The COVID-19 pandemic has introduced a number of new behaviours into daily routines, like physical distancing, mask-wearing and hand sanitizing. Meanwhile, many old behaviours such as attending events, eating out and seeing friends have been put on hold.
<p>However, one old behaviour that has persisted, and <a href="https://dx.doi.org/10.1016%2Fj.pcad.2020.04.005" target="_blank">has arguably been amplified due to COVID-19, is sitting</a> — and it is not surprising to see why. Whether sitting during transportation, work, screen time or even meals, everyday environments and activities are tailored nearly exclusively to prolonged sitting. As such, sedentary behaviours, like sitting, make up the vast majority of our waking day. </p><p>Pre-COVID-19 estimates place the <a href="https://doi.org/10.1186/s12966-020-00925-8" target="_blank">average Canadian adult's sedentary behaviour at around 9.5 hours per day</a>. Current daily sedentary time is likely even higher as a result of stay-at-home orders, limitations on businesses and recreational facilities, and <a href="https://www150.statcan.gc.ca/n1/daily-quotidien/200527/dq200527b-eng.htm" target="_blank">elevated health anxieties</a>. </p><h2>Health vs. well-being</h2><p>This is a problem, given that chronic excessive levels of sedentary time have been linked to <a href="https://doi.org/10.1371/journal.pone.0105620" target="_blank">greater risk of diabetes, heart disease, mortality and even some cancers</a>. However, for many people, their own judgments and feelings about their quality of life (also known as <a href="https://dictionary.apa.org/subjective-well-being" target="_blank">subjective well-being</a>) may be more important and relevant for informing their health decisions and behaviours than potentially developing chronic diseases.</p><p>Subjective well-being encompasses <a href="https://nobaproject.com/modules/happiness-the-science-of-subjective-well-being" target="_blank">an individual's own evaluation of their quality of life</a>. It includes concepts like <a href="https://dictionary.apa.org/affect" target="_blank">affect</a> (positive and negative feelings) and <a href="https://dictionary.apa.org/life-satisfaction" target="_blank">life satisfaction</a>. Interestingly, these evaluations can conflict with physical health outcomes. For example, a person could have diabetes but still report good subjective well-being, while someone with no physical health conditions may report poor subjective well-being. </p><p>This is important, as it means how an individual feels about their own health may not always align with what their body may demonstrate. That's why evaluating subjective well-being is vital for painting a holistic picture of health. </p><h2>Different contexts of sitting</h2><p>Relatively little research has examined the relationships between sedentary behaviour and subjective well-being. Exploring these relationships is important, as different contexts of sitting — such as socializing versus screen time — may yield different feelings or judgments of subjective well-being, unlike relationships between physical health and sedentary behaviour, which <a href="https://doi.org/10.1146/annurev-publhealth-040119-094201" target="_blank">tend to be more consistent</a>. </p><p>As health psychologists focused on physical activity and sedentary behaviour, we <a href="https://doi.org/10.1016/j.psychsport.2021.101920" target="_blank">reviewed the scientific literature</a> describing relationships between measures of sedentary behaviours such as physical inactivity and screen time, and subjective well-being as reflected by affect, life satisfaction and overall subjective well-being. </p><p><a href="https://www.sedentarybehaviour.org/2021/03/04/relationships-between-indices-of-sedentary-behavior-and-hedonic-well-being-a-scoping-review/" target="_blank">Our review</a> highlights three main findings. First, sedentary behaviour, physical inactivity and screen time demonstrated weak but statistically significant correlations with subjective well-being. In other words, those who reported sitting more often and spending longer periods with no physical activity reported lower positive affect, higher negative affect and lower life satisfaction than those who sat less and moved more. </p><p>We also found that this relationship was most apparent in studies that compared people who were very sedentary to those who had more active lifestyles. </p><h2>Not all sitting is bad sitting</h2><p>Our second main finding relates to the context of the sedentary behaviour. While many studies examined overall sedentary behaviour and physical inactivity, some studies looked at specific contexts or domains of sitting and its relationship with subjective well-being. These studies revealed that different domains of sedentary behaviour have unique relationships with subjective well-being. </p><p>For example, screen time was consistently and negatively associated with subjective well-being. However, domains like socializing, playing an instrument and reading actually demonstrated positive associations with subjective well-being. These results differ from the traditional health-related sedentary behaviour research, in which <a href="https://doi.org/10.1146/annurev-publhealth-040119-094201" target="_blank">all sedentary behaviour is viewed as harmful to health</a>. </p><p>Our review suggests that some types of sedentary behaviour may be beneficial to quality of life. Rather, not all sitting is the same in terms of subjective well-being. So when people work towards reducing their sitting time, they should consider not just how much to reduce, but what kind to reduce.</p><h2>Less sitting is good for everyone</h2><p>Our third main finding concerns overall sitting and self-perceived levels of sedentary behaviour. Most studies found a weak statistically significant association between higher overall sedentary time and lower subjective well-being. However, in studies where participants were asked to compare their sedentary behaviour to how much they normally sit, those who perceived themselves as more sedentary than usual reported significantly poorer subjective well-being.</p><p>These findings suggest that how much an individual sits overall may not be as important as how much an individual sits compared to their usual level of sitting. This infers that anyone, regardless of how much they normally sit or <a href="https://doi.org/10.1016/S0140-6736(16)30370-1" target="_blank">are physically active</a>, may potentially benefit from sitting less.</p><p>COVID-19 continues to influence daily life and routines. Even as businesses and gyms eventually reopen, and we feel more comfortable gathering with others and eventually stop wearing masks, we will almost certainly continue to sit and sitting will continue to change how we feel. While we may not be able to eliminate all of our sitting, we can all be mindful of both how much we can reduce it and where we can reduce it from to be healthier <em>and</em> feel better.<img alt="The Conversation" height="1" src="https://counter.theconversation.com/content/156289/count.gif?distributor=republish-lightbox-basic" width="1"></p><p><a href="https://theconversation.com/profiles/wuyou-sui-1024154" target="_blank">Wuyou Sui</a>, Postdoctoral fellow, Behavioural Medicine Lab, School of Exercise Science, Physical & Health Education, <em><a href="https://theconversation.com/institutions/university-of-victoria-1182" target="_blank">University of Victoria</a></em> and <a href="https://theconversation.com/profiles/harry-prapavessis-1115239" target="_blank">Harry Prapavessis</a>, Professor, Kinesiology, <em><a href="https://theconversation.com/institutions/western-university-882" target="_blank">Western University</a></em></p><p>This article is republished from <a href="https://theconversation.com" target="_blank">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/too-much-sitting-is-bad-for-you-but-some-types-are-better-than-others-156289" target="_blank">original article</a>.</p>
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Go ahead and consult ‘Dr. Google’ about your medical symptoms
The conventional wisdom may be wrong. Consulting Google for information about medical symptoms might not be as counterproductive as commonly thought, new research suggests.
