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Study highlights the importance of heart health for preventing diabetes

While genetics do contribute to the probability of developing type 2 diabetes, the findings indicate that maintaining healthy lifestyle habits, and especially having a healthy body weight, can help lower the lifetime risk of the condition.

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Heart healthy middle-aged adults are less likely to develop type 2 diabetes during their lifetime, according to a study published on World Heart Day in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC).

The research found that the importance of favorable cardiovascular health was apparent regardless of an individual’s genetic likelihood of developing type 2 diabetes. Favorable cardiovascular health was defined as having a healthy body weight, blood pressure, and cholesterol, not smoking, eating a balanced diet, and being physically active.

It is estimated that 463 million adults have diabetes and that 10% of global health expenditure is spent on the condition (USD 760 billion).

Study author Dr. Fariba Ahmadizar of Erasmus University Medical Centre, Rotterdam, the Netherlands, said: “While genetics do contribute to the probability of developing type 2 diabetes, the findings indicate that maintaining healthy lifestyle habits, and especially having a healthy body weight, can help lower the lifetime risk of the condition.”

The study included 5,993 participants of the population-based Rotterdam Study who were free of type 2 diabetes at baseline. The average age was 69 years and 58% were women. Participants received a cardiovascular health score of 0 to 12 according to body mass index, blood pressure, blood cholesterol, smoking status, diet and physical activity at baseline, with higher scores corresponding to better cardiovascular health. Participants were then divided into three categories of cardiovascular health according to their score: poor (0-5), intermediate (6-7) and ideal (8-12).

To assess genetic predisposition to type 2 diabetes, the researchers used 403 independent genetic variants related to the condition to calculate a genetic risk score. Participants were then categorised as low, intermediate or high genetic risk according to their score.

A total of 869 individuals developed type 2 diabetes during 69,208 person-years of follow-up. The researchers estimated and compared the lifetime risk for type 2 diabetes within the cardiovascular health and genetic risk categories.

Looking at cardiovascular health alone, the researchers found that the remaining lifetime risk of type 2 diabetes was lower in those with better heart health. For example, at age 55, participants with ideal cardiovascular health had a 22.6% risk of developing type 2 diabetes in their lifetime, compared to 28.3% and 32.6% risks for those with intermediate and poor cardiovascular health, respectively.

When genetic risk was taken into account, the lifetime risk for type 2 diabetes was still lower in those with better cardiovascular health. At age 55, for example, the remaining lifetime risk of diabetes in the high genetic risk group was 23.5% for those with ideal cardiovascular health, compared to 33.7% and 38.7% for those with intermediate and poor cardiovascular health, respectively. The same relationships were seen within the low and intermediate genetic risk groups.

Dr. Ahmadizar said: “Our results highlight the importance of favorable heart health in preventing type 2 diabetes among middle-aged adults regardless of whether they are genetically at high or low risk of the condition. In other words, a healthy lifestyle is associated with a significantly lower risk of type 2 diabetes within any genetic risk category. The findings applied equally to men and women and indicate that healthy habits in midlife are an effective strategy for avoiding diabetes later on.”

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Empowering psoriatic patients by breaking the stigma surrounding the disease

There is no cure for psoriasis, but there are treatments available to help manage the disease. Johnson & Johnson (Philippines), Inc. is at the forefront of bringing new and innovative solutions for this condition including biologic medicines.

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Around two million Filipinos have been diagnosed with psoriasis, an immune-mediated disease that causes red scaly patches on the skin. What is difficult about psoriasis is that it affects patients not only physically, but also psychologically as it is closely linked to anxiety, depression, and post-traumatic stress disorder.

After the birth of her third child, 42-year-old Jane Mauricio began developing lesions on different parts of her body. She was later diagnosed with psoriasis. 

“My hands, which were supposed to be embracing my child, were suddenly covered with red patches and flakes,” shared Mauricio. “I remember myself as someone who was perfectly happy with her family, her career. When psoriatic plaques started to cover my body, I began to lose my confidence—even my will to live.”

“The way people looked at me told me that they were afraid to come near me, thinking I might be infectious. Everywhere I go, I feared being bullied, humiliated, or rejected. At times, I would get so overwhelmed that I would just choose to isolate myself from the world.”

