‘Tis To Season To Be SAD-Savvy
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Seasonal Affective Disorder & SAD Lamps
For those of us in the Northern Hemisphere, it’s that time of the year; especially after the clocks recently went back and the nights themselves are getting longer. So, what to do in the season of 3pm darkness?
First: the problem
The problem is twofold:
- Our circadian rhythm gets confused
- We don’t make enough serotonin
The latter is because serotonin production is largely regulated by sunlight.
People tend to focus on item 2, but item 1 is important too—both as problem, and as means of remedy.
Circadian rhythm is about more than just light
We did a main feature on this a little while back, talking about:
- What light/dark does for us, and how it’s important, but not completely necessary
- How our body knows what time it is even in perpetual darkness
- The many peaks and troughs of many physiological functions over the course of a day/night
- What that means for us in terms of such things as diet and exercise
- Practical take-aways from the above
Read: The Circadian Rhythm: Far More Than Most People Know
With that in mind, the same methodology can be applied as part of treating Seasonal Affective Disorder.
Serotonin is also about more than just light
Our brain is a) an unbelievably powerful organ, and the greatest of any animal on the planet b) a wobbly wet mass that gets easily confused.
In the case of serotonin, we can have problems:
- knowing when to synthesize it or not
- synthesizing it
- using it
- knowing when to scrub it or not
- scrubbing it
- etc
Selective Serotonin Re-uptake Inhibitors (SSRIs) are a class of antidepressants that, as the name suggests, inhibit the re-uptake (scrubbing) of serotonin. So, they won’t add more serotonin to your brain, but they’ll cause your brain to get more mileage out of the serotonin that’s there, using it for longer.
So, whether or not they help will depend on you and your brain:
Read: Antidepressants: Personalization Is Key!
How useful are artificial sunlight lamps?
Artificial sunlight lamps (also called SAD lamps), or blue light lamps, are used in an effort to “replace” daylight.
Does it work? According to the science, generally yes, though everyone would like more and better studies:
- The Efficacy of Light Therapy in the Treatment of Seasonal Affective Disorder: A Meta-Analysis of Randomized Controlled Trials
- Blue-Light Therapy for Seasonal and Non-Seasonal Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Interestingly, it does still work in cases of visual impairment and blindness:
How much artificial sunlight is needed?
According to Wirz-Justice and Terman (2022), the best parameters are:
- 10,000 lux
- full spectrum (white light)
- 30–60 minutes exposure
- in the morning
Source: Light Therapy: Why, What, for Whom, How, and When (And a Postscript about Darkness)
That one’s a fascinating read, by the way, if you have time.
Can you recommend one?
For your convenience, here’s an example product on Amazon that meets the above specifications, and is also very similar to the one this writer has
Enjoy!
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Are Waist Trainers Just A Waste, And Are Posture Fixers A Quick Fix?
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Are Waist Trainers Just A Waste, And Are Posture Fixers A Quick Fix?
Yesterday, we asked you for your opinions on waist trainers and posture-fixing harnesses, and got the above-depicted, below-described set of results:
- The most popular response was “Waist trainers are purely cosmetic, so useless. Posture-fixers have merit”, with a little over a quarter of the votes.
- The least popular response was “Both are great tools to help us to optimal waist size and posture, respectively!”
- The other three answers each got a little under a quarter of the vote. In terms of discrete data, these were all 7±1, so basically, there was nothing in it.
The sample size was smaller than usual—perhaps the cluster of American holiday dates yesterday and today kept people busy! But, pressing on…
What does the science say?
Waist trainers are purely cosmetic, so, useless. True or False?
True, simply. Honestly, they’re not even that great for cosmetic purposes. They will indeed cinch in your middle, and this shape will be retained for a (very) short while after uncinching, because your organs have been squished inwards and may take a short while to get back to where they are supposed to be.
The American Board of Cosmetic Surgery may not be an unbiased source, but we’re struggling to find scientists who will even touch one of these, so, let’s see what these doctors have to say:
- Waist training can damage vital organs
- You will be slowly suffocating yourself
- Waist training simply doesn’t work
- You cannot drastically change your body shape with a piece of fabric*
Read: ABCS | 4 Reasons to Throw Your Waist Trainer in the Trash
*”But what about foot-binding?”—feet have many bones, whose growth can be physically restricted. Your waist has:
- organs: necessary! (long-term damage possible, but they’re not going away)
- muscles: slightly restrictable! (temporary restriction; no permanent change)
- fat: very squeezable! (temporary muffin; no permanent change)
Posture correctors have merit: True or False?
