Could ADHD drugs reduce the risk of early death? Unpacking the findings from a new Swedish study
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Attention-deficit hyperactivity disorder (ADHD) can have a considerable impact on the day-to-day functioning and overall wellbeing of people affected. It causes a variety of symptoms including difficulty focusing, impulsivity and hyperactivity.
For many, a diagnosis of ADHD, whether in childhood or adulthood, is life changing. It means finally having an explanation for these challenges, and opens up the opportunity for treatment, including medication.
Although ADHD medications can cause side effects, they generally improve symptoms for people with the disorder, and thereby can significantly boost quality of life.
Now a new study has found being treated for ADHD with medication reduces the risk of early death for people with the disorder. But what can we make of these findings?
A large study from Sweden
The study, published this week in JAMA (the prestigious journal of the American Medical Association), was a large cohort study of 148,578 people diagnosed with ADHD in Sweden. It included both adults and children.
In a cohort study, a group of people who share a common characteristic (in this case a diagnosis of ADHD) are followed over time to see how many develop a particular health outcome of interest (in this case the outcome was death).
For this study the researchers calculated the mortality rate over a two-year follow up period for those whose ADHD was treated with medication (a group of around 84,000 people) alongside those whose ADHD was not treated with medication (around 64,000 people). The team then determined if there were any differences between the two groups.
What did the results show?
The study found people who were diagnosed and treated for ADHD had a 19% reduced risk of death from any cause over the two years they were tracked, compared with those who were diagnosed but not treated.
In understanding this result, it’s important – and interesting – to look at the causes of death. The authors separately analysed deaths due to natural causes (physical medical conditions) and deaths due to unnatural causes (for example, unintentional injuries, suicide, or accidental poisonings).
The key result is that while no significant difference was seen between the two groups when examining natural causes of death, the authors found a significant difference for deaths due to unnatural causes.
So what’s going on?
Previous studies have suggested ADHD is associated with an increased risk of premature death from unnatural causes, such as injury and poisoning.
On a related note, earlier studies have also suggested taking ADHD medicines may reduce premature deaths. So while this is not the first study to suggest this association, the authors note previous studies addressing this link have generated mixed results and have had significant limitations.
In this new study, the authors suggest the reduction in deaths from unnatural causes could be because taking medication alleviates some of the ADHD symptoms responsible for poor outcomes – for example, improving impulse control and decision-making. They note this could reduce fatal accidents.
The authors cite a number of studies that support this hypothesis, including research showing ADHD medications may prevent the onset of mood, anxiety and substance use disorders, and lower the risk of accidents and criminality. All this could reasonably be expected to lower the rate of unnatural deaths.
Strengths and limitations
Scandinavian countries have well-maintained national registries that collect information on various aspects of citizens’ lives, including their health. This allows researchers to conduct excellent population-based studies.
Along with its robust study design and high-quality data, another strength of this study is its size. The large number of participants – almost 150,000 – gives us confidence the findings were not due to chance.
The fact this study examined both children and adults is another strength. Previous research relating to ADHD has often focused primarily on children.
One of the important limitations of this study acknowledged by the authors is that it was observational. Observational studies are where the researchers observe and analyse naturally occurring phenomena without intervening in the lives of the study participants (unlike randomised controlled trials).
The limitation in all observational research is the issue of confounding. This means we cannot be completely sure the differences between the two groups observed were not either partially or entirely due to some other factor apart from taking medication.
Specifically, it’s possible lifestyle factors or other ADHD treatments such as psychological counselling or social support may have influenced the mortality rates in the groups studied.
Another possible limitation is the relatively short follow-up period. What the results would show if participants were followed up for longer is an interesting question, and could be addressed in future research.
What are the implications?
Despite some limitations, this study adds to the evidence that diagnosis and treatment for ADHD can make a profound difference to people’s lives. As well as alleviating symptoms of the disorder, this study supports the idea ADHD medication reduces the risk of premature death.
Ultimately, this highlights the importance of diagnosing ADHD early so the appropriate treatment can be given. It also contributes to the body of evidence indicating the need to improve access to mental health care and support more broadly.
