants); and alcohol dependency (66 genetic variants). 

Higher genetic risk for all 3 exposure levels was associated with an increased risk of dementia, with a linear increase in dementia risk the higher the alcohol consumption. 

For example, an extra 1-3 drinks a week was associated with a 15% higher risk. And a doubling in the genetic risk of alcohol dependency was associated with a 16% increase in dementia risk.

But no U-shaped association was found between alcohol intake and dementia, and no protective effects of low levels of alcohol intake were observed. Instead, dementia risk steadily increased with more genetically predicted drinking. 

What’s more, those who went on to develop dementia typically drank less over time in the years preceding their diagnosis, suggesting that reverse causation—whereby early cognitive decline leads to reduced alcohol consumption—underlies the supposed protective effects of alcohol found in previous observational studies, say the researchers.

They acknowledge that a principal limitation of their findings is that the strongest statistical associations were found in people of European ancestry, because of the numbers of participants of this ethnic heritage studied. Mendelian randomisation also relies on assumptions that can’t be verified, they add.

Nevertheless, they suggest that their findings “challenge the notion that low levels of alcohol are neuroprotective.”

And they conclude: “Our study findings support a detrimental effect of all types of alcohol consumption on dementia risk, with no evidence supporting the previously suggested protective effect of moderate drinking. 

“The pattern of reduced alcohol use before dementia diagnosis observed in our study underscores the complexity of inferring causality from observational data, especially in ageing populations. 

“Our findings highlight the importance of considering reverse causation and residual confounding in studies of alcohol and dementia, and they suggest that reducing alcohol consumption may be an important strategy for dementia prevention.”

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Distribution of fat could influence cancer risk, study suggests

Obesity is usually measured using body mass index (BMI), but growing evidence – particularly from heart health research – suggests that BMI alone doesn’t capture the full picture when it comes to obesity-related health risks. However, the role of fat distribution in cancer risk has been relatively unexplored.  

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How fat is distributed in people’s bodies could make a difference to their risk of certain cancers, according to new research led by the University of Bristol.  The international study is published in the Journal of the National Cancer Institute (JNCI).

Scientists have already shown that having obesity increases a person’s risk of developing certain cancers. Obesity is usually measured using body mass index (BMI), but growing evidence – particularly from heart health research – suggests that BMI alone doesn’t capture the full picture when it comes to obesity-related health risks. However, the role of fat distribution in cancer risk has been relatively unexplored.  

Researchers in Bristol’s Integrative Cancer Epidemiology Programme (ICEP) investigated whether body fat at different locations across the body influences the risks of 12 obesity-related cancers – endometrial, ovarian, breast, colorectal, pancreas, multiple myeloma, liver, kidney (renal cell), thyroid, gallbladder, oesophageal adenocarcinoma, and meningioma.

They used a technique known as Mendelian randomisation, which uses statistics, computing and the natural variations in people’s genetics to identify patterns in large health data sets. 

The team found that fat distribution appears to influence cancer risk – but the relationship varies by cancer type. For some cancers, where fat is stored in the body seems more important than how much is stored; for others, the reverse is true; and, for some, both matter.  In cancers where distribution is important, the specific locations of body fat driving this seem to differ by cancer, meaning the overall picture is quite complex. 

Lead author, Dr Emma Hazelwood, who recently completed her PhD at the University of Bristol, explained: “These findings support the growing consensus that BMI, while useful for population-level trends, may be too simplistic for assessing individual health risks.

“Our results tell us that there is no ‘one-size-fits-all’ when it comes to cancer, meaning a more tailored approach to cancer prevention in people with obesity could be most effective.” 

The paper’s findings fit with recent calls for change, including the 2024 European Association for the Study of Obesity framework and the Lancet Commission on the future of obesity, which have emphasised that BMI is a flawed diagnostic tool and that fat distribution matters.  

In the future, a better understanding of how fat distribution across the body affects cancer risk could help identify those most at risk and guide more personalised approaches to obesity treatment and cancer prevention. 

The research team recommend further work is needed, using different approaches and studying non-European populations.

Dr Hazelwood added: “It is vital to understand the biological mechanisms that underpin these associations – particularly how and why different fat depots affect cancer development. In the longer term, we need to explore how obesity treatments – whether lifestyle or drug-based – influence these risk pathways.” 

Dr Julia Panina, Head of Research Funding at World Cancer Research Fund, added: “Our evidence-based Cancer Prevention Recommendations highlight the role of maintaining a healthy weight to reduce cancer risk. While this remains essential, growing scientific evidence shows that body composition – particularly how fat is distributed throughout the body – is also a crucial factor.  

“With support from our fantastic donors, we were able to co-fund the University of Bristol’s excellent team whose findings will help direct this exciting area towards possible new cancer prevention and treatments.” 

This study was funded by the World Cancer Research Fund (WCRF UK) and Cancer Research UK (Integrative Cancer Epidemiology Programme). This work was carried out at the MRC Integrative Epidemiology Unit (MRC IEU), which is supported by the Medical Research Council (MRC) and the University of Bristol. 

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Forget materialism, a simple life is happier: research

The commitment to simple living, or ‘voluntary simplicity’ as it is formally known, leads to wellbeing through providing more opportunities for personal interaction and social connection than conventional contexts of exchange, such as community gardens, sharing resources, and peer-to-peer lending platforms.

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In an age where billionaires and conspicuous consumption are increasingly on display, new Otago-led research shows a simple life really is a happier life.

The study led by University of Otago – Ōtākou Whakaihu Waka Department of Marketing researchers has recently been published in the Journal of Macromarketing.

After setting out to understand the relationship between consumption and wellbeing, the researchers found people are happier and more satisfied when adopting sustainable lifestyles and resisting the temptations of consumerism.

They analysed data from a representative sample of more than 1000 New Zealanders, made up of 51 per cent men and 49 per cent women, with a median age of 45 and a median annual household income of $50,000.

They found the commitment to simple living, or ‘voluntary simplicity’ as it is formally known, leads to wellbeing through providing more opportunities for personal interaction and social connection than conventional contexts of exchange, such as community gardens, sharing resources, and peer-to-peer lending platforms.

Women are more likely to adopt a simple life than men, although more research is needed to understand why.

Co-author Associate Professor Leah Watkins says consumer culture promotes happiness as being typically associated with high levels of income and the capability it affords to acquire and accumulate material possessions.

“However, research is clear that attitudes to, and experiences of, materialistic approaches to life do not lead to increases in happiness or wellbeing. Nor do they lead to sustainable consumption necessary for planetary health.”

Between 2000 and 2019, global domestic material consumption increased by 66 per cent, tripling since the 1970s to reach 95.1 billion metric tons.

Growing consumer affluence and higher living standards have resulted in warnings of alarming trends of environmental degradation from human consumption.

This, coupled with global warming and post-pandemic health and financial anxieties, has led researchers and policymakers to call for a better understanding of the links between simple consumer lifestyles and wellbeing.

But co-author Professor Rob Aitken says this isn’t a case of just throwing out all your worldly possessions.

“It’s not directly the commitment to material simplicity that leads to wellbeing, but the psychological and emotional need fulfilment that derives from relationships, social connection, community involvement and a sense of living a purposeful and meaningful life.

“In a world where billionaire weddings are treated like state occasions and private yachts are the new status symbols, voluntary simplicity offers a quiet, powerful counter-narrative — one that values enough over excess, connection over consumption, and meaning over materialism.”

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