True—probably, and as a stepping-stone measure only.
The Ergonomics Health Association (a workplace health & safety organization) says:
❝Looking at the clinical evidence of posture correctors, we can say without a doubt that they do work, just not for everyone and not in the same way for all patients.❞
Source: Do Posture Correctors Work? Here’s What Our Experts Think
That’s not very compelling, so we looked for studies, and found… Not much, actually. However, what we did find supported the idea that “they probably do help, but we seriously need better studies with less bias”:
That is also not a compelling title, but here is where it pays to look at the studies and not just the titles. Basically, they found that the results were favorable to the posture-correctors—the science itself was just trash:
❝ The overall findings were that posture-correcting shirts change posture and subjectively have a positive effect on discomfort, energy levels and productivity.
The quality of the included literature was poor to fair with only one study being of good quality. The risk of bias was serious or critical for the included studies. Overall, this resulted in very low confidence in available evidence.❞
Since the benefit of posture correctors like this one is due to reminding the wearer to keep good posture, there is a lot more (good quality!) science for wearable biofeedback tech devices, such as this one:
Spine Cop: Posture Correction Monitor and Assistant
Take care!
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Ageless Aging – by Maddy Dychtwald
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Maddy Dychtwald, herself 73, has spent her career working in the field of aging. She’s not a gerontologist or even a doctor, but she’s nevertheless been up-to-the-ears in the industry for decades, mostly as an organizer, strategist, facilitator, and so forth. As such, she’s had her finger on the pulse of the healthy longevity movement for a long time.
This book was written to address a problem, and the problem is: lifespan is increasing (especially for women), but healthspan has not been keeping up the pace.
In other words: people (especially women) are living longer, but often with more health problems along the way than before.
And mostly, it’s for lack of information (or sometimes: too much competing incorrect information).
Fortunately, information is something that a woman in Dychtwald’s position has an abundance of, because she has researchers and academics in many fields on speed-dial and happy to answer her questions (we get a lot of input from such experts throughout the book—which is why this book is so science-based, despite the author not being a scientist).
The book answers a lot of important questions beyond the obvious “what diet/exercise/sleep/supplements/etc are best for healthy aging” (spoiler: it’s quite consistent with the things we recommend here, because guess what, science is science), questions like how best to prepare for this that or the other, how to get a head start on preventative healthcare for some things, how to avoid being a burden to our families (one can argue that families are supposed to look after each other, but still, it’s a legitimate worry for many, and understandably so), and even how to balance the sometimes conflicting worlds of health and finances.
Unlike many authors, she also talks about the different kinds of aging, and tackles each of them separately and together. We love to see it!
Bottom line: this book is a very good one-stop-shop for all things healthy aging. It’s aimed squarely at women, but most advice goes for men the same too, aside from the section on hormones and such.
Click here to check out Ageless Aging, and plan your future!
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The Powerful Constraints on Medical Care in Catholic Hospitals Across America
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Nurse midwife Beverly Maldonado recalls a pregnant woman arriving at Ascension Saint Agnes Hospital in Maryland after her water broke. It was weeks before the baby would have any chance of survival, and the patient’s wishes were clear, she recalled: “Why am I staying pregnant then? What’s the point?” the patient pleaded.
But the doctors couldn’t intervene, she said. The fetus still had a heartbeat and it was a Catholic hospital, subject to the “Ethical and Religious Directives for Catholic Health Care Services” that prohibit or limit procedures like abortion that the church deems “immoral” or “intrinsically evil,” according to its interpretation of the Bible.
“I remember asking the doctors. And they were like, ‘Well, the baby still has a heartbeat. We can’t do anything,’” said Maldonado, now working as a nurse midwife in California, who asked them: “What do you mean we can’t do anything? This baby’s not going to survive.”
The woman was hospitalized for days before going into labor, Maldonado said, and the baby died.
Ascension declined to comment for this article.
The Catholic Church’s directives are often at odds with accepted medical standards, especially in areas of reproductive health, according to physicians and other medical practitioners.
