Greater incidence of prior trauma in people with migraine

Adults who suffer migraine headaches are more apt to have post-traumatic stress disorder (PTSD) than the general population, a new study suggests. And having PTSD and migraine may lead to greater headache-related disability.

Excerpts follow:

<snip>

Among a group of 593 adults with migraine, PTSD was present in roughly 30 percent of those who suffered chronic daily headaches and about 22 percent of those with “episodic” migraine headaches. By comparison, approximately 8 percent of the population is estimated to have PTSD.

<snip>

“The implications are such that abuse causes not just psychological distress from PTSD but also physical pain such as migraine,” Peterlin said, and there is an increased disability seen in those migraine sufferers with PTSD than those without PTSD.

<snip>

SOURCE: Headache April 2009.
The full article can be found at
http://www.canada.com/news/Post+traumatic+stress+common+migraine+sufferers/1461579/story.html

 

Half a glass of wine a day may boost life expectancy by five years

The *British Medical Journal* issued the following news release about an
article appearing in one of its associated journals (*Journal of
Epidemiology and Community Health*):

Half a glass of wine a day may boost life expectancy by five years

Long-term wine consumption is related to cardiovascular mortality and
life expectancy independently of moderate alcohol intake

Drinking up to half a glass of wine a day may boost life expectancy by
five years–at least in men–suggests research published ahead of print in
the Journal of Epidemiology and Community Health.

The Dutch authors base their findings on a total of 1,373 randomly
selected men whose cardiovascular health and life expectancy at age 50
were repeatedly monitored between 1960 and 2000.

 

Link between depression and cardiovascular disease: belly fat

Rush University Medical Center issued the following news release:

Depression linked with accumulation of visceral fat

Study explains association between depression and cardiovascular disease

Numerous studies have shown that depression is associated with an
increased risk of heart disease, but exactly how has never been clear.

Now, researchers at Rush University Medical Center have shown that
depression is linked with the accumulation of visceral fat, the kind of
fat packed between internal organs at the waistline, which has long been
known to increase the risk of cardiovascular disease and diabetes.

 

Laughter improves cholesterol, inflammation – study

The American Physiological Society issued the following news release:

Laughter remains good medicine

New study reports on the mind-emotion-disease model

The connection between the body, mind and spirit has been the subject of conventional scientific inquiry for some 20 years. The notion that psychosocial and societal considerations have a role in maintaining health and preventing disease became crystallized as a result of the experiences of a layman, Norman Cousins. In the 1970s, Cousins, then a writer and magazine editor of the popular Saturday Review, was diagnosed with an autoimmune disease. He theorized that if stress could worsen his condition, as some evidence suggested at the time, then positive emotions could improve his health. As a result, he prescribed himself, with the approval of his doctor, a regimen of humorous videos and shows like Candid Camera(c). Ultimately, the disease went into remission and Cousins wrote a paper that was published in the New England Journal of Medicine and a book about his experience, Anatomy of an Illness: A Patient’s Perspective, which was published in 1979. The book became a best seller and led to the investigation of a new field, known then as whole-person care or integrative medicine and now, lifestyle medicine.

Points from the news release:

• Beta-endorphins elevate mood state
• Human growth hormone (HGH) helps with optimizing immunity
• Cortisol and epinephrine (also known as adrenaline) are detrimental stress hormones that negatively affect immunity if chronically released.

• A group of 10 diabetics with hypertensoin and high cholesterol were assigned regularly to watch funny videos for 30 minutes. Over 12 months, their blood chemistry was compared to 10 matching people who were not made to laugh.

• Adding laughter standard diabetes care may lower stress and inflammatory response and increase “good” cholesterol levels. The authors conclude that mirthful laughter may thus lower the risk of cardiovascular disease associated with diabetes mellitus and metabolic syndrome.

In describing himself as a “hardcore medical clinician and scientist,” Dr. Berk says, “the best clinicians understand that there is an intrinsic physiological intervention brought about by positive emotions such as mirthful laughter, optimism and hope.