31 March, 2021
- Credit: bongkarn via Adobe StockConventional wisdom in healthcare holds that searching Google for medical information often leads to anxiety and false diagnoses.
- However, a recent study found that searching Google helped participants more accurately diagnose medical conditions in hypothetical cases.
- The results didn't show massive differences in accuracy, but they suggest searching Google for medical information probably won't harm patients.
<p>When you're feeling sick, or experiencing symptoms of a potential medical condition, do you consult Google?</p><p>Odds are you do: <a href="https://www.pewresearch.org/internet/2013/02/12/the-internet-and-health/" rel="noopener noreferrer" target="_blank">Surveys suggest</a> that more than half of Americans use the internet to search for medical information in any given year, while about one-third have used Google for self-diagnosis.</p><p>But some medical professionals wish those numbers were lower. The conventional wisdom in health care is that consulting Google about health concerns doesn't provide reliable information. Taken to the extreme, obsessively searching for information about medical conditions can <em>itself</em> become a medical condition: cyberchondria.</p><p style="margin-left: 20px;">"This is such a common issue that there's a running joke between healthcare professionals that if you Google a symptom (any symptom), you'll inevitably be told you have cancer," wrote the Anonymous Nurse for <a href="https://www.healthline.com/health/please-stop-using-doctor-google-dangerous#Using-Google-to-search-out-health-topics-isnt-always-a-bad-thing" rel="noopener noreferrer" target="_blank">Healthline</a>.</p>
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<a href="https://stock.adobe.com/images/shot-of-a-doctor-showing-a-patient-some-information-on-a-digital-tablet/238730671?hide_header=1"></a><a href="https://stock.adobe.com/images/shot-of-a-doctor-showing-a-patient-some-information-on-a-digital-tablet/238730671?hide_header=1"><img class="rm-lazyloadable-image rm-shortcode" type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNjAyODIyNC9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTYyODA1MzI4Nn0.IVmgBFEqB7wtPhJoB75bPKHTCBFqArhLD8Ovt3ZKhXg/img.png?width=980" id="6e8f3" width="1575" height="876" data-rm-shortcode-id="4cf5230723e62d8681252eef84e49b4c" data-rm-shortcode-name="rebelmouse-image" alt=""></a>
<small class="image-media media-caption" placeholder="Add Photo Caption...">Shot of a doctor showing a patient some information on a digital tablet</small><small class="image-media media-photo-credit" placeholder="Add Photo Credit..."><a href="https://stock.adobe.com/images/shot-of-a-doctor-showing-a-patient-some-information-on-a-digital-tablet/238730671?hide_header=1" target="_blank">Credit: bongkarn via Adobe Stock</a></small></p><div style="display: none;"><img class="rm-lazyloadable-image rm-shortcode" type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNjAyODIyNC9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTYyODA1MzI4Nn0.IVmgBFEqB7wtPhJoB75bPKHTCBFqArhLD8Ovt3ZKhXg/img.png?width=980" id="6e8f3" width="1575" height="876" data-rm-shortcode-id="dd32155a037e6c76b92302845c2be146" data-rm-shortcode-name="rebelmouse-image" alt="Doctor talking with patient"></div>
<p>But new research suggests consulting "Dr. Google" isn't as harmful as commonly thought.<br></p><p style="margin-left: 20px;">"Despite its ubiquitous use, the benefits and harms of an internet search for health information are poorly understood," wrote the authors of a <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2777835" target="_blank">new study</a> published in <em>JAMA Network Open</em>. "Previous research has been largely limited to observational studies of internet search behavior and may lack a criterion standard."</p><p>The researchers measured how consulting Google for medical information affected non-physicians' ability to accurately diagnose medical conditions and recommend appropriate triage options. They also explored whether consulting Google increased participants' anxiety.</p><p>For the study, 5,000 participants read a short vignette describing a person who was experiencing a set of medical symptoms. The symptoms listed in the vignettes described common conditions, from viruses to strokes, and the participants were asked to imagine that the person suffering from them was a close family member.</p><p>After reading the vignette, the participants predicted the most likely medical diagnosis, selected a triage option, and reported their own anxiety levels — all without searching the internet for medical information. In the next part of the study, the participants were asked to use the internet to help them select a diagnosis and triage option for the same hypothetical case. Again, they reported their anxiety levels.