The American College of Obstetricians and Gynecologists’ clinical guidelines for managing pre-labor rupture of membranes, in which a patient’s water breaks before labor begins, state that women should be offered options, including ending the pregnancy.
Maldonado felt her patient made her wishes clear.
“Under the ideal medical practice, that patient should be helped to obtain an appropriate method of terminating the pregnancy,” said Christian Pettker, a professor of obstetrics, gynecology, and reproductive sciences at the Yale School of Medicine, who helped author the guidelines.
He said, “It would be perfectly medically appropriate to do a termination of pregnancy before the cessation of cardiac activity, to avoid the health risks to the pregnant person.”
“Patients are being turned away from necessary care,” said Jennifer Chin, an OB-GYN at UW Medicine in Seattle, because of the “emphasis on these ethical and religious directives.”
They can be a powerful constraint on the care that patients receive at Catholic hospitals, whether emergency treatment when a woman’s health is at risk, or access to birth control and abortions.
More and more women are running into barriers to obtaining care as Catholic health systems have aggressively acquired secular hospitals in much of the country. Four of the 10 largest U.S. hospital chains by number of beds are Catholic, according to federal data from the Agency for Healthcare Research and Quality. There are just over 600 Catholic general hospitals nationally and roughly 100 more managed by Catholic chains that place some religious limits on care, a KFF Health News investigation reveals.
Maldonado’s experience in Maryland came just months before the Supreme Court’s ruling in 2022 to overturn Roe v. Wade, a decision that compounded the impact of Catholic health care restrictions. In its wake, roughly a third of states have banned or severely limited access to abortion, creating a one-two punch for women seeking to prevent pregnancy or to end one. Ironically, some states where Catholic hospitals dominate — such as Washington, Oregon, and Colorado — are now considered medical havens for women in nearby states that have banned abortion.
KFF Health News analyzed state-level birth data to discover that more than half a million babies are born each year in the U.S. in Catholic-run hospitals, including those owned by CommonSpirit Health, Ascension, Trinity Health, and Providence St. Joseph Health. That’s 16% of all hospital births each year, with rates in 10 states exceeding 30%. In Washington, half of all babies are born at such hospitals, the highest share in the country.
“We had many instances where people would have to get in their car to drive to us while they were bleeding, or patients who had had their water bags broken for up to five days or even up to a week,” said Chin, who has treated patients turned away by Catholic hospitals.
Physicians who turned away patients like that “were going against evidence-based care and going against what they had been taught in medical school and residency,” she said, “but felt that they had to provide a certain type of care — or lack of care — just because of the strength of the ethical and religious directives.”
Following religious mandates can be dangerous, Chin and other clinicians said.
When a patient has chosen to end a pregnancy after the amniotic sac — or water — has broken, Pettker said, “any delay that might be added to a procedure that is inevitably going to happen places that person at risk of serious, life-threatening complications,” including sepsis and organ infection.
Reporters analyzed American Hospital Association data as of August and used Catholic Health Association directories, news reports, government documents, and hospital websites and other materials to determine which hospitals are Catholic or part of Catholic systems, and gathered birth data from state health departments and hospital associations. They interviewed patients, medical providers, academic experts, advocacy organizations, and attorneys, and reviewed hundreds of pages of court and government records and guidance from Catholic health institutions and authorities to understand how the directives affect patient care.
Nationally, nearly 800,000 people have only Catholic or Catholic-affiliated birth hospitals within an hour’s drive, according to KFF Health News’ analysis. For example, that’s true of 1 in 10 North Dakotans. In South Dakota, it’s 1 in 20. When care is more than an hour away, academic researchers often define the area as a hospital desert. Pregnant women who must drive farther to a delivery facility are at higher risk of harm to themselves or their fetus, research shows.
Many Americans don’t have a choice — non-Catholic hospitals are too far to reach in an emergency or aren’t in their insurance networks. Ambulances may take patients to a Catholic facility without giving them a say. Women often don’t know that hospitals are affiliated with the Catholic Church or that they restrict reproductive care, academic research suggests.
And, in most of the country, state laws shield at least some hospitals from lawsuits for not performing procedures they object to on religious grounds, leaving little recourse for patients who were harmed because care was withheld. Thirty-five states prevent patients from suing hospitals for not providing abortions, including 25 states where abortion remains broadly legal. About half of those laws don’t include exceptions for emergencies, ectopic pregnancies, or miscarriages. Sixteen states prohibit lawsuits against hospitals for refusing to perform sterilization procedures.