More details follow:

 

Cognitive behaviour therapy helps with chronic pain – research

Wiley-Blackwell issued the following news release:

CBT and BT: Some effect against chronic pain

Cognitive Behaviour Therapy (CBT) and Behaviour Therapy (BT) show some
effect in helping the disability associated with chronic pain, according
to a Cochrane Systematic Review. The researchers assessed the use of CBT
and BT on chronic pain, mood, and disability.

“For people with chronic pain, psychological therapies can reduce
depression and anxiety, disability, and in some cases pain, but guidance
is still required on the best type and duration of treatment,” says lead
researcher Christopher Eccleston, at the Centre for Pain Research at the
University of Bath.

Both CBT and BT try to manage pain by addressing the associated
psychological and practical processes. CBT involves the avoidance of
negative thoughts. BT helps patients to understand how they can change
their behaviour in order to reduce pain. Both approaches have been in
development for around 40 years and are sometimes recommended for
patients with long lasting, distressing pain that cannot be relieved by
conventional medicines.

In a systematic review, researchers considered the results of 40 trials
of CBT and BT, which included 4,781 patients in total. Patients
suffering from pain due to any cause, except headache, migraine, or
cancer, were included. Most studies were of CBT, which showed small
positive effects on pain, disability, and mood. There was less evidence
for BT, which the researchers say had no effect on disability or mood.

“Although there is overall promise for CBT in chronic pain, the term
covers a diverse range of treatment and assessment procedures. Right
now, we are not able to say which specific features of therapy may be
critical for improvement of a patient’s condition,” says Eccleston.

According to the researchers, simpler studies of CBT and BT that focus
on a purer form of treatment, rather than a variety of mixed methods,
would benefit the field.

 

Diet and Coronary Heart Disease

Diet and Coronary Heart Disease

High quality evidence exists that the following help to protect people from coronary heart disease:
* “Mediterranean” and other high quality dietary patterns (see below)
* Nuts
* Vegetables
* Mono-saturated fats

Strong evidence exists that the following increase the risk:
* trans-fats
* foods with a high glycemic index (see below**)

Moderately good quality evidence exists that the following are also helpful in preventing CHD:
* Fish
* Folate
* Whole grains
* Vitamins C and E in the diet
* Beta carotene
* Alcohol
* Fruit
* Fibre

There is as yet insufficient evidence about:
* Vitamin C and E supplements
* Saturated and unsaturated fat and total fat
* Linolenic acid
* Meat
* Eggs
* Milk

 

Hostility, not “Type A personality”, linked to heart disease

Don’t be mad

More research links hostility to coronary risk.

By Nadja Geipert

In 1959, cardiologists Meyer Friedman and Ray Rosenman observed in top medical journals that competitive, deadline-driven, hypervigilant men-so-called Type A personalities-faced a significantly increased risk for coronary heart disease.

Yet ensuing large epidemiological studies failed to confirm the connection, and most health psychologists abandoned the concept in the late 1980s in favor of a component often found in Type A people: hostility.

A meta-analysis presented by German researcher Michael Myrtek, PhD, in his chapter on heart disease, Type A and hostility in the recently published APA book “Contributions Toward Evidence-based Psychocardiology: A Systematic Review of the Literature” (see “One heart-many threats”) confirms that there is no significant association between Type A personalities and heart disease, but that there is a connection between hostility and coronary heart disease.

“The consensus is really that it is not all aspects of Type A behavior, but just the hostility component,” says Redford Williams, MD, director of the behavioral medicine research center at Duke University School of Medicine.

 

Personality traits that are linked to a healthy old age

Boston University issued the following news release:

Researchers identify personality traits

Researchers from Boston University School of Medicine’s (BUSM) New
England Centenarian Study have noted specific personality traits
associated with healthy aging and longevity amongst the children of
centenarians. The work was conducted in collaboration with scientists
from the National Institute on Aging. These findings currently appear on-
line in the Journal of the American Geriatrics Society.