</p><p>The results showed that using the internet helped the participants select slightly more accurate diagnoses. However, the searches didn't affect their anxiety levels or their ability to select appropriate triage options.</p><p>"Our work suggests that it is likely OK to tell our patients to 'Google it,'" study author David Levine, MD, MPH, of the Division of General Internal Medicine & Primary Care at the <a href="https://www.brighamandwomens.org/" rel="noopener noreferrer" target="_blank">Brigham and Women's Hospital</a>, said in a <a href="https://medicalxpress.com/news/2021-03-dr-google-patients-diagnosis.html" rel="noopener noreferrer" target="_blank">press release</a>. "This starts to form the evidence base that there's not a lot of harm in that, and, in fact, there may be some good."</p>
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<img class="rm-lazyloadable-image rm-shortcode" type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNjAyODIzNi9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTY0MDAzNzk0OH0.GnUvq4-eWGskYnc1GWbGylw5-lOdE7CMiW6Mvt_ubMY/img.png?width=980" id="05c4c" width="1305" height="878" data-rm-shortcode-id="7bc76ac931c91b90c4bcbef8491cda17" data-rm-shortcode-name="rebelmouse-image">
<small class="image-media media-caption" placeholder="Add Photo Caption...">A woman's hand is touching screen on tablet computer iPad pro at night for searching on Google search engine.</small><small class="image-media media-photo-credit" placeholder="Add Photo Credit..."><a href="https://stock.adobe.com/images/sankt-petersburg-russia-november-8-2017-a-woman-s-hand-is-touching-screen-on-tablet-computer-ipad-pro-at-night-for-searching-on-google-search-engine-google-is-popular-internet-search-engine/283162947?hide_header=1" target="_blank">Credit: Aleksei via Adobe Stock</a></small></p>
<p>What explains the disconnect between the conventional wisdom and the results? One reason might be that search engines have gotten better at directing people to high-quality medical information.<br></p><p style="margin-left: 20px;">"For example, several search engines have their own built-in health information curated by major medical centers, and in this study, almost half of the respondents believed such information was the most helpful," the authors wrote, adding that few participants in the study consulted social media or forums for medical information.</p><p>Still, the results don't suggest Google is a replacement for medical professionals. Although searching Google did help participants reach more accurate diagnoses, the differences were small: 54 percent accuracy after searches compared to 49.8 accuracy before searches, which is statistically significant.</p><p>It's also unclear how this accuracy rate would change in a real-life situation, whether it involved a family member or the participants themselves. After all, it's likely that people would experience more anxiety when facing actual medical problems, rather than simply considering a hypothetical situation.</p><p>But it's worth noting that the participants did seem to take the hypothetical situations seriously: They tended to report higher levels of anxiety when the vignettes described more serious conditions, suggesting that they were "internalizing the cases appropriately."</p><p>Down the line, the researchers plan to explore how artificial intelligence might help people find more accurate medical information online.</p><ul class="ee-ul"></ul><p style="margin-left: 20px;">"This next study takes a generalized AI algorithm, trained on all of the open-source text of the Internet such as Reddit and Twitter, and then uses that to respond when prompted," Levine said in the press release. "Can AI supplement how people use the Internet? Can it supplement how doctors use the Internet? That's what we're interested in investigating."</p>
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Scientists discover slug that can decapitate itself, grow new body
The bizarre discovery could pave the way for advances in regenerative medicine for humans.
09 March, 2021
Credit: S. MITOH AND Y. YUSA/CURRENT BIOLOGY 2021
- In a recent study, scientists observed two species of sea slug that were able to self-decapitate, survive for weeks without organs, and regenerate entirely new bodies.
- The study authors proposed that the slugs are able to survive as severed heads because of the unique way they obtain energy from algae.
- While other animals engage in self-amputation (known as autotomy) to avoid predators, the study authors suggested that sea slugs might shed their bodies to avoid dying from parasites.