“It’s hard for the ordinary citizen to understand, ‘Well, what difference does it make if my hospital is bought by this other big health system, as long as it stays open? That’s all I care about,’” said Erin Fuse Brown, who is the director of the Center for Law, Health & Society at Georgia State University and an expert in health care consolidation. Catholic directives also ban medical aid in dying for terminally ill patients.
People “may not realize that they’re losing access to important services, like reproductive health [and] end-of-life care,” she said.
‘Our Faith-Based Health Care Ministry’
After the Supreme Court ended the constitutional right to abortion in June 2022, Michigan resident Kalaina Sullivan wanted surgery to permanently prevent pregnancy.
Michigan voters in November that year enshrined the right to abortion under the state constitution, but the state’s concentration of Catholic hospitals means people like Sullivan sometimes still struggle to obtain reproductive health care.
Because her doctor worked for the Catholic chain Trinity Health, the nation’s fourth-largest hospital system, she had the surgery with a different doctor at North Ottawa Community Health System, an independent hospital near the shores of Lake Michigan.
Less than two months later, that, too, became a Catholic hospital, newly acquired by Trinity.
To mark the transition, Cory Mitchell, who at the time was the mission leader of Trinity Health Muskegon, stood before his new colleagues and offered a blessing.
“The work of your hands is what makes our faith-based health care ministry possible,” he said, according to a video of the ceremony Trinity Health provided to KFF Health News. “May these hands continue to bring compassion, compassion and healing, to all those they touch.”
Trinity Health declined to answer detailed questions about its merger with North Ottawa Community Health System and the ethical and religious directives. “Our commitment to high-quality, compassionate care means informing our patients of all appropriate care options, and trusting and supporting our physicians to make difficult and medically necessary decisions in the best interest of their patients’ health and safety,” spokesperson Jennifer Amundson said in an emailed statement. “High-quality, safe care is critical for the women in our communities and in cases where a non-critical service is not available at our facility, the physician will transfer care as appropriate.”
Leaders in Catholic-based health systems have hammered home the importance of the church’s directives, which are issued by the U.S. Conference of Catholic Bishops, all men, and were first drafted in 1948. The essential view on abortion is as it was in 1948. The last revision, in 2018, added several directives addressing Catholic health institution acquisitions or mergers with non-Catholic ones, including that “whatever comes under control of the Catholic institution — whether by acquisition, governance, or management — must be operated in full accord with the moral teaching of the Catholic Church.”
“While many of the faithful in the local church may not be aware of these requirements for Catholic health care, the local bishop certainly is,” wrote Sister Doris Gottemoeller, a former board member of the Bon Secours Mercy Health system, in a 2023 Catholic Health Association journal article. “In fact, the bishop should be briefed on a regular basis about the hospital’s activities and strategies.”
Now, for care at a non-Catholic hospital, Sullivan would need to travel nearly 30 miles.
“I don’t see why there’s any reason for me to have to follow the rules of their religion and have that be a part of what’s going on with my body,” she said.
Risks Come With Religion
Nathaniel Hibner, senior director of ethics at the Catholic Health Association, said the ethical and religious directives allow clinicians to provide medically necessary treatments in emergencies. In a pregnancy crisis when a person’s life is at risk, “I do not believe that the ERDs should restrict the physician in acting in the way that they see medically indicated.”
“Catholic health care is committed to the health of all women and mothers who enter into our facilities,” Hibner said.
The directives permit care to cure “a proportionately serious pathological condition of a pregnant woman” even if it would “result in the death of the unborn child.” Hibner demurred when asked who defines what that means and when such care is provided, saying, “for the most part, the physician and the patients are the ones that are having a conversation and dialogue with what is supposed to be medically appropriate.”
It is common for practitioners at any hospital to consult an ethics board about difficult cases — such as whether a teenager with cancer can decline treatment. At Catholic hospitals, providers must ask a board for permission to perform procedures restricted by the religious directives, clinicians and researchers say. For example, could an abortion be performed if a pregnancy threatened the mother’s life?