Previous research on siblings and offspring of centenarians have
documented that exceptional longevity runs strongly in families. Studies
of the offspring of centenarians showed that their mortality is 120
percent lower than other members of their birth cohort and that they
also have markedly lower prevalence rates and delayed onsets of
cardiovascular disease, hypertension, and diabetes mellitus. Because
personality traits have been shown to have substantial heritable
components, the researchers hypothesized that certain personality
features may be important to the healthy aging observed in the offspring
of centenarians.

Using the NEO-Five-Factor Inventory (NEO-FFI) questionnaire, measures of
the personality traits for neuroticism, extraversion, openness,
agreeableness, and conscientiousness were obtained from 246 (125 women
and 121 men) unrelated offspring of centenarians with an average age of 75.

Both the male and female offspring of centenarians scored in the low
range of published norms for neuroticism and in the high range for
extraversion. The women also scored comparatively high in agreeableness.
Otherwise, both sexes scored within normal range for conscientiousness
and openness, and the men scored within normal range for agreeableness.

According to the researchers, personality traits in the offspring of
centenarians appear to have distinctive characteristics that may have
important implications for their longevity. “Interestingly, whereas men
and women generally differ substantially in their personality
characteristics, the male and female offspring tended to be similar,
which speaks to the importance of these traits, irrespective of gender,
for health aging and longevity.

It’s likely that the low neuroticism and higher extraversion will confer
health benefits for these subjects,” said senior author Thomas Perls,
MD, MPH, director of the New England Centenarian Study. “For example,
people who are lower in neuroticism are able to manage or regulate
stressful situations more effectively than those with higher neuroticism
levels. Similarly, high extraversion levels have been associated with
establishing friendships and looking after yourself,” he said.

Perl’s added, “These findings suggest that personality is an important
characteristic to include in studies that assess genetic and
environmental determinants of longevity. Such studies are currently underway.”

This study was supported in part by grants from the National Institute
on Aging (NIA): K-24, AG025727 (TP), K23 AG026754 (Paul Beeson Physician
Faculty Scholar in Aging Award, DT), and the Intramural Research Program
of the NIA.

—————

Of course, this makes one wonder how much we can either a) modify extraversion and neuroticism, or b) find other ways to get the benefits that these traits bring us. Maybe introverts can further develop close and abiding friendships and the joy and fun that comes with these whether you are extravert or not. And people who are prone to anxiety and distress (neuroticism) can learn to find their center?    BG

 

Child abuse can alter DNA & later stress response

Today’s new issue of *Journal of the American Medical Association* (Vol.
301 No. 13, April 1, 2009) includes an article: “Abuse and the Brain” by
Joan Stephenson, PhD.

Here’s how the article begins:

[begin excerpt]

Early childhood abuse might exert lifelong effects by altering a
person’s DNA and reducing levels of glucocorticoid receptors in the
brain, which are important for responding to stress, Canadian scientists
have found (McGowan PO et al. Nat Neurosci. 2009;12[3]:342-348).

The investigators examined brain tissue from 24 men who had committed
suicide, half of whom had a history of childhood abuse, and from 12 men
who had not been abused and died suddenly from other causes.

Men with a history of abuse had lower levels of glucocorticoid receptors
than did men who had not been abused or had not committed suicide.

In addition, in those who had been abused, a snippet of “promoter” DNA
that normally facilitates the production of glucocorticoid receptors had
been silenced by the attachment of a methyl group.

The researchers noted the work confirms their previous findings…

[end excerpt]

The article is online — but requires a subscription — at:
<http://tinyurl.com/comoql>.

Courtesy of Ken Pope

 

Summary: how much to exercise to lose / maintain weight

The journal *Medicine & Science in Sports & Exercise* (vol. 41, #2)
includes the American College of Sports Medicine’s new revised
guidelines for “Appropriate Physical Activity Intervention Strategies
for Weight Loss and Prevention of Weight Regain for Adults.”  This
updates their previous 2001 ACSM recommendations.