<p>For almost every animal, getting decapitated means certain death. But a new study shows that some species of sea slug are able to not only survive decapitation, but also regenerate entirely new bodies after splitting from their old ones.</p><p>The study, published <a href="https://www.cell.com/current-biology/fulltext/S0960-9822(21)00047-6" target="_blank" rel="noopener noreferrer">Monday in Current Biology</a>, shows that autotomy is stranger and more extreme in the animal kingdom than previously thought. </p><p>Autotomy is an evolved behavior in which animals shed a body part for a strategic purpose. For example, when salamanders are attacked, they'll often shed their tails to distract the attacker. Similarly, African spiny mice are known to automatically release chunks of their skin when attacked by predators, a sacrifice that boosts their odds of slipping away (mostly) intact. </p><p>But two species of sacoglossan sea slug take "autotomizing" to the next level. In the recent study, researchers observed that a handful of laboratory-bred slugs began to self-decapitate between 226 to 336 days after hatching. Existing as a severed head, the slugs were able to feed on algae. Within a week, they had regenerated their heart, and after three weeks they had regenerated an entirely new body. One slug even decapitated itself and grew a new body twice.</p>
<video controls id="d1e5f" width="100%" class="rm-shortcode" data-rm-shortcode-id="5ef4eb1d7cc00fa9b84b150163965434" expand="1" feedbacks="true" mime_type="video/mp4" shortcode_id="1615322094477" site_id="18943713" url="https://roar-assets-auto.rbl.ms/runner%2F22781-Science_2SupplementalInfo3Video.mp4" videoControls="true"> <source src="https://roar-assets-auto.rbl.ms/runner%2F22781-Science_2SupplementalInfo3Video.mp4" type="video/mp4"> Your browser does not support the video tag. </video><p><em>Credit: S. MITOH AND Y. YUSA/CURRENT BIOLOGY</em><em> 2021</em></p><p>As for the slugs' discarded bodies? They survived, too, and some were able to move around on their own for months. But they never regrew new heads.</p><p style="margin-left: 20px;">"The bodies gradually shrank and became pale, apparently from losing chloroplasts, and eventually decomposed," the researchers wrote. "The beating of the heart was visible just before the body decomposed."</p><p>So, why did some sea slugs evolve this extreme form of autotomy? The researchers still aren't quite sure, but the answer might not be related to escaping predators. That's because it takes hours for the slugs to split their heads from their bodies, meaning it wouldn't be a useful defense mechanism during attacks.</p>
<video controls id="6be4d" width="100%" class="rm-shortcode" data-rm-shortcode-id="27ff17f90e0f0d0ef56506c60243154c" expand="1" feedbacks="true" mime_type="video/mp4" shortcode_id="1615322106957" site_id="18943713" url="https://roar-assets-auto.rbl.ms/runner%2F22782-Science_headandbody_.mp4" videoControls="true"> <source src="https://roar-assets-auto.rbl.ms/runner%2F22782-Science_headandbody_.mp4" type="video/mp4"> Your browser does not support the video tag. </video><p><em>Credit: S. MITOH AND Y. YUSA/CURRENT BIOLOGY</em><em> 2021</em></p><p>Instead, self-decapitation might be a way for the slugs to protect themselves against parasites. The researchers noted that the several sea slugs which completely shed their body were infected with parasitic crustaceans called copepods. Meanwhile, none of the parasite-free slugs engaged in autotomy.</p><p>As for <em>how</em> the slugs can survive self-decapitation, the researchers proposed the answer has to do with the unique way the mollusks obtain energy. Sea slugs eat algae, which contains chloroplasts—structures in which photosynthesis occurs.</p><p>When sea slugs eat algae, they incorporate some of the plant's chloroplasts into their body, allowing them to draw energy from the sun. This process is known as "kleptoplasty," and it may be what allows the animals to survive for weeks without bodies.</p>
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data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTgwNTMxMi9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY3OTIzNzUyNH0.733NIk_Mlj3lIQ3tXFdbqIFhaOVrYmBcIPBblt04PdE/img.jpg?width=980"
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S. MITOH AND Y. YUSA/CURRENT BIOLOGY 2021
<p>Still, scientists aren't exactly sure how kleptoplasty interacts with autotomy in sea slugs, and the authors noted that more research is needed to confirm what drives autotomy and body regeneration in the sea creatures. But despite the uncertainties, the new study shows that extreme forms of regeneration are possible in the animal kingdom.</p><p>As scientists continue to uncover the secrets of autotomy and regeneration in animals, it could pave the way for advances in <a href="https://www.frontiersin.org/articles/10.3389/fmed.2019.00011/full" target="_blank" rel="noopener noreferrer">regenerative medicine</a>, a field that aims to harness the body's natural healing mechanisms.</p><p style="margin-left: 20px;">"One day, patients will have access to regenerative medicine treatments that will circumvent the complications of organ donation," Sharlini Sankaran, executive director of Duke University's Regeneration Next Initiative, told <a href="https://medschool.duke.edu/about-us/news-and-communications/med-school-blog/future-regenerative-medicine" target="_blank">Duke University School of Medicine.</a> "We will be able to use our bodies' own innate repair mechanisms to eliminate the wait time, cost, and limited supply of organ transplantation. Instead of transplanting organs, we will know how to repair our own."</p><p>While there are significant differences between mollusks and mammals, the drivers of regeneration in sea slugs could provide clues as to how scientists might use approaches like stem-cell therapies to repair damage to cells, tissue and organs.</p>
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How tiny bioelectronic implants may someday replace pharmaceutical drugs
Scientists are using bioelectronic medicine to treat inflammatory diseases, an approach that capitalizes on the ancient "hardwiring" of the nervous system.
24 February, 2021
Credit: Adobe Stock / SetPoint Medical
- Bioelectronic medicine is an emerging field that focuses on manipulating the nervous system to treat diseases.
- Clinical studies show that using electronic devices to stimulate the vagus nerve is effective at treating inflammatory diseases like rheumatoid arthritis.
- Although it's not yet approved by the US Food and Drug Administration, vagus nerve stimulation may also prove effective at treating other diseases like cancer, diabetes and depression.