Hassan Vally, Associate Professor, Epidemiology, Deakin University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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52 Small Changes – by Brett Blumenthal
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We see a lot of books that exhort us to get a six-pack in a month, change our life in 7 days, learn Japanese in 24 hours. The reality is, things take time!
Brett Blumenthal is more realistic while being just as motivational:
The idea is simple… Make one small change per week for 52 weeks, and at the end of the year, you’ll be healthier and happier.
At 10almonds, we’re big fans of small changes that add up (or rather: compound!) to make big differences, so this one’s absolutely our style!
Best of all, she offers us not just “do this” advice, but also “and here’s the information and resources you’ll need to make this change work the best it can for you”
The advices range in topic from nutrition to exercise to sleep to mental wellness to interpersonal stuff and more. The biggest focus is on personal health, though, with small changes to exercise and nutrition making up the lion’s share of the changes.
Bottom line: this is a book you’ll want to grab once a week. Consider setting a reminder on your phone to check in with it each Sunday, for example!
Take the first step and order “52 Small Changes” from Amazon today!
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Lime-Charred Cauliflower Popcorn
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Called “popcorn” for its appearance and tasty-snackness, this one otherwise bears little relation to the usual movie theater snack, and it’s both tastier and healthier. All that said, it can be eaten on its own as a snack (even with a movie, if you so wish), or served as one part of a many-dish banquet, or (this writer’s favorite) as a delicious appetizer that also puts down a healthy bed of fiber ready for the main course to follow it.
You will need
- 1 cauliflower, cut into small (popcorn-sized) florets
- 2 tbsp extra virgin olive oil
- 1 tbsp lime pickle
- 1 tsp cumin seeds
- 1 tsp smoked paprika
- 1 tsp chili flakes
- 1 tsp black pepper, coarse ground
- ½ tsp ground turmeric
Method
(we suggest you read everything at least once before doing anything)
1) Preheat your oven as hot as it will go
2) Mix all the ingredients in a small bowl except the cauliflower, to form a marinade
3) Drizzle the marinade over the cauliflower in a larger bowl (i.e. big enough for the cauliflower), and mix well until the cauliflower is entirely, or at least almost entirely, coated. Yes, it’s not a lot of marinade but unless you picked a truly huge cauliflower, the proportions we gave will be enough, and you want the end result to be crisp, not dripping.
4) Spread the marinaded cauliflower florets out on a baking tray lined with baking paper. Put it in the oven on the middle shelf, so it doesn’t cook unevenly, but keeping the temperature as high as it goes.
5) When it is charred and crispy golden, it’s done—this should take about 20 minutes, but we’ll say ±5 minutes depending on your oven, so do check on it periodically—and time to serve (it is best enjoyed warm).
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- We must do a main feature on the merits of cruciferous vegetables! Watch this space.
- All About Olive Oils (Extra Virgin & Otherwise)
- Capsaicin For Weight Loss And Against Inflammation
- Black Pepper’s Impressive Anti-Cancer Arsenal (And More)
- Why Curcumin (Turmeric) Is Worth Its Weight In Gold
Take care!
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The Cough Doctor
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The Cough Doctor
This is Dr. Peter Small, who worked in epidemiology since the beginning of HIV epidemic. He became a pioneer in the field of molecular epidemiology. As such, his work was a guiding beacon for the public health response to the resurgence of tuberculosis. He’s travelled the world spending years in various institutions studying all manner of respiratory illnesses…. These have ranged from tuberculosis to pneumonia to lung cancer and (back to epidemiology) Covid-19.
He’s now the Chief Medical Officer at…
Hyfe
Hyfe, a medical AI company, was founded in 2020. Its objective: to build acoustic tools for respiratory diagnostics and monitoring.
In other words: it records coughs and collects data about coughing.
❝It’s ironic how much people focus on counting steps while ignoring cough, which is far more consequential. Hyfe is a science-driven company with the technology to make cough count. Particularly now, with increased awareness of cough and the rapid growth of digital health driven by Covid-19, this technology can improve the lives of patients, the care provided by doctors, and the efficiency of health systems.❞
~ Dr. Peter Small, CMO, Hyfe
How does it do it?