How and when an ethics consultation occurs depends on the hospital, Hibner said. “That ethics consultation can be initiated by anyone involved in the direct care of that situation — the patient, the surrogate of that patient, the physician, the nurse, the social worker all have the ability to request a consultation,” he said. When asked whether a consultation with an ethics board can occur without a request, he said “sometimes it could.”
How strictly directives are followed can depend on the hospital and the views of the local bishop.
“If the hospital has made a difficult decision about a critical pregnancy or an end-of-life care situation, the bishop should be the first to know about it,” Gottemoeller wrote.
In an interview, Gottemoeller said that even when pregnancy termination decisions are made on sound ethical grounds, not informing the bishop puts him in a bad position and hurts the church. “If there’s a possibility of it being misunderstood, or misinterpreted, or criticized,” Gottemoeller said, the bishop should understand what happened and why “before the newspapers call him and ask him for an opinion.”
“And if he has to say, ‘Well, I think you made a mistake,’ well, all right,” she said. “But don’t let him be blindsided. I mean, we’re one church and the bishop has pastoral concern over everything in his diocese.”
Katherine Parker Bryden, a nurse midwife in Iowa who works for MercyOne, said she regularly tells pregnant patients that the hospital cannot perform tubal sterilization surgery, to prevent future pregnancies, or refer patients to other hospitals that do. MercyOne is one of the largest health systems in Iowa. Nearly half of general hospitals in the state are Catholic or Catholic-affiliated — the highest share among all states.
The National Catholic Bioethics Center, an ethics authority for Catholic health institutions, has said that referrals for care that go against church teaching would be “immoral.”
“As providers, you’re put in this kind of moral dilemma,” Parker Bryden said. “Am I serving my patients or am I serving the archbishop and the pope?”
In response to questions, MercyOne spokesperson Eve Lederhouse said in an email that its providers “offer care and services that are consistent with the guidelines of a Catholic health system.”
Maria Rodriguez, an OB-GYN professor at Oregon Health & Science University, said that as a resident in the early 2000s at a Catholic hospital she was able to secure permission — what she calls a “pope note” — to sterilize some patients with conditions such as gestational diabetes.
Annie Iriye, a retired OB-GYN in Washington state, said that more than a decade ago she sought permission to administer medication to hasten labor for a patient experiencing a second-trimester miscarriage at a Catholic hospital. She said she was told no because the fetus had a heartbeat. The patient took 10 hours to deliver — time that would have been cut by half, Iriye said, had she been able to follow her own medical training and expertise. During that time, she said, the patient developed an infection.
Iriye and Chin were part of an effort by reproductive rights groups and medical organizations that pushed for a state law to protect physicians if they act against Catholic hospital restrictions. The bill, which Washington enacted in 2021, was opposed by the Washington State Hospital Association, whose membership includes multiple large Catholic health systems.
State lawmakers in Oregon in 2021 enacted legislation that beefed up powers to reject health care mergers if they would reduce access to the types of care constrained by Catholic directives. The hospital lobby has sued to block the statute. Washington state lawmakers introduced similar legislation last year, which the hospital association opposes.
Hibner said Catholic hospitals are committed to instituting systemic changes that improve maternal and child health, including access to primary, prenatal, and postpartum care. “Those are the things that I think rural communities really need support and advocacy for,” he said.
Maldonado, the nurse midwife, still thinks of her patient who was forced to stay pregnant with a baby who could not survive. “To feel like she was going to have to fight to have an abortion of a baby that she wanted?” Maldonado said. “It was just horrible.”
KFF Health News data editor Holly K. Hacker contributed to this report.
Click to open the methodology Methodology
By Hannah Recht
KFF Health News identified areas of the country where patients have only Catholic hospital options nearby. The “Ethical and Religious Directives for Catholic Health Care Services” — which are issued by the U.S. Conference of Catholic Bishops, all men — dictate how patients receive reproductive care at Catholic health facilities. In our analysis, we focused on hospitals where babies are born.
We constructed a national database of hospital locations, identified which ones are Catholic or Catholic-affiliated, found how many babies are born at each, and calculated how many people live near those hospitals.
Hospital Universe
We identified hospitals in the 50 states and the District of Columbia using the American Hospital Association database from August 2023. We removed hospitals that had closed or were listed more than once, added hospitals that were not included, and corrected inaccurate or out-of-date information about ownership, primary service type, and location. We excluded federal hospitals, such as military and Indian Health Service facilities, because they are not open to everyone.