<p>Could a tiny electronic device treat some diseases more safely and effectively than pharmaceutical medicines?</p><p>For Kelly Owens, the answer was clear. She spent more than a decade suffering from Crohn's disease, a chronic inflammatory bowel disease that left her with severe arthritis in her joints. The pain forced her to use a cane, sometimes a wheelchair. She tried more than 20 medications and racked up more than $1 million in medical bills, but her condition didn't improve.</p><p>A physician told Owens and her husband that they shouldn't have children, and that she'd have to take steroids for life.</p><p>Then Owens turned to bioelectronic medicine. She reached out to Dr. Kevin Tracey, a pioneer in the field and president and CEO of the Feinstein Institutes for Medical Research in New York. Soon after, Owens and her husband moved to Amsterdam to participate in a clinical trial involving a relatively new bioelectronic approach to treat inflammation.</p><p>Doctors implanted a small electronic device in her chest that stimulated her vagus nerve, the body's longest cranial nerve. After two weeks, Owens didn't need the cane or wheelchair. Soon she was jogging on a treadmill.</p><p>A growing body of research within bioelectronic medicine shows it's possible to treat diseases by manipulating the nervous system. The field is essentially a fusion of neuroscience, molecular biology and neurotechnology. Dr. Tracey and his colleagues think the field may someday replace or supplement many pharmaceutical drugs used to treat major diseases, including cancer and Alzheimer's.</p><p>But how? The answer centers on how the nervous system controls molecular processes in the body.</p>
<blockquote>...the most revolutionary aspect of bioelectronic medicine, according to Dr. Tracey, is that approaches like vagus nerve stimulation wouldn't come with harmful and potentially deadly side effects, as many pharmaceutical drugs currently do.</blockquote>
The nervous system’s ancient reflexes
<p>You accidentally place your hand on a hot stove. Almost instantaneously, your hand withdraws.</p><p>What triggered your hand to move? The answer is <em>not</em> that you consciously decided the stove was hot and you should move your hand. Rather, it was a reflex: Skin receptors on your hand sent nerve impulses to the spinal cord, which ultimately sent back motor neurons that caused your hand to move away. This all occurred before your "conscious brain" realized what happened.</p><p>Similarly, the nervous system has reflexes that protect individual cells in the body.</p><p>"The nervous system evolved because we need to respond to stimuli in the environment," said Dr. Tracey. "Neural signals don't come from the brain down first. Instead, when something happens in the environment, our peripheral nervous system senses it and sends a signal to the central nervous system, which comprises the brain and spinal cord. And then the nervous system responds to correct the problem."</p><p>So, what if scientists could "hack" into the nervous system, manipulating the electrical activity in the nervous system to control molecular processes and produce desirable outcomes? That's the chief goal of bioelectronic medicine.</p><p>"There are billions of neurons in the body that interact with almost every cell in the body, and at each of those nerve endings, molecular signals control molecular mechanisms that can be defined and mapped, and potentially put under control," Dr. Tracey said in a <a href="https://www.youtube.com/watch?v=AJH9KsMKi5M" target="_blank">TED Talk</a>.</p><p>"Many of these mechanisms are also involved in important diseases, like cancer, Alzheimer's, diabetes, hypertension and shock. It's very plausible that finding neural signals to control those mechanisms will hold promises for devices replacing some of today's medication for those diseases."</p><p>How can scientists hack the nervous system? For years, researchers in the field of bioelectronic medicine have zeroed in on the longest cranial nerve in the body: the vagus nerve.</p><blockquote>What's more, clinical trials show that vagus nerve stimulation not only "shuts off" inflammation, but also triggers the production of cells that promote healing.</blockquote>
The vagus nerve
<img class="rm-lazyloadable-image rm-shortcode" type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTYyOTM5OC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY0NTIwNzk0NX0.UCy-3UNpomb3DQZMhyOw_SQG4ThwACXW_rMnc9mLAe8/img.jpg?width=1245&coordinates=0%2C0%2C0%2C0&height=700" id="09add" width="1245" height="700" data-rm-shortcode-id="7b0919cad274445520414149b25edd2e" data-rm-shortcode-name="rebelmouse-image" />Electrical signals, seen here in a synapse, travel along the vagus nerve to trigger an inflammatory response.
Credit: Adobe Stock via solvod
<p>The vagus nerve ("vagus" meaning "wandering" in Latin) comprises two nerve branches that stretch from the brainstem down to the chest and abdomen, where nerve fibers connect to organs. Electrical signals constantly travel up and down the vagus nerve, facilitating communication between the brain and other parts of the body.</p><p>One aspect of this back-and-forth communication is inflammation. When the immune system detects injury or attack, it automatically triggers an inflammatory response, which helps heal injuries and fend off invaders. But when not deployed properly, inflammation can become excessive, exacerbating the original problem and potentially contributing to diseases.</p><p>In 2002, Dr. Tracey and his colleagues discovered that the nervous system plays a key role in monitoring and modifying inflammation. This occurs through a process called the <a href="https://www.nature.com/articles/nature01321" target="_blank" rel="noopener noreferrer">inflammatory reflex</a>. In simple terms, it works like this: When the nervous system detects inflammatory stimuli, it reflexively (and subconsciously) deploys electrical signals through the vagus nerve that trigger anti-inflammatory molecular processes.</p><p>In rodent experiments, Dr. Tracey and his colleagues observed that electrical signals traveling through the vagus nerve control TNF, a protein that, in excess, causes inflammation. These electrical signals travel through the vagus nerve to the spleen. There, electrical signals are converted to chemical signals, triggering a molecular process that ultimately makes TNF, which exacerbates conditions like rheumatoid arthritis.</p><p>The incredible chain reaction of the inflammatory reflex was observed by Dr. Tracey and his colleagues in greater detail through rodent experiments. When inflammatory stimuli are detected, the nervous system sends electrical signals that travel through the vagus nerve to the spleen. There, the electrical signals are converted to chemical signals, which trigger the spleen to create a white blood cell called a T cell, which then creates a neurotransmitter called acetylcholine. The acetylcholine interacts with macrophages, which are a specific type of white blood cell that creates TNF, a protein that, in excess, causes inflammation. At that point, the acetylcholine triggers the macrophages to stop overproducing TNF – or inflammation.</p><p>Experiments showed that when a specific part of the body is inflamed, specific fibers within the vagus nerve start firing. Dr. Tracey and his colleagues were able to map these relationships. More importantly, they were able to stimulate specific parts of the vagus nerve to "shut off" inflammation.</p><p>What's more, clinical trials show that vagus nerve stimulation not only "shuts off" inflammation, but also triggers the production of cells that promote healing.</p><p>"In animal experiments, we understand how this works," Dr. Tracey said. "And now we have clinical trials showing that the human response is what's predicted by the lab experiments. Many scientific thresholds have been crossed in the clinic and the lab. We're literally at the point of regulatory steps and stages, and then marketing and distribution before this idea takes off."<br></p>The future of bioelectronic medicine
<img class="rm-lazyloadable-image rm-shortcode" type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTYxMDYxMy9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzNjQwOTExNH0.uBY1TnEs_kv9Dal7zmA_i9L7T0wnIuf9gGtdRXcNNxo/img.jpg?width=980" id="8b5b2" width="2000" height="1125" data-rm-shortcode-id="6682370b5a6471bf3d8b42ca3c508519" data-rm-shortcode-name="rebelmouse-image" />Vagus nerve stimulation can already treat Crohn's disease and other inflammatory diseases. In the future, it may also be used to treat cancer, diabetes, and depression.