“The relationship between psoriasis and mental health can be a vicious cycle,” said the head of the Medical Affairs Department of Johnson & Johnson (Philippines), Inc., Dr. Erwin Benedicto. “The amount of unwanted attention patients receive can cause them to develop anxiety and depression in the long run, which can trigger if not intensify psoriasis flare-ups.”

“In addition to the skin, psoriasis can put patients at higher risk of comorbidities such as psoriatic arthritis, heart disease, and diabetes. There are also studies that show links between psoriasis and Crohn’s disease, which causes the digestive tract to become swollen. This is why increasing awareness about psoriasis should be a public health priority, as to also encourage more patients to seek proper treatment.”

There is no cure for psoriasis, but there are treatments available to help manage the disease. Johnson & Johnson (Philippines), Inc. is at the forefront of bringing new and innovative solutions for this condition including biologic medicines. The company is also working with relevant stakeholders to launch and sustain programs that educate Filipinos on psoriasis, correcting misconceptions that make living with the disease even more challenging for patients. 

“One of our most recent partnerships is with the Department of Health, the Philippine Dermatological Society, and Psoriasis Philippines. Together, we conducted a lay forum entitled Psoriasis: Bigyang Halaga at Pag-aaruga where facts about the disease were highlighted to help alleviate the plight of psoriatic patients.”

“Psoriasis is a lifelong disease, but it is not fatal nor contagious,” added Dr. Benedicto. “Proper treatment and holistic care are needed to ensure that psoriatic patients will continue to lead full, productive lives. It is also our hope that someday, our society would become fully aware of what psoriasis is, to be able to break free from the stigma that fuels discrimination towards those suffering from the disease.”

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Major weight loss may reverse heart disease risks associated with obesity – study

Adults who previously had obesity were on average older than those who never, or currently had obesity, and more likely to smoke cigarettes (36% vs 24% vs 19%). After adjusting for age, gender, smoking and ethnicity, researchers found that the risk of high blood pressure and dyslipidemia were similar in those who used to have obesity and those who had always maintained a healthy weight.

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Major weight loss appears to reverse most of the cardiovascular risks linked with obesity, according to a cross-sectional analysis of the US adult population being presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD).

The findings indicate that the risk of high blood pressure and dyslipidemia (unhealthy levels of cholesterol or other fats in the blood) were similar in people who used to have obesity (but were now a healthy weight) and those who had always maintained a healthy weight. However, although the risk of current type 2 diabetes lessened with weight loss, it remained elevated in people who formerly had obesity compared to those who had never had obesity.

More than 40% of adults have obesity (BMI of more than 30kg/m²) and close to one in 10 is classed as having severe obesity. Body weight is directly associated with almost all the cardiovascular risk factors. As BMI increases, so does blood pressure, low-density lipoprotein (LDL, or bad) cholesterol, other abnormal blood fats, blood sugar, and inflammation. These changes increase the risk for heart disease, stroke, and death from cardiovascular disease. However, little is known about whether the effects of obesity persist in those who subsequently achieve and maintain healthy weight.

To find out more, researchers analysed cardiovascular risk factors in 20,271-non-elderly US adults (aged 20-69 years), comparing those who used to have obesity but had been healthy weight for at least the past year (326) to both those who were always a healthy weight (6,235) and those who currently had obesity (13,710). They used data from a series of cross sections, collected biennially from the 1999-2013 National Health and Nutrition Examination Survey (NHANES; a study conducted by the Centers for Disease Control and Prevention) to compare the prevalence of high blood pressure, dyslipidemia, and type 2 diabetes between the groups.

Adults who previously had obesity were on average older than those who never, or currently had obesity, and more likely to smoke cigarettes (36% vs 24% vs 19%). After adjusting for age, gender, smoking and ethnicity, researchers found that the risk of high blood pressure and dyslipidemia were similar in those who used to have obesity and those who had always maintained a healthy weight.

Compared to those who were always healthy weight, people who used to have obesity had three-fold higher odds of diabetes than those who never had obesity; whilst people with current obesity were seven times as likely to experience diabetes. Those who currently had obesity were also at three times greater odds of current high blood pressure and dyslipidemia.

“The key take away of this study is that weight loss is hard, but important, for cardiovascular health”, says lead author Professor Maia Smith from St George’s University in Grenada. “First of all, it’s no surprise that losing weight and keeping it off is hard. Almost everyone in our original sample who had ever had obesity, stayed that way. But don’t despair: if you do manage to lose weight, it can not only prevent but reverse significant health problems. The best time to get healthy is 20 years ago; the second best time is now.”