Catholic Affiliation
To identify Catholic hospitals, we used the Catholic Health Association’s member directory. We also counted as Catholic a handful of hospitals that are not part of this voluntary membership group but explicitly follow the Ethical and Religious Directives, according to their mission statements, websites, or promotional materials.
We also tracked Catholic-affiliated hospitals: those that are owned or managed by a Catholic health system, such as CommonSpirit Health or Trinity Health, and are influenced by the religious directives but do not necessarily adhere to them in full. To identify Catholic-affiliated hospitals, we consulted health system and hospital websites, government documents, and news reports.
We combined both Catholic and Catholic-affiliated hospitals for analysis, in line with previous research about the influence of Catholic directives on health care.
Births
To determine the share of births that occur at Catholic or Catholic-affiliated hospitals, we gathered the latest annual number of births by hospital from state health departments. Where recent data was not publicly available, we submitted records requests for the most recent complete year available.
The resulting data covered births in 2022 for nine states and D.C., births in 2021 for 23 states, births in 2020 for nine states, and births in 2019 for one state. We used data from the 2021 American Hospital Association survey, the latest available at the time of analysis, for the eight remaining states that did not provide birth data in response to our requests. A small number of hospitals have recently opened or closed labor and delivery units. The vast majority of the rest record about the same number of births each year. This means that the results would not be substantially different if data from 2023 were available.
We used this data to calculate the number of babies born in Catholic and Catholic-affiliated hospitals, as well as non-Catholic hospitals by state and nationally.
We used hospitals’ Catholic status as of August 2023 in this analysis. In 10 cases where the hospital had already closed, we used Catholic status at the time of the closure.
Because our analysis focuses on hospital care, we excluded births that occurred in non-hospital settings, such as homes and stand-alone birth centers, as well as federal hospitals.
Several states suppressed data from hospitals with fewer than 10 births due to privacy restrictions. Because those numbers were so low, this suppression had a negligible effect on state-level totals.
Drive-Time Analysis
We obtained hospitals’ geographic coordinates based on addresses in the AHA dataset using HERE’s geocoder. For addresses that could not be automatically geocoded with a high degree of certainty, we verified coordinates manually using hospital websites and Google Maps.
We calculated the areas within 30, 60, and 90 minutes of travel time from each birth hospital that was open in August 2023 using tools from HERE. We included only hospitals that had 10 or more births as a proxy for hospitals that have labor and delivery units, or where births regularly occur.
The analysis focused on the areas with hospitals within an hour’s drive. Researchers often define hospital deserts as places where one would have to drive an hour or more for hospital care. (For example: [1] “Disparities in Access to Trauma Care in the United States: A Population-Based Analysis,” [2] “Injury-Based Geographic Access to Trauma Centers,” [3] “Trends in the Geospatial Distribution of Inpatient Adult Surgical Services Across the United States,” [4] “Access to Trauma Centers in the United States.”)
We combined the drive-time areas to see which areas of the United States have only Catholic or Catholic-affiliated birth hospitals nearby, both Catholic and non-Catholic, non-Catholic only, or none. We then joined these areas to the 2021 census block group shapefile from IPUMS NHGIS and removed water bodies using the U.S. Geological Survey’s National Hydrography Dataset to calculate the percentage of each census block group that falls within each hospital access category. We calculated the number of people in each area using the 2021 “American Community Survey” block group population totals. For example, if half of a block group’s land area had access to only Catholic or Catholic-affiliated hospitals, then half of the population was counted in that category.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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The Diabetes Drugs That Can Cut Asthma Attacks By 70%
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Asthma, obesity, and type 2 diabetes are closely linked, with the latter two greatly increasing asthma attack risk.
While bronchodilators / corticosteroids can have immediate adverse effects due to sympathetic nervous system activation, and lasting adverse effects due to the damage it does to metabolic health, diabetes drugs, on the other hand, can improve things with (for most people) fewer unwanted side effects.
Great! Which drugs?
Metformin, and glucagon-like peptide-1 receptor agonists (GLP-1RAs).