Credit: Adobe Stock via Maridav
<p>Vagus nerve stimulation is currently awaiting approval by the US Food and Drug Administration, but so far, it's proven safe and effective in clinical trials on humans. Dr. Tracey said vagus nerve stimulation could become a common treatment for a wide range of diseases, including cancer, Alzheimer's, diabetes, hypertension, shock, depression and diabetes.</p><p>"To the extent that inflammation is the problem in the disease, then stopping inflammation or suppressing the inflammation with vagus nerve stimulation or bioelectronic approaches will be beneficial and therapeutic," he said.</p><p>Receiving vagus nerve stimulation would require having an electronic device, about the size of lima bean, surgically implanted in your neck during a 30-minute procedure. A couple of weeks later, you'd visit, say, your rheumatologist, who would activate the device and determine the right dosage. The stimulation would take a few minutes each day, and it'd likely be unnoticeable.</p><p>But the most revolutionary aspect of bioelectronic medicine, according to Dr. Tracey, is that approaches like vagus nerve stimulation wouldn't come with harmful and potentially deadly side effects, as many pharmaceutical drugs currently do.</p><p>"A device on a nerve is not going to have systemic side effects on the body like taking a steroid does," Dr. Tracey said. "It's a powerful concept that, frankly, scientists are quite accepting of—it's actually quite amazing. But the idea of adopting this into practice is going to take another 10 or 20 years, because it's hard for physicians, who've spent their lives writing prescriptions for pills or injections, that a computer chip can replace the drug."</p><p>But patients could also play a role in advancing bioelectronic medicine.</p><p>"There's a huge demand in this patient cohort for something better than they're taking now," Dr. Tracey said. "Patients don't want to take a drug with a black-box warning, costs $100,000 a year and works half the time."</p><p>Michael Dowling, president and CEO of Northwell Health, elaborated:</p><p>"Why would patients pursue a drug regimen when they could opt for a few electronic pulses? Is it possible that treatments like this, pulses through electronic devices, could replace some drugs in the coming years as preferred treatments? Tracey believes it is, and that is perhaps why the pharmaceutical industry closely follows his work."</p><p>Over the long term, bioelectronic approaches are unlikely to completely replace pharmaceutical drugs, but they could replace many, or at least be used as supplemental treatments.</p><p>Dr. Tracey is optimistic about the future of the field.</p><p>"It's going to spawn a huge new industry that will rival the pharmaceutical industry in the next 50 years," he said. "This is no longer just a startup industry. [...] It's going to be very interesting to see the explosive growth that's going to occur."</p>
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They don’t come as pills, but try these 6 underprescribed lifestyle medicines for a better, longer life
22 February, 2021
JULIO CESAR AGUILAR/AFP via Getty Images
The majority of Americans are stressed, sleep-deprived and overweight and suffer from largely preventable lifestyle diseases such as heart disease, cancer, stroke and diabetes.
<p> Being overweight or obese contributes to the <a href="https://www.cdc.gov/bloodpressure/facts.htm" target="_blank">50% of adults who suffer high blood pressure</a>, <a href="https://www.cdc.gov/chronicdisease/resources/publications/factsheets/diabetes-prediabetes.htm" target="_blank">10% with diabetes and additional 35% with pre-diabetes</a>. And the costs are unaffordable and growing. About 90% of the <a href="https://www.cdc.gov/chronicdisease/about/costs/index.htm" target="_blank">nearly $4 trillion</a> Americans spend annually for health care in the U.S. is for chronic diseases and mental health conditions. But there are new lifestyle “medicines" that are free that doctors could be prescribing for all their patients.</p><p><a href="https://www.lifestylemedicine.org/" target="_blank">Lifestyle medicine</a> is the clinical application of healthy behaviors to prevent, treat and reverse disease. More than ever, <a href="https://adventisthealthstudy.org/?rsource=publichealth.llu.edu/adventist-health-studies" target="_blank">research</a> <a href="https://www.nurseshealthstudy.org" target="_blank">underscores</a> <a href="https://sites.sph.harvard.edu/hpfs/">that</a> <a href="http://www.commissiononhealth.org/Home.aspx">the “pills"</a> today's physician should be prescribing for patients are the six domains of lifestyle medicine: whole food plant-based eating, regular physical activity, restorative sleep, stress management, addiction reduction or elimination, and positive psychology and social connection. </p><p>We are a primary care <a href="https://www.workpartnersblog.com/workpartners-thought-leaders-to-present-at-2019-health-benefits-conference-expo/" target="_blank">preventive medicine physician</a>