Hyfe’s AI monitors the number of times a person coughs and the sound of the cough through any smartphone or other smart device.
This data collected over time provides increasingly more reliable information than a single visit to the doctor! By constantly listening and analyzing, it can detect patterns that might otherwise go unnoticed.
How big is this “big data” effort?
Hyfe maintains the largest cough dataset in the world. This means it can compare the sound of a patient’s cough with more than 400 million cough-like sounds from 83 countries across all continents.
The human brain doesn’t handle big numbers well. So, just to illustrate: if the average cough is 1 second long, that means it’d take more than 12 years to listen to them all.
Hyfe, meanwhile, can:
- listen to many things simultaneously
- index them all against user and location,
- use its ever-growing neural net to detect and illustrate patterns.
It’s so attentive, that it can learn to distinguish between different people’s coughs in the same household.
❝Companies like Google Health see even basic information such as getting an accurate count of the number of times a person coughs a day as a useful resource, and part of a larger need to collect and chronicle more health information to refine the way doctors diagnose disease and manage treatments in the future.❞
What are the public health implications?
The most obvious application is to note when there’s a spike in coughing, and see how such spikes grow and spread (if they do), to inform of contagion risks.
Another is to cross-reference it with data about local environmental allergens. Knowing how things like pollution and even pollen affect individuals differently could be helpful in identifying (and managing) chronic conditions like asthma.
What are the private health implications?
❝It’s going to transform the whole clinical approach for this common and chronic symptom. Patients will come in, have the data on how much they are coughing, and the physician can suggest a treatment based on that information to see if it makes the coughs better❞
~ Dr. Peter Small
Dr. Small’s colleague Dr. Cai, speaking for Google Health on this project, sees even more utility for diagnostics:
❝When I was in medical school, never ever did they teach us that we could listen to somebody cough and identify whether that person has TB (tuberculosis), COPD, or a tumor. But I keep seeing more and more studies of people coughing into a microphone, and an algorithm can detect whether somebody has TB with 95% specificity and sensitivity, or if someone has pneumonia or an exacerbation of COPD❞
~ Dr. Lawrence Cai
And the privacy implications?
Perhaps you don’t quite fancy the idea of not being able to cough without Google knowing about it. Hyfe’s software is currently opt-in, but…
If you cough near someone else’s Hyfe app, their app will recognize you’re not the app’s user, and start building a profile for you. Of course, that won’t be linked to your name, email address, or other IDs, as it would if you were the app’s user.
Hyfe will ask to connect to your social media, to collect more information about you and your friends.
Whether you’d like to try this or perhaps you’re just curious to learn more about this fascinating project, you can check out:
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Pomegranate’s Health Gifts Are Mostly In Its Peel
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Pomegranate Peel’s Potent Potential
Pomegranates have been enjoying a new surge in popularity in some parts, widely touted for their health benefits. What’s not so widely touted is that most of the bioactive compounds that give these benefits are concentrated in the peel, which most people in most places throw away.
They do exist in the fruit too! But if you’re discarding the peel, you’re missing out:
Food Applications and Potential Health Benefits of Pomegranate and its Derivatives
“That peel is difficult and not fun to eat though”
Indeed. Drying the peel, especially freeze-drying it, is a good first step:
❝Freeze drying peels had a positive effect on the total phenolic, tannins and flavonoid than oven drying at all temperature range. Moreover, freeze drying had a positive impact on the +catechin, -epicatechin, hesperidin and rutin concentrations of fruit peel. ❞
Once it is freeze-dried, it is easy to grind it into a powder for use as a nutritional supplement.
“How useful is it?”