Specifically, researchers have found:
- Metformin is associated with a 30% reduction in asthma attacks
- GLP-1RAs are associated with a 40% reduction in asthma attacks
…and yes, they stack, making for a 70% reduction in the case of people taking both. Furthermore, the results are independent of weight, glycemic control, or asthma phenotype.
In terms of what was counted, the primary outcome was asthma attacks at 12-month follow-up, defined by oral corticosteroid use, emergency visits, hospitalizations, or death.
The effect of metformin on asthma attacks was not affected by BMI, HbA1c levels, eosinophil count, asthma severity, or sex.
Of the various extra antidiabetic drugs trialled in this study, only GLP-1 receptor agonists showed a further and sustained reduction in asthma attacks.
Here’s the study itself, hot off the press, published on Monday:
JAMA Int. Med. | Antidiabetic Medication and Asthma Attacks
“But what if I’m not diabetic?”
Good news:
More than half of all US adults are eligible for semaglutide therapy ← this is because they’ve expanded the things that semaglutide (the widely-used GLP-1 receptor agonist drug) can be prescribed for, now going beyond just diabetes and/or weight loss 😎
And metformin, of course, is more readily available than semaglutide, so by all means speak with your doctor/pharmacist about that, if it’s of interest to you.
Take care!
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Sweet Dreams Are Made of THC (Or Are They?)
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small 😎
❝I’m one of those older folks that have a hard time getting 7 hrs. I know a lot of it my fault…like a few beers at nite…🥰am now trying THC gummies for anxiety, instead of alcohol……less calories 😁how does THC affect our sleep,? Safer than alcohol…..I know your next article 😊😊😊😊❣️😊alot of us older kids do take gummies 😲😲😲thank you❞
Great question! We wrote a little about CBD gummies (not THC) before:
…and went on to explore THC’s health benefits and risks here:
For starters, let’s go ahead and say: you’re right that it’s safer (for most people) than alcohol—but that’s not a strong claim, because alcohol is very bad for pretty much everything, including sleep.
So how does THC measure up when it comes to sleep quality?
Good news: it affects the architecture of sleep in such a way that you will spend longer in deep sleep (delta wave activity), which means you get more restorative and restful sleep!
See also: Alpha, beta, theta: what are brain states and brain waves? And can we control them?
Bad news: it does so at the cost of reducing your REM sleep, which is also necessary for good brain health, and will cause cognitive impairment if you skip too much. Normally, if you are sleep-deprived, the brain will prioritize REM sleep at the cost of other kinds of sleep; it’s that important. However, if you are chemically impaired from getting healthy REM sleep, there’s not much your brain can do to save you from the effects of REM sleep loss.
See: Cannabis, Cannabinoids, and Sleep: a Review of the Literature
This is, by the way, a reason that THC gets prescribed for some sleep disorders, in cases where the initial sleep disruption was because of nightmares, as it will reduce those (along with any other dreams, as collateral damage):
One thing to be careful of if using THC as a sleep aid is that withdrawal may make your symptoms worse than they were to start with:
Updates in the use of cannabis for insomnia
With all that in mind, you might consider (if you haven’t already tried it) seeing whether CBD alone improves your sleep, as while it does also extend time in deep sleep, it doesn’t reduce REM nearly as much as THC does:
👆 this study was paid for by the brand being tested, so do be aware of potential publication bias. That’s not to say the study is necessarily corrupt, and indeed it probably wasn’t, but rather, the publication of the results was dependent on the company paying for them (so hypothetically they could have pulled funding from any number of other research groups that didn’t get the results they wanted, leaving this one to be the only one published). That being said, the study is interesting, which is why we’ve linked it, and it’s a good jumping-off-point for finding a lot of related papers, which you can see listed beneath it.
CBD also has other benefits of its own, even without THC:
CBD Oil: What Does The Science Say?
Take care!
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Mosquitoes can spread the flesh-eating Buruli ulcer. Here’s how you can protect yourself
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Each year, more and more Victorians become sick with a flesh-eating bacteria known as Buruli ulcer. Last year, 363 people presented with the infection, the highest number since 2004.
But it has been unclear exactly how it spreads, until now. New research shows mosquitoes are infected from biting possums that carry the bacteria. Mozzies spread it to humans through their bite.
What is Buruli ulcer?
Buruli ulcer, also known as Bairnsdale ulcer, is a skin infection caused by the bacterium Mycobacterium ulcerans.