and a <a href="https://mirm-pitt.net/our-people/faculty-staff-bios/yoram-vodovotz-phd/" target="_blank">computational immunologist</a>, both committed to applying state-of-the-art research to <a href="https://www.ardmoreinstituteofhealth.org/lmrsummit" target="_blank">inform the clinical practice of lifestyle medicine</a>. <a href="https://doi.org/10.3389/fmed.2020.585744" target="_blank">Our findings and recommendations</a> were just published. We highlight the key take-home points for each of the areas below. </p><p> <a href="https://images.theconversation.com/files/379039/original/file-20210115-15-17ils1u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" src="https://images.theconversation.com/files/379039/original/file-20210115-15-17ils1u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/379039/original/file-20210115-15-17ils1u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=473&fit=crop&dpr=1 600w, https://images.theconversation.com/files/379039/original/file-20210115-15-17ils1u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=473&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/379039/original/file-20210115-15-17ils1u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=473&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/379039/original/file-20210115-15-17ils1u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=595&fit=crop&dpr=1 754w, https://images.theconversation.com/files/379039/original/file-20210115-15-17ils1u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=595&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/379039/original/file-20210115-15-17ils1u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=595&fit=crop&dpr=3 2262w"></a></p><p> Use the Healthy Eating Plate as an evidence-based guide for creating healthy, balanced meals.</p><p> <a class="source" href="https://www.hsph.harvard.edu/nutritionsource/healthy-eating-plate/">©2011, Harvard University</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></p>
<h2>Whole-food, plant-based eating</h2><p>Diets high in fruits, vegetables and whole grains and lower in animal products and highly processed foods have <a href="https://eatforum.org/content/uploads/2019/01/EAT-Lancet_Commission_Summary_Report.pdf" target="_blank" rel="noopener noreferrer">been associated</a> <a href="http://doi.org/10.1001/jama.288.20.2569" target="_blank" rel="noopener noreferrer">with prevention</a> of many diseases. These diets have also <a href="http://doi.org/10.1001/jama.288.20.2569" target="_blank" rel="noopener noreferrer">improved health</a> <a href="https://doi.org/10.7812/TPP/17-025" target="_blank" rel="noopener noreferrer">and even reversed</a> common <a href="https://www.cdc.gov/chronicdisease/about/costs/index.htm" target="_blank" rel="noopener noreferrer">cardiovascular, metabolic, brain, hormonal, kidney and autoimmune diseases as well as 35% of all cancers</a>.</p><p>We believe that future research should include larger trials or new research methods with <a href="http://doi.org/10.1001/jamainternmed.2020.2790" target="_blank" rel="noopener noreferrer">emphasis on quality of diet</a>. This would include more data on the micronutrient composition and protein sources of plant versus animal-based foods – not just proportion of fat, carbohydrates and protein. Such trials should include children, as many adult disorders are seeded as early as infancy or in utero.</p><h2>Regular physical activity</h2><p><a href="https://wonder.cdc.gov/wonder/prevguid/m0042984/m0042984.asp" target="_blank" rel="noopener noreferrer">For decades, surgeon generals' guidelines</a> have emphasized that daily moderate-to-vigorous aerobic physical activity has both immediate and long-term health benefits. For example, why we age and the rate at which we age – chronological age versus biological age – is determined by multiple molecular processes that are directly influenced by physical activity. And now scientists are gaining a better understanding of the <a href="https://doi.org/10.1016/j.cmet.2015.05.011" target="_blank" rel="noopener noreferrer">cellular and molecular changes that exercise</a> induces to reduce disease risk.</p><p>Research priorities for scientists and physicians include obtaining a deeper understanding of the type, intensity and frequency of activity, and better insights into the molecular and <a href="https://doi.org/10.1016/bs.pmbts.2015.07.005" target="_blank" rel="noopener noreferrer">cellular alterations</a> <a href="https://doi.org/10.1016/bs.irn.2019.06.002" target="_blank" rel="noopener noreferrer">that occur with exercise</a>.</p>
<h2>Restorative sleep</h2><p>Sleep helps the cells, organs and entire body to function better. <a href="https://www.cdc.gov/sleep/about_sleep/how_much_sleep.html" target="_blank" rel="noopener noreferrer">Regular uninterrupted sleep</a> of seven hours per night for adults, eight to 10 hours for teenagers and 10 or more for children is necessary for <a href="https://doi.org/10.5665/sleep.3298" target="_blank" rel="noopener noreferrer">good health</a>.</p><p>Though understudied, there is evidence that high-quality sleep can reduce <a href="https://doi.org/10.5665/sleep.3298" target="_blank" rel="noopener noreferrer">inflammation, immune dysfunction, oxidative stress, and epigenetic modification</a> of DNA, all of which are <a href="https://doi.org/10.1016/S1389-9457(08)70013-3" target="_blank" rel="noopener noreferrer">associated with or cause chronic disease</a>.</p><p>Therefore, research into the biological mechanisms that underlie the restorative properties of sleep could lead to environmental or population-based and policy approaches to better align our natural sleep patterns with the demands of daily life.</p>