Here are their specific clinical recommendations and ratings of the
level of scientific evidence supporting each recommendation:

[begin excerpt]

*    For prevention of weight gain in most adults, physical activity of 150 to 250 minutes
per week, with an energy equivalent of 1200 to 2000 kcal/week, will
prevent weight gain of more than 3% (level of evidence, A).

*There is a dose-response effect of physical activity on weight loss, with physical activity of less
than 150 minutes per week resulting in minimal weight loss, physical activity of more
than 150 minutes per week in modest weight loss of approximately 2 to 3
kg, and physical activity of more than 225 to 420 minutes per week leading to weight
loss of 5 to 7.5 kg (level of evidence, B).

*To maintain weight after weight loss, some studies suggest that physical activity of
approximately 200 to 300 minutes per week will help minimize weight
regain, although “more is better.” To date, no well-designed,
sufficiently powered, energy-balance studies provide evidence concerning
the amount of physical activity needed to prevent weight regain after weight loss
(level of evidence, B).

*Lifestyle physical activity, which is an ambiguous term that should be better defined
to assess available evidence in the literature, may help counteract the
small energy imbalance ultimately leading to obesity in most adults
(level of evidence, B).

*If diet restriction is modest but not if diet restriction is severe, physical activity
will increase weight loss (level of evidence, A).

*Resistance training is ineffective for weight loss with or without diet
restriction, according to limited research evidence. However, some
limited data suggest that resistance training enhances gain or
maintenance of lean mass and loss of body fat during energy restriction.
Furthermore, resistance training may also ameliorate risk factors for
chronic disease, such as low high-density lipoprotein cholesterol
levels, high low-density lipoprotein cholesterol levels, insulin
sensitivity, and blood pressure (level of evidence, B).

[end excerpt]

The article notes that the new ACSM Guidelines are consistent with the
U.S. Dephysical activityrtment of Health & Human Services Physical Activity Guidelines
for Americans.

Here’s the abstract: “Overweight and obesity affects more than 66% of
the adult population and is associated with a variety of chronic
diseases. Weight reduction reduces health risks associated with chronic
diseases and is therefore encouraged by major health agencies.
Guidelines of the National Heart, Lung, and Blood Institute (NHLBI)
encourage a 10% reduction in weight, although considerable literature
indicates reduction in health risk with 3% to 5% reduction in weight.
Physical activity (physical activity) is recommended as a component of weight
management for prevention of weight gain, for weight loss, and for
prevention of weight regain after weight loss. In 2001, the American
College of Sports Medicine (ACSM) published a Position Stand that
recommended a minimum of 150 min·wk-1 of moderate-intensity physical activity for
overweight and obese adults to improve health; however, 200-300 min·wk-1
was recommended for long-term weight loss. More recent evidence has
supported this recommendation and has indicated more physical activity may be necessary
to prevent weight regain after weight loss. To this end, we have
reexamined the evidence from 1999 to determine whether there is a level
at which physical activity is effective for prevention of weight gain, for weight loss,
and prevention of weight regain. Evidence supports moderate-intensity physical activity
between 150 and 250 min·wk-1 to be effective to prevent weight gain.
Moderate-intensity physical activity between 150 and 250 min·wk-1 will provide only
modest weight loss. Greater amounts of physical activity (>250 min·wk-1) have been
associated with clinically significant weight loss. Moderate-intensity
physical activity between 150 and 250 min·wk-1 will improve weight loss in studies that
use moderate diet restriction but not severe diet restriction. Cross-
sectional and prospective studies indicate that after weight loss,
weight maintenance is improved with physical activity >250 min·wk-1. However, no
evidence from well-designed randomized controlled trials exists to judge
the effectiveness of physical activity for prevention of weight regain after weight
loss. Resistance training does not enhance weight loss but may increase
fat-free mass and increase loss of fat mass and is associated with
reductions in health risk. Existing evidence indicates that endurance physical activity
or resistance training without weight loss improves health risk. There
is inadequate evidence to determine whether physical activity prevents or attenuates
detrimental changes in chronic disease risk during weight gain.”

The article is online — but requires a subscription — at:
<http://tinyurl.com/bvycn4>.