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Children who eat more fruit and veg have better mental health

“Public health strategies and school policies should be developed to ensure that good quality nutrition is available to all children both before and during school in order to optimize mental wellbeing and empower children to fulfill their full potential.”

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Children who eat a better diet, packed with fruit and vegetables, have better mental wellbeing – according to new research from the University of East Anglia.

This study is the first to investigate the association between fruit and vegetable intakes, breakfast and lunch choices, and mental wellbeing in UK school children. It shows how eating more fruit and veg is linked with better wellbeing among secondary school pupils in particular. And children who consumed five or more portions of fruit and veg a day had the highest scores for mental wellbeing. The study was led by UEA Health and Social Care Partners in collaboration with Norfolk County Council.

The research team stated that public health strategies and school policies should be developed to ensure that good quality nutrition is available to all children before and during school to optimise mental wellbeing and empower children to fulfil their full potential.

Lead researcher Prof Ailsa Welch, from UEA’s Norwich Medical School, said: “We know that poor mental wellbeing is a major issue for young people and is likely to have long-term negative consequences. The pressures of social media and modern school culture have been touted as potential reasons for a rising prevalence of low mental wellbeing in children and young people.

“And there is a growing recognition of the importance of mental health and wellbeing in early life – not least because adolescent mental health problems often persist into adulthood, leading to poorer life outcomes and achievement.

“While the links between nutrition and physical health are well understood, until now, not much has been known about whether nutrition plays a part in children’s emotional wellbeing. So, we set out to investigate the association between dietary choices and mental wellbeing among schoolchildren.”

The research team studied data from almost 9,000 children in 50 schools across Norfolk (7,570 secondary and 1,253 primary school children) taken from the Norfolk children and Young People’s Health and wellbeing Survey.

This survey was commissioned by the Public Health department of Norfolk County Council and the Norfolk Safeguarding Children Board. It was open to all Norfolk schools during October 2017.

Children involved in the study self-reported their dietary choices and took part in age-appropriate tests of mental wellbeing that covered cheerfulness, relaxation, and having good interpersonal relationships.

Prof Welch said: “In terms of nutrition, we found that only around a quarter of secondary-school children and 28 per cent of primary-school children reported eating the recommended five-a-day fruits and vegetables. And just under one in ten children were not eating any fruits or vegetables.

“More than one in five secondary school children and one in 10 primary children didn’t eat breakfast. And more than one in 10 secondary school children didn’t eat lunch.

The team looked at the association between nutritional factors and mental wellbeing and took into account other factors that might have an impact – such as adverse childhood experiences and home situations.

Dr Richard Hayhoe, also from UEA’s Norwich Medical School, said: “We found that eating well was associated with better mental wellbeing in children. And that among secondary school children in particular, there was a really strong link between eating a nutritious diet, packed with fruit and vegetables, and having better mental wellbeing.

“We also found that the types of breakfast and lunch eaten by both primary and secondary school pupils were also significantly associated with wellbeing.

“Children who ate a traditional breakfast experienced better wellbeing than those who only had a snack or drink. But secondary school children who drank energy drinks for breakfast had particularly low mental wellbeing scores, even lower than for those children consuming no breakfast at all.

“According to our data, in a class of 30 secondary school pupils, around 21 will have consumed a conventional-type breakfast, and at least four will have had nothing to eat or drink before starting classes in the morning.

“Similarly, at least three pupils will go into afternoon classes without eating any lunch. This is of concern, and likely to affect not only academic performance at school but also physical growth and development.

“Another interesting thing that we found was that nutrition had as much or more of an impact on wellbeing as factors such as witnessing regular arguing or violence at home.

Prof Welch said: “As a potentially modifiable factor at an individual and societal level, nutrition represents an important public health target for strategies to address childhood mental wellbeing.

“Public health strategies and school policies should be developed to ensure that good quality nutrition is available to all children both before and during school in order to optimize mental wellbeing and empower children to fulfill their full potential.”

‘Cross-sectional associations of schoolchildren’s fruit and vegetable consumption, and meal choices, with their mental wellbeing: a cross-sectional study’ is published in the journal BMJ Nutrition, Prevention & Health.

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