<h2>Stress management</h2><p>Though some stress is beneficial, prolonged or extreme stress can overwhelm the brain and body. <a href="https://doi.org/10.1111/j.1467-8721.2006.00450.x" target="_blank" rel="noopener noreferrer">Chronic stress increases the risk of cardiovascular disease</a>, <a href="https://doi.org/10.1111/cns.12490" target="_blank" rel="noopener noreferrer">irritable bowel disease</a>, <a href="http://doi.org/10.1016/j.tem.2016.04.007" target="_blank" rel="noopener noreferrer">obesity</a>, depression, asthma, arthritis, autoimmune diseases, cardiovascular disease, cancer, diabetes, neurological disorders and obesity.</p><p>One of the most powerful mechanisms to reduce stress and enhance resilience is by <a href="https://doi.org/10.1056/NEJMp1917461" target="_blank" rel="noopener noreferrer">eliciting a relaxation response</a> using mind-body therapies and cognitive behavioral therapy.</p><p>More research is need to gain a better understanding of how these therapies work.</p><h2>Addiction reduction and elimination</h2><p>Many social, economic and environmental factors have fueled the national rise in substance abuse generally and, most tragically, the opioid epidemic.</p><p>Physicians and researchers are beginning to understand the underlying physiology and psychology of addiction.</p><p>Yet the <a href="https://doi.org/10.17226/25310" target="_blank" rel="noopener noreferrer">continued stigma and disjointed or absent access</a> to services remains a challenge. Clinicians and scientists need to explore how to predict who is more vulnerable to addiction and find ways of preventing it. <a href="https://doi.org/10.1080/00952990.2018.1546862" target="_blank" rel="noopener noreferrer">Treatment that incorporates integrated care</a> focused on all the patient's needs should be prioritized.</p>
<h2>Positive psychology and social connection</h2><p>Maintaining a positive mindset through the practice of gratitude and forgiveness has a significant impact on psychological and subjective well-being, which are, in turn, associated with <a href="https://doi.org/10.1007/s10902-019-00082-1" target="_blank" rel="noopener noreferrer">physical health benefits</a>.</p><p>Social connectivity, namely the quantity and quality of our relationships, has perhaps <a href="https://www.hup.harvard.edu/catalog.php?isbn=9780674503816" target="_blank" rel="noopener noreferrer">the most powerful health benefits</a>.</p><p>Conversely, <a href="https://doi.org/10.1037/0033-2909.119.3.488" target="_blank" rel="noopener noreferrer">social isolation</a> – such as <a href="https://doi.org/10.2105/AJPH.2016.303431" target="_blank" rel="noopener noreferrer">living alone, having a small social network</a>, participating in few social activities, and feeling lonely – <a href="https://doi.org/10.1212/01.WNL.0000147473.04043.B3" target="_blank" rel="noopener noreferrer">is associated with greater mortality</a>, increased morbidity, lower immune system function, depression and cognitive decline.</p><p>Further study is needed to uncover how an individual's biology and chemistry change for the better through more social interactions.</p>
<h2>Inflammation's role in lifestyle-related diseases</h2><p>Unhealthy lifestyle behaviors produce a vicious cycle of inflammation. While inflammation is a healthy, natural way the body fights infections, injury, and stress, too much inflammation actually promotes or exacerbates the diseases described above.</p><p>The inflammatory response is complex. We have been using machine learning and computer modeling to <a href="https://www.springer.com/gp/book/9783030565091" target="_blank" rel="noopener noreferrer">understand, predict, treat and reprogram inflammation</a> – to retain the healing elements while minimizing the detrimental more chronic ones. Scientists are unraveling new mechanisms that explain how chronic stress can turn genes on and off.</p>
<h2>Overcoming challenges and barriers</h2><p>We and others who study lifestyle medicine are now discussing how we can leverage all of these approaches to improve <a href="https://www.frontiersin.org/files/Articles/585744/fmed-07-585744-HTML/image_m/fmed-07-585744-g001.jpg" target="_blank" rel="noopener noreferrer">clinical studies on the impacts</a> of lifestyle interventions.</p><p>At the same time we and our colleagues realize that there are environmental challenges and barriers that prevent many people from embracing these lifestyle fixes.</p><p>There are food deserts where healthier foods are not available or affordable. Unsafe neighborhoods, harmful chemicals and substances create constant stress. Poor education, poverty, cultural beliefs and racial and ethnic disparities and discrimination must be addressed for all people and patients to appreciate and embrace the six "pills."</p><p>The application of lifestyle medicines is particularly important now because unhealthy lifestyles have caused a pandemic of preventable chronic diseases that is now exacerbating the COVID-19 pandemic, which disproportionately <a href="https://doi.org/10.1177/1559827620950276" target="_blank" rel="noopener noreferrer">afflicts those with these conditions</a>.</p><p>Ask your doctor to <a href="https://www.guidetogoodhealth.com/Articles/LifestyleMedicine.asp" target="_blank" rel="noopener noreferrer">"prescribe" these six "pills"</a> for a longer and better life. After all, they're free, work better than or as well as medications and have no side effects!</p><p><a href="https://theconversation.com/profiles/yoram-vodovotz-1193610" target="_blank" rel="noopener noreferrer">Yoram Vodovotz</a>, Professor of Surgery, <em><a href="https://theconversation.com/institutions/university-of-pittsburgh-854" target="_blank" rel="noopener noreferrer">University of Pittsburgh</a></em> and <a href="https://theconversation.com/profiles/michael-parkinson-1193974" target="_blank" rel="noopener noreferrer">Michael Parkinson</a>, Senior Medical Director of Health and Productivity, UPMC Health Plan & Workpartners, <em><a href="https://theconversation.com/institutions/university-of-pittsburgh-854" target="_blank" rel="noopener noreferrer">University of Pittsburgh</a></em></p><p>This article is republished from <a href="https://theconversation.com/" target="_blank" rel="noopener noreferrer">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/they-dont-come-as-pills-but-try-these-6-underprescribed-lifestyle-medicines-for-a-better-longer-life-152791" target="_blank" rel="noopener noreferrer">original article</a>.</p>
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