It starts off like a small mosquito bite and over many months, slowly develops into an ulcer, with extensive destruction of the underlying tissue.
While often painless initially, the infection can become very serious. If left untreated, the ulcer can continue to enlarge. This is where it gets its “flesh-eating” name.
Thankfully, it’s treatable. A six to eight week course of specific antibiotics is an effective treatment, sometimes supported with surgery to remove the infected tissue.
Where can you catch it?
The World Health Organization considers Buruli ulcer a neglected tropical skin disease. Cases have been reported across 33 countries, primarily in west and central Africa.
However, since the early 2000s, Buruli ulcer has also been increasingly recorded in coastal Victoria, including suburbs around Melbourne and Geelong.
Scientists have long known Australian native possums were partly responsible for its spread, and suspected mosquitoes also played a role in the increase in cases. New research confirms this.
Our efforts to ‘beat Buruli’
Confirming the role of insects in outbreaks of an infectious disease is achieved by building up corroborating, independent evidence.
In this new research, published in Nature Microbiology, the team (including co-authors Tim Stinear, Stacey Lynch and Peter Mee) conducted extensive surveys across a 350 km² area of Victoria.
We collected mosquitoes and analysed the specimens to determine whether they were carrying the pathogen, and links to infected possums and people. It was like contact tracing for mosquitoes.
Aedes notoscriptus was the mosquito identified as carrying the bacteria that caused Buruli ulcer.
Cameron Webb (NSW Health Pathology)Molecular testing of the mosquito specimens showed that of the two most abundant mosquito species, only Aedes notoscriptus (a widespread species commonly known as the Australian backyard mosquito) was positive for Mycobacterium ulcerans.
We then used genomic tests to show the bacteria found on these mosquitoes matched the bacteria in possum poo and humans with Buruli ulcer.
We further analysed mosquito specimens that contained blood to show Aedes notoscriptus was feeding on both possums and humans.
To then link everything together, geospatial analysis revealed the areas where human Buruli ulcer cases occur overlap with areas where both mosquitoes and possums that harbour Mycobacterium ulcerans are active.
Stop its spread by stopping mozzies breeding
The mosquito in this study primarily responsible for the bacteria’s spread is Aedes notoscriptus, a mosquito that lays its eggs around water in containers in backyard habitats.
Controlling “backyard” mosquitoes is a critical part of reducing the risk of many global mosquito-borne disease, especially dengue and now Buruli ulcer.
You can reduce places where water collects after rainfall, such as potted plant saucers, blocked gutters and drains, unscreened rainwater tanks, and a wide range of plastic buckets and other containers. These should all be either emptied at least weekly or, better yet, thrown away or placed under cover.
Mosquitoes can lay eggs in a wide range of water-filled items in the backyard.
Cameron Webb (NSW Health Pathology)There is a role for insecticides too. While residual insecticides applied to surfaces around the house and garden will reduce mosquito populations, they can also impact other, beneficial, insects. Judicious use of such sprays is recommended. But there are ecological safe insecticides that can be applied to water-filled containers (such as ornamental ponds, fountains, stormwater pits and so on).
Recent research also indicates new mosquito-control approaches that use mosquitoes themselves to spread insecticides may soon be available.
How to protect yourself from bites
The first line of defence will remain personal protection measures against mosquito bites.
Covering up with loose fitted long sleeved shirts, long pants, and covered shoes will provide physical protection from mosquitoes.
Applying topical insect repellent to all exposed areas of skin has been proven to provide safe and effective protection from mosquito bites. Repellents should include diethytolumide (DEET), picaridin or oil of lemon eucalyptus.
While the rise in Buruli ulcer is a significant health concern, so too are many other mosquito-borne diseases. The steps to avoid mosquito bites and exposure to Mycobacteriam ulcerans will also protect against viruses such as Ross River, Barmah Forest, Japanese encephalitis, and Murray Valley encephalitis.
Cameron Webb, Clinical Associate Professor and Principal Hospital Scientist, University of Sydney; Peter Mee, Adjunct Associate Lecturer, School of Applied Systems Biology, La Trobe University; Stacey Lynch, Team Leader- Mammalian infection disease research, CSIRO, and Tim Stinear, Professor of Microbiology, The University of Melbourne
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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