Studies with 500mg and 1000mg per day in people with cases of obesity and/or type 2 diabetes saw significant improvements in assorted biomarkers of cardiometabolic health, including blood pressure, blood sugar levels, cholesterol, and hemoglobin A1C:
- Effects of pomegranate extract supplementation on inflammation in overweight and obese individuals: A randomized controlled clinical trial
- Beneficial effects of pomegranate peel extract on plasma lipid profile, fatty acids levels and blood pressure in patients with diabetes mellitus type-2: A randomized, double-blind, placebo-controlled study
It also has anticancer properties:
- Punicalagin, a polyphenol from pomegranate fruit, induces growth inhibition and apoptosis in human PC-3 and LNCaP cells
- Punica granatum (Pomegranate) activity in health promotion and cancer prevention
- The extract from Punica granatum (pomegranate) peel induces apoptosis and impairs metastasis in prostate cancer cells
…and neuroprotective benefits:
- Long-term (15 mo) dietary supplementation with pomegranates attenuates cognitive and behavioral deficits
- Neuroprotective Effects of Pomegranate Peel Extract
- An Evaluation of the Effects of a Non-caffeinated Energy Dietary Supplement on Cognitive and Physical Performance
…and it may protect against osteopenia and osteoporosis, but we only have animal or in vitro studies so far, for example:
- Pomegranate Peel Extract Prevents Bone Loss in a Preclinical Model of Osteoporosis and Stimulates Osteoblastic Differentiation in Vitro
- Pomegranate and its derivatives can improve bone health through decreased inflammation and oxidative stress in an animal model of postmenopausal osteoporosis
Want to try it?
We don’t sell it, but you can buy pomegranates at your local supermarket, or buy the peel extract ready-made from online sources; here’s an example on Amazon for your convenience
(the marketing there is for use of the 100% pomegranate peel powder as a face mask; it also has health benefits for the skin when applied topically, but we didn’t have time to cover that today)
Enjoy!
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Women’s Strength Training Anatomy Workouts – by Frédéric Delavier
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We’ve previously reviewed another book of Delavier’s, “Women’s Strength Training Anatomy“, which itself is great. This book adds a lot of practical advice to that one’s more informational format, but to gain full benefit of this one does not require having read that one.
A common reason that many women avoid strength-training is because they do not want to look muscular. Largely this is based on a faulty assumption, since you will never look like a bodybuilder unless you also eat like a bodybuilder, for example.
However, for those for whom the concern remains, today’s book is an excellent guide to strength-training with aesthetics in mind as well as functionality.
The exercises are divided into sections, thus: round your glutes / tone your quadriceps / shape your hamstrings / trim your calves / flatten your abs / curve your shoulders / develop a pain-free upper back / protect your lower back / enhance your chest / firm up your arms.
As you can see, a lot of these are mindful of aesthetics, but there’s nothing here that’s antithetical to function, and some (especially for example “develop a pain-free upper back” and “protect your lower back“) are very functional indeed.
Bottom line: Delavier’s anatomy and exercise books are top-tier, and this one is no exception. If you are a woman and would like to strength-train (or perhaps you already do, and would like to refine your training), then this book is an excellent choice.
Click here to check out Women’s Strength Training Anatomy Workouts, and have the body you want!
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The Pain Relief Secret – by Sarah Warren
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This one’s a book to not judge by the cover—or the title. The title is actually accurate, but it sounds like a lot of woo, doesn’t it?
Instead, what we find is a very clinical, research-led (40 pages of references!) explanation of:
- the causes of musculoskeletal pain
- how this will tend to drive us to make it worse
- what we can do instead to make it better
A lot of this, to give you an idea what to expect, hinges on the fact that bones only go where muscles allow/move them; muscles only behave as instructed by nerves, and with a good development of biofeedback and new habits to leverage neuroplasticity, we can take more charge of that than you might think.
Warning: you may want to jump straight into the part with the solutions, but if you do so without a very good grounding in anatomy and physiology, you may find yourself out of your depth with previously-explained terms and concepts that are now needed to understand (and apply) the solutions.
However, if you read it methodically cover-to-cover, you’ll find you need no prior knowledge to take full advantage of this book; the author is a very skilled educator.
Bottom line: while it’s not an overnight magic pill, the methodology described in this book is a very sound way to address the causes of musculoskeletal pain.
Click here to check out The Pain Relief Secret, and help your body undo damage done!
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